Overview of Eating Disorders

Overview of Eating Disorders

• Definition: Eating disorders are mental health conditions characterized by harmful eating behaviors used to cope with various emotions such as anxiety, sadness, trauma, anger, or feelings of inadequacy and low self-esteem.

  • Distinction: These disorders are different from disordered eating practices, such as fad diets or occasional self-starvation.

Causes and Risk Factors

• Complexity of etiology: No single cause exists; the development of eating disorders is influenced by a mix of genetic, biological, environmental, and psychological factors.

  • Genetic predisposition: No specific gene causes eating disorders, but familial patterns and similar parenting styles are noted.

  • Experiences in childhood:

  • Bullying, particularly regarding weight, can contribute to the development of eating disorders.

  • Experiences of emotional and physical abuse.

  • Parental criticism and an unpredictable home environment are noted.

  • Societal pressures:

  • Diet culture and weight stigma can lead to harmful comparisons and behaviors.

  • The labeling of foods as “good” or “bad” further entrenches harmful eating behaviors.

  • Family connections:

  • Family members with body image issues or eating disorders can increase vulnerability.

  • Emphasis on weight in competitive fields such as athletics, dance, and modeling can contribute.

  • Cultural influences:

  • Cultural ideals that discriminate against people with higher body weights affect self-esteem, especially among children.

  • Personal traits:

  • Associated traits include perfectionism, obsessive-compulsive tendencies (not necessarily full OCD), and overachievement.

Types of Eating Disorders

Anorexia Nervosa

• Characteristics:

  • Marked by extreme food restriction and intense fear of gaining weight.

  • Persistent body dysmorphia even at low body weight; individuals may engage in excessive exercise.

• Affected organs:

  • The heart is particularly affected, leading to muscle damage and rapid heartbeat, increasing the risk of cardiac events.

• Long-term effects include:

  • Osteoporosis (loss of bone density).

  • Electrolyte imbalances posing risks for strokes.

  • Constant feelings of cold and hunger.

Bulimia Nervosa

• Definition:

  • Characterized by recurrent binge eating followed by compensatory behaviors like vomiting, laxative use, or excessive exercise at least once a week for three months.

• Medical implications:

  • Dental issues arising from stomach acid (tooth erosion); physical signs such as teeth marks and calluses on hands; esophageal damage which can be a pre-cancer sign.

  • Risks similar to anorexia: heart complications and electrolyte imbalances.

  • Dentists often first to notice issues due to erosion of teeth.

Binge Eating Disorder

• Definition:

  • Involves uncontrolled episodes of excessive eating, performed in secret, without purging.

• Triggers and emotions:

  • Often triggered by negative feelings, leading to guilt, shame, and discomfort.

  • Frequently associated with obesity and can develop or reappear after weight loss surgeries.

• Coping behaviors:

  • Often linked to rewards associated with food, rooted in family or cultural rituals.

Societal and Psychological Dimensions

• Eating disorders are classified as mental illnesses rather than choices or attention-seeking behaviors.

• Societal perceptions:

  • Thinness is often perceived positively, reinforcing unhealthy attitudes and practices.

• Global obesity trends:

  • On the rise due to sedentary lifestyles and consumption of highly processed foods.

• Onset patterns:

  • Most eating disorders manifest during adolescence, but they may also begin in conjunction with stressful transitions like attending college.

Treatment Approaches

• Effective treatments emphasize cognitive and behavioral changes rather than concentrating solely on weight.

• Therapeutic modalities:

  • Cognitive Behavioral Therapy (CBT) is commonly used along with SSRIs to manage symptoms of depression, anxiety, self-esteem issues, and compulsions.

  • Weight restoration is essential yet challenging for patients due to fear regarding weight gain, often viewed as a lack of willpower.

• Other interventions:

  • Use of medication (e.g., Ozempic) and weight loss surgeries (gastric bypass) are effective only when underlying psychological issues are addressed; otherwise, there's a risk of failure and misuse.

  • Residential care faces challenges, as patients may teach each other harmful behaviors, akin to pro-eating disorder websites.

Obesity and Associated Health Issues

• Health ramifications of obesity:

  • Leads to cardiovascular strain, sleep apnea (difficulty breathing during sleep), high cholesterol, type 2 diabetes, and joint/bone problems due to excess weight.

• Dual aspect of obesity:

  • It is both a physiological and psychological issue closely tied with eating disorders, commonly overlapping with depression to create a cycle of psychological distress and disordered eating.