Eating disorders are mental disorders defined by abnormal eating habits that negatively affect a person's physical or mental health. They include binge eating disorder where people eat a large amount in a short period of time, anorexia nervosa where people eat very little and thus have a low body weight, bulimia nervosa where people eat a lot and then try to rid themselves of the food, pica where people eat non-food items, rumination disorder where people regurgitate food, avoidant/restrictive food intake disorder where people have a lack of interest in food, and a group of other specified feeding or eating disorders. Anxiety disorders, depression, and substance abuse are common among people with eating disorders. These disorders do not include obesity. The cause of eating disorders is not clear. Both genetic and environmental factors appear to play a role. Cultural idealization of thinness is believed to contribute. Eating disorders for example affect about 12% of dancers. Those who have experienced sexual abuse are also more likely to develop eating disorders. Some disorders such as pica and rumination disorder occur more often in people with intellectual disabilities. Only one eating disorder can be diagnosed at a given time. The eating disorders anorexia nervosa, bulimia nervosa, and binge-eating disorder, and their variants, all feature serious disturbances in eating behavior and weight regulation. They are associated with a wide range of adverse psychological, physical, and social consequences. A person with an eating disorder may start out just eating smaller or larger amounts of food, but at some point, their urge to eat less or more spirals out of control. Severe distress or concern about body weight or shape, or extreme efforts to manage weight or food intake, also may characterize an eating disorder.
Symptoms and complications vary according to the nature and severity of the eating disorder. Some physical symptoms of eating disorders are weakness, fatigue, sensitivity to cold, reduced beard growth in men, reduction in waking erections, reduced libido, weight loss and failure of growth. Unexplained hoarseness may be a symptom of an underlying eating disorder, as the result of acid reflux, or entry of acidic gastric material into the laryngoesophageal tract. Patients who induce vomiting, such as those with anorexia nervosa, binge eating-purging type or those with purging-type bulimia nervosa are at risk for acid reflux. Polycystic ovary syndrome (PCOS) is the most common endocrine disorder to affect women. Though often associated with obesity it can occur in normal weight individuals. PCOS has been associated with binge eating and bulimic behavior. Pro-Ana subculture: Several websites promote eating disorders, and can provide a means for individuals to communicate in order to maintain eating disorders. Members of these websites typically feel that their eating disorder is the only aspect of a chaotic life that they can control. These websites are often interactive and have discussion boards where individuals can share strategies, ideas, and experiences, such as diet and exercise plans that achieve extremely low weights. A study comparing the personal web-blogs that were pro-eating disorder with those focused on recovery found that the pro-eating disorder blogs contained language reflecting lower cognitive processing, used a more closed-minded writing style, contained less emotional expression and fewer social references, and focused more on eating-related contents than did the recovery blogs. Psychopathology: The psychopathology of eating disorders centres around body image disturbance, such as concerns with weight and shape; self-worth being too dependent on weight and shape, fear of gaining weight even when underweight, denial of how severe the symptoms are and a distortion in the way the body is experienced. There are two types of eating disorders. They are: Anorexia nervosa and Bulimia nervosa.
Eating disorders result in about 7,000 deaths a year as of 2010, making them the mental illnesses with the highest mortality rate. Certain groups are especially at risk for anorexia nervosa, including dancers, long-distance runners, skaters, models, actors, wrestlers, gymnasts, flight attendants, college sorority members, and others for whom thinness is emphasized and overly rewarded. In a European study, a 0.48% lifetime incidence of anorexia nervosa was reported among 21,425 respondents. The lifetime prevalence of anorexia nervosa in the United States is estimated to be 0.3-1%. Some studies have shown rates as high as 4% among women. The rates among men are estimated at 0.1-0.3%. As many as 5% of young women exhibit symptoms of anorexia but do not meet the full diagnostic criteria, and some studies show disordered eating behavior in 13% of adolescent girls in the United States. Treatment of an eating disorder generally includes a team approach. The team typically includes medical providers, mental health providers and dietitians with experience in eating disorders. Treatment depends on your specific type of eating disorder. But in general, it typically includes psychotherapy, nutrition education and medication. If your life is at risk, you may need immediate hospitalization. Treatment varies according to type and severity of eating disorder, and usually more than one treatment option is utilized. There is lack of good evidence about treatment and management, which means that current views about treatment are based mainly on clinical experience. Before treatment, family doctors will play an important role in early treatment of people with eating disorders will be reluctant to see a psychiatrist and a lot will depend on trying to establish a good relationship with the person and family in primary care. Treatment can take place in a variety of different settings such as community programs, hospitals, day programs, and groups. Some of the advanced treatment methods are: Cognitive behavioral therapy (CBT), which postulates that an individual's feelings and behaviors are caused by their own thoughts instead of external stimuli such as other people, situations or events; the idea is to change how a person thinks and reacts to a situation even if the situation itself does not change. Cognitive behavioral treatment of eating disorders. • Acceptance and commitment therapy is a type of CBT • Cognitive Remediation Therapy (CRT) is a set of cognitive drills or compensatory interventions designed to enhance cognitive functioning. • Dialectical behavior therapy • Family therapy • Behavioral therapy • Interpersonal psychotherapy (IPT) • Cognitive Emotional Behaviour Therapy (CEBT) • Music Therapy • Recreation Therapy • Art therapy • Nutrition counseling and Medical nutrition therapy • Medication: Orlistat is used in obesity treatment. Olanzapine seems to promote weight gain as well as the ability to ameliorate obsessional behaviors concerning weight gain. zinc supplements have been shown to be helpful, and cortisol is also being investigated. • Self-help and guided self-help have been shown to be helpful in AN, BN and BED, this includes support groups and self-help groups such as Eating Disorders, Anonymous and Overeaters Anonymous. • Psychoanalysis • Inpatient care • There are few studies on the cost-effectiveness of the various treatments. Treatment can be expensive, due to limitations in health care coverage, people hospitalized with anorexia nervosa may be discharged while still underweight, resulting in relapse and re hospitalization.