ANOREXIA
Anorexia nervosa is a serious, potentially life-threatening eating disorder characterized by self-starvation and excessive weight loss.
Anorexia has five primary symptoms:
- Refusal to maintain body weight at or above a minimally normal weight for height, body type, age, and activity level. -Intense fear of weight gain or being "fat."
- Feeling "fat" or overweight despite dramatic weight loss.
- Loss of menstrual periods in girls and women post-puberty.
- Extreme concern with body weight and shape.
The chances for recovery increase the earlier anorexia nervosa is detected. Therefore, it is important to be aware of some of the warning signs of anorexia nervosa.
Warning Signs of Anorexia:
- Preoccupation with weight, food, calories, fat grams, and dieting.
- Refusal to eat certain foods, progressing to restrictions against whole categories of food (i.e., no carbohydrates, etc.).
- Frequent comments about feeling "fat" or overweight despite weight loss (I find this to be untrue, as we ry to hide the disorder from others)
- Anxiety about gaining weight or being "fat."
- Denial of hunger.
- Development of food rituals (i.e., eating foods in certain orders, excessive chewing, rearranging food on a plate).
- Consistent excuses to avoid mealtimes or situations involving food.
- Excessive, rigid exercise regimen--despite weather, fatigue, illness, or injury, the need to "burn off" calories taken in.
- Withdrawal from usual friends and activities.
In general, behaviors and attitudes indicating that weight loss, dieting, and control of food are becoming primary concerns.
Anorexia nervosa involves self-starvation. The body is denied the essential nutrients it needs to function normally, so it is forced to slow down all of its processes to conserve energy.
This "slowing down"
can have serious medical consequences:
- Abnormally slow heart rate and low blood pressure, which mean that the heart muscle is changing. The risk for heart failure rises as heart rate and blood pressure levels sink lower and lower.
- Reduction of bone density (osteoporosis), which results in dry, brittle bones.
- Muscle loss and weakness.
- Severe dehydration, which can result in kidney failure.
- Fainting, fatigue, and overall weakness.
- Dry hair and skin, hair loss is common.
- Growth of a downy layer of hair called lanugo all over the body, including the face, in an effort to keep the body warm.
- Destruction of teeth, rupture of esophagus, damage to lining of stomach; gastritis, gastric distress including bloat and distension
- Delayed growth and permanently stunted growth due to under-nutrition. Even after recovery and weight restoration, person may not catch up to expected normal height.
- Weakened immune system
- Anal and bladder incontinence, urinary tract infections, vaginal prolapse, and other problems related to weak and damaged pelvic floor muscles. Some problems may be related to chronic constipation, which is commonly found in people with anorexia nervosa. Structural damage and atrophy of pelvic floor muscles can be caused by low estrogen levels, excessive exercise, and inadequate nutrition. Surgery may be necessary to repair the damage.
- Because of changes in the brain associated with under-nourishment, binge eating, and purging, the person does not, and perhaps cannot, weigh priorities, make judgments, and make choices that are logical and rational for normal people. Recovery, once the process has begun, requires time for the brain to readjust -- chemically and physically -- to normal and healthy patterns of eating. This is a combined physical/psychological problem.
- Icy hands and feet
- Anemia, malnutrition. Disruption of body's fluid/mineral balance (electrolyte imbalance, loss of potassium; can be fatal)
- Fainting spells, seizures, sleep disruption, bad dreams, mental fuzziness
- Low blood sugar (hypoglycemia), including shakiness, anxiety, restlessness, and a pervasive itchy sensation all over the body.
BULIMIA
Usually descrived as eating large quantities of food in short periods of time, often secretly, without regard to feelings of "hunger" or "fullness," and to the point of feeling "out of control" while eating. Following these "binges" with some form of purging or compensatory behavior to make up for the excessive calories taken in:
- Self-induced vomiting
- Laxative or diuretic abuse
- Fasting
- Obsessive or compulsive exercise.
- Extreme concern with body weight and shape.
The chances for recovery increase the earlier bulimia nervosa is detected. Therefore, it is important to be aware of
some of the warning signs of bulimia nervosa.
- Evidence of binge-eating, including disappearance of large amounts of food in short periods of time or the existence of wrappers and containers indicating the consumption of large amounts of food.
- Evidence of purging behaviors, including frequent trips to the bathroom after meals, signs and/or smells of vomiting, presence of wrappers or packages of laxatives or diuretics.
- Excessive, rigid exercise regimen--despite weather, fatigue, illness, or injury, the need to "burn off" calories taken in.
- Unusual swelling of the cheeks or jaw area.
- Calluses on the back of the hands and knuckles from self-induced vomiting.
- Discoloration or staining of the teeth.
- Creation of complex lifestyle schedules or rituals to make time for binge-and-purge sessions.
- Withdrawal from usual friends and activities.
In general, behaviors and attitudes indicating that weight loss, dieting, and control of food are becoming primary concerns. People struggling with bulimia nervosa will often appear to be of average body weight.
Bulimia nervosa can be extremely harmful to the body. The recurrent binge-and-purge cycles can impact the entire digestive system and can lead to electrolyte and chemical imbalances in the body that affect the heart and other major organ functions.
Some of the health consequences of bulimia nervosa include:
- Electrolyte imbalances that can lead to irregular heartbeats and possibly heart failure and death. Electrolyte imbalance is caused by dehydration and loss of potassium and sodium from the body as a result of purging behaviors.
- Potential for gastric rupture during periods of bingeing. Inflammation and possible rupture of the esophagus from frequent vomiting.
- Tooth decay and staining from stomach acids released during frequent vomiting.
- Chronic irregular bowel movements and constipation as a result of laxative abuse.
- Peptic ulcers and pancreatitis.
DISORDERED EATING (EDNOS)
People who have ednos are descrived as:
- I've they have more anorexic tendencies, they will have all the anorexic simptoms, but have still a healthy BMI and girls will still have theyr perieod regularly.
- I've they have more bulimic tendencies, they will have all the bulimic symptoms, but their purging will be more "sparodic". It's harder to classify.
To make one thing clear: IT IS NOT NORMAL TO BE DIETING ALL THE TIME! Nor is it normal to be constantly thinking about food, obsessing over calories, over-exercising, or exercising purely to burn off calories.
As painful as the medical consequences of an eating disorder are, the psychological agony can be worse. It is a sad irony that the person who develops an eating disorder often begins with a diet, believing that weight loss will lead to improved self-esteem, self-confidence, and happiness. The cruel reality is that persistent undereating, binge eating, and purging have the opposite effect.
Dieting risk
Psychological problems
- Depression that can lead to self-harm and suicide
- Person feels out of control and helpless to do anything about problems
- Anxiety, self-doubt
- Guilt and shame, feelings of failure
- Hypervigilance. Thinks other people are watching and waiting to confront or interfere.
- Fear of discovery
- Obsessive thoughts and preoccupations
- Compulsive behaviors. Rituals dictate most activities.
- Feelings of alienation and loneliness. "I don't fit in anywhere."
- Feels hopeless and helpless. Cannot figure out how to make things better.
- May give up and sink into despair, fatalism, or suicidal depression.
- Because of changes in the brain associated with under-nourishment, binge eating, and purging, the person does not, and perhaps cannot, weigh priorities, make judgments, and make choices that are logical and rational for normal people. Recovery, once the process is begun, requires time for the brain to readjust -- chemically and physically -- to normal and healthy patterns of eating. This is a combined physical/psychological problem.
BINGE-EATING DISORDER
- Frequent episodes of eating large quantities of food in short periods of time often secretly, without regard to feelings of "hunger" or "fullness."
- Frequent feelings of being "out of control" during binges.
- Eating large quantities of food rapidly, without really tasting the food.
- Eating alone.
- Feelings of shame, disgust, or guilt after a binge.
Binge eating disorder often results in some of the health risks associated with clinical obesity.
Some of the potential health consequences of binge eating disorder include:
- High blood pressure
- High cholesterol levels
- Heart disease as a result of elevated triglyceride levels
- Secondary diabetes
- Gallbladder disease
- Many people who suffer from binge eating disorder have a history of depression (NIH, 1993).
- People struggling with binge eating disorder often express distress, shame, and guilt over their eating behaviors.
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