Eating Disorders

Eating disorders, in which food becomes not a source of nutrition but an enemy to be fought or an object of obsession, are most common among middle-class and upper-middle-class young women. Approximately 1 in 10 people with eating disorders will die as a result of the condition, either by suicide or a heart attack due to electrolyte imbalance or starvation.

Anorexia nervosa

People who have anorexia nervosa try to starve themselves thin. This condition usually begins in puberty, and tends to strike young people with perfectionist, obedient personalities. Some psychologists believe that people with anorexia nervosa are attempting to control their food intake and weight because they feel unable to control other aspects of their lives.

People with anorexia may also exercise obsessively, make themselves vomit, and use laxatives to purge themselves further. They may also go through phases of bulimia nervosa. If the disease progresses far enough, all the symptoms of starvation show up: irregular heartbeat; brittle hair and nails; dry, yellowish skin; and symptoms of depression. Even though someone with anorexia may be extremely thin, the person will still feel too fat. People with this condition can literally starve themselves to death.

Bulimia nervosa

People who have bulimia nervosa will binge on food and then make themselves vomit, use a laxative, or take a diuretic. Bulimics may binge and purge several times a week or even several times a day. Unlike people with anorexia, people with bulimia are often at or near a normal weight.

Symptoms of bulimia include a sore throat, tooth erosion and decay (due to the teeth being etched by stomach acid), swollen salivary glands in the neck and cheeks, and a puffy face. Serious cases of bulimia can cause dehydration and electrolyte imbalance (a proper balance of electrolytes is essential for the heart to function normally.)

Binge eating disorder

People with binge eating disorder eat large amounts of food without being hungry, and are often obese. This condition is similar to bulimia, except the person does not purge after bingeing. In men, this disorder is more common than either anorexia or bulimia. People with this condition may abuse alcohol and other drugs, and may also have a history of losing and regaining weight. Binge eating disorder is also associated with depression.

What to do

Eating disorders are difficult to treat and, following treatment, return to former abnormal eating habits is common. People with these conditions usually have underlying emotional problems such as low self-esteem, depression, and a distorted body image, and must be treated by a therapist. Treatment must often be provided in a hospital for severe cases of these illnesses. People must be taught to eat normally again, which often requires careful supervision. Treatment includes individual therapy and, sometimes, family counseling. Antidepressant medications are sometimes prescribed as well. People with eating disorders have a reasonable chance at recovery, especially if the illness is caught early.

The Food and Drug Administration (FDA) advises health care providers, patients, families and caregivers of adults and children that they should closely monitor all patients beginning therapy with antidepressants and when doses are either increased or decreased, for worsening depression and suicidal thinking. The FDA also advises that these patients be observed for certain behaviors associated with these drugs, such as anxiety, agitation, panic attacks, insomnia, irritability, hostility, impulsivity, severe restlessness, hypomania and mania, and that physicians be particularly vigilant in patients who may have bipolar disorder.

The FDA issued a warning in September 2004 that antidepressants not only cause some children and teenagers to become suicidal but that most have also failed to cure their depression. Children and teens who take antidepressants are twice as likely as those given placebos to become suicidal. Still, the overall risk for suicide is low. If 100 patients are given the drugs, two or three more will become suicidal than would have had they been given placebos.