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Eating disorders: Understanding anorexia and bulimia

Treatment can help.

At any given time, several million people are affected by an eating disorder, according to the American Psychiatric Association (APA).

These disorders are most common among women between ages 12 and 35. Without treatment, they can be fatal.

Two of the most common eating disorders are anorexia nervosa and bulimia nervosa.

Anorexia nervosa

People with anorexia nervosa can literally starve themselves to death. Their body mass index (BMI) is usually under 18.5. They try to lose weight by not eating enough, exercising obsessively and/or abusing laxatives. They believe that they are overweight despite massive weight loss.

The resulting starvation causes the body to conserve resources and can result in:

  • The stopping of menstruation.
  • A drop in pulse and blood pressure.
  • Brittle hair and nails.
  • Dry and yellowish skin.
  • Growth of a soft layer of body hair called lanugo.

In severe cases, anorexia can lead to osteoporosis (thinning of the bones), an irregular heartbeat or heart failure.

Bulimia nervosa

People with bulimia nervosa don't starve themselves, but instead gorge on food. Then they rid their bodies of the extra calories by vomiting, abusing laxatives or diuretics, having enemas, or exercising obsessively.

The cycle of "binge and purge" is difficult to detect because unlike an anorexic person, many people with bulimia maintain a normal or above normal body weight.

Friends, family members and even doctors may not realize the person has an eating disorder, according to the National Institute of Mental Health (NIMH). Some signs may include long trips to the bathroom after meals, eating huge amounts of food with no visible weight gain or the development of strange food rituals, such as hiding large amounts of junk food in unusual places.

Health problems associated with bulimia include an inflamed esophagus, chronic sore throat, swollen cheeks and worn tooth enamel. In extreme cases, bingeing can result in stomach ruptures and purging can lead to heart failure due to a loss of minerals such as potassium.

Underlying causes

Experts don't know for sure why people develop eating disorders, says APA. Some psychiatrists believe that by controlling their eating, these people gain a sense of control over their life.

An emphasis in Western culture on the attractiveness of a thin figure may lead people to become obsessed with achieving an impossible ideal.

People with eating disorders can also have problems with depression and obsessive-compulsive disorder, according to the NIMH and APA.

Getting help

People with eating disorders often deny they have a problem. This makes it harder for concerned friends or relatives to help them. Many times they don't get treatment until they're dangerously thin or malnourished.

The first step in diagnosing an eating disorder is a complete physical exam to rule out any other illnesses. Therapy can involve personal and family counseling, and drug treatment.

The goals of treatment include:

  • Correcting distorted body image.
  • Improving self-confidence and self-esteem.
  • Treating underlying depression.
  • Establishing normal eating habits.
  • Preventing relapse.

Taking action

If you think someone you know may have an eating disorder, contact your doctor for advice. You may be saving a life.

Reviewed 9/2/2022

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