About Eating Disorders
The Public Health Agency of Canada (2002) produced A Report on Mental Illness in Canada, providing statistics and Eating Disorder Info as a Health Issue. The following are direct highlights from this report.
- Approximately 3% of women will be affected by an eating disorder during their lifetime.
- Eating disorders affect girls and women more than boys and men.
- Factors believed to contribute to eating disorders include biological and personal factors as well as society’s promotion of the thin body image.
- Eating disorders carry with them a high risk of other mental and physical illnesses that can lead to death.
- Since 1987, hospitalizations for eating disorders in general hospitals have increased by 34% among young women under the age of 15 and by 29% among 15-24 year olds.
Eating disorders involve a serious disturbance in eating behaviour – either eating too much or too little – in addition to great concern over body size and shape.1 This chapter addresses anorexia nervosa, bulimia nervosa and binge eating disorder (BED).
Eating disorders are not a function of will but are, rather, unhealthy eating patterns that “take on a life of their own.” The voluntary eating of smaller or larger portions of food than usual is common, but for some people this develops into a compulsion and the eating behaviours become extreme.
- Individuals with anorexia nervosa refuse to maintain a minimally normal body weight, carry an intense fear of gaining weight and have a distorted perception of the shape or size of their bodies.
- Individuals with bulimia nervosa undertake binge eating and then use compensatory methods to prevent weight gain, such as induced vomiting, excessive exercise or laxative abuse. They also place excessive importance on body shape and weight. In order for a diagnosis of bulimia nervosa to be made, the binge eating and compensatory behaviours must occur, on average, at least twice a week for 3 months.
- A diagnosis of binge eating disorder (BED) is made if the binge eating is not followed by some compensatory behaviour, such as vomiting, excessive exercise or laxative abuse. This disorder is often associated with obesity.
- Individuals with anorexia and bulimia may recover after a single episode of the disorder. Others may have a fluctuating pattern of weight gain and relapse. Still others will continue to have issues with food and weight throughout their lives. A lifetime history of substance use disorders, drug or alcohol problems at the time of diagnosis and longer duration of symptoms before diagnosis are associated with poorer long-term outcomes.
- Individuals with anorexia and bulimia may develop serious physical problems such as heart conditions, electrolyte imbalance and kidney failure that can lead to death. Eating disorders may cause long-term psychological, social and health problems even after the acute episode has been resolved.
- Anorexic individuals are more susceptible to major depression, alcohol dependence and anxiety disorders, either at the time of their illness or later in life.8,9 Suicide is also a possible outcome.
- An eating disorder causes young people to miss school, work and recreational activities. The physical weakness associated with the illness also seriously affects their social interaction with friends and their involvement in life in general. Friends also have difficulty knowing how to react and how to help.
- Families of individuals with eating disorders also live under great stress. They may blame themselves, feel anxious about their loved one’s future, worry that the family member will die, and face the stigma associated with having a child with a mental illness. Parents especially experience the tension between their natural protective instinct to force healthy behaviours on the child (which can often make the situation worse) and the child’s need to take control over his/her illness and health.
Eating disorders can be treated and a healthy weight restored. Earlier diagnosis results in improved outcomes. Treatment is most effective if started in the early stages of the disorder. Therefore, routine assessment of teenaged girls for the early signs of an eating disorder can help identify those who would benefit from treatment.
Success of treatment depends on a comprehensive plan, including the following:
- Monitoring of physical symptoms
- Behavioural therapy
- Cognitive therapy
- Body image therapy
- Nutritional counseling
- Medication, if necessary
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