Eating disorders are a group of psychological and medical conditions in which abnormal eating habits like overeating or starving are practiced with the aim of controlling body weight and shape. Anorexia nervosa, binge eating disorder, and bulimia nervosa are the three major eating disorders. This article focuses on the three disorders. These disorders are mainly triggered by environmental and societal influences, although they could partly be genetic. A major driving force behind the adoption of eating habits that lead to these disorders is dissatisfaction with one’s body image.
Thus one strives to attain an “ideal shape and weight.” However, these habits pose adverse health risks that would eventually lead to death. It is, thus, important for these anomalies be noted and treated in time. The major ways of managing eating disorders include psychosocial and pharmacotherapy. Although some sufferers do not fully recover from these disorders, most are reversible and the sooner they are treated, the better.
Eating disorders are a group of medical, as well as psychological conditions characterized by abnormal practices of eating involving either overeating or starvation to manage one’s body weight or shape. Eating disorders comprise of self-critical and negative attitude towards one’s body, the foods they eat, as well as their eating habits that result in abnormal body function and disruption of normal activities of the day (Oudijn et al., 2013). Eating is normal, and a basic need, but a problem stems up when eating affects the life of a person. Eating less or more food considerably has an impact on one’s body image.
It is arguably evident that abnormal eating habits pose health risks to those who practice them. The effects can adversely affect the victims, both psychologically and physically. Some of the health risks resulting from eating disorders include stunted growth, vital organ damage, cardiac arrest, depression and anxiety, nutritional deficiencies, and delayed menstruation, among others. There are three common eating disorders: Anorexia nervosa, bulimia nervosa, and binge eating disorder. Other eating disorders include body dysmorphic disorder (BDD) and eating disorders not otherwise specified (EDNOS) (Oudijn et al., 2013).
Eating disorders do not have a very old history. However, reports on anorexia, indicate it occurred as early as in the 1800s. Eating disorders can generally be deemed to be a cultural phenomenon. For instance, anorexia does not exist in places where food is insufficient. Bulimia nervosa was diagnosed just ten years ago, while binge eating disorder got this name only recently. Therefore, it can be argued that eating disorders emerged as a result of the changes in eating behaviors. The ample availability of food has greatly impacted eating habits in that when there is plenty of food; people are biologically determined to add weight for survival (Focker, Knoll &, Hebebrand, 2013). The other reason for the change in eating behavior is the influence of society through its constant messages encouraging the consumption of foods. This has been significantly spearheaded by the media. The same media promotes the loss of weight by eating less.
Body weight and shape have never been considered more fashionable than they are in the contemporary world. Women are under untold pressure to change their body shapes in pursuit of an ideal weight and shape. Thus, eating disorders are considerably more pronounced in females than males. Research conducted recently found out a high prevalence of eating disorders in teenagers, especially the girls. This research determined that 46% of the girls and 26% of the boys were not satisfied with their bodies (Hoek & van Hoeken, 2003). About 70% of the girls and 42% of the boys wanted to lose weight, while 45% of the girls and 21% of the boys had already begun dieting to lose weight. Shockingly, the study found out that 51% of the girls and 33% of the boys had employed unhealthy means to manage their weight, including avoiding meals, starving, and smoking more cigarettes. On the other hand, the study determined that a third of the girls and boys were overweight (Hoek & van Hoeken, 2003).
The adoption of such eating habits has been spurred by two major assumptions: dieting can alter one’s weight as well as their shape as desired, and numerous benefits result from attaining the ideal body weight and shape. However, this is not always true because the weight and the size of one’s body are controlled by environmental factors. Others factors like genetic makeup, the rate of metabolism, and cell number of fat, among other characteristics, also influence the extent to which one can alter their body weight and shape.
For instance, dieting has remarkably failed in managing weight because only 3%-5% of those who lose weight by this strategy maintains the loss in weight (Hoek & van Hoeken, 2003). Adverse physiological, as well as emotional effects, resulting from dieting. Dieting directly impacts the rate of metabolism by depressing the resting metabolic rate. This, in turn, leads to alterations in the body chemicals in a bid to preserve fat at the expense of the tissues of the body. Dieting is attributed to depression, food obsession, lack of food control, and social isolation.
Anorexia can be defined as self-starvation (Focker, Knoll &, Hebebrand, 2013). It is an eating disorder that is characterized by an obsession or fear of adding body weight, improper eating practices, refusal to attain healthy body weight, and a distorted body image (Katzman, 2005). Anorexia nervosa victims view themselves as being too fat, when, in essence, they are thin (Focker, Knoll &, Hebebrand, 2013).
In reality, people suffering from anorexia nervosa do not lose their appetite as the word anorexia suggests; instead, they enjoy eating only, but they starve themselves to manage their weight. It is not uncommon to find such people repeatedly measuring their weight, viewing themselves before a mirror, and doing other things to check their progress in weight loss. Some people limit their eating by dieting, starving, or exercising excessively. Such people feel hungry, but they insist on denying themselves meals. Strictly speaking, this disorder can be termed as compulsive starvation, rather than loss of appetite literally (Nogal & Andrzej, 2008).
Anorexia nervosa can be divided into restricting anorexia nervosa, where weight loss is achieved by limiting what one eats and binge-purge anorexia nervosa, where weight loss is attained by the use of laxatives or self-induced vomiting (Focker, Knoll &, Hebebrand, 2013). There are varied symptoms and signs exhibited by people with anorexia nervosa. These include low levels of potassium in the circulatory system (hypokalemia), which further leads to fatigue, paralysis, and damage of the muscles. Other signs are depression, obsessive-compulsive disorder, amenorrhea, drastic weight loss, rapid mood swings, feeling fat (despite being thin), body image fixation, compulsive exercising, and the use of purgatives and diet pills (Focker, Knoll &, Hebebrand, 2013).
Many medical complications can crop up as a result of anorexia nervosa. These include retarded growth, where there is a very slow gain of height and severe loss of weight that brings growth to a halt in some cases (Katzman, 2005). The good news, however, is that this can be reversed if normal eating practices are adopted. It is, thus, imperative to treat anorexia nervosa soonest possible. Like growth, pubertal development relies on the growth hormone, as well as the gonadotropins. These hormones are suppressed in anorexia nervosa disorder, resulting in delayed attainment of puberty. However, this is also reversible on the adoption of better eating habits. Other complications include hepatic steatosis, heart attack, seizures, and eventually, death. Of all the eating and weight-related disorders, anorexia nervosa is leading in mortality rates (Katzman, 2005).
This condition is characterized by binge eating, followed by removal of the excess food taken through various means like purging and vomiting to prevent chances of weight gain. Like in anorexia nervosa, the driving force in bulimia nervosa is the fear of adding weight (Hay, & Bacaltchuk, 2008). These people feel that they do not have control over the amount of food they consume. Thus they do not strive to control what they take. However, they resolve to get rid of the food using extreme methods because they dread adding weight (Mehler, 2003). In some cases, bulimia nervosa may be characterized by starvation for some period, which is then followed by a binge or a purging episode (Russel, 2009).
Unlike in anorexia nervosa, people suffering from bulimia nervosa may be of normal body weight, but they do not want to gain more weight (Russel 2009). Various signs and symptoms characterize this disorder. They include quick and uncontrollable food consumption that ceases when someone else interrupts or the stomach aches. This is then followed by self-induced purging (Mehler, 2003). Some of the symptoms include depression, red eyes as a result of vomiting, cuts at the mouth corners, eating excessively and then getting to the bathroom and returning to eat again, low self-esteem, irregular menstruation, fixation on calories taken, and serious consciousness about one’s weight (Mehler, 2003).
It is not easy to diagnose bulimia nervosa because bulimics may be about average, somewhat beyond, or lower than average weight (Mehler, 2003). The psychological diagnostic criteria used for this disorder is the DSM-IV-TR criterion that includes repeated binge or purge episodes. The diagnosis is determined only when it is not part of the anorexic signs and symptoms, and if the sufferer is too conscious about their body weight or shape (Hay, & Bacaltchuk, 2008).
Binge Eating Disorder
This is a recently described eating disorder that is characterized by uncontrollable and excessive consumption of food (Cooper & Fairburn, 2003). Sufferers of this disorder often eat large amounts of food even to discomfort levels, but they feel that they do not have the power to control this behavior (Hudson et al., 2006). Binge eating involves eating even on a full stomach. But unlike bulimia nervosa, binge eating individuals do not strive to compensate for this disorder by purging. Thus they are often obese.
This eating habit has been strongly attributed to failure to manage emotional stresses like depression (Cooper & Fairburn, 2003). Sufferers often take too much food as a way of compensating for their emotional problems. Although they may feel satisfied at first, they end up feeling guilty about this behavior and get more depressed. It then turns into a vicious cycle whereby the more they eat, the more they get depressed, and the more they need to eat (Hudson et al., 2006).
Signs and symptoms that characterize binge eating disorder include the person having serious worries about the binge eating, eating more food than what most people eat and very fast, the binge occurs at least two times in a week for over six months, and eating alone due to embarrassments and depression, among other signs (Cooper & Fairburn, 2003). Complications like obesity, hypertension, type 2 diabetes, hypercholesterolemia, heart disease, and certain cancers can also be present (Hudson et al., 2006).
Treatment of eating disorders
It is not easy to manage eating disorders because treating the disorder may involve habits that are detrimental to a patient; for example, giving up a dream to gain an ideal figure and shape. Many specialists have found out that behavioral therapy is the most effective treatment to virtually all eating disorders. Behavior therapy seeks to replace dysfunctional behaviors with appropriate ones and helping people become planners of the environment as opposed to being victims of otherwise perceived uncontrollable forces (Oudijn et al., 2013). Behavior therapy comprises of monitoring food consumption, day-to-day activities, as well as reporting about emotional conditions. These are aimed at aiding sufferers to become their therapists (Erford et al., 2012). The other element of behavior therapy is aiming to have the sufferers cease dieting during the treatment.
This helps to stabilize blood glucose levels that would have been significantly disrupted by the eating disorders (Walsh, Wheat & Freund, 2000). Of great importance is the provision of motivation, amalgamating counseling, and re-education. For instance, a bulimic ought to know that weight loss via purging is just temporal. Behavior therapy also trains techniques for controlling the stimuli, such as evading or controlling trigger situations. This helps people to acknowledge their susceptibility and minimize their exposure to detrimental food habits (Erford et al., 2012).
The cognitive approach is another form of treatment that assists sufferers to determine and challenge their negative thoughts (Bailer et al., 2004). They are taught to be gentler to themselves and scrutinize their suppositions about what they have to become and other important things in their lives (Erford et al., 2012). This entails scrutiny into the pressures of the society regarding dieting, as well as their own goals regarding body weight (Cooper, 2005).
The other treatment options are interpersonal psychotherapy, family-based treatment (FBT), and cue exposure where the sufferer is presented with the “forbidden food” and allowed to see and smell, but not eat as a way of conditioning patient (Oudijn et al., 2013). Among the pharmacological treatments used include tricyclic antidepressants and fluoxetine MAO inhibitors, among others (Guarda, 2008). It is better to start treatment early because it makes restoration easier. It also helps in avoiding serious health problems.
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