Eating Disorders

What are eating disorders? 
- Eating disorders are characterised by abnormal attitudes towards food, difficulty controlling how much is eaten, and making unhealthy choices about food that ultimately damage the body
- Sufferers often have mental health problems that contribute to their abnormal thoughts
about food and body image
- Anorexia and Bulimia are two of the most common eating disorders which are discussed more below

What causes eating disorders? 

- There is unlikely to be a single cause of an eating disorder- it is usually a combination of factors 

- Many people use food as a coping mechanism as controlling what they eat can help control difficult and emotional situations. Some of these situations may include:

• Difficult family relationships
• The death of someone special
• Stress 
• Problems at work, school or university
• Sexual or emotional abuse

- Low self esteem can also be a cause of eating disorders, thinking that they are not good
enough and blaming this on being too fat
- There may also be a genetic cause, with an imbalance of some chemical levels in the
brain which can contribute

Who gets eating disorders? 
- Eating disorders are most common in teenage girls

- However, 10% of all eating disorders are in men

- Eating disorders are becoming more common in men

- People who are middle-aged can still develop an eating disorder, it is not exclusive to teenagers 

Anorexia 

- People who have anorexia have problems with eating. They are very anxious about their
weight. They keep it as low as possible, by strictly controlling and limiting what they eat and by sometimes exercising excessively
- In teenagers and young adults, the condition affects about 1 in 250 females and 1 in
2000 males
- Symptoms of Anorexia

• The main symptom of anorexia is the loss of a lot of weight deliberately - People with anorexia like to have full control over what they are eating and may do this by:
  • trict dieting
  • Counting the calories in food excessively
  • Avoiding food that they think is fattening
  • Eating only low-calorie food
  • Missing meals (fasting)
  • Avoiding eating with other people
  • Hiding food
  • Cutting food into tiny pieces - to make it less obvious that they have eaten very little,and the food is easier to swallow
  • Taking appetite suppressants such as slimming pills or diet pills.
  • People with anorexia may also drink lots of fluids that contain caffeine, such as coffee, tea and low calorie fizzy drinks
• Eating too little for a long time can cause health problems, resulting in physical symptoms:
  • fine downy hair may grow on their body
  • Hair on their face may increase, or their pubic hair may become sparse and thin.
  • Periods may stop in girls
  • Pain in the abdomen 
  • Feel bloated or constipated
  • Feel light-headed or dizzy

-Treatment

• If you are diagnosed with anorexia nervosa, your GP will probably be involved in yourongoing treatment and care, and an overall health assessment is likely to be carried out
• Where treatment is given depends on how severe the anorexia is, it can be: as an outpatient (at home- this is most common), as a day patient or in a day unit, as in inpatient in hospital (f your weight loss or symptoms are severe)
• Treatment for anorexia usually includes psychological treatment - talking to a therapist or counsellor, advice on eating, your diet and nutrition, to help you gain weight safely

-Recovery

• People with anorexia can recover, but it may take a long time and be very difficult for the person, and their friends and family
• To recover, someone with anorexia needs to: gain weight safely, change their eating habits, change the way they think about food. 
• Research studies have shown that: about 43% of people with anorexia recover completely,36% improve, 20% develop a chronic eating disorder, 5% die from the condition 

Bulimia

- People with bulimia tend to alternate between eating excessive amounts of food (bingeing), and making themselves sick, or using laxatives (purging), in order to maintain a chosen weight
- This is usually done in secret. People with bulimia purge themselves because they feel guilty about the binge eating, but the bingeing is a compulsive act that they feel they cannot control

-Symptoms of Bulimia

• The main symptoms are binging and purging
• Binging is repeatedly eating vast quantities of high-calorie food, without necessarily feeling hungry, or needing to eat 
• Purging is a response to the bingeing. The most common methods of purging involve making yourself sick, or using laxatives to encourage your body to pass the foodquickly. 
• Other signs of bulimia can include:
  • Regular changes in weight
  • An obsessive attitude towards food and eating
  • Episodes of over-eating
  • Periods of starvation
  • Scarred knuckles (from forcing fingers down the throat to induce vomiting)
  • Depression and anxiety

-Treatment 

• Is very similar to the treatment for anorexia - The main treatment method is psychological treatment aimed at re- establishing healthy attitudes towards food again
• Some medications that are often used to treat depression can also be used - Bulimia is very rarely treated in hospital 

This is a great website page for more information on Healthline.

Getting help for eating disorders 

- The first step is recognising that there is a problem- people with eating disorders are
extremely secretive about their problem so it maybe friends and family who recognise the problem first
- A lot of people find going to their GP very helpful as they are someone who will listen,
offer advice, and start the treatment process
- There are lots of websites and hotlines designed to help people with eating disorders
and give them advice. One website set up especially for young people is: www.b-eat.co.uk/YoungPeople/Home

Source:- https://sexpression.squarespace.com/eating-disorders/

Worries About Weight And Eating Problems: Information For Young People

About this leaflet This is one in a series of factsheets for parents, teachers and young people entitled Mental Health and Growing Up. This factsheet looks at some of the reasons why people worry about their weight, and offers advice. Janet, 18, talks about her problem with anorexia Annabelle's story, aged 16

Introduction   How do I stay a healthy and normal weight? Most of us, at some time in our lives, feel unhappy about the way we look and try to change it. Being smaller, shorter, or less well-developed than friends or brothers and sisters can make us feel anxious and lacking in confidence. So can being teased about size and weight. Many of us have an idea of the size and shape we would like to be. Our ideas about what looks good are strongly influenced by fashion and friends. You might compare yourself with the pictures in magazines. The models in these magazines are often unhealthily thin. You may then worry that you are fat, even if your weight is normal for your age and height. There are a variety of sizes and shapes that are within the normal, healthy range. If you’re interested, there are tables showing normal height and weight. Ask your school nurse, GP or library. Your weight, like your height and looks, depends a lot on your build, your genes and your diet.   Our bodies need a healthy diet which should include all the things you need to develop normally – proteins, carbohydrates, fats, minerals and vitamins. Cutting out things you might see as fattening, such as carbohydrates or fats, can stop your body from developing normally. There are some simple rules that can help you to stay a healthy weight. They sound quite easy, but might be more difficult to put into practice. You can ask your family and friends to help you to stick to these rules – and it might even help them to be a bit more healthy! Eat regular meals – breakfast, lunch and dinner. Include carbohydrate foods such as bread, potatoes, rice or pasta with every meal. Try to eat at the same times each day. Long gaps between meals can make you so hungry that you eventually eat far more than you need to. Get enough sleep. Avoid sugary or high-fat foods and junk foods. If you have a lunch of crisps, chocolate and a soft drink, it doesn’t feel as if you’re eating much, but it will pile on the pounds. A sandwich with fruit and milk or juice will fill you up, but you are much less likely to put on weight – and it’s better for your skin. Take regular exercise. Cycling, walking or swimming are all good ways of staying fit without going over the top. Try not to pay too much attention to other people who skip meals or talk about their weight. If you follow these suggestions, you will find it easier to control your weight, and you won’t find yourself wanting sweet foods all the time.

A Body To Die For: The ABC's Of Eating Disorders

I had gone to a lot of trouble to land myself in the hospital. At 15, I had embarked on a diet and had shed 50 pounds in six months. My body had started out slightly padded, clad in baggy painter's pants to conceal my thighs. As I shrank, I wore tighter pants to flaunt my success, until those too began to hang on my diminishing frame.

- from Evelyn Strauss's, "Facing the Plate" (Salon 9/13/00), a personal account of the author's experience with an eating disorder.

This is a horrifying but typical picture of a young woman suffering from an eating disorder — something that, according to the National Institute of Mental Health, affects more than five million Americans today.   Aside from cases where depression or other mental illness leads to suicide, it is hard to think of a psychological problem that poses a greater threat to a person's physical health. Those afflicted with eating disorders try to lose weight by dieting, purging or other means until they make themselves sick. Though some get treatment and recover, others literally starve themselves to death. 

As Ms. Strauss's story illustrates, a particularly troublesome aspect of this illness is that while its victims may appear not to understand that they are making themselves sick, most of the time they know exactly what they are doing to their bodies. In cases like these, friends and family members can beg, plead and try all they want to convince victims that they are too thin or that they are ruining their health but they continue to do it anyway. 

What can you do if you or someone you care about is suffering from an eating disorder? The good news is that there are treatments. The first step, however, is to become informed about what eating disorders are, the different kinds and how they affect the body. 

There are two main types of eating disorders. Their technical names are anorexia nervosa and bulimia nervosa. The table below shows the main ways in which they differ.

Eating disorders are a uniquely dangerous form of mental illness. 

Table 1.

Eating Disorders

(Based on the American Psychiatric Association's Diagnostic and Statistic Manual, IV)

Anorexia Nervosa

1. Refusal to maintain body weight at or above a minimally normal weight for age
2. Disturbance in the way in which one's body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight
3. In postmenarcheal females, amenorrhea, i.e., for at least three consecutive menstrual cycles.

Restricting Type:

person not regularly engaged in binge-eating or purging behaviors

Binge-Eating/Purging Type:

In addition to symptoms of anorexia nervosa, the person regularly engages in binge-eating or purging behaviors.

Bulimia Nervosa

1. Recurrent episodes of binge eating characterized by 1) eating in a discrete amount of time a large amount of food and 2) a sense of lack of control over eating during the episode
2. Recurrent inappropriate compensatory behaviors in order to prevent weight gain, such as self-induced vomiting, misuse of laxatives, diuretics, enemas, and other medications; fasting or excessive exercise
3. The binge-eating and inappropriate compensatory behaviors both occur, on average, at least twice a week for three months
4. Self-evaluation is unduly influenced by body shape and weight
5. The disturbance does not occur exclusively during episodes of anorexia nervosa.

Purging Type:

During episodes of bulimia nervosa, the person regularly engages in self-induced vomiting, misuse of laxatives, diuretics, or enemas.

Nonpurging Type:

During the episodes of bulimia nervosa, the person has used other inappropriate compensatory behavior such as fasting or excessive exercise but has not regularly engaged in the purgative methods listed above. 

What Are the Warning Signs?

Some of the common early warning signs of bulimia are extreme weight fluctuations, preoccupation with diet and really bad breath. Typically, a victim's family or doctor might notice that the victim's weight is going up and down over a period of months or years. The victim may begin to abuse diuretic drugs or laxatives, begin to exercise obsessively or make themselves vomit after meals. Repeated self-induced vomiting leads in the short term to bad breath and in the long run to dental and other physical problems. When confronted, however, the typical bulimic will deny everything.

When asked to explain their behavior, both anorexia and bulimia victims will insist, no matter how objectively thin they may be, that they "feel fat."  These feelings can be so extreme and unreasonable that doctors often conclude that victims are mentally ill and have lost contact with reality.3 Deep down, however, this is not the case. In fact, those with eating disorders understand how they really look and what they are doing to themselves. The problem is not that they are irrational or out of contact with reality, but rather that they cannot control their behavior. 

Another warning sign of an eating disorder is excessive concern with a particular part of the body. Victims may turn to plastic surgery or liposuction to fix a supposed physical flaw or just to "stay thin." 

Certain psychiatric problems often accompany eating disorders. These include depression, anxiety disorders (especially obsessive-compulsive disorder), borderline personality disorder and substance abuse. 

Who Are the Victims?

Traditionally, most victims of eating disorders have been thought to be White, economically well-off girls or young women. This remains largely true, although the picture does seems to be changing. Recent studies have shown that growing numbers of African-Americans and other minorities are becoming afflicted with eating disorders, especially bulimia.

Boys and men are also at increasing risk for eating disorder. Although studies show that nine out of ten victims are female, males who participate in certain sports (e.g., wrestling, gymnastics, running), are homosexual, or who suffer from addiction or personal disorders are at greater risk of developing an eating disorder. Anorexic males can be just as preoccupied with body image as females, but tend to want to have a slender waist and muscular, athletic shoulders and chest. This is sometimes called "reverse anorexia".

Eating disorders are appearing among all socioeconomic groups. They are crossing age barriers, showing up in younger and younger children. More and more preschool and grade schoolers are developing eating problems, showing preoccupation with weight and size, and going on diets.

What Is the Cause?

No one has found an exact cause of eating disorders. There are, however, circumstances and influences that make some people more vulnerable. Among preschool children, studies have found a strong association between eating problems and extreme parental attitudes about food and weight, particularly for children of a mother with an eating disorder.    Ironically, being overweight is also a contributing factor. And childhood obesity is definitely on the rise. 

Today, as many as 50% of grade school children are overweight. This has caused an increase in diseases in children that were once seen almost exclusively in adults, such as Type 2 diabetes. Studies indicate that youngsters who are teased or feel ashamed about their weight are much more likely to develop an eating disorder when they are older. (Parents should be aware that in some cases, children who show symptoms of anorexia may in fact have a pediatric autoimmune neuropsychiatric disorder (known as PANDAS) that is associated with streptococcus infection. This can be cured with antibiotics. 

Some people also seem to carry a gene that makes them more likely to develop anorexia nervosa or bulimia nervosa. 

Finally, a startlingly high percentage — in the range of 30% to 60% — of those with eating disorders are victims of past childhood physical or sexual abuse, or of a more recent adult trauma such as rape. This could explain why post-traumatic stress disorder is more common in those with eating disorders.

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