We must take eating disorders seriously!!!
We see and experience the numerous problems brought about by the developing society. One of the best examples of this is the Eating Disorder, which has been known in USA and Europe for years but only recently in our society.
Disorders regarding the motive to eat (in short "Eating Disorders”) are a special group of disorderinvolving emotional disturbances brought about by negative body type images. It is mostly observed in young females during teenage and adulthood periods, but children, pre-teens, adult women and men may also develop these problems. These disorders are divided into two main groups as Anorexia and Bulimia Nervosa and are strong enough to negatively impact general health and even become life-threatening.
The main purpose of eating is to preserve our health and maintain life via nourishment; however, sometimes we eat for fun, sharing, relaxation or to suppress negative emotions such as boredom or anger. The society and geological location we live in as well as our family and economic conditions are external factors that impact our eating habits. Internal factors are more effective in impacting whether eating will become a problem. There may be multiple factors at play in the occurrence of problems regarding eating habits.
Social Pressure: In societies where being skinny is not important, eating disorders are almost not observed at all. Whereas in societies where being skinny is very important, eating disorders are observed more frequently. For example, the media keeps trying to perfect the flaws in our appearance in our society. Physical attractiveness contributes to our social success in our culture. This pressure from society may cause us to develop a negative body image and thus put us in an effort to diet in a manner that might become dangerous.
Fear of Loss of Control: When we feel we lose control of our lives, it may be relaxing and satisfying to do some diets that make us feel we are in control. Therefore, dieting stops being a method to lose weight and instead becomes its own target.
Family Interaction: Eating is a major part of our life with others, especially family. Sometimes a teenager’s only way of expressing his emotions or impressing his family may be to say “no” to the offered food. Other times, teenagers who do not express their negative emotions but try to suppress end up eating more and throw up what they ate as if getting rid of their negative emotions. In certain cases, teenagers who do not have clear lines within the family may turn to eating disorders in an effort to gain an independent identity.
Intense Sadness/Boredom: As a reaction to negative events, the person may turn to eating or completely go off eating.
Anorexia Nervosa
Anorexia is significant weight-loss due to extensive dieting. A person with this disorder may halt food intake for so long that they may end up losing 20 to 50% of their body weight.
Anorexia is generally present in the event of below factors:
- Not accepting the minimum normal weight for age group and height,
- Fearing weight gain or obesity despite weighing less than expected for age and height
- Distorted image of weight or body shape
- Lacking minimum three consecutive periods in women.
Personality Structure in Anorexia
People with anorexia generally try to achieve perfection. They set fairly high targets and feel the need to constantly prove themselves. Generally they hold the needs of others before their own. A patient with anorexia thinks the only thing they can control in life is eating and their weight. The number on the scale every morning determines whether they were successful in their target to be thin. When they manage to lose weight, they feel strong and in control. Focusing on their calorie intake and weight is a way to block unwanted emotions. People with anorexia find it easier to lose weight instead of directly dealing with problems. In general, these people have low self-esteem and sometimes they wish they do not deserve to eat. They usually deny having a problem. They continuously deny hunger. They resist when offered help, because therapy for them is being forced to eat. Once they admit they have a problem and agree to accept help, they may be treated.
Symptoms of Anorexia
- Visible weight loss
- Becoming detached,
- Excessive exercise,
- Intense fear of weight-gain,
- Fatigue,
- Constantly feeling cold,
- Muscle fatigue
- Being overly interested in food, calories and recipes,
- Coming up with excuses not to eat (ex: “I already ate” “I don’t feel well” etc.)
- Strange eating habits (ex: dividing food into tiny pieces)
- Obvious discomfort around food,
- Complaining about being obese despite being too thin,
- Cooking for others but not eating any,
- Only limiting food intake to diet foods
- Feeling guilt or shame after eating,
- Depression,
- Controlling weight by throwing up, using laxatives or diet pills,
- Irregular periods,
- Interrupted menstruation,
- Wearing baggy clothes to hide weight-loss,
- Constantly checking weight on scale,
- Dizziness and blacking out,
- Having difficulty eating in public,
- Being tight-lipped about eating schedule,
- Pale, almost white face
- Headaches
- Perfectionist approach
- Determining self-worth with food intake,
- No physical explanation for weight-loss.
Physical/Medical Complications Associated with Anorexia
- Tiredness and lack of energy,
- Interrupted menstruation,
- Skin problems,
- Weak and easily breaking nails,
- Dizziness and headache,
- Excessive water-loss,
- Shortness of breath,
- Irregular heartbeat,
- Cold hands and feet,
- Being bloated,
- Constipation,
- Hair loss,
- Stomach cramps,
- Slowed-down metabolism,
- Water retention
- Liver and kidney failure,
- Osteoporosis,
- Insomnia,
- Anemia,
- Infertility,
- Depression,
- Potassium insufficiency,
- Heart attack and death
Bulimia Nervosa
Bulimia is observed more frequently than anorexia and is characterized by episodes of binge eating. During these episodes, the person eats more than one can eat in a short period of time. The person does not feel the need to eat or feel satiated – they have no control over it.
A person with bulimia is overcome by concern of weight-gain after involuntarily eating so much and sets their vomiting reflex off by placing their fingers in their throat. Other methods of removing food from the body are using laxatives, diuretics or enemas. Some people choose to not have any food following binge eating episodes or performing heaving exercise.
The most important thing about bulimia is that these uncontrollable eating and vomiting episodes are repetitive and chronic.
Personality Structure in Bulimia
People with bulimia generally have low self-worth. They need others’ approval. They try to make others happy and hide their own emotions. Food becomes the only area of comfort for these people. Bulimia allows a person to block their emotions from getting out. Unlike those with anorexia, people with bulimia are generally aware of their problem and have a higher chance of seeking help.
Symptoms of Bulimia
- Excessive eating,
- Eating in hiding,
- Visiting the bathroom right after eating,
- Vomiting,
- Using laxatives, diet pills or diuretic pills,
- Sudden change in weight,
- Swelling in the throat,
- Ruptured veins,
- Excessive exercising,
- Fasting,
- Sudden changes in emotions,
- Depression,
- Excessive self-criticism,
- Determining self-worth based on weight,
- Being afraid to not be able to stop eating,
- Feeling small and unworthy after eating,
- Fatigue,
- Muscle fatigue,
- Cavities,
- Irregular heartbeat,
- Avoiding restaurants, planned meals or social gatherings,
- Throat pain,
- Needing others’ approval,
- Substance abuse.
Physical/Medical Complications Associated with Bulimia
- Tiredness and loss of energy,
- Irregular or no periods,
- Dizziness,
- Headaches,
- Water loss,
- Constipation and diarrhea,
- Shortness of breath,
- Irregular heartbeat,
- Depression,
- Irritation in throat,
- Hair loss,
- Stomach pain and bloating,
- Erosion in tooth enamel,
- Chronic throat pain,
- Kidney and liver diseases,
- Enlarged glandula parotis (salivary glands)
- Bloated hands and feet,
- Low blood pressure,
- Chest pains,
- Stomach ulcer, enlarged pancreas
- Widening and tears in stomach,
- Worn hands and joints,
- Anemia
- Heart Attack and Death.
Treatment of Eating Disorders
Following the preliminary treatment to ensure the patient's weight is back to normal, the psychological therapy works on the personal and cultural psychological factors underlying both the eating disorder and the illness. During the last stage of the treatment, the patient is taught how to live at peace with herself and with food, in a healthy manner.
Eating disorder in most patients is accompanied by depression, anxiety disorder and other psychiatric disorders that need to be treated. Therefore, the ideal method of treatment accepted in eating disorders allows various clinicians from different fields, such as psychotherapist, doctor, nutritionist and nurse, to take part in the treatment. In some special cases, internal diseases specialist, Obstetrics and Gynecology for female patients and general surgery specialist - for when surgical treatment of intestinal or esophageal problems is necessary - may join the treatment. The treatment should be customized because it should address the severity of the problem as well as the patient's personal issues and needs.
Eating disorder damages the patient physically and psychologically. Therefore, people with such issues should immediately consult a doctor. If not diagnosed and treated in early stages, eating disorder may become chronic and threaten the patient's well-being. Thus, early diagnosis and precaution are essential in treatment of this illness.