An eating disorder is a mental disorder defined by abnormal eating habits that negatively affect a person's physical or mental health. They include a binge eating disorder in which people eat in large quantities in a short time, anorexia nervosa in which people eat very little and thus have a low weight, bulimia nervosa in which people eat a lot and then try to break away from food, pica where people eat non-food items, impaired stimuli in which people vomit food, impaired food intake or restrict where people have a lack of interest in food, and a bunch of other eating or eating disorders. Anxiety disorders, depression, and substance abuse are common among people with eating disorders. This disorder does not include obesity.
The cause of eating disorder is unclear. Both biological and environmental factors seem to play a role. Idealization of thinness culture is believed to contribute. Eating disorders affect about 12 percent of dancers. Those who have experienced sexual abuse are also more likely to develop eating disorders. Some disorders such as pica disorder and rumination occur more frequently in people with intellectual disabilities. Only one eating disorder can be diagnosed at any given time.
Treatment can be effective for many eating disorders. This usually involves counseling, proper diet, normal amount of exercise, and reduction of efforts to eliminate food. Hospitalization is sometimes necessary. Drugs can be used to help some related symptoms. In five years about 70% of people with anorexia and 50% of people with bulimia recovered. Recovery from eating disorders is not very clear and is estimated to reach 20% to 60%. Anorexia and bulimia increase the risk of death.
In developing countries eating disorders affect about 1.6% of women and 0.8% of men in a given year. Anorexia affects about 0.4% and bulimia affects about 1.3% of young women in a given year. Up to 4% of women have anorexia, 2% have bulimia, and 2% have overeating disorders at some point in time. Anorexia and bulimia occur almost ten times more often in women than in men. Usually they begin in late childhood or early adulthood. The level of other eating disorders is unclear. The rate of eating disorders appears to be lower in developing countries.
Video Eating disorder
Classification
Bulimia nervosa is a disorder characterized by overeating and cleansing, as well as an excessive evaluation of one's self esteem in terms of weight or shape. Cleaning can include self-induced vomiting, excessive exercise, and use of diuretics, enemas, and laxatives. Anorexia nervosa is characterized by extreme food restriction and excessive weight loss, accompanied by the fear of becoming obese. Extreme weight loss often causes women and girls who have started menstruating to stop experiencing menstrual periods, a condition known as amenorrhea. Although amenorrhea used to be a necessary criterion for the disorder, it is no longer necessary to meet the criteria for anorexia nervosa because of its exclusive nature for male, post-menopausal, or non-menstrual sufferers for other reasons. DSM-5 specifies two subtypes of anorexia nervosa - a limiting type and a binge/purge type. Those suffering from the limiting type of anorexia nervosa restrict food intake and not engage in binge eating, while those suffering from the binge/purge type lose control of their feeding at least occasionally and can compensate for this binge episode. The most striking difference between the types of anorexia nervosa binge/purge and bulimia nervosa is one's weight. Those diagnosed with anorexia nervosa binge/purge type are underweight, whereas those with bulimia nervosa may have a weight that is in the range from normal to obese.
ICD and DSM
This eating disorder is specified as a mental disorder in a standard medical manual, such as in ICD-10, DSM-5, or both. Anorexia nervosa (AN), characterized by a lack of healthy weight maintenance, an obsessive fear of gaining weight or refusal to do so, and unrealistic perceptions, or not recognizing seriousness, is currently low weight. Anorexia can cause menstruation to stop, and often cause bone loss, loss of skin integrity, etc. It greatly depresses the heart, increasing the risk of heart attack and associated heart problems. The risk of death is greatly increased in individuals with this disease. The most pressing factor researchers are starting to notice is that it may not only be a matter of pride, social, or media, but it can also be related to biological and/or genetic components. DSM-5 contains many changes that better represent patients with this condition. The DSM-IV required amenorrhea (absence of menstrual cycle) to be present to diagnose patients with anorexia. This is no longer a requirement in DSM-5. Bulimia nervosa (BN), characterized by repeated binge eating followed by compensatory behaviors such as cleansing (self-induced vomiting, feeding into vomiting, excessive laxative/overuse, or excessive exercise). Fasting and excessive exercise can also be used as a cleansing method after a party.
More
- Compulsive overeating (COE), in which individuals are accustomed to eating large quantities of food rather than binging, as is common in eating disorders.
- Prader-Willi syndrome
- Diabulimia, characterized by intentional manipulation of insulin levels by diabetics in an effort to control their weight.
- Maintenance of food, which is characterized by deviant eating behavior of children in foster care. Orthorexia nervosa, a term used by Steven Bratman to characterize an obsession with a "pure" diet, in which people develop an obsession by avoiding unhealthy food to the point where it interferes with one's life.
- A selective eating disorder, also called picky food, is an extreme sensitivity to how something feels. Someone with SED may or may not be a supertaster.
- Drunkorexia, commonly characterized by restricting dietary intake to the purpose of reserving food calories for alcoholic calories, exercising excessively to burn the calories consumed from drinking, and drinking excessive alcohol to clean up previously consumed food.
- Pregorexia, characterized by extreme diet and excessive exercise to control pregnancy weight gain. Lack of nutrition during pregnancy is associated with low birth weight, coronary heart disease, type 2 diabetes, stroke, hypertension, cardiovascular disease risk, and depression.
- Gourmand syndrome, a rare condition that occurs after damage to the frontal lobes, results in an obsessive focus on good food.
Maps Eating disorder
Signs and symptoms
Symptoms and complications vary according to the nature and severity of eating disorders:
Some of the physical symptoms of eating disorders are weakness, fatigue, sensitivity to cold, reduced male beard growth, decreased erection on waking, reduced libido, weight loss and growth failure. An obscure hoarseness may be a symptom of an underlying eating disorder, as a result of acid reflux, or ingress of gastric acid into the laryngoesophageal tract. Patients who cause vomiting, such as those with anorexia nervosa, eating binge or those with bulimia nervosa-type cleansing are at risk for acid reflux. Polycystic ovary syndrome (PCOS) is the most common endocrine disorder to affect women. Although often associated with obesity this can occur in individuals with normal weight. PCOS has been associated with binge eating and bulimia behavior. Other possible manifestations are dry lips, burning tongue, parotid gland swelling, and temporomandibular disorders.
Pro-Ana subculture
Pro-ana refers to the promotion of behaviors associated with eating disorders anorexia nervosa. Some websites promote eating disorders, and can provide a means for individuals to communicate to maintain eating disorders. Members of this website usually feel that their eating disorder is the only aspect of chaotic life that they can control. This website is often interactive and has a discussion board where individuals can share strategies, ideas, and experiences, such as diet and exercise plans that achieve very low weight. A study comparing personal web-blogs that are a pro-feeding disorder with those focused on recovery found that pro-feeding disorder blogs contain languages ​​that reflect lower cognitive processes, use a more enclosed writing style, contain fewer emotional expressions and less social references, and more focus on food-related content rather than blog recovery.
Psychopathology
Psychopathology of eating disorders centered around body image disorders, such as concerns with weight and shape; self-esteem is too dependent on weight and form; fear of gaining weight even when weight is lacking; rejection of how severe the symptoms and distortions in the way the body is experienced.
Cause
The cause of eating disorder is unclear.
Many people with eating disorders also have a dysmorphic disorder of the body, changing the way a person sees himself. Research has found that a high proportion of individuals diagnosed with body dysmorphic disorder also have some type of eating disorder, with 15% of individuals having anorexia nervosa or bulimia nervosa. The relationship between body dysmorphic disorder and anorexia begins with the fact that BDD and anorexia nervosa are characterized by preoccupation with physical appearance and body image distortion. There are also many other possibilities such as environmental, social and interpersonal issues that can promote and sustain these diseases.} Also, the media is often blamed for the increased incidence of eating disorders due to the fact that the media's description of the slim physical ideal forms of people like models and celebrities motivates or even forcing people to try to achieve the slimness itself. The media are accused of distorting reality, in the sense that the people depicted in the media are naturally thin and thus do not represent normality or unnatural by forcing their bodies to look like the ideal image by placing excessive pressure on themselves to find a certain way.. While past findings have illustrated the causes of eating disorders as environmental studies, especially psychological, environmental, and sociocultural, new evidence has found that there is a genetic aspect/common inherited cause of eating disorders.
Genetics
A number of studies have suggested a possible genetic predisposition to eating disorders as a result of Mendel's inheritance. Twin studies have found little examples of genetic variances when considering the different criteria of both anorexia nervosa and bulimia nervosa as endophenotypes contribute to overall disorder. Genetic relationships have been found on chromosome 1 in some family members of an individual with anorexia nervosa. A person who is a first-degree relative of someone who has had an eating disorder today is seven to twelve times more likely to have an eating disorder itself. Twin studies also show that at least some of the susceptibility to developing eating disorders can be inherited, and there is evidence to suggest that there is a genetic locus that exhibits susceptibility to developing anorexia nervosa. Approximately 60% of cases of eating disorders are caused by biological and genetic components. Another case is due to external reasons or developmental problems. There are also other neurobiological factors associated with emotional reactivity and impulsivity that can lead to binging and purging behavior.
Epigenetic: The epigenetic mechanism is the way in which environmental effects alter gene expression through methods such as DNA methylation; this is independent and does not change the underlying DNA sequence. They are inherited, but can also occur throughout lifetime, and potentially reversible. Dysregulation of dopaminergic neurotransmission because of the epigenetic mechanism has been implicated in various eating disorders. One study has found that "epigenetic mechanisms may contribute to known changes of ANP homeostasis in women with eating disorders." Other candidate genes for epigenetic studies on eating disorders include leptin, pro-opiomelanocortin (POMC) and brain-derived neurotrophic factors (BDNF).
Psychological
Eating disorders are classified as Axis I disorders in the Diagnostic and Statistical Manual of Mental Health Disorders (DSM-IV) published by the American Psychiatric Association. There are various other psychological problems that may be a factor of eating disorders, some meeting the criteria for a separate Axis I diagnosis or personality disorder encoded by Axis II and thus considered comorbid for diagnosed eating disorders. Axis II disorders are subtyped into 3 "clusters": A, B and C. Causality between personality disorders and eating disorders has not been fully established. Some people have previous disorders that can increase their susceptibility to developing eating disorders. Some develop it afterward. The severity and type of eating disorder symptoms have been shown to affect comorbidity. The DSM-IV should not be used by ordinary people to diagnose themselves, even when used by professionals there is considerable controversy over the diagnostic criteria used for various diagnoses, including eating disorders. There is controversy over various editions of DSM including the latest edition, DSM-V, due in May 2013.
Cognitive attention bias problem
Biased attention can have an effect on eating disorders. Much research has been done to test this theory.
Personality characters
There are various traits of childhood personality associated with the development of eating disorders. During adolescence, these traits can become more intensive due to various physiological and cultural influences such as hormonal changes associated with puberty, stress associated with the growing demands of maturity and socio-cultural influences and perceived hopes, especially in related areas with body image. Eating disorders have been linked to a fragile sense of self and with mental disorders. Many personality traits have a genetic component and are strongly inherited. Maladaptive levels of certain properties can be obtained as a result of anoxic or traumatic brain injury, neurodegenerative diseases such as Parkinson's disease, neurotoxicity such as lead exposure, bacterial infections such as Lyme disease or parasitic infections such as Toxoplasma gondii as well as hormonal influences. While the study continues through the use of various imaging techniques such as fMRI; these properties have been shown to originate in different regions of the brain such as the amygdala and prefrontal cortex. Disorders in the prefrontal cortex and executive function system have been shown to influence feeding behavior.
Celiac disease
People with gastrointestinal disorders may be at higher risk of developing irregular eating habits than the general population, especially restrictive eating disorders. Anorexia nervosa association with celiac disease has been found. The role played by gastrointestinal symptoms in the development of eating disorders seems rather complicated. Some authors report that unresolved symptoms before the diagnosis of gastrointestinal disease can create food reluctance in these people, causing a change in their diet. Other authors report that larger symptoms throughout the diagnosis lead to greater risk. It has been documented that some people with celiac disease, irritable bowel syndrome or inflammatory bowel disease are unaware of the strict importance of following their diet, choosing to consume their triggering foods to promote weight loss. On the other hand, individuals with good food management can develop anxiety, food aversion and eating disorders due to concerns about cross-contamination of their food. Some authors suggest that medical professionals should evaluate the presence of unrecognized celiac disease in all people with eating disorders, especially if they exhibit gastrointestinal symptoms (such as decreased appetite, abdominal pain, bloating, distension, vomiting, diarrhea or constipation), weight loss , or failure of growth; and also routinely ask celiac patients about weight or body shape problems, diet or vomiting to control weight, to evaluate the possibility of eating disorders, especially in women.
Environmental effects
Child abuse
Child abuse that includes physical, psychological and sexual abuse, as well as neglect has shown about three times the risk of eating disorders. Sexual harassment occurs about twice the risk of bulimia; However, this relationship is less clear for anorexia.
Social isolation
Social isolation has been shown to have a damaging effect on one's physical and emotional health. Those who are socially isolated have higher rates of mortality in general than individuals who have established social relationships. This effect on real mortality is increased in those with a pre-existing medical or psychiatric condition, and has been specifically noted in cases of coronary heart disease. "The magnitude of risk associated with social isolation is proportional to smoking and other major biomedical and psychosocial risk factors." (Brummett et al. )
Social isolation can inherently stress, suppress, and awaken anxiety. In an effort to correct this depressed feeling, one can engage in emotional eating in which food serves as a source of comfort. The loneliness of social isolation and the associated inherent stress thus has been involved as a triggering factor in the binge eating as well.
Waller, Kennerley and Ohanian (2007) argue that both eating-throwing and restriction are emotional suppression strategies, but they are used only at different times. For example, restrictions are used to prevent any emotional activation, while vomiting is used after emotion is activated.
Parental influence
The influence of parents has proven to be an intrinsic component in the development of children's eating behavior. These influences are manifested and shaped by various diverse factors such as family genetic predisposition, dietary choices as determined by cultural or ethnic preferences, body shape and diet of parents, level of involvement and expectations of their children's eating behavior as well as interpersonal relationships between parents and children. This is in addition to the general psychosocial climate of the home and the presence or absence of a stable maintenance environment. It has been shown that maladaptive parents' behavior has an important role in the development of eating disorders. Regarding the more subtle aspects of parental influence, it has been shown that diet is shaped in early childhood and that children should be allowed to decide when their appetite is satisfied as early as two years of age. A direct relationship has been shown between obesity and the pressure of parents to eat more.
Coercive tactics in the diet has not been proven efficacious in controlling the eating behavior of children. Compassion and attention have been shown to affect the level of child fatigue and their acceptance of a more varied diet.
Adams and Crane (1980), have shown that parents are affected by stereotypes that affect their perception of their child's body. Delivering these negative stereotypes also affects the child's own image and satisfaction. Hilde Bruch, a pioneer in the field of studying eating disorders, insists that anorexia nervosa is common in girls who are high achievers, obedient, and always try to please their parents. Their parents have a tendency to over-control and fail to encourage emotional expression, preventing girls from accepting their own feelings and desires. Young women in this arrogant family lack the ability to be independent of their families, but realizing the need for, often leads to rebellion. Controlling their food intake can make them feel better, as it gives them a sense of control.
Peer pressure
In various studies such as those conducted by The McKnight Investigators, peer pressure proved to be a significant contributor to the body image concerns and attitudes toward eating among the subjects in their teens and early twenties.
Eleanor Mackey and coauthor, Annette M. La Greca from the University of Miami, studied 236 adolescent girls from a public high school in southeast Florida. "The concern of adolescent girls about their own weight, about how they appear to others and their perception that their colleagues want them to be thin is significantly related to weight control behaviors," says psychologist Eleanor Mackey from Children's National Medical Center in Washington and author the main study. "That's very important."
According to a study, 40% of girls aged 9 and 10 years have tried to lose weight. Such diets are reportedly affected by peer behavior, with many of those on a diet reporting that their friends are dieting. The number of dieting buddies and the number of friends who put pressure on them to diet also plays an important role in their own choices.
Elite athletes have significantly higher levels of eating disorders. Female athletes in sports such as gymnastics, ballet, diving, etc. are found to be at highest risk among all athletes. Women are more likely than men to get an eating disorder between the ages of 13-30. 0-15% of those with bulimia and anorexia are male.
Cultural pressures
There is a cultural emphasis on the pervasive thinness in western society. A child's perception of external pressure to achieve the ideal body represented by the media predicts dissatisfaction with body image of children, dismorphic disorders of the body and eating disorders. "The cultural pressure on men and women to be 'perfect' is an important predisposing factor for the development of eating disorders." Furthermore, when women of all races base their evaluation of themselves on what is considered the ideal body of culture, the incidence of eating disorders increases. Feeding disorders become more common in non-Western countries where thinness is not seen as ideal, suggesting that social and cultural stress is not the only cause of eating disorders. For example, the observation of anorexia in all regions of the non-Western world indicates a "non-cultural" disturbance as once thought. However, studies of bullemia levels suggest that it may be culturally bound. In non-Western countries, bulimia is less common than anorexia, but non-Western countries where observed can be said to have been or may have been influenced or exposed to Western culture and ideology.
Socioeconomic status (SES) has been seen as a risk factor for eating disorders, presuming that having more resources allows for individuals to actively choose to diet and lose weight. Several studies have also shown an association between increased body dissatisfaction with increased SES. However, once high socioeconomic status is achieved, this relationship weakens and, in some cases, does not exist anymore.
The media play a major role in how people perceive themselves. Countless ads and magazine ads portray thin celebrities like Lindsay Lohan, Nicole Richie, Victoria Beckham and Mary Kate Olsen, who seem to get nothing but attention from their performances. Society has taught people that being accepted by others is necessary by all means. Unfortunately this leads to the belief that to adapt a person must see in a certain way. Television beauty competitions like the Miss America Competition contribute to the idea of ​​what it means to be beautiful because competitors are evaluated based on their opinions.
In addition to socioeconomic status is considered a cultural risk factor as well as the world of sports. Athletes and eating disorders tend to go hand in hand, especially sports where weight is a competitive factor. Gymnastics, horseback riding, wrestling, body building, and dancing are just a few that fall into this weight-dependent sport category. Eating disorders among individuals who participate in competitive activities, especially women, often lead to physical and biological changes associated with their weight that often mimic the prepubertal stage. Often when a woman's body changes, they lose their competitiveness which leads them to take extreme measures to maintain a younger body shape. Men often struggle with binge eating followed by excessive exercise while focusing on building muscle rather than losing fat, but the goal of getting muscle is as much as eating disorders as obsessed with thinness. The following statistics are taken from the book Susan Nolen-Hoeksema, (ab) normal psychology , showing the approximate percentage of athletes who struggle with eating disorders by sport category.
- Aesthetic sports (dancing, figure skating, gymnastics) - 35%
- Heavy dependent sports (judo, wrestling) - 29%
- Endurance sports (biking, swimming, running) - 20%
- Technical sports (golf, high jump) - 14%
- Sports ball game (volleyball, football) - 12%
Although most of these athletes develop eating disorders to maintain their competitiveness, others use exercise as a way to maintain their weight and figure. It's just as serious as organizing your food intake for the competition. Although there is a wide variety of evidence showing at which point the athlete is challenged with eating disorders, studies show that regardless of the level of competition all athletes are at higher risk for developing non-athlete eating disorders, especially those who participate in sports where thinness is a factor.
Pressure from the community is also seen in the homosexual community. Homosexual men are at greater risk of eating disorders than heterosexual men. In gay culture, the muscle benefits from social and sexual desires as well as strength. These pressures and ideas that other gay men may want a thinner or muscular partner can cause eating disorders. The higher the symptoms of eating disorder symptoms, the more attention is given to how other people perceive them and the more frequent excessive exercise sessions. A high level of body dissatisfaction is also associated with external motivation for work and old age; However, having a thin and muscular body occurs in younger homosexual men than older ones.
It is important to be aware of some of the limitations and challenges of many studies that attempt to examine cultural, ethnic, and SES roles. For starters, most cross-cultural studies use the definition of DSM-IV-TR, which has been criticized as reflecting Western cultural biases. Thus, assessments and questionnaires can not be established to detect some cultural differences associated with various disorders. Also, when looking at individuals in areas potentially influenced by Western culture, several studies have tried to gauge how much an individual has adopted mainstream culture or retained the traditional cultural values ​​of the area. Finally, the majority of cross-cultural studies of eating disorders and body image disorders occur in Western countries and not in the countries or regions examined.
Although there is much influence on how a person processes their body image, the media does play a major role. Along with the media, the influence of parents, peer influences, and self-efficacy beliefs also play a big role in the individual's view of themselves. The way the media presents images can have lasting effects on individual perceptions of their body image. Eating disorders are a world problem and while women are more likely to be affected by eating disorders, it still affects both sexes (Schwitzer 2012). The media affecting eating disorders is either indicated by positive or negative light, then has the responsibility to be cautious when promoting images that project an ideal that turns a lot into an eating disorder to achieve.
To try to overcome unhealthy body image in the fashion world, by 2015, France passed a law requiring a healthy model by doctors to participate in a fashion show. It also requires a retractable image to be marked like that in a magazine.
There is a connection between "thin ideal" social media content and body dissatisfaction and eating disorders among young adult women, especially in the Western Hemisphere. New research shows "internalization" of distorted images online, as well as a negative comparison among young adult women. Most of the research is based in the US, UK, and Australia, this is the place where the thin ideal is strong among women, as well as the struggle for the "perfect" body.
In addition to media exposure, there is an online "pro-eating disorder" community. Through personal blogs and Twitter, this community promotes eating disorders as a "lifestyle", and constantly sends photos of skinny bodies, and tips on keeping skinny. Hashtag "#proana" (pro-anorexia), is the product of this community, as well as images that promote weight loss, marked by the term "lightening". According to social comparison theory, young women have a tendency to compare their appearance with others, which can produce negative views of their own body and change eating behavior, which in turn can develop irregular eating behavior.
The initial diagnosis should be made by a competent medical professional. "Medical history is the most powerful tool for diagnosing eating disorders" (American Family Physician). There are many medical disorders that resemble eating disorders and comorbid psychiatric disorders. All organic causes must be set aside before the diagnosis of eating disorders or other psychiatric disorders. In the past 30 years, eating disorders have become increasingly prominent and uncertain whether changes in presentations reflect the correct improvement. Anorexia nervosa and bulimia nervosa are the most obvious subgroups of a wider range of eating disorders. Many patients come with subthreshold expressions of two major diagnoses: others with different patterns and symptoms.
Medical
Diagnostic examinations usually include a complete medical and psychosocial history and follow a rational and formative approach to diagnosis. Neuroimaging using fMRI, MRI, PET and SPECT scans has been used to detect cases where lesions, tumors or other organic conditions have been a single cause or contributory factor in eating disorders. "Right frontal intracerebral lesions with their close relationship with the limbic system may be responsible for eating disorders, therefore we recommend performing a cranial MRI in all patients with suspected eating disorders" (Trummer M et al. 2002). ), "Intracranial pathology should also be considered but it is definitely a diagnosis of early onset anorexia nervosa.2 Second, neuroimaging plays an important part in diagnosing early anorexia nervosa, both from clinical and prospective studies". (O'Brien et al. 2001). Psychological
After ruling out the organic cause and initial diagnosis of an eating disorder made by a medical professional, a trained mental health professional helps in the assessment and treatment of psychological components underlying eating disorders and comorbid psychological conditions. Doctors conduct clinical interviews and can use various psychometric tests. Some are general in nature while others are designed specifically for use in the assessment of eating disorders. Some common tests that can be used are Hamilton Depression Rating Scale and Beck Depression Inventory. Longitudinal studies show that there is an increase in the likelihood that a young adult woman will develop bulimia because of their current psychological distress and as people get older and mature, their emotional problems are changed or resolved and then the symptoms decline.
Differential diagnosis
There are some medical conditions that can be misdiagnosed as a primary psychiatric disorder, complicating or delaying treatment. It may have a synergistic effect on conditions that mimic eating disorders or eating disorders are diagnosed correctly.
- Lyme's disease is known as a "great imitator", as it can present as a variety of psychiatric or neurological disorders including anorexia nervosa.
- Gastrointestinal diseases, such as celiac disease, Crohn's disease, peptic ulcers, eosinophilic esophagitis or non-sheath gluten sensitivity, among others. Celiac disease is also known as a "great imitator", as it may involve multiple organs and cause various non-gastrointestinal symptoms, such as psychiatric and neurological disorders, including anorexia nervosa. Addison's disease is a disorder of the adrenal cortex that causes a decrease in hormone production. Addison's disease, even in subclinical form can mimic many of the symptoms of anorexia nervosa.
- Gastric adenocarcinoma is one of the most common forms of cancer in the world. Complications because these conditions have been misdiagnosed as eating disorders.
- Hypothyroidism, hyperthyroidism, hypoparathyroidism and hyperparathyroidism may mimic some of the symptoms, may occur simultaneously with, disguised or aggravated eating disorders.
- Seropositive toxoplasma: even in the absence of symptomatic toxoplasmosis, exposure to toxoplasma gondii has been associated with changes in human behavior and psychiatric disorders including comorbidities with eating disorders such as depression. In the case study reported, the response to antidepressant treatment increased only after adequate treatment for toxoplasma.
- Neurosyphilis: It is estimated there may be up to a million cases of untreated syphilis in the US alone. "This disease can present with psychiatric symptoms only, psychiatric symptoms that can mimic other psychiatric illnesses". Many possible manifestations appear unusual. Up to 1.3% of short-term psychiatric acceptance may be due to neurosyphilis, with a much higher rate in the general psychiatric population. (Ritchie, M Perdigao J,)
- Dysautonomia: various disorders of the autonomic nervous system (ANS) can cause a variety of psychiatric symptoms including anxiety, panic attacks, and depression. Dysautonomia usually involves the failure of sympathetic or parasympathetic components of the ANS system but may also include excessive ANS activity. Dysautonomia can occur in conditions such as diabetes and alcoholism.
Psychological disorders that may be confusing with eating disorders, or being comorbid with one:
- Emetophobia is an anxiety disorder characterized by a great fear of vomiting. A person suffering can develop strict food hygiene standards, such as not touching food with their hands. They can be socially withdrawn to avoid situations that, according to their perception, can make them vomit. Many who suffer from emetophobia are diagnosed with anorexia or self-starvation. In the case of severe emetophobia, they can drastically reduce their dietary intake.
- Phagophobia is an anxiety disorder characterized by a fear of eating, usually triggered by a bad eating experience such as choking or vomiting. People with this disorder may present with pain complaints when swallowing.
- Body dysmorphic disorder (BDD) is listed as a somatoform disorder affecting up to 2% of the population. BDD is characterized by excessive reflection of actual or perceived physical defects. BDD has been uniformly diagnosed among men and women. While BDD has been misdiagnosed as anorexia nervosa, it also occurs in 39% comorbid cases of eating disorders. BDD is a chronic and debilitating condition that can lead to social isolation, major depression and suicidal ideas and attempts. Neuroimaging studies to measure responses to facial recognition have shown activity especially in the left hemisphere in the left lateral prefrontal cortex, the lateral temporal lobes and the left parietal lobe showing a hemispheric imbalance in information processing. There have been reported cases of BDD development in 21-year-old men after a brain inflammatory process. Neuroimaging suggests a new atrophy in the frontotemporal region.
Prevention
Prevention aims to promote healthy development before the occurrence of eating disorders. It also aims to identify early eating disorders before it is too late to be treated. Children as young as age 5-7 are aware of the cultural message of body image and diet. Prevention comes bringing this issue to light. The following topics can be discussed with young people (as well as teenagers and young adults).
- Emotional Bites: a simple way to discuss emotional eating is to ask the children about why they might eat other than hungry. Talk about more effective ways to cope with emotions, emphasizing the value of sharing feelings with trusted adults.
- Say No to Teasing: Another concept is to stress that it is wrong to say painful things about the size of another person's body.
- Body Talk: emphasizes the importance of listening to one's body. That is, eat when you are hungry (not starving) and stop when you are satisfied (not filled). Children intuitively understand these concepts.
- Fitness Comes in All Sizes: educates children about the genetics of body size and normal changes that occur in the body. Discuss their fears and hopes about growing bigger. Focus on wellness and balanced diet.
Internet and modern technology provide new opportunities for prevention. On-line programs have the potential to increase the use of prevention programs. The development and practice of prevention programs through on-line resources makes it possible to reach a wide range of people at minimal cost. Such an approach can also make prevention programs more sustainable.
Treatment
Treatment varies by type and level of eating disorders, and usually more than one treatment option is used. There is no good treatment for eating disorders, which means that the current outlook on treatment is primarily based on clinical experience. Family doctors play an important role in the initial treatment of people with eating disorders by encouraging those who are also reluctant to see a psychiatrist. Treatment can occur in a variety of different settings such as community programs, hospitals, day programs, and groups. The American Psychiatric Association (APA) recommends a team approach to the treatment of eating disorders. Team members are usually registered psychiatrists, therapists and dietitians, but other doctors may be included.
That said, some treatment methods are: Cognitive behavioral therapy (CBT), which postulates that one's feelings and behaviors are caused by their own thoughts rather than external stimuli such as others, situations or events; The idea is to change the way a person thinks and reacts to a situation even if the situation itself does not change. See Cognitive behavioral treatment of eating disorder.
- Acceptance therapy and commitment: a kind of CBT
- Cognitive Remediation Therapy (CRT), a set of cognitive exercises or compensatory interventions designed to improve cognitive function.
There are several studies on the cost-effectiveness of various treatments. Treatment can be expensive; due to limitations in health care coverage, hospitalized people with anorexia nervosa may be depleted while still underweight, resulting in relapse and rehospitalization.
For children with anorexia, the only established treatment is the behavior of family medicine. For other eating disorders in children, however, there is no established treatment, although family treatment behaviors have been used in treating bulimia.
Results
Estimates of the results are complicated by the non-uniform criteria used by various studies, but for anorexia nervosa, bulimia nervosa, and binge eating disorders, there seems to be general agreement that full recovery rates are in the 50% to 85% range, with larger proportions. people who experience at least partial remission. The results of eating disorders (ED) vary among cases. For many, it can be a lifetime struggle or can be overcome in a few months. In the United States, twenty million women and ten million men experience eating disorders at least once in their lives. The mortality rate for those with anorexia nervosa is 5.4 per 1,000 persons per year. Approximately 1.3 deaths are due to suicide. Someone who has or has been in an inpatient room has a mortality rate of 4.6 per 1000. Of individuals with bulimia nervosa about 2 people per 1,000 people die per year and among those with EDNOS about 3.3 per 1,000 people die per year.
- Miscarriages: Pregnant women with Binge Eating Disorder have been shown to have a greater likelihood of having a miscarriage compared with other pregnant women with other eating disorders. According to a study conducted, of a group of pregnant women evaluated, 46.7% of pregnancies ended in miscarriage in women diagnosed with BED, with 23.0% in control. In the same study, 21.4% of women diagnosed with Bulimia Nervosa had a pregnancy that ended in miscarriage and only 17.7% of the controls.
- Relapse: A person who gets remissions from BN and EDNOS (Eating an Unspecified Disorder) risks falling back to the habit of self-injury. Factors such as high stress related to their work, community pressure, and other stressful events on a person can prompt a person back to what they feel will alleviate the pain. A study tracked a select group of people diagnosed with BN or EDNOS for 60 months. After 60 months of completion, the researchers noted whether the patient had relapsed or not. The results found that the probability of someone previously diagnosed with EDNOS had a 41% chance of relapse; someone with BN has a 47% chance.
- Mounting insecurity: People who show signs of anxiety attachments are likely to have difficulty communicating their emotional status and difficulty finding effective social support. Signs that a person has adopted these symptoms include not showing recognition to their caregiver or when he or she is feeling ill. In clinical samples, it is clear that in the pre-treatment phase of patient recovery, the symptoms of more severe eating disorders are directly related to higher attachment anxiety. The more these symptoms increase, the more difficult it is to achieve a reduction in eating disorders before treatment.
Symptoms of Anorexia Nervosa include an increased risk of osteoporosis. This disease causes an individual's bones to become brittle, weak, and low-density. Thinning hair and dry hair and skin are also very common. The heart muscles will also begin to change if no treatment is caused to the patient. This causes the heart to have an abnormally slow heartbeat along with low blood pressure. Heart failure becomes a key consideration when this starts to happen. The muscles throughout the body begin to lose their strength. This will cause the individual to start feeling faint, sleepy, and weak. Along with these symptoms, the body will begin to grow a layer of hair called lanugo. The human body does this in response to the lack of heat and insulation due to low body fat percentage.
Symptoms of bulimia nervosa include heart problems such as irregular heartbeat that can lead to heart failure and death can occur. This is due to electrolyte imbalance which is the result of binge processing and constant cleaning. The probability of gastric rupture is increased. Gastric rupture is when there is a sudden rupture of the stomach lining that can be fatal. Acid contained in vomit can cause rupture in the esophagus and tooth decay. Consequently, for laxative abuse, irregular bowel movements can occur simultaneously with constipation. Injuries along the lining of the stomach called gastric ulcers begin to appear and the likelihood of developing pancreatitis increases.
Any eating symptoms include high blood pressure, which can lead to heart disease if left untreated. Many patients recognize elevated cholesterol levels. The possibility of being diagnosed with gallbladder disease increases, which affects one's digestive tract.
Epidemiology
Eating disorders result in approximately 7,000 deaths per year in 2010, making them the mentally ill with the highest mortality rates.
One study in the United States found a higher rate in transgendered students.
Economy
- The total cost in the US for hospital treatment involving eating disorders increased from $ 165 million in 1999-2000 to $ 277 million in 2008-2009; this is a 68% increase. The average cost per person discharge with eating disorder increased 29% over a decade, from $ 7,300 to $ 9,400.
- For a decade, hospitalizations involving eating disorders increased among all age groups. The greatest increase occurred among those aged 45 to 65 years (88% increase), followed by hospitalization among people younger than 12 years (72% increase).
- The majority of people with eating disorders are women. During 2008-2009, 88% of cases involved women, and 12% were male. The report also showed an increase of 53% of hospitalizations for men with a primary diagnosis of eating disorders, from 10% to 12% for a decade.
See also
- Weight phobia
References
External links
- Eating disorders in Curlie (based on DMOZ)
Source of the article : Wikipedia
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