Eating disorder is defined as a psychological disorder centering on the avoidance, excessive consumption or purging of food. It is also said regarding eating disorder that it is a type of dependency. Eating becomes the object of dependency and disturbs the balance of daily life. Others define eating disorders as an illness that causes a person to adapt harmful eating habits. These disorders are more common amongst teenage girls and young women. Eating disorder is defined by psychologists as a psychological disorder that impairs normal eating behavior. Over eating, anorexia and bulimia are examples of eating disorders.
Types of Eating Disorders.
Eating disorders are basically of three types and these are presented below:
- Anorexia nervosa
- Binge eating disorders
- Bulimia nervosa
Anorexia Nervosa is an eating disorder, occurring most frequently in adolescent girls, that involves persistent refusal of food, excessive fear of weight gain, refusal to maintain minimally normal body weight, disturbed perception of body image, and amenorrhea (absence of at least three menstrual periods).
Diagnostic Criteria for Anorexia Nervosa.
A. Restriction of energy intake relative to requirements, leading to a significantly low body weight in the context of age, sex, developmental trajectory, and physical health. Significantly low weight is defined as a weight that is less than minimally normal or, for children and adolescents, less than that minimally expected.
B. Intense fear of gaining weight or of becoming fat, or persistent behavior that interferes with weight gain, even though at a significantly low weight.
C. Disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or persistent lack of recognition of the seriousness of the current low body weight.
Restricting type: During the last 3 months, the individual has not engaged in recurrent episodes of binge eating or purging behavior (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas). This subtype describes presentations in which weight loss is accomplished primarily through dieting, fasting, and/or excessive exercise.
Binge-eating/purging type: During the last 3 months, the individual has engaged in recurrent episodes of binge eating or purging behavior (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas).
The key symptoms.
- Refusal to sustain a minimal normal body weight
- Intense fear of gaining weight
- Distorted view of one’s body or weight
- Severe starvation
- Obsession in regard to Food and weight
- Intense and overwhelming fear of gaining weight
- Thinning of hair
- Dry skin
- Low blood pressure
- Fatigue and exhaustion
- Loss of memory to an extent.
- Obsessive Compulsive behavior.
1) Biological causes: It has been suggested by psychologists that genetic predisposition to anorexia plays a major role. If a young girl has a sibling with anorexia she is 10 to 20 times more likely than the general population to develop anorexia. People with anorexia have high levels of cortisol, brain hormone most related to stress, decreased levels of neurotransmitters such as serotonin and norepinephrine which are associated with feelings of well being.
2) Psychological causes: People with anorexia are emotionally driven not only in weight loss but also in other areas of their life like career, school work or fitness. It includes the psychological disturbances like:
- Low self esteem
- Mood swings
People appear to have it all together on the surface inside they feel helpless, inadequate and worthless. Generally anorexics feel harshly critical and have no confidence thus some of the traits that occur in anorexics may be a result rather than a cause of the disorder.
4) Cultural pressure: Standards of beauty for women in societies and bombarded messages from the media push women to diet for meeting the standards. This idealized ultra thin body shape is almost impossible for most women to achieve since it does not fit with the biological and inherited factors that determine natural body weight. Certain occupations like modeling, sports, running etc. pressurize the individual to maintain specific body weight.
The types of treatments are being used as follows:
1. Individual psychotherapy: It is the major step especially for people who are beyond adolescence. In this cognitive behavioral approach helps in developing healthy ways of thinking and pattern of behavior and reenter in new relationship.
2. Family therapy: It is important for family members who also push the individual towards the tendency of anorexic. This approach can assess the impact of the disorder on the family help members in overcoming from certain guilt and inferiority. This helps the individual to develop practical strategies for overcoming.
3.Group therapy: This is important in the hospital or in intensive day treatment. Some groups are task oriented and may focus on eating food, body image, etc. The other group may aim at understanding the psychological factors that may lead to the development.
4. Medication: In comparison to other interventions medication can prove effective. Depression and other emotional problems are often a result of starvation, it is best to focus on weight gain rather than medication.
It is an overeating characterized by retaining of food intake. This results in feelings of guilt and low self esteem.
This term is appropriate on many levels as bulimia is a repeated cycle of binge eating and purging. Binge eating is the abnormal over intake of large amount of food that she or he has eaten by either making herself to vomit, taking an excessive amount of laxatives, diuretics or engaging in fasting and or excessive exercise. People with bulimia known as bulimia engage in such behavior at least two times a week for a period of six months or more.
Diagnostic Criteria for Bulimia Nervosa.
A. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
1. Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances
2. A sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating)
B. Recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics or other medications; fasting; or excessive exercise.
C. The binge eating and inappropriate compensatory behaviors both occur, on average, at least once a week for 3 months.
D. Self-evaluation is unduly influenced by body shape and weight.
E. The disturbance does not occur exclusively during episodes of anorexia nervosa.
1. Culture: Culture does play a role in determining whether or not someone will develop bulimia. For example, women in the different countries and in different advertisements are bombarded with images of the “ideal” or “perfect” woman, and these women are always thin. Seeing this often enough can make it difficult for an ordinary woman to ever see herself as beautiful. Men are even starting to suffer from the same sort of self image problems as women.
2.Low self-esteem: This is a major factor when it comes to developing bulimia and is one of the causes of bulimia. It is not surprising that people who see themselves as worthless and unattractive are at high risk. Growing up and living in an environment conducive to abuse, criticism, pushing for perfection and depression can contribute to people becoming bulimic.
3. Dieting: Dieting can actually be one of the causes of bulimia. This happens because dieting too much can lead to developing an eating disorder. Drastic dieting can bring about the deprivation that may be a trigger to binge eating. Once this happens binge and purge cycle will start and continue.
Binge Eating Disorder.
Binge eating is a pattern of disorder which consists of episodes of uncontrollable eating. In such binges, a person rapidly consumes an excessive amount of food. Most people who have eating binges try to hide this behavior from others, and often feel ashamed about being overweight or depressed about their overeating.
Eating binges can be followed by the so called compensatory behavior, that is acts by which the person tries to compensate for the effects of overeating. Although people who do not have any eating disorder may occasionally experience episodes of overeating, frequent binge eating is often a symptom of an eating disorder.
Diagnostic Criteria for Binge-Eating Disorder.
A. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
1. Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than what most people would eat in a similar period of time under similar circumstances.
2. A sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating).
B. The binge-eating episodes are associated with three (or more) of the following:
1. Eating much more rapidly than normal
2. Eating until feeling uncomfortably full.
3. Eating large amounts of food when not feeling physically hungry.
4. Eating alone because of feeling embarrassed by how much one is eating.
5. Feeling disgusted with oneself, depressed, or very guilty afterward.
C. Marked distress regarding binge eating is present
D. The binge eating occurs, on average, at least once a week for 3 months.
E. The binge eating is not associated with the recurrent use of inappropriate compensatory behavior as in bulimia nervosa and does not occur exclusively during the course of bulimia nervosa or anorexia nervosa.
Causes of Binge Eating Disorder.
1. Developmental aspect: It is the belief that pressure to look a certain way and fit in through being thin is greatest during the period of adolescence. Girls are more affected by inner turmoil at this time low self esteem, anxiety and being self conscious. This approach suggests that boys usually find forming an identity somewhat easier than girls. Society also recognizes continually changing in terms of expectations of the female role.
2. Cognitive aspect: It is all about identifying and challenging negative behaviors, feelings and thoughts and beliefs about oneself. Emphasis comes on learning to interrupt destructive behavior or thought patterns which serve to keep the vicious cycle. This includes misusing laxatives, diet pills and diuretics.
American Psychiatric Association Work Group on Eating Disorders. Practice guideline for the treatment of patients with eating disorders (revision). American Journal of Psychiatry, 2000; 157(1 Suppl): 1-39.