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Introduction to Eating Disorders

Eating Disorders

Most of us live in cultures which urges us (especially women) to improve our appearance. The messages sent by magazines, television, and other media include "buy certain clothes and products; straighten and whiten your teeth; get rid of your wrinkles; and most commonly, LOSE WEIGHT and you will be happy, admired, and loved." The ongoing debate concerning the unhealthy, stick thin models used in the fashion industry is a perfect example of how strongly held our notion of "thinness equals happiness" has become.

Although many of us would benefit from eating a bit less and exercising more in order improve our health and fitness, simply watching what you eat is NOT an eating disorder. Eating Disorders are potentially life-threatening conditions with psychological and physical effects. They are characterized by a number of abnormal and harmful eating behaviors. People with an eating disorder have unhealthy beliefs, thoughts and expectations concerning eating, weight, and body shap...More

Fast Facts: Learn! Fast!

What are eating disorders?

  • There are three primary eating disorders: Anorexia Nervosa, Bulimia Nervosa, and Binge-Eating Disorder. Each disorder is characterized by a distinctive pattern of disordered and harmful eating behavior.
  • Anorexia generally involves the severe and extreme restriction of eating to lose weight.
  • Bulimia is characterized by the presence of binges, which are when someone eats an abnormally large amount of food in a short period of time. These binges are often followed by purge behaviors that are an attempt to get rid of the consumed calories.
  • Binge-Eating Disorder is similar to Bulimia because both conditions share binge-eating behavior. However, individuals with Binge-Eating Disorder do not purge or get rid of what they have consumed, unlike those with Bulimia.
  • All three eating disorders are serious mental and physical conditions with potentially life-threatening consequences.
  • These disorders can affect daily functioning and destroy general health.
  • Individuals typically experience painful emotions before, during and after the eating behaviors.
  • They often fear gaining any weight, and their self-esteem is highly affected by their weight. This focus can develop into a distorted body image.

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How common are eating disorders?

  • The World Health Organization (WHO) estimates that worldwide 70 million people have an eating disorder. Lifetime prevalence statistics suggest that about 0.4% of women and 0.04% of men will meet criteria for anorexia during their lifetimes.
  • Between 1% and 5% of women will meet the criteria for bulimia during their lifetimes (as will between .01% and .05% of men).
  • The prevalence rate for binge eating disorder is 1.6% in females and 0.8% in males.
  • Binge-eating disorder shows much less of a difference between females and males, compared to the other two conditions.
  • Eating disorders typically begin in adolescence or early adulthood.
  • It does not seem to be associated with what race someone is or their socioeconomic status (whether one is rich or poor). Instead, these disorders are problems affecting people from all different backgrounds.
  • Between 6% and 20% of people with an eating disorder will die as a result of their disease.

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What are the causes of eating disorders?

  • There are many factors that can cause an eating disorder including biological ones, personality traits, family issues, and cultural standards.
  • Eating disorders are often biologically inherited and tend to run in families. Research suggests that inherited these genetic factors contribute approximately 56% of the risk for developing an eating disorder.
  • Research suggests that several different neurotransmitters in the brain are involved in eating disorders.
  • Personality traits. such as emotional stability, obsessiveness, and perfectionism. play a large role in the progression of some eating disorders.
  • Individuals with anorexia and bulimia tend to be very competitive. They are quite driven to succeed.
  • Psychologists and other professionals have identified that individuals with eating disorders often are missing important coping skills to deal with life's situations.
  • Much of the research on eating disorders has focused on the development of healthy emotional boundaries in families.
  • Some people turn to an eating disorder after they've experienced a family trauma such as sexual or physical abuse, or neglect.
  • Particularly in modern Westernized countries, models, the media and dieting fads influence women and girls to be as thin as possible.

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What characteristics or traits help maintain an eating disorder?

  • Dysfunctional thinking and negative thoughts can keep eating disorders going.
  • Some professionals have suggested that people with eating disorders have difficulty coping with and managing strong emotions, such as anger.
  • Those with anorexia punish themselves for what they see as failures and for their self-hatred by restricting their food intake. They correct for the ever-increasing pile of mistakes they think they have made by punishing themselves through not feeding their own bodies.
  • For those with bulimia, however, their strategy for correction is through purging. Their attempt to make up for binging and the resulting sense of shame is displayed through vomiting, exercising, and laxatives as an abusive response to the body.
  • Binge-eating disorder does not focus on restricting food for not being perfect, and instead uses food as a source of comfort during times of stress or when upset.
  • Behaviors associated with eating disorders that involve food restriction or purging often develop out of a sense of shame.
  • Psychologists know that dysfunctional thinking can affect a person's vulnerability toward development and continuing an eating disorder, as well as depression.
  • Teens and young women experience a lot of pressure from their peers to be thin and to stay thin.
  • Biological factors that cause eating disorders often keep them going as well.

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What are the symptoms of eating disorders?

  • Each disorder has different symptoms and behaviors that appear.
  • There are three major criteria for diagnosis of Anorexia Nervosa. These are: 1) Restriction of food eaten - eating less than the body needs, which leads to significantly low body weight for the person's age, sex, and physical health 2) Intense fear of gaining weight or becoming fat or having ongoing behaviors that stop weight gain, even when already underweight 3) Issues with the way the person thinks about their body weight or shape. These thoughts affect how they view themselves. They also do not see the seriousness of their current low weight.
  • To be diagnosed with Bulimia Nervosa, a person needs to display the following behaviors, on average at least once a week, for 3 months: 1) ongoing episodes of binge eating 2) ongoing behaviors to prevent weight gain, such as causing one's self to vomit, misusing laxatives, diuretics, or other medications, fasting, or excessive exercise.
  • To be diagnosed with Binge-Eating Disorder, a person must have ongoing episodes of binge eating that happen, on average, at least once a week for 3 month. Binge eating is characterized by the amount of food eaten in a 2-hour period that is larger than what most people would eat in similar circumstances. It also involves a lack of control over eating during that episode. The person may feel like they can't stop eating or control what they are eating.

For more information on symptoms and characteristics of Anorexia Nervosa
For more information on symptoms and characteristics of Bulimia Nervosa
For more information on symptoms and characteristics of Binge-Eating Disorder

How is an eating disorder diagnosed?

  • One of the first steps to getting well is being evaluated by mental health and medical professionals.
  • This evaluation will generally include an interview with you (the "patient" who is displaying the eating disorder symptoms) and your family.
  • The interviewer will ask for a detailed medical and mental health history.
  • You will be asked verbal questions, as well as given paper and pencil (or computerized) tests to fill out.
  • It is important to be as honest as possible when answering questions, even though they may be difficult or painful to answer.
  • Hiding information will affect the ability of your therapist and doctor to get you the best help possible for your condition.
  • The doctor will complete a routine physical. He/she will also ask you about your eating habits, diet, and physical symptoms of the disease.
  • You will have laboratory and other tests done. These will check for any medical complications that your disordered eating may have caused and evaluate how well your body systems are working.
  • Test results will also serve as a baseline for future comparisons to check whether treatment is helping.
  • During treatment, a medical doctor will continue to monitor physical health, including ongoing checks on vital signs, hydration level and electrolytes.

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What are the treatments for an eating disorder?

  • The first priority of treatment is to regain physical health and decrease the medical dangers of the condition.
  • Nutritional rehabilitation is often one of the primary goals in the beginning and the ongoing stages of treatment.
  • Because many individuals with eating disorders are very knowledgeable about nutrition, they often believe that they don't need to work with a nutritionist. However, nutritional knowledge may be distorted by the faulty thinking that results from an eating disorders.
  • Individual therapy is designed to provide you with education and support. It will be important to talk about how and why the eating disorder developed and what keeps the behavior going.
  • The most common type of therapy used for eating disorders is Cognitive Behavior Therapy (CBT).
  • Inpatient treatment involves around the clock care in a medical or hospital setting. It is designed to treat medical complications and restore weight, as well as provide limited therapy.
  • Residential facilities offer 24-hour care to people who may not be in serious medical danger but who continue to do eating disordered behaviors.
  • Group therapy is an excellent source of treatment and support for those with bulimia or binge-eating disorder.
  • Family therapy can be used to provide loved ones with education, support, communication skills, and conflict resolution.

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Can an eating disorder be prevented?

  • By teaching adults to be aware of the most vulnerable individuals and the symptoms, eating disorders can be caught early and treated.
  • Educating both male and female children about healthy eating and body image is also an important prevention task.
  • Children need to be taught about critical thinking. This includes learning how to recognize when media images are unrealistically perfect and how to not use those images as comparisons for themselves.
  • Parents can be big supporters in building healthy body images, self-esteem and lifestyles for their children.
  • It's important to encourage children to be involved in sports and other activities that build self-esteem and promote healthy physical activity.
  • Actively teach children how to make healthy food choices.
  • Plan and eat meals together.
  • Compliment kids - a lot. Praise them for their strengths, their talents, and their efforts.
  • Provide kids with lots of physical affection and let them know that you love them for who they are.
  • Allow lots of opportunities for children to talk about their insecurities, their body image, and their efforts to fit in.
  • Educate them about the unrealistic messages in the media, and help them understand that thinness does not equal happiness.
  • Limit the number of hours in front of the television or on the computer.
  • Limit access to junk food and fast food.
  • Avoid giving food for rewards.
  • Striking a balance based on family lifestyle and the personality of the children seems to be key to actively teaching children how to make healthy choices, eat junk food in moderation, recognize when they are full, and include exercise into their life.

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