Symptoms
The most common symptoms of eating disorders are denial that there is a problem, and preoccupation with food and weight Table 02 Table 03. Anorexics continue to think they look fat, even though they are bone-thin. They obsess about their weight, and constantly worry about their next encounter with food. People with bulimia have less severe weight loss than anorexics, and are less likely to suffer physical consequences. For bulimics, binge eating is not a response to intense hunger; rather, it results from depression, stress, or other feelings related to body weight, shape, or food.
Table 2. Symptoms of Eating Disorders
Anorexia Bulemia Refusal to achieve or maintain a normal body weight Binge eating at least two times a week for three months Denial that there is a problem Feeling out of control during a binge Intense fear of gaining weight or becoming fat, even when already thin Fasting, vomiting, exercising excessively, or using laxatives and other medications to prevent weight gain at least two times a week for three months Feelings of self-worth that are dictated by body shape and weight Feelings of self-worth that are dictated by body shape and weight Amenorrhea, or absence of at least three menstrual cycles in a row ? Table 3. Physical Signs of Bulimia and Anorexia
Anorexia Bulemia Absence of menstrual periods Swelling of hands and feet Soft, downy body hair Abdominal bloating Weight loss of at least 25% of original weight (in children, failure to achieve age-appropriate weight) Fatigue/weakness Electrolyte and hormonal disturbances Puffy cheeks Sensitivity to cold Tooth sensitivity/dental erosion Bone pain/fractures Depression Impaired growth/short staturea Irregular menses and infertility Loss of scalp hair Calluses on hands Dry, scaly skin Enlargement of the salivary glands Hypotension ? Arrythmias ? Liver failure ? a In adolescents for whom the extreme weight loss occurs before the onset of the puberty
Denial and preoccupation with food and body weight can lead to strange eating habits. People with anorexia may cut their food into smaller pieces, refuse to eat in front of others, or fix elaborate feasts for others without eating the meal themselves. Binge eaters and people with bulimia view the process of bingeing and purging as a way of regaining control in their lives.
Risk Factors
If anyone in your family has had an eating disorder, you may be predisposed to the condition also. Female relatives are most often affected. If a girl has a sibling with an eating disorder, she is 10 to 20 times more likely to develop the illness herself.
Social or cultural approval of thinness can lead naturally thin or naturally heavier people alike towards having an eating disorder.
If you are involved in competitive athletics in which low body weight is promoted, you may be more likely to develop an eating disorder. Eating disorders, along with menstrual dysfunction and osteoporosis, are an increasing problem among young female athletes and dancers. Some coaches and teachers encourage calorie counting and loss of body fat so that the female athletes retain their boyish shape and competitive edge.
If you are involved in or have been linked to dysfunctional relationships or situations that induce stress and encourage a poor self/body image, you may be predisposed to developing an eating disorder. Environmental factors either cause negative feelings, resulting in a poor body image, or put undue pressure on both men and women to be the thin “ideal.” Traumatic situations and dysfunctional relationships can lead to altered eating habits, predisposing individuals to eating disorders. As a result of these two factors, men or women may exhibit personality traits such as fear of losing control, inflexible thinking, perfectionism, low self-esteem, feelings of helplessness, and an intense dissatisfaction with the way they look.
If you are employed in a profession in which thinness is a professional requirement, you may be at risk for developing an eating disorder. Society’s obsession with being thin as reflected in advertising and the media puts pressure on those in the public eye (e.g., actors, models, athletes, dancers) to remain thin.
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I'm Shereen A. Gharbia, PharmD. Welcome to PDR Health!