How do people develop eating disorders?
In the last post, we saw how:
- There are diagnostic features that can point you in the direction of bulimia in a patient.
- Triggers that could bring about binging in those with these disorders are everywhere in the environment as seen in this post.
- Being mindful is a very helpful technique that helps with triggers whenever they appear.
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 Quora. 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.
Those who have Bulimia Nervosa or BN when compared to Anorexia Nervosa tend to do better. They tend to have better rates in terms of recovery and survival.
Those who do not get good treatment do not tend to get better and even if they do the changes are not profound.
One study showed that those who followed the treatment offered to them over 10 years got better with time. Those who got better made up 70% of those who were participating in the study while those who showed a decline in their symptoms made up 30%.
One factor that stood out was substance abuse’s relationship with the probability of the patients getting better.
40% of the patients who made full recovery were in good health on follow-up.
The mortality rate for BN is around 2%.
Those who have binge eating disorder tend to eat frequently large food sizes but they do not compensate like is seen in BN with exercising or with the use of drugs. They tend to hide to consume high-calorie meals. The person complains that do not have any control over their feeding.
This is the most common type of eating disorder. They make up to 50% o those who are obese seeking medical care and 50-75% of those with severe obesity whose BMI is greater than 40. It is seen more in females than in males.
Nobody knows why those who have this disorder indulge in these eating styles but they have been noted in times of stress and it is believed that eating this way helps them reduce anxiety.
Approximately half of the individuals with binge eating disorders are obese. Additionally,
obese individuals with binge eating disorder have an earlier onset of obesity than those without the disorder. Patients with binge eating disorder are also more likely to have an
unstable weight history with frequent episodes of weight cycling (the gaining or losing
of more than 10 kg). The disorder may be associated with insomnia, early menarche,
neck or shoulder and lower back pain, chronic muscle pain, and metabolic disorders.
The clinical features seen in these patients are that they eat quickly past the point of comfort, they eat large sizes of food even they are not hungry, they may have emotions of sadness or anger about their eating bouts and it happens once a week for about 3 weeks.
Close to 50% of those who have this disorder suffer from obesity. Those who have this disorder also tend to have obesity earlier in their lives than is seen in those without the disorder.
Those that have this disorder may go those episodes of gaining and losing weight if up to 10kg. This disorder is associated with early menstruation
Causes of Eating Disorders (Reaction post)
In Jenna's post, she narrates her ordeal with eating disorders and how it all started for her. She talks about pair group influence and how friends may start influencing the way a person thinks and how days may go by and the person may start seeing food differently. The exercise and exercise go from mild to severe as the food becomes less and less.
She explains that gradually she had to cut out even dinner and would go just water on a day-to-day basis or would take just broccoli for breakfast.
She explains that after a month of practising these habits it becomes more and more enticing to continue because of the compliment that you start getting. But all you have every day is just water, no food for days or hardly any and you keep going every day.
According to the Mayo Clinic, nobody is sure about the causes of eating disorders which is true about mental health conditions but there are biological, psychological and social factors that have been noted to be contributory.
Those who have first-degree relatives with eating disorders may end up having eating disorders themselves which leads scientists to believe that there are genes that might be playing a role in the cause of these conditions.
Psychologically some factors could play a role in the development of these disorders like it has been noticed that some of those who have these disorders tend to suffer from some other mental health problems like anxiety and depression.
A social factor that could lead to these conditions is factors like things as friends and family that encourage these eating habits consciously and unconsciously.
Other mental health conditions tend to be seen with eating disorders such as anxiety, depression and obsessive-compulsive disorder.
Some researchers believe that starvation and dieting may put a person at risk of eating disorders. They hypothesize that the neurochemical released during starvation tends to make an individual more prone to eating disorders or restrictive eating habits.
Treatment
The most effective way to treat Binge Disorders is with CBT. With CBT there have been noticeable reductions in the frequency of binging and the mental health disorders associated with it like depression. The issue with CBT is that the weight loss in these patients has not been very effective. Studies show however that when CBT and pharmacotherapy are used together, there appear to better result in terms of weight loss.
Particularly effective drugs are Selective Serotonin Reuptake inhibitors. Exercise has also been seen t be effective. Interpersonal Therapy is effective in dealing with the issues that may be leading to binge eating disorder but not the eating disorder.
Self-help discussion groups where people come together to discuss the issues surrounding binge eating disorder have been seen to have good results some examples are Overeater Anonymous. Some other organizations are also helpful for obesity like Weight Watchers.
Questions
- What did you learn about Eating Diorders?
Conclusion
- Binge eating disorders are a significant cause of obesity.
- The cause of the eating disorder can be narrowed down to the BioPsychoSocial model.
- CBT is the mains stay of treatment for dealing with Binge Eating disorder.
References
- Kaplan-Sadocks-Comprehensive-Textbook-Psychiatry
- Page demarcations made with Inkscape.org
- Mayo clinic