Helping People With Anorexia and Other Eating Disorders
Helping People With Anorexia and Other Eating Disorders
Helping Those With Eating Disorders
Dr. Samson Omotosho, PhD, APRN/PMHN
Definition: An eating disorder is a maladaptive response due to inability to regulate eating habits and the tendency to overuse or under use food. It is more common in females. The problem may be characterized by an imbalance in the eating pattern, an excessive or inadequate caloric intake or an inappropriate body weight for the individual’s age and height. Types of Eating Disorders: Bulimia Nervosa, Anorexia Nervosa, Binge Eating Disorder, and Night Eating Syndrome.
Bulimia Nervosa: This is an eating disorder characterized by uncontrollable binge eating, alternating with vomiting or dieting. Most (90%) of bulimia nervosa is found in females. It occurs in 2.5% of the population. The age of onset is 15-18 years. About 72% of patients recover. Early detection and treatment of the illness improves chances of recovery. It is mostly found in normal weight persons. The patient may, in addition, have anorexia nervosa.
Anorexia Nervosa: This is an eating disorder in which the person experiences hunger but refuses to eat because of a distorted body image and false perception of fatness, leading to starvation. It occurs in about 1% of the population. The onset may be at any age, mostly 13-20 years. Mostly (90%) occurs in females. About 72% of patients recover and about 5% die. Alcohol use increases mortality from anorexia nervosa.
Binge Eating Disorder (BED): This is an eating disorder in which the person rapidly consumes large quantities of food without any attempt to control weight gain. It is found in about 3% of the population. About 30% of obese persons have this disorder. Therefore, clinicians want to assess obese persons for BED.
Night Eating Syndrome (NES): This is a severe eating problem in which the person experiences anorexia in the morning, depression in the evening, insomnia at night and multiple awakenings to eat at night. About 1.5% of the population has NES. 8% of obese persons have NES.
Possible Factors: There has been a genetic link to eating disorders. Other factors include disorder in the appetite regulation center in the brain (hypothalamus); low serotonin and high dopamine levels in the brain; the individual’s psychological makeup such as being a perfectionist, impulsive, or rigidity; early separation problems; low self esteem; high sense of shame and guilt; compulsion and obsession; environmental factors; multiple childhood illnesses or surgeries; parental separation; deaths in the family; parental overemphasis on athletics and slimness; parental disapproval of overweight persons in the presence of the child; skipping meals; preoccupation with wanting to be a model, poor nutritional habits; societal value of thinness; school’s emphasis on weight and size; occupations such as dancing, acting, modeling, and fashion that emphasize body weight and size; mass media reinforcement of the thinness culture;
What to look for: Look for any of the factors listed above. Do or suggest a full physical assessment. Check for the individuals’ satisfaction with their eating pattern; if they ever eat in secret; actual weight versus desired weight; food avoidances, including restrictions, dieting, and fasting; use of laxatives, diuretics, diet pills, and purging; compulsive exercise patterns; frequency, timing, and preferences about eating. Assessment for Binging: Check for consumption of hundreds or thousands of calories in one sitting; excessive intake and loss of control in eating; secretive consumption of food; eating accompanied with sense of shame; history of unsuccessful dieting in the past. Binging may range form occasional to more than ten times per day. Assessment for Anorexia Nervosa: Look for fasting and restriction of calorie intake to 200-700/day while patient yet perceives her intake as adequate; the design of limited unbalanced diet for self; insistence on particular choice of food repeatedly; insistence on a particular eating time, order, and pattern; bizarre food preferences; avoidance of fatty foods; prolonged fasting; obsession with food, cooking, and food-related jobs. Assessment for Bulimia: Look for forced vomiting, excessive exercise, and the use of diet pills, diuretics, laxatives, steroids, insulin, cocaine, heroine, thyroid hormones, nicotine, hallucinogens, antidepressants, benzodiazepines, and analgesics.
Complications: For Anorexia nervosa: starvation, scanty menstruation, osteoporosis, cold intolerance, fast heartbeat, low blood pressure, constipation, electrolyte imbalance, and leg edema (swelling). Bulimia Nervosa: low blood potassium, muscle weakness, irregular heartbeat, stomach and intestinal problems, dental enamel erosion, and parotid enlargement.
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