VERIFIED CONTENTAuthor: lek. Tomasz Nęcki

Eating disorders constitute a fairly extensive group of psychiatric entities, which include, among others, anorexia and bulimia. Sometimes these problems are underestimated, while most of them can cause serious, sometimes even fatal complications. But what exactly distinguishes eating disorders, what are the characteristics of each of them and what methods can be treated?

Eating disorder - what is it?

Eating disordersbelong to the group of mental disorders and require treatment. Today, almost everyone has heard about eating disorders - hardly anyone has ever come across the term anorexia or bulimia. The listed problems are indeed some of the most famous individuals in this group, but they are certainly not the only possible eating disorders - there are definitely more of them.

In fact, eating disorders can occur in people of any age (even anorexia in the elderly is possible), but they typically develop in adolescents and young adults. The problem affects women much more often. However, the statistics on the exact prevalence of eating disorders differ, according to one of them, up to 4% of women suffer from anorexia at some point in their lives, and up to 2% of female representatives suffer from bulimia and binge eating disorders.

Eating disorders: causes

Until now, it has not been possible to state unequivocally what exactly is responsible for the occurrence of various eating disorders - most likely the etiology of these entities is multifactorial. As with many different medical conditions, there is a lot of attention to genetics in eating disorders, and this is likely to be a good lead.

It turns out that people who have a close relative with some eating disorder have a 7 to 12 even greater risk of developing this problem themselves. Theories about the influence of genes on the occurrence of eating disorders are confirmed by studies conducted on monozygotic twins - it turned out that when one of them suffered from an eating disorder, the risk that the other twin would bestruggled with the same problem, it was even 50%.

Genes are definitely not everything - various types of psychosocial factors are also considered to be the causes of eating disorders. Attention is drawn to the fact that, among others, those people who in their childhood were controlled by their parents at every step.

In general, various inappropriate parental attitudes can contribute to an eating disorder. However, the most important thing is the excessive focus of caregivers on the weight of both their own and the child's weight.

The media also has an influence on the occurrence of eating disorders. For years, the promotion of a certain model of beauty has been clearly visible - it can be noticed, for example, on fashion catwalks or in various advertising campaigns, where slim, sometimes even skinny people are presented as successful people. This type of message builds the belief in many young people that only such appearance is acceptable and will allow them to achieve success in the future.

Eating disorders: symptoms

Most eating disorders share some common features - these are, first of all, excessive concentration on one's appearance, incorrect eating habits, and a belief that there is an abnormal body image.

Among the problems that may indicate that a loved one may have one of the disorders belonging to this group, the following can be mentioned:

  • changing eating behavior (e.g. avoiding eating with the family),
  • weight loss (typically an eating disorder patient denies counting calories or following any diet),
  • dissatisfaction with your appearance,
  • deterioration of he alth (e.g. worse skin appearance, deterioration of hair condition, unjustified weakness or lethargy),
  • sudden start of intense physical activity,
  • statements about having too much body weight (especially disturbing when their author is a person with too low weight).

Eating Disorders: Types

Basically, the most famous eating disorder is anorexia, or anorexia nervosa. This problem is generally related to limiting the number of meals, and it is also often accompanied by intensive sports.

All activities of a person with anorexia nervosa have one goal - to have the lowest possible body weight. In the case of anorexia, the patients' misconceptions may be so intense that even when their weight is extremely low andall their bones become visible, patients may still believe that they weigh too much and that they are simply fat.

Bulimia (bulimia nervosa) is a problem slightly different than anorexia - in its case patients usually have a normal body weight. Characteristic of bulimia nervosa are bouts of uncontrolled overeating, which later make the patient feel guilty - in order to prevent weight gain, they use various methods, such as e.g. inducing vomiting or using laxatives.

Binge Eating Disorder is a problem somewhat similar to bulimia nervosa. In its course, there are also episodes of uncontrolled consumption of large amounts of food, but the difference is that patients with binge eating disorders do not use various methods that would prevent them from gaining weight.

Pica is another eating disorder that causes disgust in some people. It consists in the fact that the patient eats things that are definitely not suitable for eating - such can be, for example, soap, earth, coal or … hair. The most common drink is found in children, pregnant women and people with intellectual disabilities.

The American DSM-V classification distinguishes an eating disorder defined as avoidant / restrictive food intake disorder. It is associated with difficulties in eating meals, resulting from an extreme reluctance to eat food itself or an aversion to specific tastes, smells or texture of food.

Eating disorders: new entities

In medical classifications, the group of eating disorders will most likely undergo various changes in the coming years - more and more often other problems than those mentioned above are mentioned, which could also be included in this group.

The units that are currently not included in the medical classifications of diseases and disorders, and which are also discussed more and more today, include such problems as:

  • orthorexia (a disorder in which the patient consumes only he althy, wholesome products),
  • diabulimia (found in people struggling with diabetes who specifically manipulate insulin doses to avoid weight gain),
  • drunkorexia (also known as alcoholorexia, the problem of avoiding food consumption so that the calories that the patient then supplies with the consumed alcohol do not increase his weight),
  • Gourmand syndrome (also called gourmet syndrome, may occur after damage to the frontal lobes of the brain and is associated with the fact that the patient begins to want to eat only refined meals).

Eating disorders: comorbidities

Eating disorders are often not the only psychiatric concern that the patient struggles with. Often with them, in the same person, other individuals coexist - among those who appear most often with eating disorders, the following can be mentioned:

  • depressive disorder,
  • anxiety disorders,
  • personality disorders.

It is worth mentioning here that patients with eating disorders are at increased risk of abuse and addiction to psychoactive substances.

Eating disorders: diagnosis

Mental he alth specialists - psychiatrists and psychologists - deal with the diagnosis of eating disorders. Often, before the patient goes to such doctors, he visits completely different medics - such conduct is not a mistake at all, contrary to appearances. In fact, before making a diagnosis of eating disorders, it is necessary to exclude other possible, organic causes of weight loss or other abnormal eating behavior - the differential diagnosis should include:

  • hormonal disorders (such as thyroid dysfunction or Addison's disease),
  • gastrointestinal diseases (such as celiac disease, Crohn's disease, peptic ulcer disease).

Sometimes it takes a while from the start of the diagnostic process to the final diagnosis. In a situation where we suspect that a loved one may have an eating disorder, there is nothing to wait for - you need to seek help as soon as possible, because their consequences, unfortunately, can be even deplorable.

Eating disorders: complications

There are many complications of eating disorders. Unfortunately, the truth is that in a relatively short time, they can lead to considerable havoc in the entire body of the patient. For example, in the course of anorexia, there may be such problems as:

  • fertility disorders (including infertility),
  • severe arrhythmias,
  • loss of muscle mass,
  • skeletal weakness,
  • rapid changes in mood.

Bulimia is also dangerous - in its case complications may include, among others, such problems as:

  • damage to tooth enamel,
  • serious disorderselectrolyte,
  • heart rhythm disturbance,
  • esophagus damage (caused by inducing vomiting).

It is worth emphasizing here that patients with eating disorders have an increased risk of attempting suicide. Considering the problems described above, it becomes obvious that eating disorders not only need to be treated, but also that treatment should be started as soon as possible.

Eating disorders: treatment

In the treatment of various eating disorders, therapeutic interactions play the most important role. Cognitive-behavioral therapy is probably the most mentioned in this case, but other types of therapies, such as systemic therapy or psychodynamic therapy, can also be helpful.

In young patients - children and adolescents - family therapy is very important in the treatment of eating disorders. Various techniques are sometimes used in the treatment of the discussed problems, for example, therapeutic contracts are used in patients with anorexia.

Sometimes pharmacological treatments are also used to treat eating disorders. However, it will not lead to a full recovery - for this it is necessary to start psychotherapy.

Pharmacotherapy in eating disorders is used primarily when symptoms of additional mental disorders, e.g. depressive disorders, are observed in the patient.

Some may wonder under what conditions an eating disorder should be treated. It all depends on the patient's condition - in the case of stable patients, it is possible to start outpatient treatment, but if, for example, a person with anorexia has an extremely low BMI, hospitalization may be necessary.

It is worth noting here that it does not necessarily have to take place in a psychiatric hospital at once - in severe exhaustion, it may be necessary to first treatment in a pediatric or internal medicine ward (depending on the patient's age), and only after stabilizing his somatic state, it may be possible be his transfer to a psychiatric facility.

Some parents of anorexic patients would expect their child's weight to increase as quickly as possible in the hospital. This approach is understandable, but from the medical point of view, too fast weight gain is not beneficial. For people with anorexia, weight gain must be gradual - if it does happen too quickly, there is a risk of developing a life-threatening problem such as Renutrition Syndrome.

Eating disorders: prognosis

It is difficult to come up with a specific prognosispeople with eating disorders - these problems are really different and have very different severity of symptoms. In general, however, in the case of anorexia, bulimia and binge eating disorders, it is reported that improvement - in the form of partial or complete relief of symptoms - is observed in 50% to even 85% of all patients treated for these individuals.

On the other hand, it should be clearly emphasized here that eating disorders are considered to be mental disorders with the highest mortality. This information, like the previously mentioned possible complications of eating problems, clearly shows how important it is to react quickly and seek help in a situation where our loved one may suffer from one of the individuals included in this group.

  • Tooth damage in eating disorders
  • Selective Eating Disorder: Causes, Symptoms, and Treatment

Category:

Psychiatry