By Dr Ananya Mandal, MD
Eating disorders are mental illnesses that cause serious disturbances in a person’s everyday diet. It can manifest as eating extremely small amounts of food or severely overeating. The condition may begin as just eating too little or too much but obsession with eating and food over takes over the life of a person leading to severe changes.
In addition to abnormal eating patterns are distress and concern about body weight or shape. These disorders frequently coexist with other mental illnesses such as depression, substance abuse, or anxiety disorders.
Eating disorders when manifested at a young age can cause severe impairment in growth, development, fertility and overall mental and social wellbeing. In addition, they also raise the risk of an early death. People with anorexia nervosa are 18 times more likely to die early compared with people of similar age in the general population.
Who gets eating disorders?
Eating disorders can affect both men and women and are slightly more common among women. Often these disorders begin during adolescence or young adulthood but may also develop during childhood or later in life.
Types of eating disorders
Anorexia nervosa – This is characterized by an intense fear of being obese and a continued pursuit of becoming thin.
Eating disorders not otherwise specified (EDNOS) – this includes eating disorders that do not meet the criteria for anorexia or bulimia nervosa. Binge eating could be a type of EDNOS. EDNOS is the most common diagnosis among people who seek treatment
Symptoms of eating disorders
There is a loss of at least 15 percent of body weight resulting from refusal to eat adequately despite feeling hungry. There is an unnatural fear of becoming fat. There is a distortion of self-perception. Thin anorexics may feel they are fat. There may be a tendency to exercise obsessively. Anorexic women may go months without getting their periods, suffer weight loss and may suffer from infertility. A significant proportion of people with anorexia will also develop bulimia.
These patients first eat too much (binging) and then purge or vomit it all out. Eating binges involve consumption of large amounts of calorie-rich foods. The person feels totally out of control and self-disgust during these periods. After such binges they attempt to purse out the food to compensate for binges and to avoid weight gain. This could be by self-induced vomiting or misuse of laxatives. A person with bulimia is usually close to their normal body weight and are less recognisable than a person with anorexia.
Binge eating disorder
This is characterized by frequent episodes of binge eating. Individuals feel loss of control during these binge episodes. The binge eating can lead to serious health consequences such as obesity, diabetes, hypertension (high blood pressure) and heart disease.
Treatment for eating disorders
Eating disorders can be effectively treated. The earlier they are detected, the easier it is to treat them. Recovery can take months or years, but the majority of people recover. Once diagnosed, treatment is a multidisciplinary approach.
The health care providers involved include psychiatrists, psychologists, physicians, dieticians or nutritional advisers, social workers, occupational therapists and nurses.
Treatment includes diet education and advice, psychological interventions and treatment of concurrent mental ailments like depression and anxiety disorders.
Desperately Hungry Housewives (BBC Documentary)
Anorexia and bulimia are not just the preserve of teenage girls but are on the increase among older women too. With seemingly successful and settled lives, Jane, Tracey and Georgia are battling with their food and eating behind closed doors, as they struggle with the fallout from their eating disorders. Acclaimed BBC Documentary.
Reviewed by April Cashin-Garbutt, BA Hons (Cantab)