In the last post, we saw how:
- Bn can present with other disorders such as mood disoders.
- Injuries on the knocke are common presentation in those who have BN
- Self-help may be a viable form of therapy for those who have BN.
guess we’re not beating the bulimia allegations with my hand looking like this lol pic.twitter.com/MEivqH1cri
— 🥣✰ () November 28, 2022
Welcome to Medic Vibes, where we discuss mental health disorders and make sense of them. Dr Ebingo Kigigha is a medical doctor (aspiring psychiatrist) and creative person (illustration and music). This has been our routine for four consecutive months. This month will be dedicated to Eating Disorders. In the first month, we discussed Depression, and in the subsequent month, anxiety. We just finished with Schizophrenia.
In this post, we are looking at Tik Tok posts. To learn more just keep scrolling down. You can also skip to the key point of the post if you which or go to the conclusion to get the summary.
There is proof that those who have BN are of different types. Those who have binge disorders and do not purge tend to sufferer less from body image issues and do not have anxiety about food and eating. Those who have BN and do not purge are usually in the overweight and obese class of weight.
The bodies of those who have BN and purge functions when they binge id also different this is why those who have bulimia tend to be separated between those who purge and those who don’t.
Those who purge tend to use laxatives or may induce vomiting in themselves while those who don’t tend to use restrictive diets and over exercising.
Those who purge may have hypokalemia because of the continuous vomiting and they can have hyperchloremic alkalosis because of the use of laxatives. Because of the vomiting, they may have Mallory Weiss's tears.
Eating habits in Eating Disorders (Reaction post)
According to current statistics, as many as 10% of the population in America have an eating disorder, that’s about 30 million people. 20 million of which are women and 10 million of which are men. With such a high prevalence in America, it is very likely that someone over there may have these problems.
Those who have this disorder usually do not tell anybody about it and can hide it for a very long time even until it kills them.
They could have a change of diet that could be fatal to them. They may have eating restrictions(where they eat very little) or binge and purge disorder.
They typically will start out with diet or potion control and they take it to levels that are unhealthy. They will typically not be okay with their body image or their weight or both.
One very clear change is the change in their mood from before the disorder.
Anorexia is the most common type of eating disorder. These patients usually see themselves are overweight even though they are clearly underweight. They usually will weigh themselves as often as possible and will eat food in low caloric amounts. Among the mental illnesses, this one has the highest chance of fatality.
In bulimia, the patient will have the same problems with body image and body size they may they restrictive diet for a while but they are usually within normal weight, they may be underweight or overweight. Some literature differentiates them from Anorexia by the fact that they will have feelings of guilt when they binge eat or overeat and will try different means to compensate including self-induced vomiting.
Some literature will separate binge and purge disorders which are seen sometimes in both disorders and put them in a class of their own.
The American journal of psychiatry ranks it as the most deadly mental health disorder. Eating disorders are treatable but they need to be caught on as early as possible. This disorder usually starts to be seen as early as the teenage years. Eating disorders are the third most common chronic illness in teenage girls after asthma and obesity. They are not as common in adults but they can continue to affect the patient until they are adults. It is very important that the common symptoms of eating disorders are known by as many people as possible so they can be reported as soon as possible.
Sometimes it is not clear how the patient may be struggling with these features, It is also possible for a patient to have this disorder and look okay in terms of body weight. Some of them who binge may even get overweight.
If a person has an eating disorder here are some clinical features they may express.
They may reduce the variety in the food they eat, they usually d not like going to fast food places with family, they will usually reject food because they are not hungry at the time, they are the type to gym excessively and they go to the bathroom after eating.
They may also start wearing bigger clothes to make themselves look bigger, they tend to have dental issues because of the effects of gastric acid on the teeth, they may have issues menstruating because the body tries to conserve resources while starving, they may take laxatives to help them purge and they typically suffer from constipation.
They are very unobjective about tier assessment of their body Image.
The first step to helping a person with this disorder is to get them help as soon as possible.
Treatment
The broad clinical community agrees that CBT is the best form of therapy for those who suffer from BN. It is usually offered and monitored on clinic visits. The National Institute of Care and Excellence suggest that this form of therapy should be the first therapy offered to those who have BN. The same is the case for those who have binge disorders and it is the top three for those who have AN.
In one study two groups of 70 women were assessed who had BN, one group received 5 months with 20 sessions of CBT and the second group psychoanalytic therapy for 2 years weekly.
A majority of those who got better from the study were those got better were those who received CBT. There were fewer cases of binge eating disorders in these patients
In another study, CBT was compared with Interpersonal therapy which is also used for ED it had a 66% remission rate for those who had CBT. This result was even better over an extended period.
Questions
- What did you learn about Eating Diorders?
Conclusion
- There are different Subtypes of bulimia, particularly those who binge and purge and those that compensate with fasting or exercise.
- Those who have eating disorders tend to have abnormal habits towards food.
- CBT is the best form of therapy for those who suffer from eating disorders in general.
References
- Kaplan-Sadocks-Comprehensive-Textbook-Psychiatry
- Page demarcations made with Inkscape.org
- Spine-Health
- Eating Disorder Hope