Anorexia nervosa - People with this disorder see themselves as overweight even though they are dangerously thin. The process of eating becomes an obsession, and unusual eating habits develop, such as avoiding food or carefully weighing and portioning food. They may repeatedly check their body weight and engage in compulsive exercise, vomiting and abuse of laxatives.
• Resistance to maintaining body weight at or above a minimal normal weight for age and height.
• Intense fear of gaining weight even though underweight.
• Body image problems.
• Absence of menstruation.
Bulimia nervosa - People with bulimia usually weigh within the normal range for their age and height. However, they may fear gaining weight or feel intensely dissatisfied with their bodies. People with bulimia often binge in secret and feel relief after purging.
• Recurrent episodes of binge eating characterized by eating an excessive amount of food within a
short period of time, typically two hours or fewer and by a sense of lack of control over eating during the episode.
• Self-induced vomiting or misuse of laxatives, fasting or excessive exercise.
• Binging and purging behaviors occur, on average, at least twice a week for three months.
• Body image problems.
Additional warning signs:
• Preoccupation with food.
• Swollen salivary glands.
• Broken blood vessels in the eyes.
Eating disorders facts
More than 5 million Americans experience eating disorders.
Anorexia nervosa, bulimia nervosa, and binge-eating disorder are real, treatable illnesses that take on a life of their own.
About 90% of individuals with anorexia nervosa or bulimia nervosa (18) and about 60% of those with binge eating disorder are female.
A young woman with anorexia is 12 times more likely to die than other women her age without anorexia.
Thirteen percent of young women have substantially disordered eating behaviors.
Between 10% and 15% of those diagnosed with bulimia nervosa are men.
Thirty-seven percent of fourth graders report that they have dieted to lose weight during the past year and 30% report that they are currently dieting.
About half of those with anorexia or bulimia have a full recovery, 30% have a partial recovery, and 20% have no substantial improvement
An estimated 0.5 to 3.7 percent of females suffer from anorexia nervosa in their lifetime. Symptoms of anorexia nervosa include:
Resistance to maintaining body weight at or above a minimally normal weight for age and height
Intense fear of gaining weight or becoming fat, even though underweight
Disturbance in the way in which one's body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight
Infrequent or absent menstrual periods (in females who have reached puberty)
People with Anorexia disorder see themselves as overweight even though they are dangerously thin. The process of eating becomes an obsession. Unusual eating habits develop, such as avoiding food and meals, picking out a few foods and eating these in small quantities, or carefully weighing and portioning food. People with anorexia may repeatedly check their body weight, and many engage in other techniques to control their weight, such as intense and compulsive exercise, or purging by means of vomiting and abuse of laxatives, enemas, and diuretics. Girls with anorexia often experience a delayed onset of their first menstrual period.
The course and outcome of anorexia nervosa vary across individuals: some fully recover after a single episode; some have a fluctuating pattern of weight gain and relapse; and others experience a chronically deteriorating course of illness over many years. The mortality rate among people with anorexia has been estimated at 0.56 percent per year, or approximately 5.6 percent per decade, which is about 12 times higher than the annual death rate due to all causes of death among females ages 15-24 in the general population.6 The most common causes of death are complications of the disorder, such as cardiac arrest or electrolyte imbalance, and suicide
An estimated 1.1 percent to 4.2 percent of females have bulimia nervosa in their lifetime.1 Symptoms of bulimia nervosa include:
Recurrent episodes of binge eating, characterized by eating an excessive amount of food within a discrete period of time and by a sense of lack of control over eating during the episode
Recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self-induced vomiting or misuse of laxatives, diuretics, enemas, or other medications (purging); fasting; or excessive exercise
The binge eating and inappropriate compensatory behaviors both occur, on average, at least twice a week for 3 months
Self-evaluation is unduly influenced by body shape and weight
Because purging or other compensatory behavior follows the binge-eating episodes, people with bulimia usually weigh within the normal range for their age and height. However, like individuals with anorexia, they may fear gaining weight, desire to lose weight, and feel intensely dissatisfied with their bodies. People with bulimia often perform the behaviors in secrecy, feeling disgusted and ashamed when they binge, yet relieved once they purge
Eating disorders treatment
Eating disorders can be treated and a healthy weight restored. The sooner the eating disorders are diagnosed and treated, the better the outcomes are likely to be. Because of their complexity, eating disorders require a comprehensive treatment plan involving medical care and monitoring, psychosocial interventions, nutritional counseling and, when appropriate, medication management. At the time of diagnosis, the clinician must determine whether the person is in immediate danger and requires hospitalization.
Treatment of anorexia calls for a specific program that involves three main phases: (1) restoring weight lost to severe dieting and purging; (2) treating psychological disturbances such as distortion of body image, low self-esteem, and interpersonal conflicts; and (3) achieving long-term remission and rehabilitation, or full recovery. Early diagnosis and treatment increases the treatment success rate. Use of psychotropic medication in people with anorexia should be considered only after weight gain has been established. Certain selective serotonin reuptake inhibitors (SSRIs) have been shown to be helpful for weight maintenance and for resolving mood and anxiety symptoms associated with anorexia.
The acute management of severe weight loss is usually provided in an inpatient hospital setting, where feeding plans address the person's medical and nutritional needs. In some cases, intravenous feeding is recommended. Once malnutrition has been corrected and weight gain has begun, psychotherapy (often cognitive-behavioral or interpersonal psychotherapy) can help people with anorexia overcome low self-esteem and address distorted thought and behavior patterns. Families are sometimes included in the therapeutic process.
The primary goal of treatment for bulimia is to reduce or eliminate binge eating and purging behavior. To this end, nutritional rehabilitation, psychosocial intervention, and medication management strategies are often employed. Establishment of a pattern of regular, non-binge meals, improvement of attitudes related to the eating disorder, encouragement of healthy but not excessive exercise, and resolution of co-occurring conditions such as mood or anxiety disorders are among the specific aims of these strategies. Individual psychotherapy (especially cognitive-behavioral or interpersonal psychotherapy), group psychotherapy that uses a cognitive-behavioral approach, and family or marital therapy have been reported to be effective. Psychotropic medications, primarily antidepressants such as the selective serotonin reuptake inhibitors (SSRIs), have been found helpful for people with bulimia, particularly those with significant symptoms of depression or anxiety, or those who have not responded adequately to psychosocial treatment alone. These medications also may help prevent relapse. The treatment goals and strategies for binge-eating disorder are similar to those for bulimia, and studies are currently evaluating the effectiveness of various interventions.
People with eating disorders often do not recognize or admit that they are ill. As a result, they may strongly resist getting and staying in treatment. Family members or other trusted individuals can be helpful in ensuring that the person with an eating disorder receives needed care and rehabilitation. For some people, treatment may be long term