Eating Disorders: Dying to Be Thin

A tortured relationship with food

In a society which places excessive values on being slim, many women have a tortured relationship with food and their bodies. Sadly, eating disorders are rife, particularly among teenage girls, however, women and men of all ages can be afflicted by eating disorders.

Official figures talk about 1 % of young women being afflicted by anorexia, 2% suffering from bulimia and 2% suffering from a binge-eating disorder. Of course, figures do not count unreported cases, nor the hidden, nor borderline cases; for instance, women who follow very strict diets by periods of bingeing, for whom this kind of eating pattern is so common that they consider it normal or at least inevitable.

Eating disorders are usually onset in adolescence and affect more women than men.

Diagnosis criteria for eating disorders

If you want to help yourself or someone who you know and suspect of being afflicted by an eating disorder, identifying the early signs of the condition is very important in order to look for professional help as soon as possible.

• Early signs of eating disorders may include:
• Withdrawal from family and friends
• Increased sensitivity to criticism
• Sudden increased interest in physical activity
• Anxiety
• Depressive symptoms.
• Refusal to maintain body weight at or above a minimally normal weight for age and height
• Intense fear of gaining weight or becoming fat, even though underweight
• Distorted self image
• Denial of the seriousness of current low body weight
• In women, the absence of three consecutive menstrual cycles

Pointing at the exact cause of eating disorders is impossible. A person’s obsession with food may start at any time. Obsession with body image can occur at primary school, during adolescence, after pregnancy, and even when aging. The onset of eating disorders in men has more to do with sports performance and body image, therefore a man at any age is also a candidate for suffering from an eating disorder.

In general, people who suffer from eating disorders tend to be perfectionists and at the same time suffer from low self esteem.

Eating disorders may be a symptom of other emotional problems or strained relationships and food might feel like the only thing they can control in their life.

Often women use their bodies as a focus of their unhappiness and the fact that slim often equals beautiful in our society certainly encourages the problem.

Unfortunately there are no specific tests to pinpoint eating disorders. No single laboratory test helps with the diagnosis of an ED. However, a group of tests of tests should be performed to rule out medical complications. For example a general screen which includes checking for levels of electrolytes, glucose, calcium, phosphate, BUN, and Cr, Mg are useful for a diagnosis. Liver and thyroid function tests, are also important to discard any other disease.

People afflicted by Eating disorders generally have two options for treatment, either as an inpatient or an outpatient.

Inpatient treatment is often reserved for extreme cases where a patient weights less than 70% his ideal body weight and outpatient treatment has already failed.

Outpatient treatment usually concentrates in treating the complications of living with and eating disorder.

Outpatient treatment includes nutritional counselling; behavioural therapy to change patterns of behaviour towards food, cognitive therapy to alter anorexic attitudes and improve self esteem.

Bulimia

Sadly bulimics who binge then purge by vomiting or taking handfuls of laxatives destroy their health and their looks.  Constant vomiting erodes the enamel on their teeth and makes the glands swell, making their faces look chubbier. 

The worst part is that while handfuls of laxatives might cause stomach cramps, and constant visits to the toilet, they have no big effect on calorie intake.  Calories are absorbed higher in the gut, while laxatives affect the lower intestine.  Vomiting can only expel a half to a third of what has been eaten, so bingers still absorb a lot of calories. 

Anorexia

Anorexics who refuse to eat literally starve themselves, some of them until they die; others will get treatment and gain weight, but anorexia is very difficult to treat.

• Don’t keep your problem to yourself.  You might feel ashamed or disgusted but it is important that you seek help.
• Eating disorders are best helped by a professional therapist, so ask your doctor for a referral.

• People who binge find that they no longer know how to eat normally. Try to organize three regular meals and two snacks a day. Plan when you are going to eat and stick to your timetable. Regular meals will reduce your urge to binge and gradually normal sensations of hunger and fullness will return.
• When you feel the urge to binge do something else instead. Take a bath, have a manicure, go for a walk, etc. Continue this activity until the urge to binge passes. Don’t be disheartened if you don’t always succeed.
• Monitor your problem and try to work out what triggers your urge to binge. Do you binge when you are tired? Bored, or upset? What would be a better way to deal with these feelings? Try to work out through your problems rather than hide them with food.
• Do you follow very strict diets and then binge when you can’t keep to them? If the answer is yes, stop dieting this way. Try a different regime, one that leaves you satisfied both in terms of quantity and quality of food ingested.
• Do certain foods trigger binges? Do you binge eat every time you have chocolate or freshly baked bread in front of you? If you have been avoiding those foods to avoid binging, gradually introduce these foods into your diet on days when you feel in control. Focus on the easiest foods for two weeks. Then gradually introduce others. After about eight weeks you should have eaten all your trigger foods. You don’t have to eat these foods regularly, only until the thought of eating them no longer disturbs you.

Long-term follow-up shows recovery rates ranging from 44% to 76%, with prolonged recovery time (57 to 59 months).

Mortality (up to 20%) is primarily from cardiac arrest or suicide.

Based on the little long term data collected, it can be said that short-term success is 50% to 70%, with relapse rates between 30% and 50% after 6 months.