Anorexia

Bulimia

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Anorexia Nervosa Anorexia nervosa is characterized by dramatic weight loss and/or restricted food intake coupled with a great disturbance in body image. The DSM-IV suggests that a person be at least 15% below their normal expected body weight (factoring in age, height, and body frame), but that is only a guideline. In women, the DSM-IV criteria also requires amenorrhea, or cessation of the menstrual cycle, for an "official" diagnosis.

If a person is anorexic and still has regular menses, or has lost a great deal of weight yet still is of "normal" or borderline weight, most therapists would have to officially classify this as ed-nos, but effectively, this is still anorexia.

There are two subtypes of anorexia: the restricting type, and the purging type.

It's not about not eating

 The fact is, people with anorexia do eat at least periodically, but greatly restrict food intake. Food restriction may consist of allowing only a certain number of calories per day, or to only certain "safe" foods.

Some people with anorexia may restrict for periods of time, and later binge and often subsequently purge; these behaviors are also seen in bulimia nervosa, although a person with anorexia generally restricts overall food intake more than one with bulimia. Other anorectics may purge after eating normal or very small amounts of food, especially when made to eat with family members. This is how the two "subtypes" of anorexia come into play.

It's not vanity or a "diet"

Although going on a "diet" often precedes an eating disorder, there is much more to anorexia than an overzealous attempt at dieting. There is a greatly disturbed body image which causes the anoretic to have a perception (albeit distorted) of being "fat." An entire self-worth based on the number on the scale, the size of their clothes, or their perceived size in relationship to those around them, perhaps because they don't feel they can "measure up" any other way, so to speak. And there are deep psychological issues, most often a low level of self-esteem and a high level of self-hatred. In other words they want to “fade away to nothing”.

To all those people who want to become “ana” because they think it would be great, well guess what it’s not!

 Do you really want to have such low self-esteem that you are ashamed to go out with friends, relax and have fun, to always worry about how fat you look in your clothes, and feel you don’t deserve to live, well that’s just the beginning. After awhile you start to become obsessed with food, how many calories you’ve consumed, how much you weigh and no matter how skinny and weightless you may be it’s never good enough and you keep fighting to lose more by fasting, taking pills, lying about your habits, hiding from everyone and even when you sit in your room alone and know that you have no one left in you life except ana it’s still not good enough. Now, I ask you do you really want that life??

This disease knows no bounds

Another common myth is that only teenage girls develop anorexia. The fact is, anorexia in young adults, middle-aged women, and even the elderly, is on the rise. 

The fact that the disorder is more commonly seen in females is partly due to the fact that society sends different messages to males and females about what their bodies should look like, but the fact that there are males with the disorder should prove my point that anorexia is more than just an overzealous bout of dieting.

 Anorexia isn't a "white" thing, either. Rates of eating disorders among African-Americans, Hispanics, and Asians are also on the rise, although researchers have not focused on these groups for study until fairly recently.

"But you don't LOOK anorexic..."

For some reason, many individuals have the notion that if a person does not look like he or she just stepped out of a concentration camp, then that person cannot be anorexic. This is an extremely dangerous belief. NOT all anoretics look like skeletons; in fact, very few do.  But just because a person is not completely emaciated doesn't mean that they do not have anorexia. Conversely, not every single person who is underweight necessarily suffers from an eating disorder. Remember: an eating disorder is about your behavior and thought patterns... not how much you weigh.

Signs of food restriction

·  Weight loss probable

·  Wearing baggy clothing (to hide weight loss)

·  Making excuses for not eating

·  Hides food or lies about eating habits

·  Making lists of "good" and "bad" foods

·  Refusing to eat certain foods

·  Obsessively measuring/weighing food

·  Looks pale

·  Finding diet pills or chromium supplements

·  Complains of being light headed

·  Constantly feeling cold at normal room temperatures

·  Fingernails turning blue

·  Dizzy or fainting spells

·  Buying diet pills or appetite suppressants

·  On the head: hair loss or brittle hair

·  Other parts of the body: increased hair growth (lanugo)

·  Unexplained lost or irregular menstrual cycle

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Bulimia Nervosa: Bulimia is perhaps the most common eating disorder seen in celebrities and one of the more common seen in general society. Simply because it's the eating disorder which is easiest to hide.

Bulimia Nervosa as defined by the DSM-IV is characterized by episodes of binge eating (uncontrolled consumption of a large amount of food in a relatively short period of time) followed by an inappropriate "compensation" such as forced vomiting, laxative or diuretic abuse, a subsequent fast or period of food restriction, or excessive exercising. The last is sometimes called "exercise bulimia" and is probably more common that people think.

The DSM-IV requires that this cycle of binge eating and subsequent compensatory behaviors occur on an average of at least two times a week for three months or more, but any sort of binge/purge cycle is effectively bulimia. Don't kid yourself that you don't have a problem just because you haven't been doing it that long or that often. Keep it up long enough, and it becomes a serious, potentially deadly problem

The DSM-IV also has two sub-types of bulimia nervosa: purging and non-purging. Forced vomiting, or abuse of laxatives or diuretics, is considered "purging" by DSM-IV standards. Fasting or engaging in excessive exercise after a binge to compensate for the calories consumed is considered "non-purging." A person who regularly binge eats, but does not purge or otherwise compensate for the excessive intake, is generally classified as having binge eating disorder. Sometimes it can be sort of a fuzzy line between bulimia and the binge/purge type of anorexia. However, if a patient meets all other criteria of anorexia nervosa, that is generally the diagnosis which is made.

Why would someone do this?

The binge/purge cycle is difficult to understand if you don't have an eating disorder yourself. The "logical" way to maintain weight is to just eat a healthy diet and exercise in moderation. (Then again, who ever said eating disorders were logical?) But incredibly, some statistics show that about one in four women has tried to use binge eating and purging to lose weight at one time or another. Even if they "only" do it once, that's a pretty frightening thought.

A person may binge eat as a way to cope with stress and/or anxiety, or to fill an emotional void. It also might be due to legitimate hunger, if the person has previously been restricting food intake. This is why even people with anorexia may develop bulimic tendencies. Subsequent "compensation" (the throwing up, taking laxatives or diuretics, obsessive exercise) is sometimes a way to punish themself for the binge, or as a way to assert control over themself...especially since during a binge, they may feel out of control). Purging may also be "symbolic" of getting something bad out of their bodies... abuse victims who were forced to perform oral sex on others, for instance. Again, although on the surface it may appear to be all about food, it is mostly due to underlying issues.

Bulimia is not "better"

Some people also think that it's "better" to have bulimia (as opposed to suffering from anorexia) because "at least they are still getting some nutrition" and "they're still maintaining their weight." Nothing could be further from the truth! Just because the consequences aren't always as obvious as those of anorexia doesn't make them any less severe. For one thing, bulimics often binge on not-so-nutritious foods, which should throw THAT rationale right out the window. Second of all, not all people with bulimia maintain weight... the binge/purge cycle usually causes very large fluctuations in weight that wreak havoc on the person's metabolism...not to mention their psyche.

Frequent purging can also do a tremendous amount of damage to a person's body, anything from electrolyte imbalance, to severe dehydration, to dental cavities, to gastric or esophogal rupture, to acid reflux, to heart failure. Bulimia is just as dangerous as anorexia or any other eating disorder. It could almost be argued that bulimia is actually more dangerous.

Even if a person with bulimia does not dramatically lose weight, this doesn't mean they are not suffering terrible physical and psychological consequences from their eating disorder. You can't measure a person's pain on a scale any more than you can determine their worth by how much they weigh. A person with bulimia needs and deserves just as much care and attention as any other eating disordered patient.... or anyone else in the world.

 

Signs of Purging, excessive exercise, diuretic or laxative abuse, etc.

·  Weight loss possible

·  Scarring on the knuckles

·  Exercises more than necessary or healthy

·  Injuries from excessive exercise

·  Exhaustion (from overexercise or dehydration)

·  Frequent visits to bathroom

·  Frequent trips to drug store

·  Eating a lot but not gaining weight

·  Wrappers of diuretics, laxatives, etc.

·  Frequent sore throats

·  Frequent dizzy or fainting spells (due to dehydration)

·  Odor of vomit in the bathroom

·  Red or puffy eyes

·  Swollen face or "chipmunk cheeks"

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BED

Binge eating disorder has just been recognized has a eating disorder by the DSM-IV (no longer classed as ed-nos). It is very similar to bulimia nervosa, except that there is no "compensation" for the binge.

Many people may binge eat from time to time, but it becomes an eating disorder when it is recurrent and out of control. People with BED are often overweight or even obese, but the disorder may affect people of "normal" weight as well. People who binge eat who were sexually abused may actually be doing this in an attempt to make themselves overweight, and therefore (in this society anyway) sexually unattractive.

As in bulimia, binges may be triggered by intense emotions such as anxiety, depression, or fear. Research also suggests that there is a chemical aspect of so-called "food addiction." Blood sugar rises abruptly when there is a sudden, extreme intake of carbohydrates, then crashes just as abruptly very shortly therafter. This is not unlike a "high" achieved by recreational drugs. Food is used as self-medication to soothe or distract from negative feelings. This is why many people with B.E.D. also suffer from anxiety, depression, or other mood disorders.

Complications of binge eating and/or being significantly overweight may include high blood pressure, diabetes, heart disease, high cholesterol, and gallbladder disease. There may also be significant psychological effects such as depression or anxiety...which are, ironically enough, emotions which often can trigger more binges. Thus the disorder can be quite a vicious cycle.

Signs & Symptoms

 ·  Large quantities of food mysteriously disappearing

·  Frequent trips to grocery store

·  Weight gain possible

·  Dramatic weight flucuations possible

·  Eating much more rapidly than usual

·  Frequently eating well past the "full point"

·  Subjective experience of eating being "out of control"

·  Eating large quantities of food when not physically hungry

·  Feelings of depression

·  Isolation and eating in secret

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