EDs

Public Service Pamphlet: Three Eating Disorders

Historical perspective: Although not formally called “eating disorders” until the 20th century, anorexia, bulimia, and binge eating have been recorded for quite some time. Ancient Romans occasionally gorged on food and vomited afterwards. Many religious saints deprived themselves of food as a means of self-abnegation, and anorexia was sometimes called “wasting disease” between the 17th-19th centuries (Deans, 2011). Binge eating is likely the most common of the three major eating disorders.

Biological Basis: There is some controversy over whether there is a biological basis for any of the three major eating disorders. Recent research shows that a hormone called estradiol has been indicted in some adolescent female cases of eating disorders (Grohol, 2010). Estradiol is a type of estrogen that releases into the body around puberty. There may also be a genetic component to eating disorders, as well as a neuropsychological one as well. However, research is varied on whether there are biological causes of eating disorders, or if eating disorders are behavioral or psychological in nature, only.

Causes and Risk Factors: Being female is certainly a risk factor for both anorexia and bulemia, as incidences of eating disorder in women far outnumbers cases of men. In terms of psychological risk factors, they differ depending on the type of eating disorder. With anorexia, sexual inhibition may be a risk factor. Perfectionism has also been deemed a risk factor in some cases (University of Maryland Medical Center, 2012). Avoidant personality disorder, obsessive-compulsive personality, and other disorders may also be risk factors. Causes and risk factors of binge eating are different from anorexia and bulimia, which is why binge eating is sometimes dealt with under the rubric of obesity rather than eating disorder.

Who is at affected: Anorexia and bulimia are more common among young females than any other group. Binge eating can affect anyone.

Symptoms and warning signs: Symptoms of both anorexia and bulimia include body dysmorphia (a warped sense of body; the feeling of being fatter than one actually is); compulsive exercising; and abnormal eating habits. Symptoms of binge eating can be similar to those of bulimia: evidence of food missing from the house; wrappers and packaging; and secret eating.

How is it distinguished from other similar/related conditions: The difference between anorexia and bulimia is that anorexia entails food deprivation. Bulimia entails binge eating, followed by a type of purge (usually vomiting). These eating disorders can be differentiated from normal loss of appetite by the length and duration of the symptoms, as well as the presence of other psychological symptoms. Binge eating is distinguished from bulimia because it does not entail a purge cycle. Sporadic binge eating may not be a sign of an eating disorder.

How is it diagnosed: Diagnosis of anorexia might begin with physiological measurements including body mass index, weight, and heart readings. Diagnosis of bulimia or anorexia might entail long sessions with psychologists, who use the DSM-IV to assess the individual. Binge eating disorder does not have a distinct DSM-IV classification but could be indicated by psychologists nonetheless as part of an overall diagnosis.

How does it progresses/stages: Anorexia can progress to being physically dangerous to the individual, as massive weight loss causes great stress on the body. Malnutrition and heart complications can arise. Bulimia can also lead to a number of physiological problems related to malnutrition, with the added complications of frequent purging such as eroded tooth enamel. Binge eating can results in unhealthy weight gain and obesity.

Treatment options: For bulimia, a combination of therapies is often advised. This may include individual counseling, group counseling, cognitive-behavioral therapy, and pharmaceuticals. The use of pharmaceuticals could be especially indicated when there is comorbidity with other psychological disorders such as anxiety and depression. For anorexia, pharmaceuticals may also be prescribed. Similarly, any person exhibiting symptoms of a binge eating disorder might see a doctor for possible signs of anxiety and depression. Medications can help resolve the underlying problem causing the behavior. However, with all three eating disorders, counseling and cognitive-behavioral therapy may preclude the need for medications. Alternative and complementary medicine interventions can also be helpful. These include meditation, yoga, and other forms of relaxation techniques. According to the Mayo Clinic (2012), acupuncture, massage, and mind-body therapies might also be helpful.

Hope for the Future: Progress has been made in the identification and treatment of all three of these eating disorders. Current research combines expertise in developing pharmacological interventions targeting underlying issues such as depression, with psychological treatment therapies such as art and music therapy. The use of complementary medicine also offers opportunities to explore the underlying causes of the three major eating disorders without resorting to potentially harmful medications.

Recommendations for Stakeholders: The best way to treat eating disorders in your community is to prevent them. Preventing eating disorders means raising awareness among parents and students. The target age for intervention should be pre-pubescent girls.

References

Deans, E. (2011). A History of Eating Disorders. Psychology Today. Retrieved online: http://www.psychologytoday.com/blog/evolutionary-psychiatry/201112/history-eating-disorders

Grohol, J.M. (2010). Eating disorders may have biological basis. PsychCentral. Retrieved online: http://psychcentral.com/news/2010/06/07/eating-disorders-may-have-biological-basis/14349.html

Kristeller, J.L. & Hallett, C.B. (1999). An exploratory study of a meditation-based intervention for binge eating disorder. Journal of Health Psychology 4(3).

Mayo Clinic. (2012) Eating disorders. Retrieved online: http://www.mayoclinic.com/health/eating-disorders/DS00294/DSECTION=treatments-and-drugs

University of Maryland Medical Center (2012). Eating disorders. Retrieved online: http://www.umm.edu/patiented/articles/who_develops_eating_disorders_000049_2.htm