Eating Disorders

  • Basics

    People with eating disorders such as anorexia nervosa, binge eating, or bulimia nervosa have an intense and extreme preoccupation with food and weight. Eating disorders affect people of all backgrounds. Eating disorders often begin in the teenage years; however, they may begin as early as age 8. Eight million people in the U.S. have been diagnosed with an eating disorder, ninety percent of whom are women. Of college freshmen, 4.5% to 18% of women and 0.4% of men have a history of bulimia. As many as 1 in 100 females between the ages of 12 and 18 have anorexia. Binge eating disorder is present in about 2% of the general population, mostly in women.

    People with anorexia avoid eating because they fear gaining weight, while those with bulimia eat large amounts of food, or binge, and then purge by vomiting or using laxatives. Anorexia and bulimia are both illnesses in which individuals are obsessed with their weight and food intake. This obsession leads to severe weight loss in people with anorexia, and a binge/purge cycle for people with bulimia. Both anorexics and bulimics may over-exercise and use laxatives or diet pills to “control” their weight.

    An illness that is similar to bulimia nervosa is binge-eating disorder. Like bulimia, it is characterized by bouts of uncontrollable eating. However, the disorder differs from bulimia because those who suffer from it do not purge their bodies of excess food or use other extreme methods of weight control. People with binge-eating disorder are more likely to be male, and they are frequently overweight.

    Some eating disorders do not meet the criteria for any specific eating disorder. For example, some people have all the behaviors of bulimia, however, they may engage in the binge and purge cycle less than twice a week or for less than three months. Others may try to compensate for having consumed food, but may do so after only eating small amounts of food rather than the large amounts typically consumed during a binge.

    In most cases, eating disorders can be treated with help from a mental health professional and a nutritionist. A multidisciplinary approach is important, and includes a physician consultation and hospitalization for weight restoration, where necessary.

  • Causes

    Psychological, environmental, and genetic factors predispose people to eating disorders Table 01. While there is no one cause for eating disorders, a broad range of factors can produce anorexia, bulimia, and binge eating. Psychological factors include chemical imbalances that are linked to personality and emotional disorders. Of all patients with eating disorders, 40% to 96% experience depression and anxiety disorders. Other factors include cultural and familial pressures, and situations that promote a dissatisfaction with the way one looks. Genetic factors have also been associated with eating disorders. In fact, relatives of patients with anorexia or bulimia are ten to twenty times more likely than others to have eating disorders.

    Table 1.   Factors Involved In Eating Disorders

    Dysfunctional families/relationships
    Personality traits (e.g., fear of losing control, inflexible thinking, perfectionism, low self-esteem, feelings of helplessness)
    Cultural pressures to be slender
    Stressful situations (e.g., rape, abuse, trauma)
    Participation in sports in which low weight is emphasized
    Repeated critical comments regarding body image
    Other psychiatric disorders; e.g., depression
    Personal and family history of obesity (relevant to bulimia)

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