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. Eating disorders result in about 7,000 deaths a year as of 2010, making them the mental illnesses with the highest mortality rate. Treatment of an eating disorder generally includes a team approach. The team typically includes medical providers, mental health providers and dietitians — all 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. However, there is lack of good evidence about treatment and management, which means that current views about treatment are based mainly on clinical experience. Therefore, before treatment takes place, 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.
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