ANOREXIA or EATING DISORDER
A characteristic feature of eating disorder is disturbance in normal eating behavior and an obsession with body image or size. There are two types of eating disorders:
· Anorexia nervosa and
· Bulimia nervosa.
was the English physician William Gull who coined the word Anorexia Nervosa in
1868. Dr Gull emphasized the physiological causes of the condition, the need to
restore weight, and the role-played by the family.
Anorexia nervosa is a severe eating disorder characterized by low body weight. It is prevalent mostly in about 0.5% to 1% in women with an average onset of the disorder around 17. Statistical studies reveal that it is common in industrialized societies and in higher socio-economic classes. Those having it generally have difficulty with self-esteem and a fear of losing control. Normally people who equate low body weight with attractiveness develop eating disorders; hence models and dancers are more prone to have it. Ana Carolina Reston for example was an anorexic model who did not get help. She died after consuming only apples and tomatoes. At the time of her death her 5’8” tall body weighed only 88 pounds. Another model Luisel Ramos died after eating only lettuce and diet coke for 90 days. Both models were only in their early 20s. Such individuals exercise intensely to lose weight and alter body shape. Many restrict food intake and a few others resort to binging and purging (using laxative, diuretics, and enemas or even induced vomiting). The French model Isabelle Caro will however be remembered for long as the living face of anorexia. She became well known after an advertising campaign on anorexia
Anorexia nervosa is therefore of two types, viz. restricting and binge eating/purging type. However patients with anorexia nervosa do not have any loss of appetite, they just refuse to eat. When medical complications arise they must be clinically treated, after which psychotherapy begins. When patients are less medically ill, supervised meals, weight and electrolyte monitoring, and individual psychotherapy is initiated. What causes anorexia nervosa has not been clearly established and is still being investigated. Preliminary studies suggest that a gene located at chromosome 1p seems to be involved in determining a person’s susceptibility to anorexia nervosa. Other plausible reasons suspected to cause this are dysfunction in the hypothalamus, and imbalances in neurotransmitter levels in the brain
TYPES OF THERAPIES USED
Probes the unhealthy thoughts contributing to anorexia nervosa and tries to change our distorted beliefs and poor self image.
Tries to change eating habits using rewards and reinforcements. It is done in a graded manner using achievable goals and monitoring our self.
Probes the family dynamics of the patient the support they can provide.
Supervised interaction of people afflicted by anorexia where they share their experiences and help them break their isolation
Some of the health issues associated with untreated anorexia nervosa includes:
- Calcium deficiency
- Kidney stones
- Liver disease
- Interrupted menstrual cycles
- Heart failure
- Nerve damage
- Muscle loss
- Emotional withdrawal
- Gum disease & tooth erosion
- Hair loss
- Sleep disorders
Bulimia nervosa is a eating disorder characterized by binge eating with maintenance of body weight. Its incidence is mostly in women and afflicts 1 to 3% of the female population. Food binges are precipitated by stress or altered moods. As in anorexia nervosa, bulimia is of two types: purging and non-purging. Though unlike anorexia nervosa, medical complications of starvation do not exist, gastric or esophageal rupture, constipation, dehydration, metabolic acidosis, electrolytic abnormalities, anemia, hypotension, edema, dry skin are just some of the medical complications that can arise. Psychotherapy focuses on control of eating behavior with cognitive therapy aimed at correcting self-image and assistance in increasing self-esteem. To some extant anti-depressants are more effective in treating bulimia nervosa than anorexia nervosa.