1.19.2012

DISTURBANCES IN EATING BEHAVIOR


Eating disorders involve serious disturbances in eating behavior, usually in the forms of extreme and unhealthy reduction of food intake or severe overeating. They are not due to a failure of will; rather, they are real and treatable medical illnesses in which certain behavior patterns get out of control. The main types are anorexia nervosa, bulimia nervosa, and binge-eating disorder (technically categorized with “eating disorders not otherwise identified”). These disorders usually develop in adolescence or early adulthood and often occur with other illnesses such as depression, substance abuse, and anxiety disorders. They are much more common among females; only about 5% to 15% of anorexia or bulimia patients and 35% of binge eaters are male. If not treated, eating disorders can lead to serious complications, including heart conditions and kidney failure, which may result in death.

Anorexia nervosa affects an estimated 0.9% of all females. Symptoms include resistance to maintaining weight at minimally healthy levels, intense fear of gaining weight, exaggerated importance of body weight or shape in one’s self image, and infrequent or absent menstrual periods. Anorexics see themselves as overweight even when they are dangerously thin. In response, they avoid food and take other extreme measures to lose weight, such as exercising compulsively or purging by means of vomiting or laxatives and enemas. While some anorexics fully recover after a single episode, others may relapse frequently or experience chronic deterioration

Bulimia nervosa affects an estimated 1.5% of females. It is characterized by recurrent uncontrolled binge-eating episodes followed by what is believed to be compensatory behavior to prevent weight gain, such as self-induced vomiting, exercising excessively, or fasting. Persons with bulimia can weigh within the normal range for their age and height, but they still fear gaining weight and are intensely dissatisfied with their bodies. They often perform their behaviors in secret, feeling shame when they binge and relief when they purge.

Binge-eating disorder, which is not officially approved as a psychiatric diagnosis, affects an estimated 2% to 3.5% of males and females in the U.S. As with bulimia, a bingeeating disorder involves episodes of excessive eating during which the sufferer may feel a complete lack of control. But individuals with this disorder do not compensate by purging, exercising, or fasting. Many are thus overweight, and the shame they feel can lead to further bingeing.
Eating disorder sufferers may not admit they are ill. Early diagnosis and a comprehensive treatment program are essential to recovery. Some patients may need immediate hospitalization. For anorexia, treatment usually follows three established steps: weight restoration, usually in an inpatient hospital setting; treatment of any accompanying psychological disturbances, including the use of medications; and achieving long-term remission or recovery by reducing or eliminating negative thoughts and behaviors.

Source: National Institute of Mental Health, National Institutes of Health, U.S. Dept. of Health and Human Services. Apud 'The World Almanac and Book of Facts, 2011', World Almanac Books, New York, 2011. Adapted and illustrated to be posted by Leopoldo Costa.




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