Eating Disorders: Anorexia Essay, Research Paper

Eating Disorders: Anorexia

Each year millions of people in the United States are affected by serious and

sometimes life-threatening eating disorders. The vast majority are adolescents

and young adult women. Approximately one percent of adolescents girls develop

anorexia nervosa, a dangerous condition in which they can literally starve

themselves to death. Another two to three percent develop bulimia nervosa, a

destructive pattern of excessive overeating followed by vomiting or other ”

purging ” behaviors to control their weight. These eating disorders also occur

in men and older women , but much less frequently. The consequences of eating

disorders can be severe. For example, one in ten anorexia nervosa leads to death

from starvation, cardiac arrest, or suicide. Fortunately, increasing awareness

of the dangers of eating disorders, sparked by medicall studies and extensive

media coverage, has led many poeple to seek help. Nevertheless, some people with

eating disorders refuse to admit that they have a problem and do not get

treatment. Family and friends can help recognize the problem and encourage the

person to seek treatment.

Anorexia nervosa is a disorder where people intentionally starve themselves. It

usually starts around the time of puberty and involves extreme weight loss.

Sometimes they must be hospitalized to prevent starvation because food and

weight become obsessions. For some, the compulsiveness shows up in strange

eating rituals, some even collect recipes and prepare gourmet feasts for family

and friends. Loss of monthly menstrual periods is typical in women with this

disorder and men with this disorder usually become impotent.

People with bulmia nervosa consume large amounts of food and then rid their

bodies of the excess calories by vomiting, abusing laxatives or excersising

obsessively. Some use a combination of all these forms of purging. Many

individuals with bulimia ” binge and purge ” in secret and maintain normal or

above normal body weight, they can often successfully hide their problem from

others for years. As with anorexia, bulimia typically begins during adolescence.

The condition occurs most often in women but is also found in men. Many

individuals with bulimia, do not seek help until they reach their thirties or

forties. By then, their eating behavior is deeply ingrained and more difficult

to change.

Medical complications can frequently be a result of eating disorders.

Individuals with eating disorders who use drugs to stimulate vomiting, may be in

considerable danger, as this practice increases the risk of heart failure. In

patients with anorexia, starvation can damage vital organs such as the heart and

brain. To protect itself, the body shifts into ” slow gear “: monthly menstrual

periods stop, breathing, pulse and, blood pressure rates drop, and thyroid

function slows. Nails and hair become brittle, the skin dries, yellows, and

becomes covered with soft hair called lanugo. Excessive thirst and frequent

urination may occur. Dehydration contributes to constipation, and reduced body

fat leads to lowered body temperature and inability to with stand cold. Mild

anemia, swollen joints, reduced muscles mass, and light headedness also commonly

occur in anorexia. If the disorder becomes severe, patients may lose calcium

from their bones, making them brittle and prone to breakage. Scientists from the

National Institute of Mental Health ( NIMH ), have also found that patients

suffer from other psychiatric illnesses. They may suffer from anxiety,

personality or substance abuse disorders, and many are at a risk for suicide.

Obsessive compulsive disorder, an illness characterized by repetitive thoughts

and behaviors, can also accompany anorexia.

Bulimia nervosa patients- even those of normal weight- can severly damage their

bodies by frequet binge eating and purging. In rare instances, binge eating

causes the stomach to rupture, purging may result in heart failure due to loss

of vital minerlas, such a potassium. Vomiting causes other less deadly, but

serios, problems. The acid in vomit wears the outer layer of the teeth and can

cause scarring on the backs of hands when fingers are pushed down the throat to

induce vomiting. Further the esophagus becomes inflamed and glands near the

cheeks become swollen. As in anorexia, bulimia may lead to irregular menstual

periods and interest in sex may also diminish. Some individuals with bulimia

struggle with addictions, including abuse if drugs and alcohol, and compulsive

stealing. Like individuals with anorexia, many people with bulimia suffer from

clinical depression, anxiety obsessive compulsive disorder, and other

psychiatric illnesses. These problems place them at high risk for suicidal

behavior. People who binge eat are usually overweight,so they are prone to

medical problems, such as high cholesterol, high blood pressure, and diabetes.

Research, from the NIMH scientists, has shown that individuals with binge eating

disorder have high rates of co-occuring psychiatric illnesses, especially

depression.

Eating disorders are most successfuly treated when diagnosed early. Unfortunalty,

even when family members confront the ill person about his or her behavior, or

physicians make a diagnosis, individuals with eating disorders may deny that

they have a problem. Thus, people with anorexia may not receive medical or

psychological attention until they have already become dangerously thin and

malnourished. People with bulimia are often normal weight and are able to hide

their illness from others for years. Eating disorders in males may be overlooked

because anorexia and bulimia are relatively rare in boys and men. Consequently,

getting and keeping people with these disorders into treatment can be extremely

difficult.

In any case, it cannot be overemphasized how important treatment is for the

people who have these disorders. The longer eating behaviors persist, the more

difficult it is to overcome the disorder and its effect on the body. If an

eating disorder is suspected, particularly if it involves weight loss, the first

step is a complete physical examination to rule out any other illnesses. Once an

eating disorder is diagnosed, the clinician must determine whether the patient

is in immediate medical danger and requires hospitalization. While most patients

can be treated as outpatients, some need hospital care. Conditions warranting

hospitilization include excessive and rapid weight loss, serious metabolic

disturbances, clinical depression or risk of suicide, severe binge eating and

purging, or psychosis. The complex interaction of emotional and physiological

problems in eating disorders calls for a comprehensive treatment plan, involving

a variety of experts and approaches. Ideally the treatment team includes an

internist, a nutritionist, an individual psychotherapist, and a

psychopharmacologist. To help those with eating disorders deal with their

illness and underlying emotional issues, some form of psychotherapy is usually

needed. Group therapy, in which people share their experiences with others, has

been especailly effective for individuals with bulimia.

NIMH supported scientist, have examined the effectiveness of combining

psychotherapy and medications. In a recent study of bulimia, researchers have

found that both intensive group therapy and antidepressants medications,

combined or alone, benefited patients. In another study of bulimia, the combined

use of cognitive behavioral therapy and antidepressant medications was most

beneficial. This comibination treatment was particularly effective in preventing

relapse once medications were discontinued. For patients with binge eating

disorder, cognitive behavioral therapy and antidepressant medications may also

prove to be useful. For anorexia, preliminary evidence shows that some

antidepressant medications may be effective when combined with other forms of

treatment. Fluoxetine has also been useful in treating some patients with binge

eating disorder and depression.

The efforts of mental health professionals need to be combined with those of

other health professionals to obtain the best treatment. Physicians treat any

medical complications, and nutritionists advise on diet and eating regimens. The

challenge of treating eating diorders is made more difficult by the metabolic

changes associated with them. Just to maintain a stable weight, individuals with

anorexia may actually have to consume more calories than someone of similar

weight and age without an eating disorder. This is important, because consuming

calories is exactly what the person with anorexia wishes to avoid, yet must do

to regain the weight necessary for recovery. In contrast, some normal weight

people with bulimia may gain excess weight if they consume the number of

calories required to maintain normal weight in others of similar size and age.

Treatment can save the life of someone with an eating disorder. Friends,

relatives, teachers, and physicians all play an important role in helping the

ill person start with a treatment program.

Encouragemnt, caring, and persistence, as well as information about eating

disorders and their dangers, may be needed to convince the ill person to get

help, stick with treatment, or try again.

Family members and friends can call local hospitals or university medical

centers to find out about eating disorder clinics and clinicians experienced in

treating the illnesses, for the college students, treatment progams may be

available in school counseling centers.

Family and friends should read as mush as possible about eating disorders, so

they can help the person with the illness understand his or her problem. Many

local mental health organizations and the self help groups provide free

literature on eating disorders. Some of these groups also provide treatment

program referrals and information on local self help groups. Once the person

gets help, he or she will continue to needs lots of understanding and

encouragement to stay in treatment.

NIMH continues its search for new and better treatments for eating disorders.

Congress has designated the 1990’s as the ” Decade of the Brain, ” making the

prevention, diagnosis, and treatment of all brain and mental disorders a

national research priority. This research promises to yield even more hope for

patients and their families by providing a greater understanding of the causes

and complexities of eating disorders.