It seems as though everywhere you look these days people are dieting. They are either counting carbs, watching fats, only eating certain food combinations at specific times of the day, or are following some other latest fad.
What happens when someone takes their "healthy eating plan" too far? How can you tell if what started out as a healthy diet has turned into an obsession and something that will lead to a decrease in health? Often it is a fine line.
Eating disorders come in many different forms and affect many different types of people. Most people commonly associate eating disorders with those in appearance related sports such as gymnastics, ballet dancing, and figure skating or those who make their living by how they look such as models and celebrities; however they can also affect many other people as well.
Everyday women who are simply not happy with their bodies may turn to an eating disorder as a way to feel in control of their life while also becoming more and more popular with the males as well.
With males, some of them suffer from the typical eating disorders where they want to be thinner, however a more likely occurrence is for males to want to go the other way and become obsessed with bulking up. This particular form is more evident in the bodybuilding world more than anywhere else.
In this part of the article, we will look at the first two types of eating disorder, Anorexia Nervosa and Bulimia Nervosa.
Anorexia Nervosa
Anorexia Nervosa is characterized by a desire to become thinner where the person will go to extreme means to achieve this by denying themselves of food. This form likely starts out with the typical diet, where one is counting calories and then just starts progressively eating less and less in an effort to lose more weight.
Pretty soon they find themselves existing on a mere salad and diet coke for the entire day. A person with this disorder does not see their real appearance in the mirror and usually sees someone much larger looking back at them, almost as if they have lost touch with reality.
Symptoms
The common symptoms that are associated with Anorexia Nervosa are:
- A decrease in body weight (usually characterized by a decrease of at least 25% of their previous weight)
- Loss of menstruation (in women)
- Growth of body hair on various parts of their body such as stomach and back (lanugo)
- Low blood pressure
- Slowed heart beat
- Feeling of coldness
- Numbness in the hands and feet
- Dizziness (often due to low blood sugar)
- Muscle loss and weakening of the bones
- Decreased libido
- Lack of interest in activities they used to enjoy
- Frequent mood swings
- Depression
- Irregular sleep patterns
- Fear of gaining weight
- Lack of energy
- Constipation
If the disorder is left to progress long enough, these symptoms can result:
- Decreased bone mass and density leading to osteoporosis and bone fractures
- Menstrual dysfunction leading to infertility
- Brain abnormalities (the brain will become damaged when it is deprived of fuel (glucose) for too long)
- Organ malfunction
- Eventually death (10% of the cases are usually fatal)
Exerting "Control"
Often however, Anorexia Nervosa is not solely about body image or the desire to become thinner. Many women use this disorder as a way to feel in control of their lives.
They may feel that they aren't doing what they would like to be doing with their careers or relationships and feel that by being in control of their eating and weight they gain a sense of accomplishment.
Escape Mechanism
Others may use this as a way to block out other areas of their lives that are bothering them.
If they are so focused on food and weight than they don't have to pay attention to the real issues that are bothering them, therefore they are almost using the disorder as an escape mechanism.
Denial
People with this form of eating disorder are also the ones most likely to deny that there is any type of problem. They learn to hide their disease very well so that no one knows what's going on, and make up excuses as to why they can't eat. They will also wear very baggy clothing so others cannot see how thin they have become.
The sad thing is that sometimes these individuals are reinforced for their behavior when they initially start losing weight and are complimented on how they look. This will serve to promote their disorder, pushing them to new levels of starvation and a desire to continue to lose weight.
Treatment
Treatment for this disorder is often a very lengthy and involved process. There needs to be both nutritional and psychological counseling as both factors play an important role.
Nutrition:
Nutritionally, the person needs to learn what it means to eat normal again and often needs to re-introduce foods back into their diet.
They may have cut out entire food groups in an effort to lose weight and will now be scared to consume them once again. They need to be put on a meal plan that is providing them with enough calories so that they can begin to gain weight.
Often it will work best to slowly increase their calories so it is more psychologically tolerable to the patient, as they will be very frightened at first at the thought of consuming more food again.
In some cases, patients will be given liquid calories through a tube if they are refusing to eat and they're problem is severe enough that they could risk death if they lost any more weight.
Psychology:
On the psychological end of things, a counselor needs to sit down with the patient and discuss what issues created the disorder in the first place.
- Was it pressure coming from someone else to fit a certain size (this is often the case with athletes)?
- Was it the feeling of being out of control with their work or home life?
- Or was it simply that they are trying to fit the media's image of what constituted an 'ideal' body?
Risk Factors:
Anorexia is typically stereotyped as being a disease of teenage females. However, in real-life, almost any individual can be a sufferer, as even children as young as three have been known to develop the disease.
While anorexia may occur in individuals across the demographic divides, it definitely appears to be far more prone to developing among those in certain groups, such as:
- Females (95% of anorexia nervosa sufferers are females).
- Those of age 10 through 25.
- Athletes; especially swimmers, dancers, and gymnasts.
- People who are active in dancing, modeling or gymnastics.
- People of European racial descent.
- Students who are under heavy workloads.
- Those who have suffered traumatic events in their lifetime such as child abuse and sexual abuse.
- Those positioned in the higher echelons of the socioeconomic scale.
- The highly intelligent and/or high-achievers.
- Perfectionists.
By getting to the route of the problem, the counselor and patient can work on ways to reshape the persons thinking so they can learn to value themselves as a person more and not just base their worth on how they look.
Relapse:
One important point to consider however is that for treatment to be most successful, the patient must first be willing to admit that there is a problem.
If they are still in the denial stage, chances are that they may gain the weight back, however since the initial problem that caused the disorder is still lingering, they will likely relapse once again.
If they are ready to admit there is a problem though and are asking for help, then that shows they are going to work towards getting better and will most likely not want to venture down this path once again.
Bulimia Nervosa
The next eating disorder that we will look at is called Bulimia Nervosa.
This eating disorder is slightly different from that of Anorexia Nervosa in that often the patients can either be underweight or be of normal weight.
In Anorexia, a patient has to be underweight to be clinically diagnosed. What happens during this disorder however is that instead of starving themselves in order to get thin, the bulimic purges their food after it has been eaten.
This will ensure that their body is not absorbing the calories in the food and thus prevent them from gaining weight. Often, this disorder comes in the form of binge and purge, so the individual will eat enormous amounts of foods at one time and then just go to the bathroom and throw it up or use a laxative.
Often, while engaging in this act, the bulimic tends to experience a great deal of loss of control, which leads to feelings of guilt and worthlessness, thus compounding their problem.
In order to be classified as a bulimic, the person must have a minimum average of two binge eating periods per week for a period of at least three months.
Symptoms
Characteristics of people with Bulimia Nervosa are:
- Swollen throat and glands
- Stomach pains
- Mouth infections
- Irregular periods
- Dry skin
- Difficulty sleeping
- Damaged teeth (from stomach acid)
- Uncontrollably eating large quantities of food
- Being sick after eating
- Numerous trips to the bathroom after meals
- Moods swings
- Depression
- Controlling behavior
- Dehydration and electrolyte imbalances
- Internal bleeding
- Rupture of the esophagus
Treatment
Treatment for people of this disorder is very dependant on what type of bulimic the person is.
Trigger Factor:
The initial step in treatment is identifying the trigger factor that makes this person want to purge.
Weight Control:
Is it their way of controlling their weight, just as an anorexic starves herself?
If this is the case than you would need to approach treatment in a similar fashion as that with anorexia. You would need to find out the underlying reasons why this person feels the need to be so thin and work on changes those thought processes.
At the same time you would want to get them on a sensible diet so they can learn to eat comfortably without throwing up their food.
Stress, Loss Of Control:
If on the other hand they eat normally most of the time but have certain times when they binge and then purge, the treatment goal would be locating this trigger and finding ways to avoid it. Triggers can be things like stress, a feeling of out of control, or a certain food or situation.
It might be a matter of avoiding a certain type of food altogether, if that can simply be done or else trying to find a way for the patient to focus themselves and remain in control when they encounter a situation that would normally lead to a binge, such as stress relief techniques, self talk, or relaxation techniques.
Unfortunately, although bulimia is not usually as serious as anorexia, the recovery rate is usually lower than that of anorexics, and their chances of relapse are quite higher.
More Common In Athletes:
This type of eating disorder may be more common in athletes that have to diet for certain events such as bodybuilders and fitness models. The reasoning for this is because they eat normally for most of the year however then undergo a period where they are severely restricting themselves.
Because they are not used to this they have a hard time with it psychologically and they may find themselves going through periods where they eat whatever it is they are denying themselves of, feel guilty about 'messing up their progress' and then resort to either being sick or using laxatives to get it out of their system.
For this reason, it is more preferable for someone involved in these sports to maintain a healthy diet year round and not let themselves put on so much body fat in the off season so that way they are not forced to deprive themselves so much when it comes time to get ready to compete once again.
Conclusion
In the next part of this discussion, we will talk about the final eating disorder, binge-eating disorder, and discuss eating disorders in the male population.