Eating disorder is a pattern of disordered and harmful eating behavior. They develop partly in response to difficult life situations such as abuse or social pressures during adolescence. Genetic and Cultures are also considerable factors for eating disorder. According to a latest research, more than one in ten women suffers from eating disorder.
There are three main eating disorders: Binge Eating Disorder, Bulimia Nervosa and Anorexia Nervosa.
The following are some briefs about the above said three eating disorders.
1. Eating uncomfortably full in a very short period is Binge Eating.
2. A frequent episode of binge eating followed by frantic efforts to avoid weight gain is Bulimia Nervosa.
3. Anorexia Nervosa is irrational dread of becoming fat coupled with a relentless pursuit of thinness.
Each has a distinct pattern of disordered behavior. People with eating disorder may be depressed and may have obsessions.
BINGE EATING DISORDER
Consuming an unusually large quantity of food in a short period of time (less than 2 hours) uncontrollably, eating until they are uncomfortably full, is the prime symptom of Binge Eating Disorder.
Associated with these frequent binges are
• Intense feelings of being out of control and powerless to stop eating
• Disgust, shame and depression
However, unlike individuals with bulimia, binge eaters do not engage in compensatory behaviors, such as vomiting, exercising or misusing laxatives and diuretics. While this ultimately makes them physically healthier than their bulimic peers, they gain weight as a result of high-calorie food consumption. The weight of each individual is usually characterized as above average or overweight, and sufferers tend to have a more difficult time losing weight and maintaining average healthy weights. Unlike with Bulimia, they do not purge following a Binge episode.
The reasons for binge eating may be a way to hide emotions, to fill a void they feel inside and to cope with the daily stress and problems in their lives.
Binge eating is also called as compulsive overeating. It is estimated that 2% of adults have binge eating disorder. It is common among obese people and who have experienced yo-yo effect (a repeated cycle of weight loss followed by weight gain than the original weight). Binge eating is more common in women: almost 60% of women are affected.
Binge eaters may often suffer from diabetes-2, high blood pressure, high cholesterol, gallbladder disease, heart diseases, respiratory problems, menstrual irregularities, bone and joint deterioration, arthritis, and certain types of cancer.
Binge eating disorder can be successfully treated in therapy. Therapy can teach you how to fight the compulsion to binge, exchange unhealthy habits for healthy ones, monitor your eating and moods, and develop effective stress-busting skills. They are
Cognitive Behavioral Therapy: Focuses on the dysfunctional thoughts and behaviors involved in binge eating. The therapist helps one to recognize their binge eating triggers and learn how to avoid or combat them. This also involves education about nutrition, healthy weight loss, weight maintenance and relaxation techniques.
Interpersonal Psychotherapy: Focuses on the relationship problems and interpersonal issues that contribute to compulsive eating. The therapist will help one to improve their communication skills and develop healthier relationships with family members and friends. As they learn how to relate better to others and get the emotional support they need, the compulsion to binge becomes more infrequent and easier to resist.
Dialectical Behavior Therapy: Combines cognitive-behavioral techniques with mindfulness meditation. The emphasis of therapy is on teaching binge eaters how to accept themselves, tolerate stress better, and regulate their emotions. The therapist will address unhealthy attitudes they may have about eating, shape and weight.
BULIMIA NERVOSA
Bulimia nervosa is characterized by frequent episodes of binge eating, from twice a week to multiple times a day, followed by frantic efforts to avoid gaining weight.
During an average binge, a bulimic consumes 3,000 to 5,000 calories in one short hour. After it ends, the person turns to drastic measures to “undo” the binge, such as taking ex-lax, inducing vomiting, or going for a ten-mile run.
The illness came to prominence in the mid-1990s when Diana, Princess of Wales, admitted that she had been a sufferer.
The key features of bulimia nervosa are:
• Regular episodes of out-of-control binge eating
• Inappropriate behavior to prevent weight gain
• Self-worth is excessively influenced by weight and physical appearance
The medical complications related to bulimia are very serious. Many of the physical side effects are the result of chronic vomiting. Apart from weight gain, abdominal pain, bloating, swelling of hands and feet, chronic sore throat, broken blood vessels in the eyes, swollen cheeks and salivary glands, weakness and dizziness, tooth decay and mouth sores, ulcers, ruptured stomach/esophagus, loss of menstrual periods, chronic constipation from laxative abuse.... the list is long.
Since poor body image and low self-esteem underlie bulimia, psychotherapy is an important aspect of treatment. Many people with bulimia feel isolated and ashamed by their bingeing and purging, and therapists can help with these feelings. The treatment for bulimia is cognitive-behavioral therapy. Cognitive-behavioral therapy for bulimia involves two phases:
Phase-I: Breaking the binge-and-purge cycle – This focuses on stopping the vicious cycle of bingeing and purging and restoring normal eating patterns. Patients learn to monitor their eating habits, avoid situations that trigger a desire to binge, cope with stress in ways that don’t involve food, eat regularly to reduce food cravings, and fight the urge to purge.
Phase-II: Changing unhealthy thoughts and patterns – This focuses on identifying and changing dysfunctional beliefs about weight, dieting, and body shape. Patients challenge their “all-or-nothing” attitudes about eating, explore the connection between emotions and eating, and rethink the idea that self-worth is based on weight.
ANOREXIA NERVOSA
Anorexia nervosa is characterized by an irrational dread of becoming fat coupled with a relentless pursuit of thinness. The key features of anorexia nervosa are:
• Refusal to sustain a minimally normal body weight
• Intense fear of gaining weight, despite being underweight
• Distorted view of one’s body or weight, or denial of the dangers of one’s low weight
Anorexia is most common in adolescent girls and young women, with a typical age of onset between the ages of 13 and 20. But people of all ages —including men and children—can suffer from anorexia.
Persons suffering from Anorexia Nervosa can live with very restricted calories and it varies from person to person. It is medically possible because the body produces Endorphins which are morphine-like narcotic and strong painkiller. Endorphins mask the pain of starvation.
Karen Carpenter, an American singer was a victim of Anorexia Nervosa. She died at the age of 32 from heart failure due to anorexia. She went on a water diet to lose weight and to appear more attractive. She continued to diet even after losing 20 lbs, until her death at the age of 32. This disorder came to limelight when skinny and boney models started to die.
The effects of anorexia include loss of menstrual periods, lack of energy, feeling cold all the time, dry skin, constipation and abdominal pain, insomnia, dizziness, headaches, growth of fine hair all over the body and acne. Over some time anorexia causes hair loss, infertility, stunted growth, osteoporosis, heart problems, kidney failure, and death. Other effects of anorexia include tooth decay and gum damage from malnutrition and vomiting (here no vomiting, I think. Vomiting is given as the side effect of anorexia), and damage to the esophagus and larynx from acid reflux. Anorexia can also lead to depression, severe mood swings, and thoughts of suicide.
Therapy plays a crucial role in anorexia treatment. Its goals are to identify the negative thoughts and feelings about weight and the self that are behind the anorexic behaviors, and to replace them with healthier and less distorted attitudes. Another important goal is to teach the anorexic how to deal with difficult emotions, relationship problems, and stress in a productive, rather than a self-destructive, way.
Cognitive therapy: Focus is on increasing self-awareness, challenging distorted beliefs, and improving self-esteem and sense of control. It also involves education about anorexia.
Behavior therapy: Promotes healthy eating behaviors through the use of rewards, reinforcements, self-monitoring, and goal setting. Teaches the patient to recognize anorexia triggers and deal with them using relaxation techniques and coping strategies.
Family therapy: Examines the family dynamics that may contribute to anorexia or interfere with recovery. Often includes some therapy sessions without the anorexic patient—a particularly important element when the person with anorexia denies having an eating disorder.
Group therapy: Allows people with anorexia to talk with each other in a supervised setting. Helps to reduce the isolation many anorexics may feel. Group members can support each other through recovery and share their experiences and advice.
People who experience any level of depression any with low self-esteem are at a higher risk of developing an eating disorder. Kids who are particularly sensitive are also vulnerable for eating disorders. The onset of puberty in both boys and girls is a time to watch out for. This is when a pre-teen is likely to start obsessing with their appearance, overly caring what their peers think, and being confused about the changes in their bodies. A person who must have things done flawlessly, who sets their goals extremely high and who isn’t satisfied with anything but perfection, is setting themselves up for an eating disorder, particularly anorexia.
Eating disorders can be prevented by
• Teaching healthy coping mechanisms
• Developing positive relationships
• Spending quality time with the family – getting together for meals, making healthy food choices etc.
• Student advisors/teachers can make regular assesment of their wards and make note of their behavior and can boost their esteem.
• Having open talks with friends or people who are close to them regarding the pressures they endure or the abnormal eating habits they have developed
While handling people with eating disorder, one should know to shift their focus from body image to other things they really love. Reinforcing ideas about body image will not help. Children should be encouraged to take food in response to hunger. With unconditional love, children develop immunity to the perils of childhood and adolescence. Emphasising critical thinking, self assertion and self-esteem strengthens children to withstand pressures they experience to change and harm their bodies. An allround network connecting parents, teachers and friends can help children who are expressing problems with their eating and body image.
Posted by: Vanmathi Sakthikkumaran, Dr.K.Padmanaban
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