We all are fond of eating good food especially when it comes to a celeberation , party OR when someone is not in a good mood ; he/she feels better after eating something favourite which satiates and elevates the mood. Food in itself is a mood uplifter.
But eating too much or too less is a sign of mental disorder . These disorders are characterized by an altered food inta ke and the presence of inappropriate behaviours for the control of one’s body weight and figure . commonly it is seen as a lifestyle problem but it is much more to that.
If the urge to eat more and less is becoming out of control , then it can be an eating disorder. Common eating disorders Include Anorexia nervosa ,Bulimia nervosa ,Night eating syndrome and binge eating disorders. Eating diorders can occur in men, women, young ,old ,adults ,rich ,poor and people from any race or any cultural background. The earlier these are detected ; the earlier these can be cured. Those dealing with eating disorders can have a variety of symptoms . However, the major symptoms include the restriction of food, eating less due to an obsession of body shape , Binges or vomiting /purging or over exercising due to the guilt of eating more .
What is the Cause ?
These are psychological conditions and can be caused by a variety of factors . the etiology have been viewed as sociocultural in origin .
- Personality patterns like neuroticism ,perfectionism and impulsivity are the three major traits which contr- -ibute to the risk Of developing an eating order .
- Genetic factors also play a major role in developing an eating disorder.
- Environmental factors like the pressure of remaining thin especially in girls , carrying the belief that THIN IS BEAUTIFUL.
- Peer pressure ,cultural preferences for thinness . Separation anxiety disorder can sometimes also lead to Eating disorder
Types of Eating disorder
Anorexia Nervosa – In this disorder , the individual has a distorted body image that lead herself/himself as overweight . Often refusing to eat ,exercising compulsively and people from this disorder develop unusual habits such as refusing to eat in front of others . The person suffering from this disorder may lose large amounts of weight and even starve himself /himself to death. It is typically diagnosed after a person is 25 to 30 percent below are there :
- R–AN –( Restricting anorexia nervosa ) Individuals tend to lose weight purely by dieting and exerci- sing without binge eating and purging.
- BP-AN ( Binge –purging type anorexia ) Individuals with this type also exercise and diet and restrict Their food intake but periodically engage in binge eating and purging .
Bulimia Nervosa - This is a disorder where people eat excessive amounts of food , sometimes they eat much more than what is required and then they feel the guilt of having fed so much due to which they take use of laxatives , medicines ,diuretics or even they purge their food out by doing voluntary vomiting . The person is often ashamed and disgusted of binge eating and feels relieved of tension and negative emotions after purging . Its more of a serious ,potentially life –threatening disorder . It is diagnosed if the Binge-purge cycle occurs at least two times a week. The act of Purging can cause the oesaphugus and teeth and it can also cause the gag reflex to be less sensitive.
Non –purging Bulimia is also diagnosed and is characterized by Using inappropriate methods of compensation of Binge episodes such as excessive fasting . In these cases The typical forms of purging such as self-induced vomiting are not regularly utilized.
Binge eating - According to DSM -5 Binge eating has been defined by several criteria In this type of disorder .There are frequent episodes of out- of –control eating. The individual often often tends to eat at a higher speed than normal and continues eating till he or she feels comfortably full. In fact a large amount of food is eaten when the person is not hungry even .
In addition, a person fails to control over one’s eating behaviour during this time .At least three characterstics must also be present ; summing food much more rapidly than normal eating food until uncomfortably full consuming food alone to avoid embarrassment or feeling disgusted , depressed ,or guilty after eating the event .
The diagnosis also requires that a significant amount of distress be associated with the binge episodes ,which Must occur at least once per week for 3 months or more .Lastly the disorder must not be met by any Compensatory behaviour nor should the binge eating occur solely during an episode of bulimia nervosa or anorexia nervosa
Night eating syndrome (NES ) The other form of eating disorder is Night eating syndrome which is mostly related to obesity or overweight .It was first described by Stunkard et al among were consuming 25% or more at a time when individuals without obesity would not be eating .In addition to this patients experienced insomnia and morning Anorexia. NES was neglected until 1990 . It is characterized by recurrent episodes of night eating , which is described as either excessive food consumption in the evening after Dinner time i.e evening hyperphagia or eating after awakening from sleep.
Morning Anorexia The presence of strong urge to eat between dinner and sleep and or during the night sleep onset The presence of depressed mood or mood worsening in the evening or with the belief that one cant go to Sleep without eating. NES is classified in the DSM fifth edition as an other specified feeding or eating disorder.
Side effects of eating disorders :
- Osteoporosis – Anorexics are more at risks due to lowered food intake
- Taste receptors damaged - For all the taste stimuli (sweet ,salty ,sour and bitter ) intensities on the Palate have been found in bulimic subject than in control subject
- Oral health - Due to self-induced vomiting , regardless of whether the diagnosis is anorexia or bulimia ,the oral pathology gets affected which is characterized by dental erosion on palatal surfaces. Dental Caries and dry mouth secondary to salivary gland dysfunction also occur.
- Other side effects are also there like decreased concentration and other cognitive changes , gastrointestinal changes ,headaches, dizziness fluid retention
Types of Treatment
Collaboration with other clinicians –
Assessing and monitoring eating Disorder behaviours and symptoms–
Psychological Therapy –
and behaviour positive regard , reassurance and support . Psycho-education including self-help books ,workbooks , information on community based and internet resources . Team approach with care is the recommended and work best.
A tailored approach that includes other physicians, dental physicians ,psychologists ,registered dieticians and community social workers works best .<
Patients’s history ,symptoms ,behaviours and mental status is the first step in the diagnosis .Thorough review of the patient history like height ,weight ,patterns of eating should be monitored properly.
Most important step for treatment of eating disorder REBT (Rational emotive behaviour Therapy ) which focusses on the thoughts and feelings related to An eating disorder .It helps to restructure the faulty patterns of thinking which one can’t recognize While developing the wrong eating patterns .
You are the most important person in your life and taking care of yourself is the first and foremost step while taking any treatment plan. Actively participate and help yourself . WE ARE WITH YOU!!