 Eating
Disorders
Popular opinion when thinking of an eating disorder
is that the person must have a problem with food.
Contrary to this opinion is that the eating disorder
is actually an indication that the person has underlying
(sub conscious) problems in his / her life. This page
provides you with information pertaining to anorexia
nervosa, bulimia nervosa, binge eating disorder and
compulsive eating.
Anorexia
Anorexia nervosa is similar to Bulimia in some ways,
but has different symptoms of the food and body controlling
way of thinking. The diagnostic criteria for Anorexia
Nervosa are:
Refusal to maintain body weight over a minimally normal
weight for age and height. Weight loss leading to maintenance
of less than 85% of expected weight.
Intense fear of gaining weight or becoming fat even
though underweight.
Disturbance in the way that body weight, size or shape
is experienced
Amenorrhoea in females with absence of at least 3
menstrual cycles
Those with eating disorders tend to be perfectionists,
they have unrealistic expectations of themselves and
others, they feel worthless, inadequate and everything
is good or bad, fat or thin. If they think of a thin
person, which is good, thinner is better and thinnest
is best. Many use it to take control of their lives
and themselves. They usually win with any power struggle,
but inside feel hopeless, powerless, defeated, resentful
and often angry with themselves. Its this anger turned
inwards, because they are so frightened of criticism,
looking for approval, that they can only express their
anger and control by starving themselves.
In Britain the incidence of Anorexia in young women
has been estimated to range between 1% and 5% - the
same as the USA. In the male population the numbers
seem to be increasing. Twenty years ago it was thought
that for every 15 women with Anorexia or Bulimia there
was one man. Today researchers find that for every four
females with Anorexia, there is one male.
Anorexia (including Bulimia & Binge Eating Disorder)
can affect anyone regardless of social class, age, race
or gender. 86% of people with Eating Disorders report
onset by age 20 and 10% report onset at 10 years or
younger. Nearly 50% or pre-pubescent girls admit to
dieting or using other methods of weight control. Most
sufferers come from respectable homes or affluent families,
and many do not seek professional help with their problems
until it becomes life threatening, mortality rates ranging
from 5-15%, mainly from suicide. Many believe that Anorexia
is of a very recent origin, however, patients with such
a disorder have been described by doctors from the 17th
century.
Those that develop Anorexia are usually attractive,
sensitive, thoughtful and nice intelligent young females
between the ages of 12 and 25 years old, although there
are other considerable variations in age. Typically,
they have been good children; conscientious; wanting
to please; seeking approval; avoiding conflict with
a desire to take care of others; Dichotomist; striving
for perfection; feeling inadequate; having a defect;
attempting control by losing weight; feel stressed;
anxious especially with new situations; unrealistic
standards for themselves; rigid ways of thinking; cannot
maintain excellence; adopt rigid routines; do not risk
anything; fear growing up; fear responsibility; cling
to parents; prefer to live at home; dislike sexual activity;
feel insecure; dont fit in; dislike criticism and
rejection; abundant frequent exercise. Of course these
are main examples, some will have all of the above,
others only 50% or more, others may have other states
such as depression etc.
Overview of Symptoms
Brain chemistry alters to Euphoria disorientation
Imbalance of Sodium, potassium, Calcium & Bicarbonates.
Intense fear of becoming fat
Hair loss or thinning
Lanugo downy hair
Hands swell
Thyroid Function decreases
Incorrect body perception
Constipation Slow gut motility
Low white blood cell count
Rigid dieting
Wears large or baggy clothes to hide thin body
Can feel cold extremities
Compulsive exercising
Amenorrhoea (loss of menstrual cycle)
Arrhythmias (irregular heart beat) & heart failure
Bradycardia (slow heart rate)
Panic with smallest increase in weight
Inability to obtain pleasure sex
Rough dry scaly skin
Rigid lifestyle
Muscle wasting
Perfectionist
Risk of osteoporosis
Organ deterioration
Bulimia Nervosa
This is a diet binge purge disorder and like Anorexia
can kill. The sufferer puts on a courageous effort to
be normal but often experience depression, loneliness,
inner anger, self doubt and feel ashamed / guilty when
they are by themselves and are unable to talk about
their feelings. They can be promiscuous, take illicit
substances, binge drink and become reckless with shoplifting,
often from food stores.
Their friends often say they are fun to be with, and
would never assume there was anything wrong with them.
They have distorted body image and obsessed with their
body weight, frequently having a history of failed diets.
The difference between them is that while Anorexics
feel better when they dont eat, Bulimics are confronted
every day with their explanation of their failure to
control themselves and their food intake. As mentioned
above, they gain a sense of control by using diuretics,
enemas, suppositories, laxatives, forcibly vomiting
with their fingers or taking emetic agent, so they feel
more in control, as the excessive amount of food eaten
can be got rid of. The other important factor is they
do not show other people (especially parents), work
colleagues, that they are losing weight or look anorexic
in appearance.
Body weight may vary from normal to mild, moderate,
or severe obesity. This of course keeps everyone happy,
which is what the Bulimic is attempting to achieve.
The only person that may be aware is the Dentist as
their tooth enamel deteriorates, or a Doctor who finds
a biochemical imbalance, for example low potassium,
magnesium and sodium levels. There is a possibility
of losing substantial weight, however, they regain this
without any medical intervention.
Persons in the Bulimic category are more likely to accept
elimination of Binge Eating as a primary goal. They
can consume vast quantities of food, usually carbohydrates
very rapidly, fast for days then have another binge.
Often when emotional problems are resolved and better
coping skills and strategies are employed the outcome
of therapy is generally good in most clients.
Simple Bulimia most commonly seems to occur when females
are about 18 years of age. They have usually been slightly
under confident and unassertive, although fairly popular.
The illness is frequently started by a period of unhappiness
or depression and this can be caused by a destructive
relationship with a boyfriend. The feelings of self
dislike focuses on appearance, so they begin to diet
to improve self-esteem and confidence.
In comparison to an Anorexic, the diet is not very successful,
with the rigid control needed in breaking down into
spells of cheating. Vomiting is employed to achieve
the weight loss and so the cycle of bingeing and vomiting
begins. There is more loss of control as the bodys
normal mechanisms of appetite control are over ridden
and confused. The weight will remain near to normal
but the eating regime becomes gradually poor.
This form of Bulimia is the least severe but does vary
considerably in intensity. There are probably many females
with reasonably mild symptoms who never seek help, but
there is a significant risk that it will slowly get
worse with time. A frequent time for those with mild
Bulimia to seek help is when they are planning to start
a family in their early twenties and are concerned about
possible effects of conceiving or having children. Often
when emotional problems are resolved and better coping
skills are employed, the outcome of therapy is generally
good.
Bulimia Overview
Possible recklessness
Possible shoplifting (food stores)
Guilt & low self esteem
Obsessed with weight
Many are normal within weight parameters
Large weight increase and / or loss
Depression / suicide
Tooth enamel deteriorates
Rupture of the Oesophagus
Inner anger
Eating huge amounts of food in a short time
Gastric rupture
Binge eating in secret
Ulcers & pancreatitis
Distorted body image
Constipation
Gastric ulcers
Perfectionist
The diagnostic criteria for Bulimia are as follows:
Recurrent episodes of Binge Eating (which is characterised
by a sense of lack of control over eating large amounts
of food in a discrete time period)
Recurrent, inappropriate compensatory behaviour in
order to prevent weight gain, eg. Vomiting, abuse of
laxatives, diuretics or other medications, fasting or
excessive exercise.
A minimum average of two episodes pf binge eating
and inappropriate compensatory behaviours per week for
the past three months. Self evaluation unduly influenced
by body shape and weight.
The disturbance does not occur exclusively during
episodes of Anorexia Nervosa. Bulimia nervosa clients
are further subdivided into purging type and non-purging
type, based on the regular use of self induced vomiting,
laxatives, diuretics or other medications, fasting or
excessive exercise.
Binge Eating Disorder (B.E.D.)
is an ailment with a distinct difference from
Bulimia in that the sufferer does not purge their body
of the food through vomiting, laxative abuse or over
exercise. Therefore, they often eat abnormal amounts
of food in a very short period of time, usually less
than 2 hours. They eat so rapidly and swallow without
chewing, and often for a long time, with a distinct
lack of control over eating, usually secretly, tending
to hide food as well. They eat for emotional reasons
to avoid anxiety-provoking situations, reduce emotional
pain and comfort themselves.
Eating at night or eating when they are not hungry frequently
causes them to feel disgusted with themselves afterwards,
as they attempt to cope with stress, anxiety, and unhappiness
and then add to the disappointment with themselves about
bingeing. Most are depressed and have anxiety states.
They can eat such great quantities of food, manifesting
in discomfort and pain. This in time causes obesity
and a possibility of diabetes, hypertension, high cholesterol
and many other complications.
Research suggests that around 60% of American adults
are overweight, 34% are obese which means they are 20%
or more above an average healthy weight. Many of these
are binge eaters. Not included in this, is that 31%
of American teenage girls and 28% of teenage boys are
overweight, and 15% of girls are obese along with 14%
of boys. (Stats 2004). Some of the possible causes are
fast food, high sugar content snacks, use of automobiles;
longer periods spent watching tv, video games and computers.
A reported study shows 1% of females in the USA have
a binge eating disorder and 30% of females seek treatment
to lose weight.
Symptoms
Social isolation
Need to be in control
Eating huge amounts usually alone
Eating large quantities when not hungry
Vascular disorders
Depression
Obstructive sleep apnoea
Hypertension
Gall bladder disease
Stroke
Diabetes
Heart disease
High cholesterol levels
Musculo-skeletal problems
Thrombosis
Compulsive Overeating
Attempting to cope with stress, anxiety, depression,
low confidence or self-esteem, emotional conflicts,
Compulsive Eating can become a detrimental problem to
their health, becoming overweight. They often deny or
recognise that there is a problem. Compulsive overeating
can begin in early childhood when eating patterns are
formed.
Most people who become Compulsive Eaters are those
who never learned the proper way to deal with stressful
situations and used food instead as a way of coping.
Unlike Anorexia and Bulimia, there are a high proportion
of excessive eaters. Over time, if this continues, can
become morbid obesity where gastric banding or stapling
would be necessary for survival. Obviously other factors
need to be eradicated first, such as thyroid functioning.
They frequently withdraw from activities because of
embarrassment about weight and many have tried so many
different diets and feel tormented by these over eating
habits where the main focus of life is on weight. They
always think about food and often have secret hoards
of food, becoming anxious when eating, and believing
that hunger makes them feel uneasy or vulnerable. They
then compulsively eat, which reduces their negative
thought processes, then feel bad or guilty about over
eating, and the whole process starts over again.
By significantly reducing their stressors, anxiety,
depression or other underlying fears or concerns, enables
them to cope easier with life.
Compulsive Eating Overview
Depression
Social isolation
Need to be in control
Eating huge amounts, usually alone
Eating large quantities when not hungry
Vascular disorders
Obstructive sleep apnoea
Hypertension
Gall bladder diseases
Stroke
Diabetes
Heart disease
High cholesterol levels
Musculo-skeletal problems
Thrombosis
Queries and Questions
Please email Geoffrey
Schofield for further information.
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