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Eating Disorders
Eating disorders occur when someone begins to obsess about losing weight by dieting and exercising, sometimes by vomiting. These disorders are much more common in females than males. There are two major types of eating disorders called anorexia nervosa and bulimia nervosa. Eating disorders can cause many severe problems including infertility, osteoporosis, heart problems, gastrointestinal dysfunction, tooth erosion and low levels of nutrients that are important for the body to function normally.
This is most common in adolescent females with only 5% of cases being male. People suffering from this are often “perfectionists” who put a lot of pressure on themselves to excel in school or athletics. They also often have pressure from parents to do extremely well in these things. Sometimes there is a major event that causes anorexia such as the divorce of parents or a death in the family. Only about a third of these people are actually overweight when anorexia starts. However, no matter how much weight they lose, they think they are fat. In order to lose weight, these patients diet and exercise and may even make themselves vomit. Usually vomiting is done in secret right after a meal. About 40% of all patients will recover and 25% show some improvement. Usually these people still have unreasonable thoughts about weight and food. Symptoms: Different people will lose different amounts of weight. Some adolescents that are growing may not actually lose weight, but they will still be underweight for their height. Usually, temperature, pulse and blood pressure are low. Skin is dry and scaly and knuckles can be scarred if someone is causing him or herself to vomit. Girls may also stop having a regular period. Treatment: Treatment is aimed towards weight gain. If there are any life-threatening effects of anorexia, the patient may need to be hospitalized until the patient is out of danger. Psychiatric counseling is also often used on these patients. There is no known drug that helps people with anorexia nervosa.
Bulimia nervosa occurs when someone eats large amounts uncontrollably, called binging, and then tries to prevent weight gain by “compensatory” measures. This may be vomiting, extensive exercise or dieting or taking laxatives to empty their bowels. Foods high in sugar and carbohydrates such as ice cream, cakes and cookies are preferred. Binge episodes usually last about an hour and are usually done in secret. Afterwards, they usually feel overwhelmed by guilt, shame or humiliation and try to undo it. Most commonly, the affected person makes him or herself vomit. Bulimia usually occurs in females in mid to late adolescence, later than anorexia nervosa. Affected people are usually not overweight or just slightly so and often have low self-esteem. Usually binges become less sever and less frequent and most people have recovered by middle age. Unlike anorexia nervosa, there is usually no weight loss with bulimia nervosa. Symptoms: Salivary gland swelling, tooth erosion, bruised or scratched knuckles, constipation, irregular periods and sore throat are some symptoms of bulimia. Most of these come from repetitive vomiting. Treatment: Bulimia nervosa is usually treated by psychotherapy to help the patient control their binge eating. Antidepressant drugs have also been shown to help treatment.
Sources Felman, Mitchell and John Christensen. Behavioral Medicine in Primary Care: A Practical Guide. Stamford, CT: Appleton and Lange, 1997. Forman, Sara F. “Eating disorders: Epidemiology, pathogenesis, and clinical features”, UpToDate 2005, www.uptodate.com. Moore and Jefferson, Handbook of Medical Psychiatry, 2nd Ed. Mosby, 2004. (accessed by MD Consult). Noble, Textbook of Primary Care Medicine, 3rd Ed. Mosby, 2001. (accessed by MD Consult).
Information Provided By Women in Medicine at the UConn Health Center, a group of first, second and third year female medical students at the University of Connecticut School of Medicine. |
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Weight-loss has become a major pre-occupation of today’s society. With this focus on body image, it is no wonder that eating disorders are becoming more and more common. According to the 2001
Youth Risk Behavior Survey, 35% of adolescent girls believe that they are overweight.