Essay/Term paper: Eating disorders: anorexia

Essay, term paper, research paper:  Science Reports

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.