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Things to Know About Eating Disorders [internet]


Taken from: http://www.eating-disorder.com/

In a culture where thinness is too often equated with physical attractiveness, success, and happiness, nearly everyone has dealt with issues regarding the effect their weight and body shape can have on their self-image. However, eating disorders are not about dieting or vanity; they're complex psychological disorders in which an individual's eating patterns are developed--and then habitually maintained--in an attempt to cope with other problems in their life.

Each year, more than 5 million Americans are affected by serious and often life-threatening eating disorders such as anorexia nervosa, binge-eating, bulimia nervosa, compulsive eating, obesity, and pica. Left untreated, the emotional, psychological and physical consequences can be devastating, even fatal. Eating disorders know no class, cultural, or gender boundaries and can affect men, women, adolescents, and even children, from all walks of life.

Common Types of Eating Disorders and Their Symptoms

Anorexia Nervosa

Anorexia nervosa is an extremely dangerous, life-threatening eating disorder in which a person intentionally deprives themselves of food and can literally starve to death in an attempt to be what they consider "thin." The disorder involves extreme weight loss--at least 15 percent below the individual's "ideal" weight-and a refusal to maintain body weight that is even minimally normal for their age and height. Even if they become extremely emaciated, an anorexic person's distorted body image convinces them they are "fat." The self-esteem of individuals with this disorder is directly dependent on their body shape and weight. Weight loss for them is viewed as an impressive achievement and an indication of extraordinary self-discipline, whereas weight is perceived as an unacceptable failure of self-control..


Binge-Eating

The essential features of binge-eating disorder are recurrent, out-of-control episodes of consuming abnormally large amounts of food. People with this disorder eat whether they are hungry or not and continue eating well past being uncomfortably full. If left untreated, the consequences of binge-eating can be severe. The disorder often leads to obesity, which is responsible for as many as 300,000 deaths year, or other serious and often life-threatening eating disorders such as bulimia nervosa and anorexia nervosa. Those who suffer from binge-eating disorder are also at high risk of substance-related disorders and serious psychiatric conditions, including depression, panic disorders, anxiety disorders, and personality disorders.


Compulsive Eating Disorder

Compulsive eaters feel incapable of controlling how much or how often they eat. They may feel unable to stop eating, eat very fast, eat when they're not hungry, eat when they're only alone, or eat nearly non-stop throughout the day. Compulsive eaters often over-indulge in sugary foods and use them in an attempt to elevate their mood. When they don't eat the foods they crave, they often experience severe withdrawal symptoms.


Bulimia Nervosa

People who have bulimia nervosa routinely "binge," consuming large amounts of food in a very short period of time, and immediately "purge," ridding their bodies of the just-eaten food by self-inducing vomiting, taking enemas, or abusing laxatives or other medications. If left untreated, bulimia nervosa can lead to serious and even life-threatening problems, such as depression, anxiety disorders, heart damage, kidney damage, injury to all parts of the digestive system, and severe dental damage. Those with bulimia nervosa are at risk for dangerous impulsive, self-destructive behaviors, such as sexual promiscuity, kleptomania, self-mutilation, and alcohol and/or drug abuse.

Obesity

The consequences of obesity can be severe. If left untreated, an obese person is at pronounced risk of developing serious mental disorders, such as depression, personality disorders, or anxiety disorders as a direct consequence of their obesity. For many, obesity leads to chronic and often life-threatening eating disorders such as bulimia nervosa or anorexia nervosa. People who are obese are also at much greater risk of developing a variety of serious medical conditions including high blood pressure, stroke, high cholesterol, heart disease, diabetes, breast cancer, gallbladder disease, upper respiratory problems, arthritis, skin disorders, menstrual irregularities, ovarian abnormalities, and complications of pregnancy. Obesity is one of our nation's most critical health problems and is directly responsible for as many as 300,000 deaths each year.


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What You Need to Know About Eating Disorders

Top 10 Worst Things to Say to Someone With an Eating Disorder

National Eating Disorder Information Centre - Know the Facts

Helping Someone With an Eating Disorder: Signs and Treatment

Symptoms of an Eating Disorder

Common Types of Eating Disorders and Their Symptoms

Bulimia Nervosa Information [internet]


Bulimia Nervosa

Taken from: http://www.medicinenet.com/bulimia/article.htm

What is bulimia?

Bulimia, also called bulimia nervosa, is a disorder in the eating disorder spectrum. Bulimia is characterized by episodes of secretive excessive eating (bingeing) followed by inappropriate methods of weight control, such as self-induced vomiting (purging), abuse of laxatives and diuretics, or excessive exercise. Like anorexia, bulimia is a psychological disorder. It is another condition that goes beyond out-of-control dieting. The cycle of overeating and purging can quickly become an obsession similar to an addiction to drugs or other substances. The disorder generally occurs after a variety of unsuccessful attempts at dieting.

Bulimia is not as obvious as anorexia, but is actually more common. It affects at least 3% to 10% of adolescent and college- age women in the United States. Approximately 10% of identified bulimic patients are men. Bulimics are also susceptible to other compulsions, affective disorders, or addictions. Unlike anorexics, bulimics experience significant weight fluctuations, but their weight loss is usually not as severe or obvious as anorexics. The long-term prognosis for bulimics is slightly better than for anorexics, and the recovery rate is felt to be higher. However, many bulimics continue to retain slightly abnormal eating and dieting behaviors even after the recovery period.

The secrecy of bulimia stems from the shame that bulimics often attach to the disorder. Binge eating is not triggered by intense hunger. It is a response to depression, stress, or other feelings related to body weight, shape, or food. Binge eating often brings on a feeling of calm or happiness (euphoria), but the self-loathing because of the overeating soon replaces the short-lived euphoria.

Often, the individual will feel an impairment or loss of control during the binge eating and the purging becomes a way of regaining control. Not all bulimics engage in self-induced vomiting or the misuse of laxatives, diuretics, or enemas during the current episode. Some may fast for days following a binge episode. Others may resort to excessive exercise as a method to regain their control and rid their body of the possible weight gained during the binge. Excessive exercise is that which interferes with normal daily activities or when it occurs at inappropriate times or in inappropriate settings, or when it continues despite illness or injury.

What causes bulimia?

As with anorexia, there is currently no definite known cause of bulimia. Because of the complexity of the disorder, researchers within the medical and psychological fields continue to explore its dynamics.

Bulimia is generally felt to begin with a dissatisfaction of the person's body. The individual may actually be underweight, but when she looks in a mirror she sees a distorted image and feels heavier than she really is. At first, this distorted body image leads to dieting. As the body image in the mirror continues to be seen as larger than it actually is, the dieting escalates and can lead to bulimic practices.

In certain neurological or medical conditions, there can be disturbed eating behavior, but the essential psychological feature of bulimia, the extreme concern with body shape and weight, is not present. Overeating is a common feature in depression. These individuals, however, do not engage in inappropriate weight loss behaviors and do not exhibit the overconcern with body image and weight loss that is characteristic of the bulimic.

Organic causes for bulimia have not been identified, but are under investigation. Other studies have shown that the affected individual's family has a tendency toward obesity, but this has not been definitely established.

How is bulimia diagnosed?

As with anorexia, denial and secrecy complicate the diagnosis of bulimia. The individual usually does not come to the attention of the practitioner until an associated medical condition or serious psychological problem manifests itself. Truthful disclosure of behaviors is critical for an accurate diagnosis. The actual criteria for bulimia nervosa are found in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV).

There are five basic criteria in the diagnosis of bulimia:

- Recurrent episodes of binge eating. This is characterized by eating within a two-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.

- A sense of lack of control over the eating during the episode, or a feeling that one cannot stop eating.

- In addition to the binge eating, there is an inappropriate compensatory behavior in order to prevent weight gain. These behaviors can include self-induced vomiting, misuse of laxatives, diuretics, enemas or other medications, fasting, or excessive exercise.

- Both the binge eating and the compensatory behaviors must occur at least two times per week for three months and must not occur exclusively during episodes of anorexia.

- Finally, the behavior above is unduly influenced by body image.

The DSM-IV also identifies two subtypes. The purging type regularly engages in self-induced vomiting or the misuse of laxatives, diuretics, or enemas. The nonpurging type engages in other inappropriate behaviors, such as fasting or excessive exercise, rather than purging methods.

What medical complications can bulimia have?

The medical complications that result from bulimia are generally due to continual bingeing and purging. The type of purging behavior used can have varied effects on different body systems.

Self-induced vomiting can result in oral complications. Repeated exposure to acidic gastric contents can erode tooth enamel, increase dental cavities, and create a sensitivity to hot or cold food. Swelling and soreness in the salivary glands (such as the parotid glands in the cheeks) from repeated vomiting can also be a concern.

The esophagus and the colon are the areas most affected by bulimic behaviors. Repeated vomiting can result in ulcers, ruptures, or strictures of the esophagus. Acid that backs up from the stomach (reflux) can also become a problem.

There are a number of intestinal and systemic complications. The misuse of diuretics can create an abnormal buildup of fluid (edema). Continual use of laxatives can result in dependency on them and can cause the normal elimination process to become dysfunctional. Loss of normal colonic function can necessitate surgical intervention in some cases. Restoration of normal bowel function may take weeks after the misuse has been discontinued. The misuse of diuretics and laxatives combined can place the bulimic at great risk for electrolyte imbalance, which can have life-threatening consequences.

The complex physical and chemical processes involved in the maintenance of life can be disrupted with serious consequences by the continuation of bulimic and purging behaviors. Additional complications can affect an unborn fetus of a practicing bulimic or the infant of an active bulimic mother. Psychological problems can escalate to serious levels if untreated and interfere with the restoration of normal body functions.

How is bulimia treated?

Patients with bulimia present a variety of medical and psychological complications which are usually considered to be reversible through a multidisciplinary treatment approach. Treatment can be managed by either a physician, psychiatrist, or in some cases, a clinical psychologist. The extent of the medical complications generally dictates the primary treatment manager. A psychiatrist, with both medical and psychological training, is perhaps the optimum treatment manager.

Some patients may require hospitalization due to the extent of the medical or psychological complications. Others may seek outpatient programs. Still others may require only weekly counseling and monitoring by a practitioner. Stabilization of the patient's physical condition will be the immediate goal if the individual is in a life-threatening state. The primary goals of treatment should address both physical and psychological needs of the patient in order to restore physical health and normal eating patterns. The patient needs to identify internal feelings and distorted beliefs that led to the disorder initially. An appropriate treatment approach addresses underlying issues of control, self- perception, and family dynamics. Nutritional education and behavior management provides the patient with healthy alternatives to weight management. Group counseling or support groups can assist the patient in the recovery process as well. The ultimate goal should be for the patient to accept herself and lead a physically and emotionally healthy life. Restoration of physical and mental health will probably take time, and results will be gradual. Patience is a vital part of the recovery process. A positive attitude coupled with much effort on the part of the affected individual is another integral component to a successful recovery.


Bulimia At A Glance

- Bulimia (also called bulimia nervosa) is a psychological eating disorder.
- Bulimia is felt to be based on a person's dissatisfaction with their own body image.
- Bulimia is diagnosed according to five basic criteria.
- There are two types of bulimia: the purging and nonpurging types.
- The purging type regularly engages in self-induced vomiting or the misuse of laxatives, diuretics, or enemas.
- The nonpurging type engages in other inappropriate behaviors such as fasting or excessive exercise, rather than purging.
- Bulimia can have serious medical complications.
- The successful treatment of bulimia is often multidisciplinary involving medical and psychological approaches.
- The goals of treatment are to restore physical health and normal eating patterns.

Compulsive Eating Disorder Information [internet]


Taken from: http://www.brown.edu/Student_Services/Health_Services/
Health_Education/nutrition/ec_compulsiveeating.htm
(link is broken so it won't stretch the page, copy and paste it together)

What is it?

Compulsive overeating is characterized by uncontrollable eating followed by feelings of guilt and shame. It is different from bulimia in that it does not involve any purging. While it inevitably results in weight gain, it is also not to be confused with obesity. Not everyone who is overweight has an eating disorder.

What are the warning signs of compulsive eating?

- bingeing, or eating uncontrollably
- purging by strict dieting, fasting, vigorous exercise, vomiting or abusing
- using laxatives or diuretics in an attempt to lose weight
- using the bathroom frequently after meals
- preoccupation with body weight
- depression or mood swings
- irregular periods
- developing dental problems, swollen cheek glands, heartburn and/or bloating
- experiencing personal or family problems with alcohol or drugs


What are the physical complications of overeating?

- weight-related hypertension and/or fatigue
- nausea
- weight gain
- increase in risk of diabetes, high blood pressure, and some forms of cancer (for obese individuals only)

Why do it?

While people who compulsively overeat are usually very preoccupied with issues of food, eating, and weight, uncontrollable bouts of eating are an attempt to manage other hidden issues. That is, as a compulsive overeater, you use food to cope with stress, upset, emotional distress, and other problems (i.e., depression, anxiety, and low self-esteem). However, the negative feelings blocked by the overeating
are only momentarily avoided, as you inevitably feel guilty and shameful about the overeating.

How does it start?

Compulsive overeating generally has a gradual beginning, often starting in early childhood when eating patterns are formed. It usually starts very subtly, when a child turns to food whenever they were upset. Over time, you learn that food in fact will soothe the upset feelings. The destructive pattern continues as you do not learn to trust that feelings pass and that you are capable of self-soothing without food.

Why is it so hard to stop?

Like someone with bulimia, when you compulsively overeat, you usually try every way you can think of to stop. Often the attempt at control takes the form of rigorous dieting or living by inflexible standards of eating. While strict dieting may help intermittently with the weight gain, in the long run it doesn't do anything to remedy the emotional reasons for the compulsive overeating. Moreover, restrictive dieting is so depriving that it creates a situation of compounded desperation to eat. Therefore, dieting often backfires and just perpetuates the compulsive overeating.

Misunderstanding and prejudice

Compulsive overeating has only recently come to be taken seriously and straightforwardly in our culture. Prejudicial impressions remain very strong. With this kind of disordered eating, people are often stereotyped as lazy and gluttonous, or, at best, as having too big an appetite and lacking in willpower or self-control. Your pain is then overlooked not only by yourself, but also by other people.

Change

Recovery is completely possible for compulsive overeaters through a gradual process of lifestyle change and with the help of others. Along with the medical, psychological and nutritional assistance helpful to anyone with distorted eating habits, oftentimes groups such as Overeaters Anonymous are very useful.

Obesity Information [internet]


Obesity

Taken from: http://www.nlm.nih.gov/medlineplus/ency/article/
003101.htm
(link is broken so copy and paste it, I didn't want to stretch the page)

Definition

Obesity is also defined as a BMI (body mass index) over 30 kg/m2. Patients with a BMI between 25 and 29.9 are considered overweight, but not obese. See also diet and calories.

More than half of the U.S. population is overweight. But being obese is different from being overweight. An adult male is considered obese when his weight is 20% or more over the maximum desirable for their height; a woman is considered obese at 25% or more than this maximum weight. Anyone more than 100 pounds overweight is considered morbidly obese.

Considerations

Rates of obesity are climbing. An ominous statistic is that the percentage of children and adolescents who are obese has doubled in the last 20 years.

The basic nutritional needs of most people are approximately 2,000 calories a day for women and 2,500 for men. However, people who are very active, such as professional athletes or manual laborers, may need 4,000 or more. Pregnant women and nursing mothers require about 300-500 more calories/day than women who are neither pregnant nor nursing.

The body cannot store protein or carbohydrates, so excess protein or carbohydrate intake is converted to fat for storage. One pound of fat represents about 3,500 excess calories.

Obesity increases a person's risk of illness and death due to diabetes, stroke, coronary artery disease, hypertension, high cholesterol, and kidney and gallbladder disorders. Obesity may increase the risk for some types of cancer. It is also a risk factor for the development of osteoarthritis and sleep apnea.

Genetic factors play some part in the development of obesity -- children of obese parents are 10 times more likely to be obese than children with parents of normal weight.

Common Causes

- Consumption of more food than the body can use
- Excess alcohol intake
- Sedentary lifestyle

Home Care

See intentional weight loss.

To help prevent an increase in weight:

Avoid the following:
- excess alcohol consumption.
- stress
- depression
- boredom and frustration
- Avoid a sedentary lifestyle by increasing your activity level:
- Perform aerobic exercise for at least 30 minutes a day, 3 times a week
- Increase physical activity in general by walking rather than driving.
- Climb stairs rather than using an elevator or escalator.
- Reduce consumption of food that is high in fat and sugar.

For additional help in losing weight:

- Join a support group (see eating disorders - support group). Many people find it easier to follow a reduction diet and exercise program if they join a group of people with similar problems.

- Avoid over-the-counter drugs that claim to aid in weight loss -- most are ineffective, and some can be dangerous.

- Also, be sure to set realistic goals for weight reduction. A loss of 1 to 2.5 pounds a week may seem slow, but losing weight too fast often does not work. Weight lost quickly is usually regained quickly.

Call your health care provider if:

- You are unable to lose weight on your own.

What to expect at your health care provider's office

- Medical history will be obtained and a physical examination performed.

- Medical history questions documenting obesity in detail may include:

Time pattern
- Has there always (or since childhood) been a tendency to be heavy?
- Has the person been slender until recently, and then begun to gain weight?

Eating habits
- Has diet changed recently?
- Have eating habits changed?
- What percent of the daily calories are from fat?
- How many meals are eaten in a day? What type?
- How many snacks? What type?

Exercise habits
- Has activity level changed?
- Has there been a decrease in daily activity?

Other factors
- Is there an increase in emotional stress?
- Have you increased your alcohol consumption?
- What other symptoms are occurring at the same time?
- Skin fold measurements may be taken to assess body composition.
- Blood studies to test endocrine function may be performed.

Treatment:

Medications are usually not recommended to aid intentional weight loss. They often cause harmful side effects or adverse reactions. At best, the drugs control appetite only for short time periods and don't help change eating habits.

Gastric outlet stapling may be indicated for the morbidly obese. Your primary care provider may want to refer you to a general surgeon for more information about this.

If You Think You/Someone Else May Have an Eating Disorder [internet]


Questionnaire for those who think they may have an eating disorder/know someone who could have an eating disorder


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Taken from: http://kidshealth.org/teen/your_mind/friends/friend_eating_disorder.html


Signs of Eating Disorders

In our image-obsessed culture, it can be easy for teens (and adults, for that matter) to be critical of their bodies. Normal concerns about body image can cross the line and become eating disorders when a person starts to do things that are physically and emotionally dangerous — things that could have long-term health consequences.

Some people go on starvation diets and can become anorexic. Others go on eating binges and then purge their bodies of the food they've just eaten through forced vomiting, compulsive exercise, taking laxatives, or a combination of these (known as bulimia).

Although eating disorders like anorexia and bulimia are far more common in girls, guys can get them, too. So how do you know if a friend has an eating disorder? It can be hard to tell — after all, someone who's lost a lot of weight or feels constantly tired may have another type of health condition. But some of the signs that a friend may have an eating disorder include:

•Your friend has an obsession with weight and food (more than general comments about how many calories he or she eats in a day). It might seem like your friend talks about food, weight and being thin and nothing else.

•Your friend knows exactly how many calories and fat grams are in everything that he or she eats — and is constantly pointing this out.

•Your friend feels the need to exercise all the time, even when sick or exhausted.

•Your friend avoids hanging out with you and other friends during meals. For example, he or she avoids the school cafeteria at lunch or the coffee shop or diner where you usually meet on weekends.

•Your friend starts to wear big or baggy clothes. Lots of people wear baggy clothes as a fashion statement, but someone who wears baggy clothes to hide their shape might have other issues.

•Your friend goes on dramatic or very restrictive diets, cuts food into tiny pieces, moves food around on the plate instead of eating it, and is very precise about how food is arranged on the plate.

•Your friend seems to compete with others about how little they eat. If a friend proudly tells you she only had a diet soda for breakfast and half an apple for lunch, it's a red flag that she could be developing an eating disorder.

•Your friend goes to the bathroom a lot, especially right after meals, or you've heard your friend vomiting after eating.

•Despite losing a lot of weight, your friend always talks about how fat he or she is.

•Your friend appears to be gaining a lot of weight even though you never see him or her eat (people with bulimia often only eat diet food in front of their friends).

•Your friend is very defensive or sensitive about his or her weight loss or eating habits.

•Your friend buys or takes laxatives, steroids, or diet pills.

•Your friend has a tendency to faint, bruises easily, is very pale, or starts complaining of being cold more than usual (cold intolerance can be a symptom of being underweight).


What to Do

If a friend has these symptoms and you're concerned, the first thing to do might be to talk to your friend, privately, about what you've noticed. Tell your friend that you're worried. Be as gentle as possible, and try to really listen to and be supportive of your friend and what he or she is going through.

It's normal for people with eating disorder to feel guarded and private about their eating problems. Try not to get angry or frustrated. Remind your friend that you care.

People with eating disorders often have trouble admitting — even to themselves — that they have a problem. Trying to help someone who doesn't think he or she needs help can be hard. Many people feel successful and in control when they become thin, but those with eating disorders can become seriously ill and even die. If your friend is willing to seek help, offer to go with him or her to see a counselor or a medical expert.

If your concerns increase and your friend still seems to be in denial, talk to your parents, the school guidance counselor or nurse, or even your friend's parents. This isn't easy to do because it can feel like betraying a friend. But it's often necessary to get a friend the help he or she needs.

Eating disorders can be caused by — and lead to — complicated physical and psychological illnesses. You can support your friend by learning as much as you can about eating disorders. Your friend's body image and behavior may be a symptom of something else that's going on. Many organizations, books, websites, hotlines, or other resources are devoted to helping people who are battling eating disorders.

Being a supportive friend also means learning how to behave around someone with an eating disorder. Here are some ways to support a friend who is battling an eating problem:

•Try your best not to talk about food, weight, diets, or body shape (yours, your friend's, or even a popular celebrity's).

•Try not to be too watchful of your friend's eating habits, food amounts, and choices.

•Try not to make statements like, "If you'd just eat (or stop working out so much), you'll get better."

•Focus on your friend's strengths — that he or she has a great smile, is helpful and friendly, or good at math or art.

•Try to avoid focusing on how your friend looks physically.
Most important, remind your friend that you're there no matter what. You want to help him or her get healthy again. Sometimes you'd be surprised how asking simple questions such as "what can I do to help?" or "what would make you feel better?" can lead to a great conversation about how you can help your friend heal.

Resources [internet]

If you know of any more, please post and tell me, and I will add them to the list. 3nodding


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Looking Glass Foundation For Eating Disorders

Websites for Girls

Campaign for Real Beauty

Body Talk (.pdf) - Self-esteem and body image workshop form

Reserved.