Anorexia nervosa and bulimia nervosa may be described as major eating disorders. These may also be described as psychological disorders associated with eating and not eating. The compulsion to eat or to go on diet is extreme, which is gradually increased and gets out of control. These people fear becoming fat or perceive themselves as being fat, when actually they are not. Apart from anorexia and bulimia, the other food related disorders include binge eating disorders, food phobias etc.
Although not much is known about what actually causes eating disorders, there are several theories on how people develop them. Eating disorders are generally evident between the ages of 13 and 17. This is a period associated with adolescent growth and with immense emotional and physical changes. This is also a period where there is academic and peer pressure on an individual, just when he or she struggles with relationships and identity. During puberty, teens get a feeling that they are not in control of their individual freedom, which sometimes include their own bodies (Nemours, 2010). It is normal for girls to put on weight during puberty, which may even be said as being necessary too. However many may see this increase in weight as an adverse development, desperately wanting to get rid of it. Eating disorders can also lead to depression, anxiousness and obsessive compulsive disorder.
Anorexia was formally diagnosed for the first time in 1873. In 1873 Charles Laseque and William Withey wrote about intentional restriction of food, in which they described symptoms to diagnose anorexia that were similar to what is followed today. The symptoms however have been observed 300 years early. While anorexia is associated with restriction of food, bulimia is associated with consuming and vomiting it. Physicians in the 18th century perceived bulimia with respect to overeating and vomiting. It was more considered as a gastric dysfunction than an eating disorder with a psychological bearing. Bulimia has also been known for centuries although its prominence and relevance has increased only in the last few decades. It has been recorded that people in ancient Rome used to vomit food, they consumed during a feast. There were even specially designated places ‘vomitorium’. It was only in the 20th century that an awareness of anorexia and bulimia came to prominence with a better understanding. In the 1970s, systems of bulimia were identified that were different from anorexia.
Anorexia may be described as a condition associated with dieting that has got out of control. Anorexia often begins with dieting, intended to lose weight. With time however, achieving weight loss is seen as a sign of mastery and control, and the fear and need to control the body becoming important. The urge to become thinner is actually not the primary concern. The individual takes to destructive eating which is often associated with other behaviors like use and overuse of diet medications, over exercising and use of laxatives. It must be noted here that some disorders may be associated with a lack of appetite, but the characteristic feature of anorexia is the deliberate restricting of food. In order to experience a sense of control over the body, these individuals take to extreme limits like even moving close to starvation. The restrictive eating cycles become an obsession, which in many ways is a type of addiction. Women are more prone to anorexia with about 95% of affected population being women although men too can develop the disorder. Anorexia normally manifests in an individual during the early adolescence period.
Bulimia is also an eating disorder associated with excessive or binge eating, only to be followed by inappropriate weight control methods like over exercising, induced vomiting and abuse of laxatives. The condition occurs subsequent to uncontrolled dieting. The individuals quickly get obsessed with the cycle of over eating and vomiting, similar to drug and substance addiction. The disorder manifests after a sequence of unsuccessful dieting attempts. Bulimia is also closely associated with addictions and compulsions. It has been estimated that about 20 to 40% women affected with Bulimia have a history of drug and alcohol abuse, indicating behavioral control problems. Sometimes bulimic behavior is also seen in anorexia. Binge eating is not actually driven by hunger but triggered by depression, stress and other feelings associated with body weight and shape.
Generally there is a feeling of satisfaction or happiness after binge eating, but soon there is self-loathing that sinks the short-lived happiness. There is a loss of control during binge eating and the individual resorts to vomiting in an effort to regain control. It should be noted here that all bulimics do not engage in induced vomiting, use of enema or laxatives. While some resort to fasting for a few days to compensate a binge session, others may resort to excessive exercising. The excessive exercising includes exercising at inappropriate times and places or indulging in it even when sick or injured. Bulimics often experience weight fluctuations, but however their weight loss is not as severe as in anorexia. Also long term prognosis and recovery rate is higher for bulimics compared to anorexics.
Eating disorders can be successfully treated when diagnosed early. Anorexia and bulimia are often overlooked in males, as these are relatively rare in boys and men. Identifying people with such disorders and bringing them under treatment is indeed difficult. The longer the disorders prevail, the greater is the treatment difficulty and its effects on the body. Long term treatment might also be required in some cases. Family and friends can contribute to the success of the treatment by playing a crucial role by offering support and encouragement.
Whenever an eating disorder is suspected, a physical examination must first be carried to rule out all other illnesses for the weight loss. Based on the assessment by the clinician, the patient may be hospitalized or treated as an outpatient. Conditions requiring hospitalization include excess and rapid weight loss, extreme binge eating and purging, clinical depression, major metabolic disturbances etc. Given the complex association of psychological and emotional problems in eating disorders, a comprehensive treatment plan involving various experts is necessary. The treatment team should ideally include an internist, a psychotherapist, a nutritionist and a psychopharmacologist, or an expert in psychoactive medications.
People with eating disorders require their emotional issues to be identified and addressed and therefore psychotherapy is generally used. Mental health professionals provide emotional support and help the patient to understand and cope with the illness. Group therapy has been proved to be successful in the treatment of bulimia. The effectiveness of combined psychotherapy and medications has been studied by scientists of the National Institute of Mental Health. Researchers have recently established that group therapy and antidepressant medications are beneficial to patients, when administered either alone or in combination. Antidepressant medications were also seen to be most beneficial when combined with cognitive-behavioral therapy.
Given the increasing prevalence of anorexia and bulimia, today’s society has an important role in tackling eating disorders. The food and fashion industry in particular have a responsible role to ensure that people in our society have a perfect physical and mental health. Teenagers watching television fall for the idea that they would only be accepted when they are thin. They are brainwashed into believing that becoming thin is important and aspire to be as thin as their models on the screen. The diet commercials give the implication that losing weight would lead to happiness. Magazines claim to provide the newest and the best diet, each month.
Most of these diets are actually unhealthy, depriving the body of the required nutrition and also initiating health problems. Dieting can be rightfully said to have become obsession with a large section of the population in North America. Today, we see and respect the persona from the outside rather than the inside that actually matters. We need to accept and love for what we are and not for what we look. Children need to be taught to emphasize on who they are, and to accept others for who they are. They need to be taught healthy eating habits and the irrelevance of being thin.
