DEFINITIONS
Eating disorders are characterized by a disturbance of eating habits or weight-control behavior which results in a clinically significant impairment of physical health or psychosocial functioning. These disorders are mainly prevalent in teenage girls and young adult women.
Eating disorders consist of three diagnostic categories: anorexia nervosa, bulimia nervosa and atypical eating disorders. All three have similar features and patients often move from one diagnosis to the other. The causes of eating disorders seem to arise from social, psychological and biological constructs. In both anorexia and bulimia, female and male share a common psychopathology of over-evaluating their shape and weight. They measure their self-worth largely or exclusively based on their shape, their weight and their ability to control them instead of looking at several aspects of their life.
ANOREXIA
Description
Anorexia nervosa is the condition in which the pursuit of weight loss is successfully achieved. Patients do not see their low body weight as a problem but more as an accomplishment. Thus, making it very hard to treat as it is challenging to shift their motivation towards another goal.
Onset
Anorexia often starts in mid-teenage years and it is the one disorder which is associated with high mortality rates either by medical complication or by suicide. This eating disorder seems to be highly genetically heritable. Some environmental factors appear to have a part in it too. For example, premorbid conditions such as childhood abuse seem to have an impact on symptomatic behavior of anorexic patients.
Diagnosis
The diagnostic criteria for anorexia are over-evaluation of shape and weight, active maintenance of low body weight <17kg/m2 and no menstruation. This eating disorder is often accompanied by symptoms such as depression, anxiety disorder, irritability, loss of sexual drive and obsessional features. Anorexic patients manage to keep a low weight by over-exercising, misusing diuretics and laxatives and vomiting.
Treatment
The aim for therapies to help deal with anorexia is to help show patients they need help and once this has been done, they need to maintain motivation. While patients need to restore weight some therapies such as Cognitive behavioral therapy (CBT), family therapies and others have been develop in order to reevaluate their views on body weight and shape and their eating habits. Hospitalization is only seen as a last resource in the case of suicidal attempts or severe interpersonally problems at home or failure of less intensive care.
BULIMIA
Description
Bulimia nervosa is different from anorexia because the attempts to restrict food intake are punctuated by binge eating. Another major difference is that the body-weight is normal in bulimic patients. Binge eating is defined as an episode of eating during which there is an aversive sense of loss of control and an unusually large amount of food eaten. To compensate for the amount of food ingurgitate, between 1000-2000 kcals, patients undergo a purging phase right after by using laxatives or vomiting.
Onset
The onset for bulimia is later than anorexia however this disorder tends to be self-perpetuating and patients on average are ready to go and seek help 5 years after the first episode. The research around genetic heritability for bulimia is still quite unsure some seem to found very mild effects while others account an 80% liability of gene causing the disorder. Similar to anorexia premorbid experience seem to have an impact on the disorder as well as exposure to childhood and parental obesity and parental alcoholism.
Diagnosis
The diagnostic criteria for bulimia nervosa is over-evaluation of shape and weight, recurrent binge eating, extreme weight control behavior and not meeting some criteria for anorexia. Often patients have a low self-esteem and they become distressed by their loss of control over eating and ashamed of it so easier to engage in treatment. Depression and anxiety disorders are comorbidities of bulimia nervosa.
Treatment
Patients diagnosed with bulimia can be treated with CBT which focuses on modifying specific behaviors and ways to break the vicious circle. Additionally, antidepressant drugs have been found to have an antibulimic effect which reduces the binge eating and purging, while improving the mood.
ATYPICAL
Atypical eating disorders closely resemble anorexia and bulimia however patients do not meet the diagnostic criteria for either of the disorders. This shows how similar these eating disorder are. Often patients move from one to another. The similarities between these disorders suggest that there must be an underlying biology disfunction common to all.
Cause
The central nervous system is very important in the regulation of food intake. Thus, a deregulation or malfunctioning of hormones, receptors and ions could lead to these disorders. More and more research is focusing on neurobiological components of these disorders. Some findings show that the serotonergic system might be of importance in the regulation of eating disorders.
Current research
Additionally, the balance and the well-being of the body is crucial for mental well-being, dysregulation of food intake due to psychopathological beliefs would impact the physical aspect of a patient, eg; not menstruating anymore, which would in turn impact hormonal system and creating chemical imbalance which would further impact the mental wellbeing, eg: could lead to depression. Thus, making it harder to find some solutions to get out of this horrendous vicious circle.
BINGE EATING
HOW TO HELP
1. Please avoid any comments such as “Control yourself” or “Maybe you should eat less” because it just much stronger than our will. It’s like an addiction. We can’t stop thinking about it. The worse is during the moment of withdrawal when it feels like a matter of life or death.
However, don’t be passive.
2. The best you can do is offer an ear to listen but don’t pressurise us into talking about it, because the pressure is already so high from society, from the guilt and most importantly from the shame we put on ourselves. Don’t push, don’t judge. We are just individuals in pain.
3. Another thing that would help is avoiding over talking about food. Mentioning it as a normal activity: “let’s go grab lunch”. Avoid any comments such as “you’ve eaten so little” because like any shameful action, we are good at hiding our overconsumption of food or purging strategies. Thus, only reminding us that something is wrong.
The change has to come from within us. Reconnecting to ourselves, trying to gain control back. Small things that helped me gain control again were doing sports, being in the nature and doing meditation. Connecting my mind and my stomach. Trying to control this unbearable urge, to eat created by my brain, with my whole body to then gain control back and reason myself that I am not hungry right now.
4. The best thing to do would go and see a professional so they can elect which strategy would be the most efficient. They are quite a view options available such as CBT, self-help, hypnosis, family therapy so don’t be put off if one does not work. Try again it will work because everyone is capable of change. It’s not your fault and your body does not define your self-worth. You are so much more.
CONTACT
Lucie is an avid nature lover who spends her spare time posing as a social butterfly and making people happier. You can talk to and ask her any questions (she welcomes anything, including memes) via her email: lucie.mathieu@kcl.ac.uk (:
Comments
Post a Comment