Eating Disorders and Associated Factors

Eating Disorders

Eating Disorders: Pathological means of coping with various psychological issues, including anxiety, sadness, depression, trauma (especially), anger, and feelings of inadequacy (especially low self-esteem).
Distinction from Disordered Eating: Disordered eating encompasses behaviors such as fad diets and self-starvation but does not necessarily meet the criteria for eating disorders.
Causes: Eating disorders have no singular cause; they are complex conditions that involve both biological and environmental factors.
- Genetic Factors: There is no specific gene linked to eating disorders; however, family patterns play a role due to similar parenting styles and environmental influences.
- Temperament: Certain temperament traits, which can be identified in early childhood, may predispose individuals towards eating disorders.
- Perfectionism: Often viewed as a defense mechanism to exert control over chaotic life situations; includes obsessive-compulsive tendencies (not diagnosed as OCD) and is commonly seen among overachievers.

Childhood Experiences:
- Bullying (primarily focused on weight).
- Emotional and physical abuse.
- Parental criticism.
- Living in an unpredictable and uncontrollable home environment.
Cultural Influences:
- Diet Culture: Portrays certain foods as good or bad; ideally, it should be framed as healthy vs. unhealthy.
- Belief that willpower equates to self-worth (e.g., the perception that being obese is bad).
- Extreme emphasis on nutrition and exercise.
- Presence of family members with body image issues.
- Athletic cultures that stress weight management are particularly influential in disciplines like wrestling, dance, horse riding, and gymnastics.
- Modeling culture perpetuates thin ideals.
- Weight stigma associated with teasing and discrimination, especially in children, leading to binge-eating and/or restrictive behaviors.

Characterized by extreme food restriction and intense fear of gaining weight even when underweight.
Patients often experience body dysmorphia (seeing themselves as overweight) and may over-exercise.
Medical Implications:
- Most affected organ: the heart (potential damage in heart muscles, leading to tachycardia).
- Long-term consequences include osteoporosis (bone thinning, making bones brittle), electrolyte imbalances (which can lead to heart attacks or strokes), and possible cardiac arrest.
- Symptoms include constant feelings of cold and hunger.
Treatment:
- Inpatient treatment is often ineffectual; patients may find ways to subvert recovery.
- Cognitive Behavioral Therapy (CBT) is recommended as it focuses on altering negative self-perception regarding weight.
- Weight restoration: A crucial yet challenging part of treatment due to the patient's perception of increased weight as negative.
- No medication is a cure; only psychological and medical interventions apply.
- Success may involve SSRIs for anxiety management once medically stable.
Primarily affects women but men are also increasingly impacted.

Defined by recurrent binge eating episodes, followed by compensatory behaviors such as laxative use or excessive exercise.
Binge episodes occur at least once weekly for three months.
Medical Implications:
- Dentists commonly detect bulimia due to tooth damage from frequent purging.
- Physical symptoms include calluses and teeth marks on the hands due to forceful vomiting; possibly leading to esophageal damage and increased cancer risk from stomach acid exposure.
- Shares similar heart-related medical issues as anorexia nervosa.
Binge Eating Disorder:
- Involves consuming large quantities of food uncontrollably, usually triggered by negative emotions.
- Unlike bulimia, binge eating is not followed by purging; individuals generally do not eat to satisfy hunger but to cope with feelings of shame, guilt, or loss of control.
- Often associated with obesity, these patients may experience feelings of disgust toward their behavior but find temporary relief.

Eating disorders are classified as mental illnesses, not intentional nor attention-seeking behaviors.
Families often pursue treatment for loved ones, though patients may resist due to feelings of control derived from their disorder.

Weight loss medications (e.g., Ozempic) are increasingly used, but caution is required as they can exacerbate eating disorders.
Gastric bypass surgery: Generally reserved for obesity management but should not be prescribed for individuals with existing eating disorders due to the risk of misuse.
Societal perceptions favor thinness over heavier body types, further complicating recovery and acceptance of different body shapes.

The obesity rate is progressively increasing due to sedentary lifestyles and reliance on processed foods, with Saudi Arabia identified as the most obese nation, and the US and UK following closely.
Eating disorder treatments often center on CBT and SSRIs, addressing underlying mental health issues such as depression and anxiety associated with eating disorders.
Binge eating contributes to issues of obesity; overeating and feeling guilt lead to a vicious cycle of emotional distress.
Medical Concerns:
- Complications can include overworking the heart and lungs, leading to potential heart attacks.
- Increased stress and related conditions, such as type 2 diabetes, might arise due to obesity.