- Psychological Issues
Anorexia and bulimia are the two most serious eating disorders.
Each illness involves a preoccupation with control over body weight, eating and food.
People with anorexia are determined to control the amounts of food they eat.
People with bulimia tend to feel out of control where food is concerned.
Anorexia affects two out of every 100 teenage girls, although the illness can be experienced earlier and later in life. Most anorexia sufferers are female, but males also suffer from the disorder.
Bulimia affects one in six females from the late teens. More females than males suffer from bulimia.
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:
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/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:
This includes media and other presentations of the ideal shape in western societies as slim and fit, and a tendency to stereotype fat people in a negative manner.
This includes chemical or hormonal imbalances (perhaps associated with adolescence).
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:
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.
For information on services, check the Community Help and Welfare Services and 24-hour emergency numbers in your local telephone directory.