“One cannot think well, love well, sleep well, if one has not dined well.” -Virginia Woolf.
Eating disorders are illnesses in which people experience severe disturbances in their eating behaviors, related thoughts and emotions. They typically become pre-occupied with food and their body weight and shape.
It affects most often women between the ages of 12 and 35yrs.
TYPES
- Anorexia nervosa – an eating disorder characterized by self starvation due to an intense fear of gaining weight and a distorted perception of one’s weight despite an abnormally low body weight.
They place a high value on controlling their weight and shape, using extreme means like self starvation, excessive exercise, and sometimes forced vomiting or use laxatives.
They deny having an abnormal eating behavior.
Over time, the following complications may develop:
- Menstrual periods cease
- Thinning of the bones
- Brittle nails and downy hair(lanugo)
- Skin dries & can take on a yellowish cast
- Mild anemia & muscle wasting
- Severe constipation
- Drop in blood pressure, slowed breathing & pulse rates
- Feeling cold all the time
- Depression & lethargy
- Bulimia Nervosa primarily characterized by binge eating & compensatory behaviors meant to reverse the anticipated weight gain or shape change e.g. vomiting, laxative abuse & excessive exercise.
They feel out of control during the binges & can eat very rapidly. Their binges often end only when they are interrupted by another person, or fall asleep or their stomach hurts from overstretch.
This cycle is usually repeated at least several times a week or, in serious cases, several times a day.
Most appear to be of average weight.
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- Complications are –
- Inflamed & sore throat.
- “Chip-munk cheeks” – salivary glands in the neck & below the jaw become swollen with puffy cheeks.
- Tooth erosion and discolouration from exposure to stomach acids.
- Constant vomiting causes gastroesophageal reflux disorder
- Laxative abuse lead to intestinal problems
- Diuretics cause kidney problems
- Severe dehydration from purging.
Rare but potentially fatal complications includes esophageal tears, gastric rupture, and cardiac arrhythmias.
3. Binge Eating Disorder:
People with binge eating disorder have episodes of binge eating in which they consume very large quantities of food in a brief period (at least once a week for three months), and feel out of control during the binge.
They do not try to get rid of the food.
Associated with 3 or more of the following:
- Eating more rapidly than normal
- Eating until uncomfortable
- Eating when not hungry
- Eating alone because of embarrassment due to food’s quantity.
- Feeling disgusted, depressed or guilty afterward
- Complications are severe obesity, diabetes and cardiovascular diseases.
- Avoidant-restrictive food intake disorder (ARFID) is an eating disorder characterized by lack of interest in food, fears of negative consequences of eating, selective or picky eating that is unresolved by late childhood & frequent complaints about bodily discomfort with no apparent cause.
They are also unable or reluctant to eat in front of others
- Pica- Persistent eating of non-nutritive, non-food substances over a period of at least 1 month.
- This must be inappropriate to the developmental level of the individual.
- Rumination disorder
- Repeated regurgitation of food over a period of at least 1 month. Regurgitated food may be re-chewed, re-swallowed, or spat out. It is associated with a feeling of fullness, nausea relieved by effortless regurgitation, typically within 10 minutes of eating.
It also associated with bad breath and unintentional weight loss.
Appears to be caused by an increase in abdominal pressure.
OTHER SPECIFIED FEEDING OR EATING DISORDER (OSFED)
- Atypical Anorexia Nervosa: criteria for AN met but weight is not below normal
- Subthreshold Bulimia Nervosa: criteria for BN met but with less frequent occurrences
- Subthreshold Binge Eating Disorder: criteria for BED met but occurs at a lower frequency
- Purging Disorder: purging without binge eating
- Night Eating Syndrome: excessive nighttime food consumption
CAUSES – Possible causes can be broadly divided in biological, psychological and social factors.
Biological factors e.g genetic predisposition, abnormalities of brain chemicals.
Psychological factors e.g Personality traits – Perfectionism, obsessive-compulsiveness, neuroticism, negative emotionality, harm avoidance, core low self-esteem, Traits associated with avoidant personality disorder.
Socio-cultural influences – Media influences and social pressures, gender (female more than male), teenage years.
MANAGEMENT – is very important due to the high mortality rate associated with these disorders if left untreated. It involves multidisciplinary approach to address both the physical and psychological causes, symptoms and complications and could necessitate admission sometimes.
You can save a live today by visiting the hospital when you discover any of the aforementioned symptoms.
“Pull up a chair. Take a taste. Come join us. Life is so endlessly delicious.” ― Ruth Reichl
DR KILANI HASSAN TAIWO, MBBS ILO.