Eating Disorders

Anorexia Nervosa, Bulimia, Orthorexia Nervosa

Anorexia Nervosa & Bulimia are abnormal ways of controlling weight - but neither is what is popularly described as the 'slimmer's disease'

Both are expressions of deep inner turmoil,of psychological problems that are too difficult for the person to cope with any other way

Anorexia Nervosa

Dieting is easy to be good at,you just have to starve yourself. But it's possible for an Anorexic to believe it is the only thing she's good at,so thinness becomes and obsession.Anorexics judge themselves only according to how much they've eaten,the less they eat the more successful they judge themselves to be.All their self-worth becomes bound up in not eating and so starving becomes very difficult to give up Anorexics hate food and crave love.They remember the time when they felt secure in being loved and did not have to take any grown-up responsibilities,so they may subconsciously try to remain a child.As a child they did not have to perform and they did not have to excel.By starving they fight against their developing body,they lose or don't develop breast and they don't menstruate

Symptoms of Anorexia

Severe weight loss,Distorted ideas about body size & weight,Excessive exercising,Vomitting or purging,Social isolation,Emotianal and irritable behaviour,Difficulty sleeping,Loss of Menstrual periods,Perfectionism,Feeling cold - poor circulation,Growth of downy body hair

Bulimia

Bulimics go for several days with very little food and then become crazed with an uncontrollable desire to eat so that they gorge on almost anything in sight that is edible.This may mean eating extraordinry mixtures of raw and cooked food,sweet and savoury mixed in huge quantities.Some women have died after a binge - because their stomachs have ruptured under the strain.Some women eat normally, but then force themselves to vomit immediately afterwards or take huge quantities of laxatives to induce purging.This pattern of starving,bingeing,vomiting and purging is very hard to break.It is also much more common than people thin,but treatments can help

Symptoms of Bulimia

Normal weight,Binge-eating large amounts of food,Vomiting or purging after eating,Disappearing tothe toilet after meals,Secretive and ritual behaviour,Feeling helpless and lonely,Erratic menstrual periods,Sore throat and tooth decay caused by vomiting,Dehydration and poor skin condition,Social isolation,Swollen salivary glands

Causes of Eating Disorders

1. The desire for control: Dieting can be very satisfying,especially for girls in their teens who feel that weight is the only part of their lives over which they have control.Not eating becomes and end in itself 2. Social pressure:In societies that don't value thinness,eating disorders are very rare.In surroundings such as ballet schools, or modeling schools,where people value thinness hightly,they are common 3. Cultural pressure: Generally in Western culture 'thin is beautiful'.The media are full of slim,attractive young men and women and there is a huge pressure to conform 4. Family: Some children and teenagers find saying no to food is the only way they can make their feelings felt and have influence in the family.Eating becomes an important social tool with which to exert pressure on parents 5. Not growing up: A girl with Anorexia may lose or not develop some of the physical traits of an adult woman,such as pubic hair breasts and monthly periods.As a result,she may look very young for her age.Not eating therefore can be seen as a way of putting off some of the demands of growing up,particularly the sexual ones 6. Depression: Many bulimics are depressed and binges may start off as a way of coping with unhappiness.A third of people with eating disorders are depressed and can be helped with the new generation of antidepressants 7. Upsets: For some people,Anorexia and Bulimia seem to be triggered off by an upsetting event,such as the break-up of a relationship.Sometimes it need not even be a bad event,just an important one,such as a marriage or leaving home

Consequences of Anorexia & Bulimia

1. Starvation - leads to broken sleep,constipation,difficulty to concentrating or thinking straight,depression,feeling the cold,brittle bones that break easily,muscles becoming weaker - it becomes an effort to do anything,mensturation failing to start or stopping,inability to have a baby and even death 2. Vomiting - Stomach acid dissolves the enamel on teeth and swollen salivary glands leads to a puffy face,irregular heartbeat,muscle weakness,eventually to kidney damage and even epileptic fits 3. Laxative use - Causes persistent tummy pain,swollen fingers and damage to bowel muscles that may lead to long-term constipation 4. Bladder Problems - Become common.New research shows that women with Anorexia, are far more likely to have bladder problems than other women. Nearly two-thirds of women with Anorexia,at least three time more thannon-sufferers, had symptoms suggestive of an unstable bladder,with a sudden and overwhelming desire to go to the loo 8 x or more in 24 hours and sometimes actual incontinence.These symptoms usually start about a year after Anorexia began

Treatment of Eating Disorders

The sooner you ADMIT to having an eating disorder and ACCEPT HELP,the better the chance of a cure.Left untreated,Anorexia has one of the highest death rates of all psychiatric illnesses,though deaths can be prevented by proper treatment.No one form of treatments in 100% effective,what is effective for one person may not be effective for you.And despite best efforts,some people only partly recover.But there are lots of avenues to explore

1. Your GP - to help yourself,you have to be open and honest with your family doctor.You don't need to be ashamed of being Anorexic or Bulimic or reluctant to admit that you have a problem.You don't need to be frightened of the concequences of admitting that your have an eating disorder.You are entitled to complete confidentiality.It is your right to be referred for assessment by a specialist who has training in eating disorders and you should be seen as soon as possible so that delays and waiting lists can be avoided.You may get worse if you wait too long and then need 'in-patient' rather than 'day-patient' treatment

2. Self Help - self-help support groups can be a very useful addition to treatment but they are not an alternative.They are very helpful in getting patients and families to understand they are not alone with the illness

3. General Treatment - Treatments mus address the psychological aspects of Anorexia & Bulimia Nervosa as well as the abnormal eating pattern.All these treatments work,so don't be afraid to try them - Counselling,Psychotherapy,Cognitive Therapy, Group Therapy,Family Therapy,Day hospital programmes,In-patient treatment,Dietetic advice, Drugs can be of help in the short term,particularly to Bulimics who are depressed. Re-feeing is last resort,but may be necessary to save life. Alone,however,it is only successful in short-term weight-restoration,but usually is not effective in the long term

4. Counselling - For Anorexia,counselling is more effective during the early stages - when less than 25% of body weight has been lost.Research shows that cognitive behaviour therapy is especially effective for people with Bulimia

5. Specialist Treatment - You should be involved as much as possible in your treatment programme and care plan,so you should be able to see your case notes and be involved in setting target weights.Therapy should not be conditional on weight gain,and vegetarian menus and appropriate food for minority groups shoud be available

6. Hospital Treatment - Some severely underweight people with Anorexia Nervosa can be treated sucessfully as day-patients rather than in-patients.If you need in-patient treatment,you have the right to - a quite and safe environment,continuity or care from staff with an understanding of eating disorder,support during and after your meals,appropriate food,on-going counselling or psychotherapy,follow-up and support after in-patient care

7. Compulsory Admission - Out of people who had been admitted or detained against their wishes,50% said they thought it had been 'a good thing' in retrospect.So,in extreme circumstances,and when all other alternatives have failed,people may be detained under the Mental Health Act - in order to save life or reduce risk

8.Teamwork - Good treatment demand selfless teamwork with families,careres and friends all working together.The impact on the family of someone with an eating disorder can be enormous.Families also need support .They need advice on what they should and should not do to help a person's recovery

Orthorexia Nervosa

Orthorexia was first described in 1997. The name of the condition is derived from the Greek word 'orthos' - which means 'right' or 'pure' and 'rexia' - appetite

People suffering from this disease, obsesses with eating the right food and not with being thin

They cross the line between healthy eating habits and an obsession that can deprive them of important nutrients and eventually make them sick and even in severe this condition can lead to death

This is a condition where the sufferers become so obsessed with eating healthy - that they cut out more and more foods from their diet in an attempt to eat as naturally and purely as possible

The condition develops gradually, starting with cutting out one food group such as diary, wheat or sugar - usualy due to illness such as high cholesterol, asthma or diabetes.

Later they increasingly limit their food choices

If they eat 'wrong' foods - they feel guilty

If they stick to the rules - they feel in control and even euphoric

For some sufferers, it becomes almost a Spiritual mission to convert others to their diet

Ironically some sufferers may binge on 'wrong or junk' food just to feel very guilty filled with self hate afterwards- resulting in them fasting to try and make up for it

Orthorexia often incorrectly diagnosed as Anorexia

They eventually land up being painfully thin and undernourished and sick and this could lead to getting incorrectly diagnosed as Anorexic

Unlike Anorexics they aren't usually obsessive about exercise - many don't exercise

Possible Causes & Profile

A poor self-image and problems at home can trigger Orthorexia

Some sufferers may come from homes where the focus was on health rather than being thin

They are usually educated people in the middle age high-income bracket who can afford 'pure' foods

They are good academic achievers

And come from close-knit somewhat overprotective families

They are often perfectionists and seek approval

Sufferers often don't realise they have a problem and even if they are aware of it, they can't escape the hold the condition has on them

The boom in the health shop and organic food culture, a resistance to the junk food labelling - all play a role in the increase in Orthorexia

Sufferers take supplements and health shakes and devour every bit of information about the nutritional value of food

Processed foods and any sign of pesticides or toxins in food are taboo

They eat natural & wholewheat products and only a certain kind of muesli or sweets

Only certain restaurants are good enough for them

The nutritional value of food is always more important than the enjoyment of eating

They study food labels in the finest detail - how much and what kinds of fats, carbohydrates, proteins and so on each type of food contains

They overlook the body's need for fat and carbohydrates as a supply of energy and therefore limit fat & carbohydrates to the minumum or cut them out completely. They become physically tired

They often feel proud of having a healthier diet than other people and may come across as feeling slightly superior about it

They are always on the lookout for healthy recipes

Psychologically they torture themselves by splitting hairs about how much and what they should eat and end up becoming depressed

Precaution & Solutions

1. Parents can play a role in preventing their kids from becoming obsessive about healthy eating by allowing them to eat a wide variety of healthy food

2. There should not be too many restrictive rules about eating

3. Nor should children be bribed into eating more healthily

4. Don't overact if your child wants to eat sweets, cake or junk food - It's not harmful if they do it only occasionally

5. Make Mealtimes relaxed and enjoyable

6. Parents can consult a dietician about preparing healthy balanced meals

7. Caution - If your interest in food becomes increasingly obsessive and you cut out more food types, you run the risk of becoming Orthorexic

8. Remember that moderation is the key word. Normal healthy eating habits don't cause problems in your relationships and isolate you from others

9. Someone with a healthy attitude to food can deviate occasionally from their usual healthy eating habits without feeling guilty or that they have to compensate for indulging by fasting or exercising

** support groups **

or

**www.orthorexia.com / www.beyondveg.com**

info sources:

You Magazine

Dr.Mirriam Stoppard - Family Health Guide