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It
seems as though everywhere you look these days people are dieting.
They are either
counting carbs, watching fats, only eating certain food combinations at
specific times of the day, or are following some other latest fad.
What happens when
someone takes their 'healthy eating plan' too far? How can you tell if
what started out as a healthy diet has turned into an obsession and
something that will lead to a decrease in health? Often it is a fine
line.
Eating disorders
come in many different forms and affect many different types of people.
Most people commonly associate eating disorders with those in appearance
related sports such as gymnastics, ballet dancing, and figure skating or
those who make their living by how they look such as models and
celebrities; however they can also affect many other people as well.
Everyday women who
are simply not happy with their bodies may turn to an eating disorder as
a way to feel in control of their life while also becoming more and more
popular with the males as well.
With males, some of
them suffer from the typical eating disorders where they want to be
thinner, however a more likely occurrence is for males to want to go the
other way and become obsessed with bulking up. This particular form is
more evident in the bodybuilding world more than anywhere else.
In this part of the
article, we will look at the first two types of eating disorder,
Anorexia Nervosa and Bulimia Nervosa.

Anorexia
Nervosa

Anorexia Nervosa is
characterized by a desire to become thinner where the person will go to
extreme means to achieve this by denying themselves of food. This form
likely starts out with the typical diet, where one is counting calories
and then just starts progressively eating less and less in an effort to
lose more weight.
Pretty soon they
find themselves existing on a mere salad and diet coke for the entire
day. A person with this disorder does not see their real appearance in
the mirror and usually sees someone much larger looking back at them,
almost as if they have lost touch with reality.
Symptoms
The common symptoms
that are associated with Anorexia Nervosa are:
-
A decrease
in body weight (usually characterized by a decrease of at least
25% of their previous weight)
-
Loss of
menstruation (in women)
-
Growth of
body hair on various parts of their body such as stomach and
back (lanugo)
-
Low blood
pressure
-
Slowed heart
beat
-
Feeling of
coldness
-
Numbness in
the hands and feet
-
Dizziness
(often due to low blood sugar)
-
Muscle loss
and weakening of the bones
-
Decreased
libido
-
Lack of
interest in activities they used to enjoy
-
Frequent
mood swings
-
Depression
-
Irregular
sleep patterns
-
Fear of
gaining weight
-
Lack of
energy
-
Constipation
If the disorder is
left to progress long enough, these symptoms can result:
-
Decreased
bone mass and density leading to osteoporosis and bone fractures
-
Menstrual
dysfunction leading to infertility
-
Brain
abnormalities (the brain will become damaged when it is deprived
of fuel (glucose) for too long)
-
Organ
malfunction
-
Eventually
death (10% of the cases are usually fatal)
Exerting
"Control"
Often however,
Anorexia Nervosa is not solely about body image or the desire to become
thinner. Many women use this disorder as a way to feel in control of
their lives.
They may feel that
they aren't doing what they would like to be doing with their careers or
relationships and feel that by being in control of their eating and
weight they gain a sense of accomplishment.
Escape
Mechanism
Others may use this
as a way to block out other areas of their lives that are bothering
them.
If they are so
focused on food and weight than they don't have to pay attention to the
real issues that are bothering them, therefore they are almost using the
disorder as an escape mechanism.
Denial
People with this
form of eating disorder are also the ones most likely to deny that there
is any type of problem. They learn to hide their disease very well so
that no one knows what's going on, and make up excuses as to why they
can't eat. They will also wear very baggy clothing so others cannot see
how thin they have become.
The sad thing is
that sometimes these individuals are reinforced for their behavior when
they initially start losing weight and are complimented on how they
look. This will serve to promote their disorder, pushing them to new
levels of starvation and a desire to continue to lose weight.
Treatment
Treatment for this
disorder is often a very lengthy and involved process. There needs to be
both nutritional and psychological counseling as both factors play an
important role.
Nutrition
Nutritionally, the
person needs to learn what it means to eat normal again and often needs
to re-introduce foods back into their diet.
They may have cut
out entire food groups in an effort to lose weight and will now be
scared to consume them once again. They need to be put on a meal plan
that is providing them with enough calories so that they can begin to
gain weight.
Often it will work
best to slowly increase their calories so it is more psychologically
tolerable to the patient, as they will be very frightened at first at
the thought of consuming more food again.
In some cases,
patients will be given liquid calories through a tube if they are
refusing to eat and they're problem is severe enough that they could
risk death if they lost any more weight.
Psychology
On the psychological
end of things, a counselor needs to sit down with the patient and
discuss what issues created the disorder in the first place.
-
Was it
pressure coming from someone else to fit a certain size
(this is often the case with athletes)?
-
Was it
the feeling of being out of control with their work or home
life?
-
Or was
it simply that they are trying to fit the media's image of
what constituted an 'ideal' body?
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Risk
Factors
Anorexia
is typically stereotyped as being a disease of teenage
females. However, in real-life, almost any individual can be
a sufferer, as even children as young as three have been
known to develop the disease.
While
anorexia may occur in individuals across the demographic
divides, it definitely appears to be far more prone to
developing among those in certain groups, such as:
·
Females
(95% of anorexia nervosa sufferers are females).
·
Those of
age 10 through 25.
·
Athletes;
especially swimmers, dancers, and gymnasts.
·
People
who are active in dancing, modeling or gymnastics.
·
People of
European racial descent.
·
Students
who are under heavy workloads.
· Those
who have suffered traumatic events in their lifetime such as
child abuse and sexual abuse.
·
Those
positioned in the higher echelons of the socioeconomic
scale.
·
The
highly intelligent and/or high-achievers.
·
Perfectionists. |

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By getting to the
route of the problem, the counselor and patient can work on ways to
reshape the persons thinking so they can learn to value themselves as a
person more and not just base their worth on how they look.
Relapse
One important point
to consider however is that for treatment to be most successful, the
patient must first be willing to admit that there is a problem.
If they are still in
the denial stage, chances are that they may gain the weight back,
however since the initial problem that caused the disorder is still
lingering, they will likely relapse once again.
If they are ready to
admit there is a problem though and are asking for help, then that shows
they are going to work towards getting better and will most likely not
want to venture down this path once again.

Bulimia
Nervosa

The next eating
disorder that we will look at is called Bulimia Nervosa.
This eating disorder
is slightly different from that of Anorexia Nervosa in that often the
patients can either be underweight or be of normal weight.
In Anorexia, a
patient has to be underweight to be clinically diagnosed. What happens
during this disorder however is that instead of starving themselves in
order to get thin, the bulimic purges their food after it has been
eaten.
This will ensure
that their body is not absorbing the calories in the food and thus
prevent them from gaining weight. Often, this disorder comes in the form
of binge and purge, so the individual will eat enormous amounts of foods
at one time and then just go to the bathroom and throw it up or use a
laxative.
Often, while
engaging in this act, the bulimic tends to experience a great deal of
loss of control, which leads to feelings of guilt and worthlessness,
thus compounding their problem.
In order to be
classified as a bulimic, the person must have a minimum average of two
binge eating periods per week for a period of at least three months.
Symptoms
Characteristics of
people with Bulimia Nervosa are:
-
Swollen
throat and glands
-
Stomach
pains
-
Mouth
infections
-
Irregular
periods
-
Dry skin
-
Difficulty
sleeping
-
Damaged
teeth (from stomach acid)
-
Uncontrollably eating large quantities of food
-
Being sick
after eating
-
Numerous
trips to the bathroom after meals
-
Moods swings
-
Depression
-
Controlling
behavior
-
Dehydration
and electrolyte imbalances
-
Internal
bleeding
-
Rupture of
the esophagus
Treatment
Treatment for people
of this disorder is very dependant on what type of bulimic the person
is.
Trigger Factor
The initial step in
treatment is identifying the trigger factor that makes this person want
to purge.
Weight Control
Is it their way of
controlling their weight, just as an anorexic starves herself?
If this is the case
than you would need to approach treatment in a similar fashion as that
with anorexia. You would need to find out the underlying reasons why
this person feels the need to be so thin and work on changes those
thought processes.
At the same time you
would want to get them on a sensible diet so they can learn to eat
comfortably without throwing up their food.
Stress, Loss Of
Control
If on the other hand
they eat normally most of the time but have certain times when they
binge and then purge, the treatment goal would be locating this trigger
and finding ways to avoid it. Triggers can be things like
stress,
a feeling of out of control, or a certain food or situation.
It might be a matter
of avoiding a certain type of food altogether, if that can simply be
done or else trying to find a way for the patient to focus themselves
and remain in control when they encounter a situation that would
normally lead to a binge, such as stress relief techniques, self talk,
or relaxation techniques. Unfortunately, although bulimia is not usually
as serious as anorexia, the recovery rate is usually lower than that of
anorexics, and their chances of relapse are quite higher.
More Common In Athletes
This type of eating
disorder may be more common in athletes that have to diet for certain
events such as bodybuilders and fitness models. The reasoning for this
is because they eat normally for most of the year however then undergo a
period where they are severely restricting themselves.
Because they are not
used to this they have a hard time with it psychologically and they may
find themselves going through periods where they eat whatever it is they
are denying themselves of, feel guilty about 'messing up their progress'
and then resort to either being sick or using laxatives to get it out of
their system.
For this reason, it
is more preferable for someone involved in these sports to maintain a
healthy diet year round and not let themselves put on so much bodyfat in
the off season so that way they are not forced to deprive themselves so
much when it comes time to get ready to compete once again.

Conclusion

In the next part of
this discussion, we will talk about the final eating disorder,
binge-eating disorder, and discuss eating disorders in the male
population.
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