In the last post, we saw how:
- Anorexia usually presents with being underweight while bulimia can be within the normal weight range.
- To help the patient you must stay focused on them getting better while being empathetic
- Patients do better when they arrive early for treatment in the course of the condition.
What is the best way to help a friend who is suffering from an eating disorder?
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 Everything you need to know about. 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 the best treatment results for eating disorders are those who are diagnosed as soon as the condition starts and at an earlier age. This is why is good to visit the primary healthcare hospital as a family. This will help the whole family and for a condition like anorexia, it can be noted as early as possible.
In anorexia, there is an element of denial of symptoms and it can be hard for parents to notice symptoms as they arise. In anorexia, the person can not stay within the expected body weight.
The person uses these habits to deal with emotional trauma and it is expressed as a need to lose weight. They achieve this by restricting diet and overcompensating with exercise.
In bulimia, they tend to have the inability to control their appetite and this is shown by overeating and purging as a compensatory mechanism. These patients do not lose weight like those who are anorexic. They may be with the normal weight for age and height.
These two disorders are known for their body image dysmorphia where they have a distorted self-image.
Everything You need to know about eating disorders
From our understanding over the month of study, these are a group of mental health problems that is conditions that are characterised by poor feeding and eating habits that have adverse physical and social effect.
Mayo Clinic in their definition adds the persistent nature of this condition as they typically can go on for months or even years.
The complications of this disorder lead to the death of the patient or a significant reduction in the quality of life.
Girls in their teenage years and younger women are more likely to suffer from these conditions although in recent times as noted by Healthline, we are seeing a rise in the number of cases in young boys and men of specific vocations and sexual orientations.
In this post, we want to introduce you to eating disorders as a hidden killers and explain why you should be aware of their features.
Young women
It is widely accepted that social pressure is a present theme in eating disorders as has been shown over time with increased globalisation with the internet. Images of models are now accessible to a larger audience and many have taken this to be the cause of the rising prevalence of eating disorders.
A study done in Nigeria showed a 15% prevalence of the attributes and precipitating factors of eating disorders. This value is about 10% higher than was found 20 years ago in the prevalence of anorexia.
Teenage girls are more impressionable and also more critical about their body image and for this reason, tend to use feeding as a coping mechanism for emotional stressors.
In certain professions like modelling and ballet, women are put under this pressure and tend to develop eating disorders while in men wrestlers were more likely to develop eating disorders.
There are also character traits that are more common in anorexics such as perfectionism and a high level of endurance.
Men
The rising incidence among men has been attributed by some to be related to the rise in LGBTQ+ acceptance. It was previously more common also to find anorexic men in the gay community in earlier studies as noted by Kaplan.
Other specified feeding or eating disorder
Eating disorders such as anorexia and bulimia are more well-known but are not the most common. The reason for their popularity may be due to the complications of these conditions.
These include night eating syndrome, purge disorder and sub-threshold anorexia
For anorexia, it is more common to find those who have this condition looking underweight although it is no longer part of the DSM criteria for the condition, it appears to be more memorable. The same is the case for those who are overweight and bulimic.
The most common eating disorder however is another specified feeding or eating disorder and those who suffer from this condition do not fit into other classes of eating disorders
In Anorexia nervosa (originally derived from Greek meaning extreme starvation of nervous cause) there are 3 main features self-induced starvation, fear of gaining weight and the effects of starvation.
Bulimia nervosa has episodes of binge eating followed by weight gain control through unhealthy means and psychological self-reprimanding guilt or depression. Those who suffer from bulimia may be within the normal weight for height or may be overweight.
Causes
Nobody is very sure of the cause of eating disorders but as with mental health problems, there are biological, psychological and social factors. For example in anorexia twin studies have revealed that there might be a genetic component. Bulimic patients also respond to Selective Norepinephrine Reuptake Inhibitors.
Psychological traits such as perfectionism are also seen in those with anorexia while those who have bulimia tend to suffer from anxiety.
Socially we have seen that certain jobs tend to have anorexics such as modelling in women and wrestling in men.
Clinical features
The features seen in eating disorders depend on the type of eating disorder. Anorexia makes people their body image, avoid gatherings where food will be served, and restrict the size and the type of food eaten.
People who have eating disorders may use drugs such as laxatives or use exercising as a means to compensate for eating bigger than they wanted to. This is seen in anorexia and bulimia but anorexics are successful at achieving weight loss.
The features of an eating disorder can be very difficult to spot because of the tendency to hide their symptoms from those around them. They may lose weight in a very short space of time and this can be a giveaway for a condition like anorexia but in bulimia, there might be weight gain.
It has also been noted that more than 50% of those who have night eaters syndrome are obese.
Seeing a doctor
If you or your loved one is going through these changes described above it can be helpful to reach out to a primary healthcare centre so you can be seen by a physician. Those who have the best response to therapy are those who start treatment early in life and those who start treatment early in the course of the condition.
The doctor's responsibility is to see if these claims are true and to refer you to a specialist if they are or monitor you over time.
The specialist will make their assessment and will commence treatment which will include cognitive behavioural therapy or family therapy or a mixture of both.
Some drugs such as antidepressants are effective for managing symptoms of bulimia but for anorexia, there has been no effective medical treatment.
It is very difficult for those who have eating disorders to reveal their symptoms to people and when they do they are met with criticism. It is important to be aware of this while helping a person who is going through this.
Complications
Those who suffer from eating disorders may have a condition complicated by starvation and its effects. The features will similar to starvation from any other cause. There is weight loss, hair changes, sunken eyes, dizziness, hypotension and signs of electrolyte derangement and vitamin deficiency.
Electrolyte (hypokalemia) derangement is particularly more common in those who have purge disorder or those with bulimia who use vomiting as a compensatory mechanism for binging.
There may be plaques on the back of the hand from eliciting vomiting in these patients.
Questions
- What did you learn about Eating Disorders?
Conclusion
Eating disorders are a matter of global health concern and their incidence is increasing. Knowledge of this disorder is a step in the right direction to help curb this noticeable rise and to end its stigma.
In this regard, we all have a part to play in making sure this knowledge is more common than the disorder itself.
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References
- Kaplan-Sadocks-Comprehensive-Textbook-Psychiatry
- Page demarcations made with Inkscape.org
- Healthline
- NCBI 1
- NCBI 2