- Psychological Issues
Anorexia affects two out of every 100 teenage girls, although the illness can be experienced earlier and later in life. Most people who have anorexia are female, but males also develop the disorder. Bulimia may affect up to three in every hundred teenage girls. More females than males develop bulimia.
While these rates show that few people meet the criteria for eating disorders, it is far more common for people to have unrealistic attitudes about body size and shape. These attitudes may contribute to inappropriate eating habits or dieting practices. Both illnesses can be overcome and it is important for the person to seek advice about either condition as early as possible.
Anorexia is characterised by:
Usually, anorexia begins with a weight loss, either resulting from a physical illness or from dieting. Favourable comments cause the person to believe that if thin is good, thinner is better. The body does not react well to starvation, and erratic eating behaviour begins to dominate the person’s life. About 40 per cent of people with anorexia will later develop bulimia.
Bulimia is characterised by:
A person with bulimia is usually average or slightly above average weight for height, so is often less recognisable than the person with anorexia.
Bulimia often starts with rigid weight reduction dieting in the ‘pursuit of thinness’. Inadequate nutrition causes tiredness and powerful urges to binge eat. Vomiting after a binge seems to bring a sense of relief, but this is temporary and soon turns to depression and guilt. Some people use laxatives, apparently unaware that laxatives do not reduce kilojoules or fat content, and serve only to eliminate vital trace elements and to dehydrate the body.
The person can make frantic efforts to break from the pattern, but the vicious binge/purge/exercise cycle, and the feelings associated with it, may have become compulsive and uncontrollable.
A person with bulimia may experience chemical imbalances in the body which bring about lethargy, depression and clouded thinking.
The causes of anorexia and bulimia remain unclear. Biological, psychological and social factors are all involved. For some people, some of the following may compound low self-esteem and contribute to the onset of anorexia or bulimia:
The physical effects can be serious, but are generally reversible if the illnesses are tackled early. If left untreated, severe anorexia and bulimia can be life-threatening. Responding to early warning signs and obtaining early treatment is essential.
Both illnesses, when severe, can cause:
Many of the effects of anorexia are related to malnutrition, including:
Severe bulimia is likely to cause:
These are likely to include:
Changes in eating behaviour may be caused by several illnesses other than anorexia or bulimia, so a thorough physical examination by a medical practitioner is the first step. Once the illness has been diagnosed, a range of health practitioners can be involved in treatment as the illnesses affect people physically and mentally. These may include psychiatrists, psychologists, physicians, dietitians, social workers, occupational therapists and nurses.
Outpatient treatment and attendance at special programs are the preferred treatment for people with anorexia. Hospitalisation may be necessary for those severely malnourished through lack of food. Treatment can include medication to assist severe depression and to correct hormonal and chemical imbalances.
Dietary education assists with retraining in healthy eating habits. Counselling and specific therapies are used to help change unhealthy thoughts about eating, and educating the person that family and friends are supportive.