Eating Disorders

eating disorder
Doctor writing word Eating Disorders with marker, Medical concept

Eating disorders are serious and often fatal illnesses that lead to severe abnormalities in eating behaviours of patients. There is too much obsession with food, body weight and body shape that signal an eating disorder. Eating disorders are due to complex interactions of genetic, biological, behavioural, psychological and social factors. Eating disorders may run in families. There are several research ongoing to identify the genes for this order as well as brain imaging studies that can indicate different brain activity patterns.    

The followings are the common eating disorders:

  1. Anorexia nervosa
  2. Bulimia nervosa
  3. Binge eating disorder

Eating disorders are commonly seen in adolescents but may also develop during childhood and adults. Both males and females are affected, although rates among females is higher than males. Eating disorders commonly coexist with anxiety, substance abuse or depression.

Causes of Eating Disorders:

The exact cause of  eating disorder is not known but there could be multiple factors that leads to this behaviour. Some of the possible causes of eating disorders are:

  1. Irregular hormones function
  2. Nutritional deficiencies.
  3. Negative body image
  4. Poor self esteem
  5. Dysfunctional family
  6. Certain profession requiring weight control eg. Dancing, model etc.
  7. Certain sports to maintain lean body eg. Diving, gymnastics, wrestling etc.
  8. Childhood trauma like sexual abuse
  9. Peer pressure among friends

Symptoms:

The symptoms of eating disorders vary depending on the type of disease.

  1. Anorexia Nervosa:

It is a potentially life threatening disorder with abnormally low body weight, intense fear of gaining weight, and a distorted perception of weight or shape. Patients with this disorder do several methods to excessively limit their calories like reduced eating, excessive exercises, using laxatives and diuretics. They may induce vomiting after eating to reduce the body weight.

Anorexia nervosa can cause severe health problems, sometimes to the point of starvation      and death.

The common symptoms of anorexia nervosa include dramatic weight loss, hide weight loss, preoccupied with calories, food, dieting etc., frequent comments on weight and dieting, abdominal pain, constipation, denies feeling hungry, cold intolerance, loss of menstruation, feels ineffective, cramps, anaemia, low potassium, reduced heart rate and sleep problems.

  • Bulimia Nervosa:

Bulimia is excessive eating disorder that is potentially serious and life threatening. It is     characterized by a cycle of bingeing and compensatory behaviours such as self-induced vomiting. Designed to undo or compensate for binge eating. The diagnostic criteria for bulimia nervosa are:

  1. Recurrent episodes of binge eating: Eating in a discrete period of time, an amount that is definitely larger than most people would eat during a similar period of time or under similar circumstances.
  2. A sense of lack of control over eating during the episode.
  3. Recurrent inappropriate compensatory behaviour in order to prevent weight gain such as self-induced vomiting, misuse of laxatives, diuretics, or other medications, fasting or exercises.
  4. The binge eating and inappropriate compensatory behaviour both occur on average at least once a week for three months.
  5. Self-evaluation is unduly influenced by body shape and weight.     

Evidence of binge eating include disappearance of large amount of food in short period of time or lots of empty wrappers and containers, frequent trips to bathroom after meals, appear uncomfortable eating around others, develop food rituals, fear of eating in public, steals food in strange places, drink excessive amount of water, use excessive amount of mouthwashes, mints and gum, baggy clothes, looks bloated from fluid retention, withdraws from friends. Frequent checking in mirror, extreme mood swings.

Physical signs and symptoms of binge eating include body weight fluctuation, stomach cramps, poor concentration, dizziness, fainting, feeling cold, sleep problems, dry skin, thin hairs, muscle weakness, menstrual irregularities, poor immune function.

C. Binge Eating Disorder (BED):

 It is commonly known as compulsive overeating or consuming abnormal amount of food while feeling unable to stop and at loss of control. BED typically occurs on average a minimum of twice per week for a duration of six months. BED can occur both in men and women that often leads to unwanted weight gain or obesity, which indirectly reinforce further compulsive eating. 

Patients with BED suffer from emotions of guilt and disgust and often have depression or anxiety. Some of the symptoms of BED are as follows:

  • Continually eating even when full
  • Inability to stop eating
  • Stockpiling of food to consume at a later time.
  • Feeling of stress and anxiety that is relieved only by eating
  • Feel of numbness or lack of sensation while bingeing
  • Never experience the state being satisfied irrespective of the amount of food consumed.

Some of the complications of BED are cardiovascular disease, Type 2 diabetes, loss of sleep, high blood pressure, gall bladder disease, muscle and joint pain, depression and anxiety.

Treatment of Eating Disorders:

The treatment program  for eating disorders should focus on central cause of the problem. Professional support and treatment from health professionals, including psychiatrists, nutritionists and therapists is the key in the effective management of eating disorders.

It is necessary to concentrate on healing from emotional triggers that may be causing eating disorders. There are three types of therapy that is effective in the treatment of eating disorders.

  1. Cognitive-behavioural therapy (CBT): CBT is a treatment that focuses on patterns of thinking that are distorted and beliefs that are root cause of irrational thinking. CBT incorporates psychodynamic and behavioural therapies to help relieve symptoms.
  • Interpersonal psychotherapy (IPT): IPT focuses on an individual’s  relationship with family members and peers. IPT is founded on the idea that interpersonal factors may be associated with psychological problems. This targeted method of treatment create rapid improvement for patients with depressions and eating disorders.
  • Dialectical Behaviour Therapy (DBT): DBT focuses on teaching individuals skills to cope with stress and regulate emotions. It connects cognitive and behavioural therapies as a way of helping patient learn and adapt healthier methods of coping with painful emotions.

Besides above methods, group therapy sessions by trained eating disorder therapists may also be helpful in treatment of eating disorders.         

The patient with anorexia nervosa can sometime develop acute medical complications and require hospitalization to control associated problems. The treatment is essentially supportive to restore nutritional deficiency, correction of electrolytes and any other organ dysfunction. The patient with bulimia nervosa are sometimes prescribed specific antidepressants to control eating and associated psychological impairment.