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Eating Disorders
What Is an Eating Disorder?
An eating disorder is an illness that
leads people to overeat, starve
themselves, or adopt other unhealthy
behaviors surrounding food and body
weight. These disorders -- binge eating,
anorexia nervosa, and bulimia -- are not
simply bad habits. They interfere with
daily life and without proper treatment
they can cause serious health problems.
WHAT IS BINGE EATING
DISORDER?
Episodes of extreme overeating are the hallmark of this illness, which is the most common eating disorder. People who struggle with it are usually overweight or obese -- male or female. In contrast with bulimia, this illness does not lead people to purge (vomit), fast, or over-exercise. It can develop at any age but is often diagnosed in middle age. It can lead to type 2 diabetes, high blood pressure, and heart disease.
BINGE EATING
SYMPTOMS
Many of us overeat from time to time; binge eating is different. People describe feeling out of control when they overeat. They may eat more quickly than usual during a binge. They may eat until they are painfully full, or binge when they aren't hungry. Many people with binge eating disorder say that stress, anxiety, depression, or boredom can trigger a binge.
BINGE EATING SYMPTOM:
GUILT
It's common for someone with binge eating
disorder to feel guilty, ashamed, or depressed
after a binge. This can lead to a vicious cycle in
which bingeing causes emotional distress, and
then emotional distress causes more bingeing.
Guilt and shame cause many people with binge
eating disorder to hide the behavior, which can
make it harder to diagnose.
BINGE EATING
SYMPTOM: WEIGHT
CHANGE
It's not uncommon for someone with binge eating
disorder to have weight fluctuations because of
attempts to diet between bingeing episodes. But
until the bingeing behavior is under control,
weight loss efforts are unlikely to be successful in
the long term.
DIAGNOSING
BINGE EATING
DISORDER
Most binge eaters hide their overeating, even
from close family members, so getting a diagnosis
can be difficult. One sign is a history of bingeing
at least twice a week for six months or more.
Diagnosis may also include a physical exam and
a discussion of eating patterns, medical history,
and family history.
TREATING BINGE EATING
DISORDER
Successful treatment may come from a combination of approaches. Talking with a therapist -- particularly cognitive behavioral therapy -- can help to change unhealthy eating habits and thinking patterns. Nutrition education, family counseling, and support groups can provide further help. Weight loss programs can also help get long-term control over binge eating. If depression is an issue, a doctor may prescribe medicine.
WHAT IS ANOREXIA?
People with anorexia nervosa develop an unusual fear
of gaining weight, which can drive them to become
dangerously thin. It's more common in women and
girls, but it affects boys and men, too. It can start
after life change, a traumatic event, or the desire to
excel in sports such as gymnastics or cross-country
running. Anorexia is a serious health problem, but
with support and the right treatments people can and
do get better.
ANOREXIA SYMPTOM:
RAPID WEIGHT LOSS
People with anorexia go to great lengths to lose
weight. Besides eating too little food, they may
compulsively exercise, or take diet pills. Taking
pills to urinate (diuretics) or have a bowel
movement (laxatives) are other unhealthy
strategies to keep weight down. People may
continue to lose, despite symptoms of starvation -
- and hide a rail-thin body in baggy clothes.
ANOREXIA SYMPTOM:
FOOD OBSESSION
Food becomes an obsession in anorexia. People
may eat very little, but think about food
constantly. They may portion their food carefully,
eat very small amounts of restricted foods, count
calories, or weigh food before eating it. People
with this illness may simply move food around
the plate without actually eating anything.
ANOREXIA SYMPTOM:
FALSE BODY IMAGE
Though people with anorexia may be dangerously
thin, they still see themselves as fat. They are
often extremely critical of themselves. Anorexia
may in part develop out of perfectionism. But the
drive to achieve a "perfect" body spirals out of
control until it becomes unhealthy and even life-
threatening.
ANOREXIA: OTHER
SYMPTOMS
Physical symptoms of anorexia can include:
Brittle hair and nails
Yellowing skin
Fine hair growth all over the body
Cold sensitivity
Constipation
Slow reactions or lethargy
Loss of menstrual periods
DIAGNOSING ANOREXIA
Because anorexia can be life-threatening, it's
important to get a diagnosis as soon as possible.
Generally, a diagnosis of anorexia can be made if
a person is less than 85% of what is considered a
normal weight, if she shows an intense fear of
gaining weight, and has a very distorted body
image. A doctor may run tests to rule out other
diseases before confirming a diagnosis of
anorexia.
TREATING ANOREXIA:
HOSPITALIZATION
A stay in the hospital may be needed for people
with serious health complications, dangerously
low weight, or thoughts of harming themselves.
Hospital stays are usually short. Outpatient
programs are common, with people going to
daytime appointments and staying at home at
night. This approach is generally less disruptive
to a person's daily life.
TREATING ANOREXIA:
THERAPY
Anorexia treatment has three goals: restore a healthy weight, treat any psychological issues, and reduce unhealthy thoughts and actions that might lead to a relapse. Family therapy that includes parents is helpful for children and teens with anorexia. Treating anorexia in adults is trickier; therapy may be combined with additional treatments. With every approach, food and nutrition counseling is key.
TREATING ANOREXIA:
MEDICATION
Antidepressants and other medications are often
prescribed to treat underlying mood problems in
people with anorexia. The results have been
mixed: Some people get better on medication,
while others may still relapse. Research has
found that a combined approach -- medications
and therapy -- works better than one treatment
alone.
WHAT IS BULIMIA?
Bingeing and purging are the hallmarks of bulimia.
Though anyone can get bulimia at any time, 85% to
90% of bulimics are female, and it often strikes in the
teen and young adult years. Factors that play a role
include stressful life events, biology, culture and
habits within a family, and social pressures to be
thin. The good news: Bulimia is not a life sentence.
Treatment can stop the cycle of bingeing and purging.
BULIMIA SYMPTOM:
EATING AND PURGING
A person with bulimia eats large amounts of food
very quickly and then compensates by throwing
up, taking pills to have a bowel movement
(laxatives), or exercising excessively. Bingeing
and purging can happen a few times a week or
many times in a single day. People say they feel
out of control when bingeing and they keep it
secret out of shame
EATING DISORDERS ARE A GROUP OF SERIOUS CONDITIONS IN
WHICH YOU'RE SO PREOCCUPIED WITH FOOD AND WEIGHT THAT
YOU CAN OFTEN FOCUS ON LITTLE ELSE. THE MAIN TYPES OF
EATING DISORDERS ARE ANOREXIA NERVOSA, BULIMIA NERVOSA
AND BINGE-EATING DISORDER.
BULIMIA SYMPTOM:
WEIGHT OBSESSION
Unlike anorexia, people with bulimia are usually
at a normal weight or just slightly overweight.
But they're deeply afraid of gaining weight. In
the grip of the illness, those with normal body
weight and size may believe they're actually
terribly fat, called a distorted body image. The
drive to lose weight can also lead people to abuse
diet pills.
BULIMIA SYMPTOM:
DEPRESSION
Bulimia is more than just a problem with food.
For many people, the cycle of food binges and
purging is an attempt to control negative
feelings. It's common for people with bulimia to
struggle with depression, anxiety, or substance
abuse. Someone with bulimia may be moody or
irritable and may withdraw from friends and
family.
BULIMIA: OTHER
SYMPTOMS
The physical effects of bulimia can include:
A chronic sore throat
Worn tooth enamel
Swollen salivary glands in the cheeks
Heartburn
Constipation and other digestive problems
Dehydration
Irregular periods
DIAGNOSING BULIMIA
To diagnose bulimia, a doctor will ask about a history of bingeing and purging. Many people deny and hide these behaviors, which can make it tough to get a diagnosis and proper treatment. If you suspect bulimia, talk to a health care professional. The earlier a person gets treatment for bulimia, the more likely they are to recover completely
TALK AND SUPPORT
If you think a loved one is struggling with an
eating disorder, don't hesitate to talk about it. Do
voice your concerns respectfully, avoiding guilt or
blame. Focus on the specific behaviors that worry
you, and encourage the person to get help.
Though you can't force a person to change, you
can let them know that they have your support.
TREATING BULIMIA
Treatment for bulimia is most successful when
a combination of therapies are tailored to the
individual. Nutritional counseling and therapy
can help the person establish healthy eating
habits and develop a better relationship with
food and eating. Research has shown that
antidepressants can help break the cycle of
bingeing and purging and prevent relapses.