The main reason for eating disorders is that the feelings and thoughts related to food are disturbing to the person in serious dimensions. Dieting behavior is a common stimulant leading to the development of eating disorders. Excessive obsession with food, weight, and appearance in the body affects health, relationships and daily activities. Eating Disorders are not only related to food and weight. Physical symptoms seem to be front-line, but they go along with serious psychiatric problems. A resulting eating disorder is an external solution to the inner living complexity.
The causes of eating disorders are not fully known. It is believed that biological and psychosocial factors play a role together in etiology. The underlying causes of eating disorders; low self-esteem, depression, feeling of loss of control, worthlessness, identity confusion, problems in family communication.
Although it seems to affect adolescents and young women in general, it can be an eating disorder in every age and sex. According to the Academy for Eating Disorders (AED), 10 million women and 1 million male individuals in the United States are estimated to have eating disorders. Eating disorders seen in men, in contrast to the predictions, have doubled in the last 10 years. Eating disorders are psychiatric disorders that cause significant physical health problems, as well as increased morbidity and increased risk of death.
- 1 Types of Eating Disorders
- 2 Eating Disorders Treatment
Types of Eating Disorders
In the criteria published by the American Psychiatric Association (APA) in 2013 (DSM 5), Eating Disorders are finally classified as:
- Anorexia Nervosa,
- Bulimiya Nervoza,
- Compulsive Eating Disorder (Defined for the first time),
- Eating disorder not otherwise specified (EDNOS)
Anorexia Nervosa (AN)
Anorexia nervosa patients are usually; low self-esteem, critical and perfection. Even though they are weak at dangerous times, they feel “fat” and when they look in the mirror they see themselves on the desired weight. She is extremely afraid of getting fat and getting fat. They deny that they have problems with their eating behavior in the early stages of the disease, but food, food and weight control have become obsessed with them.
Some anorexia nervosa patients go into the cycle of overeating and then have a very limited diet and excessive exercise, self-emotional or laxative (diuretic) behavior. In most cases, other psychiatric disorders such as anxiety, panic, obsessive-compulsive disorder, alcohol and substance abuse may accompany the eating disorder.
The diagnostic criteria of the anorexia nervosa are:
- To be able to provide physical health according to age and height, be expected to be less than 85% of the expected weight or be under the expected weight in the growth process,
- Being afraid of being overweight or getting fat, even though the expected weight is well below,
- Denial of thoughts and beliefs about body weight or structure, denial of body weight or shape by self assessment, or denial despite the fact that the weight is too low,
Symptoms of anorexia nervosa eating disorder
The following symptoms are anorexia symptoms.
- Unable to regl,
- Bone fragments or fractures due to calcium loss,
- Breaks in hair and nails,
- Skin foundation and skin cream,
- Anemia, muscle breakdown, heart problems due to weakness in the heart,
- Excessive constipation,
- Low blood pressure, slow breathing and low pulse rate,
- Body temperature falls,
- Depression, decline in perception ability, slowing down movements.
Bulimia Nervosa (BN)
Bulimia nervosa patients consume too much food during their eating seasons. Often they can choose very high calorie foods with high sugar, carbohydrate and fat ratios, eat very fast, sometimes eat without eating. During eating seasons, the patients feel themselves out of control. After the attack: hunger, self-exertion, excessive use of laxative or diuretic, excessive exercise, or a combination of all of these behaviors. He usually makes bulimic behaviors secretly because he has a sense of disgust or shame. The vomit after each meal of the patient also brings medical problems. These are answers of the “what is bulimia” question.
The diagnostic criteria of the bulimia nervosa are:
1.The following repetition:
◦Consuming too much food normally over a period of 2 hours,
◦Feeling of loss of control during the shooting incident,
2. The application of compensatory behaviors (such as vomiting) once a week to prevent the purchase of cheeses,
3.It is affected by body weight or shape without reason,
4.To be different from eating anorexia nervosa.
- Chronic fried and injured throat,
- Swelling of salivary glands and glands under the chin,
- Cheeks and face swelling and a “squirrel-like” appearance,
- Due to the contact of the stomach acids, the dissolution of tooth minerals and tooth decay,
- Continuous vomiting causes deterioration of the stomach lid and reflux,
- Bowel incontinence and problems due to laxative use,
- Kidney diseases due to urine remover drugs,
- Problems related to fluid loss.
Compulsive Eating Disorder / Binge Eating
A patient with a compulsive eating disorder loses control over eating. Unlike bulimia nervosa disease, it does not compensate for eating behavior (vomiting, exercising, and starving). At the same time, guilt, embarrassment, and distress caused by excessive eating lead to the same life of the same evolutionary cycle again.
As a result, the weight of these patients is usually slightly above normal or over normal. Obese patients have especially cardiovascular diseases and high blood pressure risk.
The diagnostic criteria of the compulsive eating disorder are:
- To live binge eating episodes while the following people are repeating together:
◦ Under normal conditions and time, any individual will eat much more than they can eat, eat in a short time (for example, every 2 hours)
◦ Feeling of loss of control during the attack (eg unable to stop eating or how much you have eaten)
2. Compulsive eating episodes should include at least 3 of the following:
◦ Eating faster than normal,
◦ Until you feel saturated at an uncomfortable level,
◦ Although you do not feel physically hungry, eat excessive amounts,
◦ Ashamed to see the amount of their cakes, and therefore,
◦ Feeling depressed or guilty after a meal,
- Compulsive eating episodes should occur at least once a week for 3 months,
- In compensatory behavior (vomiting, laxative use, enema) after a compulsive eating disorder.
Eating Disorders Treatment
Eating Disorders indicate an inseparable integral link between mental and physical health. In order for physical health to be continuous, the mental state must also be corrected, and the same is true for the opposite. So the first step in treating Anorexia Nervosa patients is to bring the weight to a healthy level; In bulimia nervosa patients, the first step is to prevent eating and vomiting seizures. However, in order to be able to travel in this treatment, it is first necessary to solve the underlying emotional problems that cause the patient to become ill or worsen his or her illness.
Most commonly used method of eating disorder treatment is psychotherapy. Psychotherapy is absolutely necessary for people with eating disorders to learn and understand the thoughts, feelings and behaviors that trigger their illnesses. At the same time, the use of certain medications along with psychotherapy and nutritional counseling has been shown to be effective in the treatment of this disease. In the treatment of eating disorders, General Medical Care, Nutrition Counseling, Psychiatric Treatment and Psychotherapy Support Programs should be carried out together.
FAQ and answers about binge eating
1-What are Eating Disorders? Is it a psychiatric disorder?
Eating Disorders is a group of diagnoses in which psychiatric disorders such as anorexia nervosa, bulimia nervosa, and recent binge eating disorder are included. These illnesses are spiritual and somatic signs seem to be frontal but they are associated with serious mental problems.
2-What is anorexia nervosa a psychiatric disorder?
Basic symptoms in anorexia nervosa; desire to have a weak body, extreme fear from weight gain, disorientation in body image and menses. The patient develops special behaviors in order to lose weight. Approximately half of the patients lose weight by reducing all food intake further. Some patients exercise extensively. The other half of the patients apply strict diet, occasionally lose control, binge eat, and then vomit. Patients can also take medicines such as laxatives (diarrhea), diuretics (water throwers) to reduce the weight gain of the foods they are taking. As a result, the patient has weakened to a degree that threatens his health.
3-What is a disease of bulimia nervosa?
Bulimia nervosa is a table of eating disorders where excessive eating habits and subsequent vomiting are the forerunners. Since the patient wants to have a weak body again, the patient has to resort to various ways to get rid of the culinary effects such as anorexia nervosa. However, unlike this table, the patient is mildly overweight or normal body weight.
4 – How often are eating disorders seen? Are you seen in men?
It is reported that the rate of anorexia nervosa in young girls is one percent and that of bulimia nervosa is one percent. It is rarely seen in men. In clinical cases, male to female ratio is 1/10.
5 – What are the causes of eating disorders?
No specific cause for eating disorders is known. If the onset age of anorexia nervosa is taken into account, it may be appropriate to explain the disease with adolescent changes and inability to adapt to these changes. The fact that these diseases are seen more clearly in women emphasizes the importance of feminine psychology in the development of the disease. Social changes also play a role, especially in the development of bulimia nervosa.
6-How does today’s social and cultural changes affect eating disorders?
Current descriptions for the development of these disorders are multifaceted, emphasizing that dietary behavior is a common stimulus leading to the development of eating disorders. In modern societies it is acceptable to have a fine body. The majority of those who voluntarily diet are aiming to be more attractive. Another group of those who voluntarily diets are those who are in competition in business life such as mannequins, dancers, ballerinas, athletes, jockeys, and are at high risk of developing eating disorders. It is assumed that some women are unable to cope with professional and social demands, have a conflict, and are dieting by directing to physical activity.
7- How does an anorexia nervosa patient notice?
Patients completely reduce food intake, especially carbohydrates and fat-containing foods. They can be extremely mobile or exercise. The majority deal with food at a mental level, collect recipes, and make special meals for their families. Carbohydrate foods can be stored, packed, carried in the bag. He looks at the chest long enough to believe you have not lost weight. Some people perceive themselves as being completely obese, while others recognize that some are weak, but some regions, such as the belly, calf, and hip, are fat.
They will not realize that their weakness has reached a dangerous dimension. Feeling that they are ineffective, losing weight is an impressive achievement and strengthens self-esteem and control. Self-worth depends on their weaknesses. Treatment is low. Often sexual compatibility is bad. Psychosocial sexual development of most anorectal adolescents is delayed and attention to sexuality is greatly reduced by the onset of illness in adults. Treatment of anorexia includes a treatment that people of all ages can refer to.
8- What are the physiological and metabolic changes in anorexia nervosa?
These changes are due to hunger or withdrawal behavior and are recyclable. There are abnormalities in the blood chart. Subtraction behaviors result in low levels of potassium. This can lead to cardiac problems. Electrolyte disorders include weakness, dizziness, and heart rhythm disorders. Disturbances in the heart rhythm can lead to a sudden death by causing heart arrest. Fat can be seen in the liver. Serum cholesterol levels can rise. Dental decay, dry skin, feathering, osteoporosis, fractures, delayed discharge, constipation, reduced thyroid metabolism, low body temperature is other biological complications. Anorexia nervosa treatment should be done by specialist physicians.
9 – How is a bulimia nervosa patient noticed?
Bulimia nervosa usually develops after one or more years of diet. Dieting makes you lose weight or you can not be successful, but weight loss is never the quality of anorexia nervosa. Restricting feeding can lead to a tipping culmination, resulting in a feeling of discomfort in the abdomen, self-emanation or the pressure of social circulation. Appearance is often followed by feelings of guilt, depression and self-criticism. Some patients use laxatives for weight control, and cramping, long-term hunger is repeated in succession.
Many patients use water-spraying medicines. The food that is eaten during the harvest is high calorie and will make eating fast. Patients have a lot of weight fluctuations. Clogs are average 1 hour. Some patients have nausea caused by vomiting on their backs. There may be abuse of stimulants to reduce appetite. Most patients do not eat regularly, and at the end of a normal meal they have difficulty in feeling saturation. They usually prefer to eat alone at home.
The majority prefers the lower limit of the normal weight range as the ideal weight, even though they are at the upper limit of the normal weight range or are slightly overweight. Approximately 10% of the patients are significantly inflated. For most patients, cramping may be the rewarded behavior for alleviating stress and strain. They often exhibit complex, interpersonal problematic relationships, impulsive behaviors, and high levels of anxiety and compulsive behavior. Self-concepts are weak and mood disorders are more common. Matter and alcohol abuse are common. Four of the patients have problems with food, clothing and jewelry.
10- What are the harms of bulimia nervosa in the body?
Similar medical problems in anorexia nervosa due to removal behavior, teeth wear, parotid gland enlargement, stomach enlargement, food borne injuries, abdominal pain, and heart failure are important complications.
11-What diseases does anorexia nervosa confuse with?
You should be sure that there is no other medical condition leading to weight loss. Weight loss is common in depressive disorders. In the depression, appetite diminishes, but in the anorexia nervosa the patient negates the presence of appetite. In the later stages of anorexia nervosa, appetite diminishes. The hyperactivity in the anorexia nervosa is separated from the depressed agitation by its planned and repetitive nature. Foods are overly concerned with calorie content, gathering recipes, preparing food for others, fear of fatness, body image disturbance does not appear in depressed patients.
Weight loss, vomiting, eating special meals can be seen in somatization disorder. However, weight loss here is not as serious as anorexia nervosa and there is no fear of fatness. It is unusual for menstrual periods of 3 months or longer to be cut. Food-related delusions in schizophrenia are rarely associated with caloric content. Fear of obesity and hyperactivity are not seen. Chronic medical diseases that cause weight loss; Hyperthyroidism, Addison’s disease and diabetes mellitus.
12- At what age do eating disorders start?
The most risky ages for anorexia nervosa are 14 to 15 years. It is generally reported to start in puberty, but very rarely there are studies reporting that it started at the age of 9 and women after menopause. For bulimia nervosa, the typical beginning is between the ages of 18-19.
13- What are the medical problems encountered in eating disorders?
These diseases affect many organs in the body and the functioning of these organs in a negative way. For this reason, various medical problems arise:
- Cardiovascular system: Sudden cardiac arrest is the leading cause of low blood pressure, decreased pulse rate, cardiac arrhythmia, cardiac muscle proliferation, electrolyte disturbances.
- Gastrointestinal system: Gastrointestinal disorders related to vomiting and tearing, swelling, constipation, bowel disorders due to laxative use
- Hormonal changes: Menstrual irregularities and menstruation
- Bones: Bone marrow (osteoporosis), quick breaks in bones
- Teeth: Melting, tooth decay in toothpicks
- Reduction of anemia and defensive cells of the body
- Can eating disorders be the cause of death?
Yes. Anorexia nervosa and bulimia nervosa are the most lethal of all psychiatric disorders. Especially patients with anorexia nervosa are at greater risk. Even in countries with well-organized eating disorder clinics, about 10% of patients with anorexia nervosa die from this disease.
15- How is eating disorder treatment?
The treatment should be carried out in cooperation with other medical branches such as internal medicine, gynecology and delivery according to the condition of the patient, under the leadership of the psychiatric specialist. It is appropriate to help the patient with the convergence of many approaches from a single treatment approach.
Psychotherapy is indispensable, cooperation with the family and participation of the family in the treatment is important. The first goal of treatment is to ensure that the patient, who has a low demand for treatment, will have a treatment business association. You can apply to any eating disorder treatment center.
16- Are there medicines in the treatment of eating disorders?
There is no definitive drug treatment and the actual treatment is not drug use. It should be used together with psychotherapy. Drugs only play an auxiliary role. Recently, however, the benefits of some new drugs have been demonstrated in alleviating the various symptoms of both anorexia nervosa and bulimia nervosa. If it is used in the proper dosage and time, it will have treatment benefits.
17 – Do you need inpatient treatment for eating disorders?
Eating disorder treatments are maintained in several ways. Inpatient treatment is one of these. Particularly in severe cases hospitalization is compulsory. Situations that require hospitalization include:
- too much and fast weight loss
- unstoppable vomiting,
- the existence of various medical problems listed above,
- previous remedies have not improved,
- the presence of other psychiatric disorders other than eating disorders.
18-When will inpatient treatment be terminated, then how should a follow-up plan be made?
There is no definite time limit for termination of inpatient treatment. But
- the right nutrition principles are applied,
- close to the patient’s healthy body,
- where medical problems are resolved,
- remote treatment can be passed where vomiting and laxative use can be controlled.
Inpatient treatment is only part of the overall treatment. The major part is performed during remote treatment. Patients should be monitored for a long time after they leave the hospital. During these follow-up, individual and group psychotherapies, family treatments are applied.