The Identifying And Treating Of Eating Disorders

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You have heard persons talking about it; you have seen persons, either in real life or on television, suffering from it. But what exactly defines an eating disorder?
Over the years, pictures have been circulated with young women and men suffering from anorexia and they seem quite gruesome. On the contrary, some of these images are meant to raise awareness about eating disorders among young people.
But did you know that anorexia is not the only eating disorder that persons can suffer from?
It is commonly thought that eating disorders are actually a lifestyle choice, in that, the sufferers can actually just snap out of it or choose to eat properly. This is a common perception in Guyana and the world over where there is not much focus on mental health issues of this sort.
However, it must be noted that eating disorders are grave and often fatal diseases that can cause severe disturbances to a person’s eating behaviours. Certain obsessions with food, body weight, and shape may also signal the presence of an eating disorder. Eating disorders that frequently occur include anorexia nervosa, bulimia nervosa, and binge-eating disorders.
People with anorexia nervosa often times see themselves as being grossly overweight, despite the fact that they are dangerously underweight. It is not uncommon for persons with anorexia to constantly weigh themselves during the day, sometimes four to five times within a 24-hour period.
They also tend to severely restrict the amount of food they consume and only eat very small quantities of just certain foods. Of all the eating disorders and all the psychiatric disorders for that matter, anorexia nervosa has the highest mortality rate.
Most young people with this disorder tend to die from complications associated with starvation. However, due to the depression, others die of suicide. Suicide is much more common in women with anorexia than with most other mental disorders.

Symptoms of anorexia may include:

  • Eating extremely small amounts
  • Extreme emaciation (thinness)
  • The relentless urge to get thinner and unwillingness to maintain a normal or healthy weight
  • A deep and intense fear of gaining weight
  • Distorted body image, a self-esteem that is heavily influenced by perceptions of body weight and shape
  • Denial of the seriousness of low body weight

Some other symptoms may develop over time due to the initial starvation. These would include:

  • Thinning bones, referred to as osteopenia or osteoporosis
  • Anemia, muscle wasting and weakness
  • Brittle hair and nails
  • Dry and yellowish skin
  • Growth of fine hair all over the body (lanugo)
  • Severe constipation
  • Low blood pressure, slowed breathing and pulse
  • Decreased heart function due to damage
  • Brain damage
  • Multi-organ failure
  • Drop in internal body temperature, causing a person to feel cold all the time
  • Lethargy
  • Infertility

Now, people with bulimia nervosa have frequent episodes of eating unusually large amounts of food and having little to no control over them. This binge-eating behavior is usually followed by a compensating behaviour for the overeating such as purging, overuse of laxatives or diuretics, prolonged fasting, excessive exercise, or a combination of all. Unlike anorexia, bulimia patients are usually able to maintain a healthy or relatively normal body weight.

Symptoms of bulimia nervosa may include:

  • Chronically inflamed and sore throat due to purging
  • Swollen salivary glands in the neck and jaw area
  • Worn tooth enamel and increasingly sensitive and decaying teeth as a result of exposure to stomach acid
  • Acid reflux disorder and other gastrointestinal problems
  • Intestinal distress and irritation from laxative abuse
  • Severe dehydration from purging of fluids
  • Electrolyte imbalance (too low or too high levels of sodium, calcium, potassium and other minerals) which can lead to stroke or heart attack

Finally, people with a binge-eating disorder lose total control over his or her eating habits. Unlike bulimia, the periods of binge-eating are not followed by purging, excessive exercise, or fasting. As such, binge-eaters are commonly, very overweight or obese.

Some of the symptoms associated with binge eating include:

  • Eating unusually large amounts of food in a specific amount of time
  • Eating even when you’re full or not hungry
  • Eating fast during binge episodes
  • Eating until you’re uncomfortably full
  • Eating alone or in secret to avoid embarrassment
  • Feeling distressed, ashamed, or guilty about your eating
  • Frequently dieting, possibly without weight loss

What then are some of the risk factors associated with developing these disorders?
Research dictates that these disorders usually occur during the teenage years or into young adulthood but can also begin during childhood or later on in life. They affect both genders, although women are two out of five times more likely to develop them as compared to men.
Unlike women who may tend to have body image distortions concerning being overweight, men may have muscle dysmorphia, a type of disorder marked by the need to become more muscular.
Research has shown that eating disorders are caused by a complex interaction of genetic, biological, behavioural, psychological, and social factors. So for those suffering from any of the above, it might not just be one trigger, it may be a combination, which is why not many Guyanese know how to deal with them when diagnosed.

Treatments and Therapies
Ensuring that there is adequate nutrition, helping to reduce excessive exercise and putting an end to purging behaviours are the mainstay of treatment. However, treatment plans are tailored to each individual’s needs and may include one or more of the following:

  • Psychotherapy
  • Medical care
  • Counseling on nutritional
  • Medications
  • Medications such as antidepressants, antipsychotics, or mood stabilizers have been found to be very helpful for treating eating disorders and illnesses occurring hand in hand, such as anxiety or depression.
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Columns · Health · Issue 27 · Psychological · Publication

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