Anorexia nervosa is characterized by persistent restriction on food intake, an intense fear of gaining weight or of becoming fat, and a distortion of body weight or shape. An individual with anorexia nervosa will maintain a body weight that is below a minimally normal level for age, sex, and physical health.
Some people with anorexia lose weight by dieting, fasting, or exercising excessively; this is called the restricting type of anorexia. Others lose weight by self-induced vomiting or misusing laxatives, diuretics, or enemas. People who use these methods are considered to have the binge-eating/purging type of anorexia. More characteristics of anorexia nervosa include:
- Significant weight loss
- Continual dieting
- Intense fear of gaining weight or becoming fat, even if underweight
- Undue influence of body weight or shape on self-evaluation
- Preoccupation with calories or nutrition
- Preference to eat alone
- Compulsive exercise
- Bingeing and purging
- Brittle hair or nails
- Infrequent or absent menstrual periods (in females who have reached puberty)
- Growth of fine hair over body
- Mild anemia, and muscle weakness and loss
- Severe constipation
- Low blood pressure, slowed breathing and pulse
- Drop in internal body temperature, causing a person to feel cold all the time
Some people with anorexia nervosa feel they are overweight in all areas of their body, while others may recognize that they are thin but are concerned that certain body parts are "too fat," such as their abdomen or buttocks. They may use many different techniques to evaluate their body size or weight, such as frequent weighing and obsessive measuring of body parts. Additionally, the self-esteem of individuals with anorexia is closely tied to their perceptions of their body shape and weight. Weight gain is often viewed as a major failure, while weight loss is an impressive achievement.
Many people with anorexia have coexisting psychiatric and physical illnesses, including depression, anxiety, obsessive behavior, substance abuse, cardiovascular and neurological complications, and impaired physical development. The semi-starvation state of anorexia can also result in serious and potentially life-threatening conditions. The 12-month prevalence of anorexia among young females is estimated to be 0.4 percent.
Bulimia nervosa is characterized by recurrent and frequent episodes of eating unusually large amounts of food (binge-eating), and feeling a lack of control over the eating. This is followed by some type of behavior that compensates for the binge, such as purging (vomiting, excessive use of laxatives or diuretics), fasting, and/or excessive exercise. Unlike individuals with anorexia nervosa, people with bulimia maintain body weight at or above a minimally normal level. Additional symptoms include:
- Recurrent episodes of binge eating
- Purging by strict dieting, fasting, vigorous exercise, or vomiting
- Abuse of laxatives or diuretics to lose weight
- Frequent use of bathroom after meals
- Reddened fingers
- Swollen cheeks
- Self-evaluation that is unduly influenced by body shape and weight
- Depression or mood swings
- Irregular menstrual periods
- Dental problems, like tooth decay
- Heartburn or bloating
- Intestinal distress and irritation from laxative abuse
- Kidney problems from diuretic abuse
- Severe dehydration from purging of fluids
People with bulimia tend to feel embarrassed or ashamed of their eating behaviors and try to hide their symptoms by binge eating in secrecy. The most common triggers for binge eating are negative affect (e.g. sadness, fear, guilt), interpersonal stressors (e.g. arguments), inadequate food intake, negative feelings about body weight or shape, and boredom. The 12-month prevalence of bulimia among young females is estimated to be 1.5 percent.
Binge-eating disorder is characterized by recurrent binge-eating episodes during which a person feels a loss of control over his or her eating. An episode of binge-eating is defined as eating an amount of food that is definitely larger than most people would eat in a similar period of time under similar circumstances. Unlike bulimia, binge-eating episodes are not followed by purging, excessive exercise, or fasting. As a result, people with binge-eating disorder are often overweight or obese. Community surveys have estimated that 1.6 percent of females and 0.8 percent of males experience binge-eating disorder in a twelve-month period.
Characteristics of binge-eating disorder include:
- Binge-eating occurring, on average, at least once a week for six months
- Eating much more rapidly than normal
- Eating until feeling uncomfortably full
- Eating large amounts of food when not hungry
- Eating alone because of embarrassment caused by how much is eaten
- Feeling disgusted with oneself, depressed, or guilty after binge eating
- Marked distress about the binge-eating behavior
- Binge-eating not associated with regular use of compensatory behaviors (purging, fasting, excessive exercise)
Avoidant/Restrictive Food Intake Disorder
Avoidant/restrictive food intake disorder (ARFID) is characterized by the avoidance or restriction of food intake. This diagnoses replaces the DSM-IV diagnosis of feeding disorder of infancy or early childhood, and broadened the diagnostic criteria to include adults. Individuals with ARFID have a lack of interest in eating or food, or avoid food based on a past negative experience with the food or the sensory characteristics of the food (e.g., appearance, smell, taste, texture, presentation). This form of "picky eating" typically develops in infancy or early childhood and may continue into adulthood. It may also be present in individuals with heightened sensory sensitivities associated with autism.
Characteristics of ARFID include:
- Significant weight loss
- Failure to achieve expected weight gain in children
- Significant nutritional deficiency
- Inability to participate in normal social activities, such as eating with others
Rumination disorder is characterized by repeated regurgitation of food after eating. Individuals with this disorder bring up previously swallowed food into the mouth without displaying any signs of nausea, involuntary retching, or disgust. This food is typically then re-chewed and spit out or swallowed again. The regurgitating behavior is sometimes described as habitual or outside of the control of the individual.
Characteristics of rumination disorder include:
- Repeated regurgitation of food over a period of at least one month
- The repeated regurgitation is not a result of an associated gastrointestinal or other medical condition
- Weight loss and failure to make expected weight gains in children
- Attempts to hide the regurgitation behavior by placing a hand over the mouth or coughing
- Avoidance of eating before social situations, such as work or school
Rumination disorder can develop in infancy, childhood, adolescence, or adulthood. Infants with the disorder tend to strain and arch their back with their head held back, making sucking movements with their tongue. Malnutrition may occur despite ingestion of large amounts of food, particularly when regurgitated food is spit out. In infants as well as in older people with intellectual disability, the regurgitation and rumination behavior seems to have a self-soothing or self-stimulating function, much like other repetitive motor behaviors (i.e. rocking, head banging).
Pica is characterized by the eating of one or more nonnutritive, nonfood substances on a persistent basis. Some of the substances commonly eaten among people with pica include paper, soap, hair, gum, ice, paint, pebbles, soil, and chalk. People with pica do not typically have an aversion to food in general.
In order for Pica to be diagnosed, the behavior of eating nonnutritive, nonfood substances must be present for at least one month. Children below the age of two are typically not diagnosed with pica to exclude the developmentally appropriate mouthing of objects by infants that may result in ingestion. People may experience medical complications from pica, such as bowel problems and intestinal obstruction. People may also experience infections if they have eaten feces or dirt. The prevalence of pica is unknown, but it is more prevalent among people with intellectual disability. Some pregnant women also develop pica when specific cravings such as chalk or ice occur.
Essay on Biological Causes of Anorexia Nervosa and Bulimia Nervosa
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Biological Causes of Anorexia Nervosa and Bulimia Nervosa
Anorexia nervosa and bulimia nervosa affect millions of people each year in the United States (1). Popular thought holds that these disorders are caused by women trying to fulfill a culturally imposed ideal body image which stresses thinness. As anorexia and bulimia have proven difficult to treat solely with a psychological-based treatment plan it is likely that there are many factors contributing to these disorders. Research has shown, however, that there is a significant biological component which leads to a manifestation of these disorders (2). Current ideas on the biological origins of anorexia and bulimia will be explored in this paper. These include areas ranging from…show more content…
There is a tremendous discord between actual weight and perceived body weight. While the woman may feel fat she is actually excessively underweight. "When she came in for consultation she looked like a walking skeleton. Alma insisted that she looked fine and that there was nothing wrong with her being so skinny. 'I enjoy having this disease and I want it. I cannot convince myself that I am sick and that there is anything from which I have to recover." (3)
Bulimia nervosa is a related disorder which affects two to three percent of young American women (1). This disease is most commonly described as the cycle of eating huge quantities of food, thousands of calories in one sitting, then ridding the body of this food through some form of self purging. Purging is accomplished through excessive exercise, abuse of laxatives or diuretics, enemas, or vomiting. Many of these methods are often incorporated simultaneously. The bulimic frequently thinks this practice of bingeing and purging is disgusting and does so in private, making it hard to detect and treat.
"Lisa would eat pounds of candy and cake at a time, and often not stop until she was exhausted or in severe pain. Then, overwhelmed with guilt and disgust, she would make herself vomit." (1)
Studies have shown genetic predisposition for developing an eating disorder. Females in a family which has a member with an eating disorders are more likely then average women to develop