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Eating Disorders

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Eating Disorders

Eating disorders are a group of mental disorders that interfere with normal food consumption. They may lead to serious health problems and, in the case of both bulimia nervosa and anorexia nervosa, even death. The major recognized eating disorders are anorexia nervosa, bulimia, and binge eating disorder. "Over one person's lifetime, at least 50,000 individuals will die as a direct result of their eating disorder" (Tabah).

Bulimia nervosa is more common than anorexia and it usually begins early in adolescence. It is characterized by cycles of bingeing and purging. Bulimia is often triggered when young women attempt restrictive diets, fail, and react by binge eating. (Binge eating involves consuming amounts of food within a two-hour period that is larger than average portions.) In response to the binges, patients compensate, usually by purging, by vomiting, by using enemas, or by taking laxatives, diet pills, or drugs to reduce fluids. Patients then revert to severe dieting, excessive exercise, or both. (Some patients with bulimia follow bingeing only with fasting and exercise. They are then considered to have non-purging bulimia.) The cycle then swings back to bingeing and then to purging again. "Some studies have reported that patients with bulimia average about 14 episodes of binge-purging per week" (BambooWeb). To be diagnosed with bulimia, however, a patient must binge and purge at least twice a week for three months.

(Some experts believe that going through the cycle only once a week is enough for a diagnosis.) In some cases, the condition progresses to anorexia. Most people with bulimia, however, have a normal to high-normal body weight, although it may change by more than 10 pounds because of the binge-purge cycle. Medical problems directly linked with bulimic behavior are teeth erosion, cavities, gum problems, water retention, swelling, abdominal bloating, fluid loss with low potassium levels (This occurs from excessive vomiting or laxative use. In severe cases it can cause extreme weakness, near paralysis, or lethal heart rhythms), acute stomach distress, and problems in swallowing. This is an area of concern because of repetitive assaults on the esophagus (the food pipe) from forced vomiting. It is not clear, however, if this problem is common. Rupture of the esophagus, or food pipe. (Cases have been reported with forced vomiting but are not common.) In rare cases, rectal walls may weaken to the extent that they protrude through the anus. This is a serious condition that requires surgery. Most studies report that patients with bulimia that is not accompanied by severe weight loss have a much better outlook than patients with anorexia. "Some studies have suggested that between 60% and 80% of bulimic patients are in remission within three months of treatment" (The World of Eating Disorders Exposed). However, relapse is common and over half of women with bulimia continue to battle disordered eating habits for years. "In one study, bulimia itself persisted in 10% to 25% of patients after treatment" (Tabah).

Bingeing without purging is characterized as compulsive overeating (binge eating) with the absence of bulimic behaviors, such as vomiting or laxative abuse (used to eliminate calories). Binge eating usually leads to becoming overweight. To be diagnosed

as a binge eater, a person typically Binges at least twice a week for six months, Consumes 5,000 to 15,000 calories in one sitting, Eats three meals a day plus frequent snacks, and overeats continually throughout the day, rather than consuming large amounts of food during binges.

Anorexia nervosa involves an dislike to food that leads to a state of starvation and emaciation. It is a very serious illness that some experts believe is an entirely different condition from bulimia and should be not be diagnosed as a simple eating disorder. At least 15% to as much as 60% of normal body weight is lost. The patient with anorexia nervosa has an intense fear of gaining weight, even when he or she is severely underweight. Individuals with anorexia nervosa have a unclear image of their own weight or shape and deny the serious health consequences of their low weight. Women with anorexia nervosa miss at least three consecutive periods. (Some experts believe women can be anorexic without this occurrence.)Patients with this condition are often characterized as anorexia restrictors or anorexic bulimic patients. The term "anorexia" literally means absence of appetite. For example, severe anorexia is common in the elderly, who may experience weight loss because of social isolation, impaired gastrointestinal function, or loss of certain chemicals related to the feeding drive. Such anorexia, however, is not the same with anorexia nervosa, which is a psychological disorder. According to different studies, the risk for early death is higher for people that are younger, have bulimia anorexia (The mortality rate is twice as high in this group as in the anorexic-restrictor types.), severely low in weight at the time of treatment, sick for more than six years, been previously obese, have personality disorders, have an

accompanying severe psychological disorder have a dysfunctional marriage, and being male. (The higher risk for life-threatening medical problems in males may be due to their tendency to be diagnosed with anorexia later than women.)

It is mainly young women whom develop the potentially life-threatening eating bulimia nervosa and anorexia nervosa. The National Center for Health Statistics estimates that about 9,000 people admitted to hospitals were diagnosed with bulimia in 1994, the latest year for which statistics are available, and about 8,000 were diagnosed with anorexia. Studies indicate that by their first year of college, 4.5 to 18 percent of women and 0.4 percent of men have a history of bulimia and that as many as 1 in 100 females between the ages of 12 and 18 have anorexia. Males account for only 5 to 10 percent of bulimia and anorexia cases. While people of all races develop the disorders, the vast majority of those diagnosed are white (Tabah).

In trying to understand the causes of eating disorders, scientists have studied the personalities, genetics, environments, and biochemistry of people with these illnesses. Most people with eating disorders share certain personality traits: low self-esteem, feelings of helplessness, and a fear of becoming fat. In anorexia, bulimia, and binge eating disorder, eating behaviors seem to develop as a way of handling stress and anxieties. People with anorexia tend to be "too good to be true." They rarely disobey, keep their feelings to themselves, and tend to be perfectionists, good students, and excellent athletes. Some researchers believe that



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