EatingDisorders PDF
EatingDisorders PDF
EatingDisorders PDF
DISORDERS
NATIONAL INSTITUTE OF MENTAL HEALTH
eating
Disorders
National Institute of mental health
Table
of
contents
TWO what are eating disorders ?
two
The two main types of eating Eating disorders frequently
disorders are anorexia nervosa appear during adolescence or
and bulimia nervosa. A third young adulthood, but some
category is “eating disorders not reports indicate that they can
otherwise specified (EDNOS),” develop during childhood or later
which includes several variations in adulthood. Women and girls
of eating disorders. Most of these are much more likely than males
disorders are similar to anorexia to develop an eating disorder.
or bulimia but with slightly Men and boys account for an
different characteristics. Binge- estimated 5 to 15 percent of
eating disorder, which has re- patients with anorexia or bulimia
ceived increasing research and and an estimated 35 percent of
media attention in recent years, those with binge-eating disorder.
is one type of EDNOS.
Eating disorders are real, treat-
able medical illnesses with
complex underlying psychological
and biological causes. They
frequently co-exist with other
psychiatric disorders such as
depression, substance abuse, or
anxiety disorders. People with
eating disorders also can suffer
from numerous other physical
health complications, such as
heart conditions or kidney
failure, which can lead to death.
Eating disorders are treatable
diseases.
FOUR
Anorexia
nervosa
anorexia nervosa is Many people with anorexia see
characterized by emaciation, themselves as overweight, even
a relentless pursuit of thinness when they are starved or are
and unwillingness to maintain clearly malnourished. Eating, food
a normal or healthy weight, a and weight control become ob-
distortion of body image and sessions. A person with anorexia
intense fear of gaining weight, typically weighs herself or himself
a lack of menstruation among repeatedly, portions food care-
girls and women, and extremely fully, and eats only very small
disturbed eating behavior. Some quantities of only certain foods.
people with anorexia lose weight
Some who have anorexia re-
by dieting and exercising exces-
cover with treatment after only
sively; others lose weight by
one episode. Others get well but
self-induced vomiting, or misusing
have relapses. Still others have a
laxatives, diuretics or enemas.
more chronic form of anorexia,
in which their health deteriorates
over many years as they battle
the illness.
According to some studies, Many people with anorexia
people with anorexia are up also have coexisting psychiatric
to ten times more likely to and physical illnesses, including
die as a result of their illness depression, anxiety, obsessive
compared to those without behavior, substance abuse,
the disorder. The most common cardiovascular and neurological
complications that lead to death complications, and impaired
are cardiac arrest, and electro- physical development.
lyte and fluid imbalances.
Suicide also can result.
six
Treating anorexia
M
involves three components :
1. restoring the person to a healthy weight;
2. treating the psychological issues related to the eating
disorder; and
3. reducing or eliminating behaviors or thoughts that lead
to disordered eating, and preventing relapse.
eight
Bulimia
nervosa
bulimia nervosa is charac- and are intensely unhappy with
terized by recurrent and frequent their body size and shape.
episodes of eating unusually Usually, bulimic behavior is done
large amounts of food (e.g., secretly, because it is often
binge-eating), and feeling a lack accompanied by feelings of
of control over the eating. This disgust or shame. The binging
binge-eating is followed by a type and purging cycle usually repeats
of behavior that compensates several times a week.
for the binge, such as purging
Similar to anorexia, people with
(e.g., vomiting, excessive use of
bulimia often have coexisting
laxatives or diuretics), fasting
psychological illnesses, such as
and/or excessive exercise.
depression, anxiety and/or
Unlike anorexia, people with substance abuse problems. Many
bulimia can fall within the normal physical conditions result from
range for their age and weight. the purging aspect of the illness,
But like people with anorexia, including electrolyte imbalances,
they often fear gaining weight, gastrointestinal problems, and
want desperately to lose weight, oral and tooth-related problems.
Other symptoms include:
• chronically inflamed and sore throat
• swollen glands in the neck and below the jaw
• worn tooth enamel and increasingly sensitive and decaying
teeth as a result of exposure to stomach acids
• gastroesophageal reflux disorder
• intestinal distress and irritation from laxative abuse
• kidney problems from diuretic abuse
• severe dehydration from purging of fluids
ten
As with anorexia,
TREATMENT FOR BULIMIA
often involves a combination of options and
depends on the needs of the individual.
twelve
Psychotherapy, especially CBT, is
also used to treat the underlying
psychological issues associated
with binge-eating, in an individual
or group environment.
FDA WARNINGS ON
ANTIDEPRESSANTS:
Despite the relative safety and of warning on prescription drug
popularity of selective serotonin labeling. The warning emphasizes
reuptake inhibitors (SSRIs) and that children, adolescents and
other antidepressants, some young adults taking antidepres-
studies have suggested that they sants should be closely monitored,
may have unintentional effects on especially during the initial weeks
some people, especially adoles- of treatment, for any worsening
cents and young adults. In 2004, depression, suicidal thinking or
after a thorough review of data, behavior, or any unusual changes in
the Food and Drug Administra- behavior such as sleeplessness,
tion (FDA) adopted a “black box” agitation, or withdrawal from
warning label on all antidepres- normal social situations. However,
sant medications to alert the results of a comprehensive review
public about the potential in- of pediatric trials conducted
creased risk of suicidal thinking between 1988 and 2006 suggested
or attempts in children and that the benefits of antidepressant
adolescents taking antidepres- medications likely outweigh their
sants. In 2007, the FDA proposed risks to children and adolescents
that makers of all antidepressant with major depression and anxiety
medications extend the warning disorders. The study was partially
to include young adults up funded by the National Institute
through age 24. A “black box” of Mental Health.
warning is the most serious type
How are men AND
BOYS AFFECTED?
Although eating disorders Boys with eating disorders
primarily affect women and exhibit the same types of emo-
girls, boys and men are also tional, physical and behavioral
vulnerable. One in four preado- signs and symptoms as girls, but
lescent cases of anorexia for a variety of reasons, boys
occurs in boys, and binge-eating are less likely to be diagnosed
disorder affects females with what is often considered a
and males about equally. stereotypically “female” disorder.
fourteen
How are we working to
better understand and
treat eating disorders?
Researchers are unsure of imaging (MRI), may also lead
the underlying causes and to a better understanding of
nature of eating disorders. eating disorders.
Unlike a neurological disorder,
Neuroimaging already is used
which generally can be pinpoint-
to identify abnormal brain activ-
ed to a specific lesion on the
ity in patients with schizophrenia,
brain, an eating disorder likely
obsessive-compulsive disorder
involves abnormal activity dis-
and depression. It may also help
tributed across brain systems.
researchers better understand
With increased recognition
how people with eating disorders
that mental disorders are brain
process information, regardless
disorders, more researchers
of whether they have recovered
are using tools from both mod-
or are still in the throes of
ern neuroscience and modern
their illness.
psychology to better understand
eating disorders. Conducting behavioral or psy-
chological research on eating
One approach involves the study
disorders is even more complex
of the human genes. With the
and challenging. As a result,
publication of the human ge-
few studies of treatments for
nome sequence in 2003, mental
eating disorders have been
health researchers are studying
conducted in the past. New
the various combinations of
studies currently underway,
genes to determine if any DNA
however, are aiming to remedy
variations are associated with
the lack of information available
the risk of developing a mental
about treatment.
disorder. Neuroimaging, such as
the use of magnetic resonance
Researchers also are working
to define the basic processes of
the disorders, which should help
identify better treatments.
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NIH Publication No. 07-4901
Revised 2007