Many believe that the fashion for excessive thinness, anorexia and bulimia has finally and irrevocably sunk into oblivion. However, despite the absence of high-profile scandals or deaths in the press or on television, there are still many people suffering from various eating disorders, which should be tested at the slightest suspicion. Let's look into the details, because minor symptoms today and tomorrow can become truly threatening.
Just about the complex: what is an eating disorder
If you think that there is nothing wrong with such disorders, then you are deeply mistaken. Usually, starting with the most harmless things, like refusing breakfast or dinner, or maybe vice versa, systematic nightly “overeating,” this can develop into something much more dangerous. Therefore, it doesn’t hurt to find out what eating disorders are like in adults and children in order to assess the scale of the “disaster” yourself.
In medical terms, an eating disorder is a behavioral syndrome caused by psychogenic causes. It is directly related to disturbances in meals, skipping meals, additional large snacks and other non-standard situations that become habitual. They can lead to very sad consequences, even death, therefore, at the slightest suspicion, action must be taken immediately.
Types and forms of eating disorders: symptoms
Medicine distinguishes several types eating disorders. In most cases, a complex effect is observed, which significantly aggravates the situation. Our website contains separate materials on these issues.
In a nutshell, patients experience a persistent reluctance to eat, even with a strong physiological need. A person can literally die of hunger, but stubbornly refuse the food offered. There are a number of symptoms that can be used to “calculate” anorexia nervosa.
- Self-restraint in eating even with relatively low weight.
- Unfounded belief in the presence of excess weight.
- Amenorrhea (cessation of menstruation in girls).
One or more signs may not appear, then the disease is called atypical. Most often, doctors manage to help patients with this disease on an outpatient basis, but in the most difficult cases, placement in a hospital is possible, sometimes even forcibly.
This disease is polar to anorexia. The disorder is that the patient cannot control the amount of food consumed at one time. Because of this, they systematically overeat. After eating, people with bulimia consciously vomit to get rid of what they have eaten. Other types of compensatory behavior are also possible, for example, exhausting oneself with long-term intense training for wear and tear. At the same time, there is a psychological fear of gaining weight, getting fat, and complexes about body parameters. The symptoms of the disease are simple.
- Frequently eating large quantities of food.
- Regular vomiting.
- Constant use of laxatives.
- Excessive physical activity.
Typically, patients begin with binge eating episodes occurring once or twice a week. If the picture does not normalize within three months, treatment is prescribed. Ninety percent of cases affect women under 25 years of age.
An irresistible, obsessive desire to constantly eat something may be a symptom of a psychogenic illness. That is, a person does not feel hungry, but continues to eat. Usually the body's response to stress. Troubles at home, at work, problems with parents or children, a busy work schedule - all this can trigger an attack. People who are prone to obesity are especially susceptible.
- Large quantities of food eaten during the day.
- Strong feeling of hunger.
- Eating food at high speed.
- Hunger even after eating.
- Responsibility and guilt. The desire to punish yourself.
- Stealth, eating in secret, alone.
Unlike bulimia, such overeating does not precede purging, which is why it is especially dangerous. People often gain weight and suffer from obesity and its associated symptoms. Low self-esteem and feelings of guilt lead to depression and suicidal tendencies.
Psychogenic vomiting and other diseases
This eating disorder is placed on a par with disorders. The cause may be mental and emotional symptoms. Most often, people with this disease suffer from exhaustion. May be a consequence of hypochondriacal and dissociative disorders. But there are other variants of diseases. They are less common, but in no way safer or less serious.
- Loss of appetite of a psychogenic nature.
- The need to eat something inedible, not of biological nature (plastic, metal, etc.).
- Tendency to eat inedible biological origin.
- Orthorexia is an obsession with proper nutrition.
- Obsessive-compulsive overeating, associated with constant thoughts about food, set tables, and a variety of dishes.
- Selective eating disorder – refusal of any foods or their groups. This also includes the desire to eat only a strictly defined set of foods, and the reluctance to try something new.
- External type of eating behavior. That is, the desire to eat arises not because of physiological needs, but because of the type of food, the table set, and appetizing dishes.
Psychiatrists believe that even the most seemingly minor eating disorders should not be taken lightly. One disorder can easily transform into another, which is why often even experienced doctors cannot immediately determine the type, type, nature of the disease, or determine the path to recovery.
Among eating disorders, obsessive calorie counting is common, and somewhat less common is refusal to eat from other dishes, food in a certain sequence, in a specific place. At the same time, such mental problems cannot be called purely psychological. They are complex, combining disorders with physiological factors (exhaustion, excessive physical activity, various metabolic disorders in the body).
Causes of eating disorders
There are many reasons why people develop eating disorders.
- Genetic. Recent research by scientists in this regard shows that the risk of developing bulimia or anorexia, provided that parents or other family members had the same problems, is much higher. The probability reaches sixty percent, which is very high.
- Educational (family). Most often, children learn by looking at adults, so the example of their parents becomes a kind of defense mechanism. However, sometimes being too focused on food issues can have the opposite effect on a child.
- Social. Eating disorders appear more often in those who have experienced negative emotional experiences, ostracism from society, and have been unable to adapt to the outside world after leaving their home. Severely low self-esteem is the main sign of such a development of events.
- Traumatic incidents or events. It is believed that they can cause various psychogenic disorders, including food disorders. People who have experienced physical or mental violence often suffer.
- Excessive perfectionism. Oddly enough, such patients often also suffer from eating disorders, unable to fit the world around them into the framework of an ideal order.
The impetus can be anything, and often sudden changes in life, traumatic events and incidents: the death of loved ones, moving far from familiar places, a change in occupation, the collapse of stereotypes or worldviews. .
Dutch Eating Behavior Questionnaire (DEBQ)
Back in 1986, Dutch experts jointly developed a special questionnaire, The Dutch Eating Behavior Questionnaire. This is currently the best test for eating disorders known to medicine. It allows you to use just a few simple questions to determine not only the presence of a disease, but also the likely ways of treating it. Moreover, there can be only three main reasons.
- The habit of “eating” unpleasant or pleasant emotions.
- Inability to fight temptations (inability to resist “sweets”).
- The desire to strictly and radically limit oneself in food.
By taking this simple questionnaire, you can find out what is wrong in your relationship with food, and how you can correct the problem.
Instructions on how to take the questionnaire, results
In general, the test consists of thirty-three questions, which must be answered as honestly and openly as possible. In this case, you must immediately give answers, without hesitating for a long time. For each answer “Never” you will receive only 1 point, for “Very rarely” – 2, for “Sometimes” – 3, for “Often” – 4, and for “Very often” – 5.
*For question number 31, answers should be scored in reverse order.
- Add up the scores for questions 1-10 and divide by 10.
- Sum up the scores for questions 11-23, divide by 13.
- Add up the points for questions 24-33 and divide the total by 10.
- Add the points you receive.
To complete this you will need a pen and a piece of paper where you will write down your answers.
Questions to answer
- Do you eat less if you notice that your body weight is increasing?
- Do you try to consume less than you would like, limit yourself in nutrition during any meal?
- Do you often refuse to eat or drink because you are worried about being overweight?
- Do you always control the amount of food you eat?
- Are you making food choices to lose weight?
- After overeating, do you eat smaller amounts the next day?
- Do you try to limit food to avoid gaining weight?
- Do you often have to try not to snack between meals because you are struggling with your weight?
- Do you try to avoid eating in the evening because you are watching your weight?
- Do you think about your body weight before you eat anything?
- Do you feel like eating when you're irritated?
- Do you feel like eating in moments of idleness and laziness?
- Do you feel like eating when depressed or discouraged?
- Do you eat when you are alone?
- Do you feel like eating after the betrayal of loved ones or deception?
- Do you feel hungry when plans are disrupted?
- Do you eat when you anticipate trouble?
- Do worries and tension make you want to eat?
- If “everything is wrong” and “falls out of your hands,” do you start to seize it?
- Do you want to eat when you're scared?
- Do dashed hopes and disappointments cause pangs of hunger and the desire to eat?
- When you are upset or very nervous, do you immediately want to eat?
- Are anxiety and fatigue the best reason to eat?
- When food is delicious, do you eat large portions?
- If food smells good and looks appetizing, will you eat more of it?
- Do you want to eat as soon as you see delicious, beautiful food with a pleasant aroma?
- Do you eat all the delicious food you have right away?
- Do you want to buy something tasty while passing by retail outlets?
- Do you want to immediately refresh yourself if you pass by a cafe that smells nice?
- Does the sight of other people eating food whet your appetite?
- Are you able to stop when you eat something very tasty?
- When you eat with others, do you eat more than usual?
- When you cook yourself, do you often taste the dishes?
Interpretation of survey results
Restrictive behavior (1-10 questions)
The ideal average score is 2.4 points. This suggests that in the absence of other disturbing factors, there is no need to worry too much. If your result is much lower, it means you have almost no idea what, how, in what quantities, when you eat. It is worth paying more attention to your diet. If the answer is more, then most likely you tend to strictly limit yourself, which can border on frustration. Such people often experience anorexia and bulimia.
Emotionogenic line of behavior (11-23 questions)
These questions indicate whether you generally have a tendency to “eat up” all sorts of emotional (mental) problems, troubles and troubles. The lower the number of points scored, the better, and the average can be considered 1.8. Higher rates indicate that you have a habit of pouncing on “sweets” as soon as your mood deteriorates, out of boredom or idleness.
External eating behavior (24-33 questions)
The latest answers to the questions show how easily you can be tempted to eat something tasty. Here the average score will be 2.7, and you will need to navigate by it. The more you count, the easier it is to give in to the desire to snack, even if you didn’t feel hungry at all before. If the results are much higher, then there is definitely a problem and it needs to be solved as quickly as possible.
A simple algorithm: how to get rid of an eating disorder
As soon as you realize that the problem really exists, you need to take action immediately, without waiting for anorexia or obesity to bring many unpleasant surprises into your life.
Acceptance and understanding
There are three very basic steps that you will have to follow before choosing methods to relieve the symptoms of an eating disorder.
- The main condition for treating any psychogenic factor is recognition of the problem. As long as a person does not see the problem, it does not exist, and he simply will not go to the doctor. Having realized that the disease is real, you need to seek help from a psychotherapist or psychiatrist.
- After the doctor examines, interviews and conducts research, he will prescribe treatment. The entire course must be completed from beginning to end. Not brought to logical conclusion treatment may be ineffective, and the problem will certainly make itself felt over time.
- Both before prescribing a course of treatment, and during it, and at the same time after, you need to diligently avoid traumatic situations.
Stress, troubles at work or at home, the inability to find a common language with colleagues, parents or children, teachers or superiors, all this can lead to breakdowns and a return to the original stages of the disease.
Treatment methods
Talking about in different ways treatment of eating disorders, you need to understand that all patients react to them differently. Even with exactly the same symptoms, people’s behavior can be very different, and what helps one person will be completely ineffective for another. Below are the most popular treatment methods. Some of them have proven themselves very well, while others are more reminiscent of healer dances with a tambourine.
Psychotherapy
This approach primarily involves the doctor working with a person’s thoughts, behavior, emotions, attitude towards food and interpersonal relationships in the family and close environment.
- Transactional analysis.
- Dialectical behavioral psychotherapy.
- Cognitive-behavioral, analytical therapy.
Most often, such methods are practiced by psychologists, less often by psychiatrists. However, the developed treatment models can also be used by psychotherapists, as well as various behavioral consultants. Provided that a competent, experienced specialist is selected, the prognosis for such treatment is mostly positive, and a cure is one hundred percent possible.
Family approach
This type of therapy is often used to combat eating disorders in children or adolescents. It implies active participation in the healing of not only the patient himself, but also his family members, friends and loved ones. The essence of this technique is simple - you need to train correct principles nutrition of all family members so that they can independently control the problem in the future, as well as stop crises if they arise. This is quite real and accessible.
Typically, in clinics where a family approach is developed, several specialists work simultaneously with one unit of society. This could be a nutritionist, psychiatrist, psychologist, cosmetologist, behavioral disorder specialist. Team methods of this type give excellent results.
Drug treatment
When eating disorders come more than one, but bring with them “friends” (depression, psychosis, insomnia, excessive sleepiness, causeless anxiety), then doctors prescribe medication treatment. Moreover, all these variants of negligence are classified as concomitant diseases.
You cannot “prescribe” such medications for yourself, since they usually have strict instructions, as well as a large number of “side effects”. Only a specialist can prescribe or cancel certain medications. They help only in combination with other measures of influence. It is important to understand that medications alone will not cure behavioral disorders. There is no cherished magic pill that will immediately make you well.
Diet therapy
Since this disorder is primarily related to food, it will be quite difficult to cope with it without an experienced nutritionist. However, even an ordinary therapist from a clinic can advise the correct diet. The rules here will be the same in all cases. It is important that the patient receives with food, in small quantities, all the substances necessary for life: minerals, vitamins, proteins, fats, amino acids, macro- and microelements.
With the right approach, patients can easily develop correct eating habits, which they can then usefully use throughout their lives. For example, many recommend paying attention to, with virtually no restrictions. However, you need to understand that a nutritionist is far from an expert on disorders, and therefore is not able to cure them on his own.
Traditional methods and self-medication
Many people do not attach much importance to alarming symptoms until the problem begins to grow like a snowball. Therefore, instead of turning to specialists, they begin to look for alternative methods of struggle, often very absurd. For example, no sorcerer grandfather or healer grandmother will brew a potion that can correct eating habits.
And taking independent steps without the help of professionals can hardly help in the very initial stages, when there is no disorder as such yet. The Russian Association of Eating Disorders (RAED) notes that any steps taken without a doctor end in breakdowns and a return to previous behavioral patterns in more than 93% of cases. It makes you think.
Features of the formation of eating disorders in adolescents
Children are in the most dangerous risk group, because their eating habits are formed under the influence of their environment. With poor heredity, a tendency to emotional breakdowns, and mental instability, the chances of developing eating disorders in adulthood increase significantly.
According to studies conducted on children and adolescents, only 23% of the total do not have any disorders, while the other 77% are susceptible to various kinds of “problems” or are prone to developing problems of this kind. This is due to the increasingly developing “cult of the Hamburger,” when children consider fast food an indicator of wealth and prestige. It is very important to identify a teenager’s problems in the early stages, “switch” him, get him interested in something, without allowing him to get hung up on issues of food and eating habits.
Prevention
Preventive measures to stop the very possibility of eating disorders exist. Moreover, they can be used very effectively, paying more attention to children's educational institutions, schools, and universities. But any adults can pay attention to ways to prevent possible food addiction in order to protect themselves and their loved ones.
- Correct and objective perception of your own body.
- Respectful, competent and positive attitude towards the body.
- Understanding that appearance does not in any way indicate the inner qualities of a person, his character.
- Stop worrying too much about being overweight or underweight.
- Understanding and knowledge are half the solution to a problem. Accepting yourself and your weight leads to finding ways to recover.
- Playing sports and body culture not because it is necessary, but to gain satisfaction, positive emotions, maintain activity, and get in shape. .
Socialization is very important preventive factor. Man is a herd animal; he requires communication and the approval of others. Therefore, one must always pay attention to the situation in the team where he is located. If an unhealthy atmosphere of ridicule, prodding, and reproach reigns there, then you should think about whether to change this place of work, school, or hobby club to some other one. Negativity needs to be left in the past, tuning in only to positive emotions; without this, it will be difficult to cope with the disorder.
Popular books and films about eating disorders
Books
“Sociological methods for studying addictive behavior. Preventive and clinical medicine" Sukhorukov D.V.
“Food dependencies, addictions - anorexia nervosa, bulimia nervosa” Mendelevich V. D.
“Preserving the health of schoolchildren as a pedagogical problem” Pazyrkina M. V., Buinov L. G.
“Anorexia nervosa in children and adolescents” Balakireva E. E.
Movies
Girl, Interrupted (1999), directed by James Mangold.
Sharing a Secret (2000), directed by Katt Shea.
"Hunger" (2003), directed by Joan Micklin Silver.
"Anorexia" (2006), directed by Lauren Greenfield (documentary).
"Example for Weight Loss" (2014), directed by Tara Miel.
"To the Bone" (2017), directed by Marti Noxon.
Eating disorders or eating disorders - a group of mental disorders that are associated with food intake. An eating disorder can manifest itself as partial refusal of food, periods of overeating alternating with periods of fasting, artificially induced vomiting after eating, as well as other eating habits that go beyond the norm. The most common eating disorders are anorexia and bulimia.
The causes of eating disorders are varied. This is a malfunction nervous system, failure of processes occurring in the body, heredity, childhood psychological trauma and characteristics of upbringing, the pressure of beauty standards imposed by society and disorders of the emotional sphere. Some occupations increase the risk of developing eating disorders. So among models, dancers and television presenters the figure reaches 40-50%. All professions associated with publicity and requiring an impeccable appearance are considered risky in this regard.
Over the past 50 years, the number of people with eating disorders has increased tenfold. Such statistics are associated with an increase in the number of urban residents, an increase in stress levels, and the cult of thinness and a fit figure. The majority of people with eating disorders are women, but a rapidly increasing percentage are men. Over the past 10 years, their number has doubled and now accounts for 15% of those suffering from eating disorders. The number of children with eating problems is also increasing.
The consequences of eating disorders are not nearly as harmless as they might seem. Anorexia and bulimia rank first in mortality among mental disorders of all types. Among their consequences: diabetes, heart and kidney failure. People with eating disorders are at high risk of attempting suicide.
How is appetite formed?
In order to understand the nature of eating disorders, it is necessary to understand how appetite is normally formed.
In the cerebral cortex, hypothalamus and spinal cord there are centers responsible for eating behavior. They analyze signals coming from the digestive system and the entire body and then analyze them. When it's time to replenish nutrients, blood glucose levels drop. Sensitive cells in the “hunger centers” pick up these signals and analyze them. In response, foci of excitation appear in the brain, which form appetite.
Appetite- This is a pleasant anticipation of eating food. It is he who is responsible for a person’s actions in obtaining and preparing it: buying food, cooking and eating food. Appetite also activates the functioning of the digestive organs - saliva, gastric juice, pancreatic secretions, and bile are produced. This is how the body prepares to process and absorb food.
There are two forms of appetite
General appetite- occurs when the sensitive cells of the hypothalamus feel a lack of all nutrients. At this moment, a person wants to eat any familiar food.
Selective appetite- this is a state when there is a desire to eat a certain type of food - sweets, fruits, meat, fish. Selective appetite is formed in the cerebral cortex when sensitive cells detect a deficiency of certain substances.
After eating, a person feels full and satisfied with food. The stomach receptors send a signal of satiety to the digestive centers, at this stage the person feels that he has eaten enough and stops eating.
What problems may arise
Lack of appetite– no excitement occurs in the centers that are responsible for its appearance. This is possible if there is a disruption in signal transmission from the digestive system to the brain, a disruption in the interaction between nerve cells, problems with the reuptake of serotonin, or a predominance of inhibition processes in the brain (for example, with depression)
Increased general appetite– associated with a persistent focus of excitation in the hypothalamus. Causes bouts of gluttony and a tendency to overeat.
Desire to eat only certain foods. The cerebral cortex, or more precisely a group of neurons located in hunger centers, is responsible for this behavior. Selective eating, orthorexia, and perverted appetite are signs that these areas of the brain are not functioning properly.
Relationship between eating disorders and mental factors
The appearance of eating disorders is associated with a number of mental factors. Several personality traits are thought to contribute to these disorders:
- Low self-esteem;
- Dependence on the opinions of others;
- Need for approval;
- The desire to control what is happening, at least within the confines of your body;
- The desire for perfectionism and unattainable ideals of beauty.
- As a rule, the beginnings of eating disorders begin in childhood, which is facilitated by:
- Lack of emotional support from parents;
- An overbearing mother and a father who paid little attention to the child;
- Excessive demands on the child, which he is unable to justify;
- Frequent reproaches, expressions of dissatisfaction, criticism of appearance, manners;
- Problems with separation from parents during adolescence. Increased dependence of the child on parents. Thus, one of the popular theories explains the development of anorexia and bulimia by the desire to return to childhood;
- Excessive care and lack of freedom in adolescence.
- It can be argued that an eating disorder develops in a person with certain mental characteristics if life circumstances contribute to this.
Anorexia nervosa
Anorexia nervosa– an eating disorder, which is manifested by refusal to eat and an obsessive desire to lose weight. The purpose of not eating is to lose weight or prevent obesity. It is common for patients to experience unreasonable fears about being overweight, although, as a rule, they are thin or have a normal physique.
The vast majority of patients are young women and girls. Up to 5% of this population group suffers from various manifestations of anorexia. Anorexia nervosa occurs 10 times less frequently in men than in women.
Causes of Anorexia Nervosa
– from parents to children, peculiarities of the functioning of the nervous system are transmitted, which determine the tendency to the appearance of anorexia nervosa (low self-esteem, immaturity, need for approval). The claim increases for people who have close relatives suffering from anorexia and bulimia.
Disorders of neurotransmitter metabolism(serotonin and dopamine), which provide communication between nerve cells. This disrupts the interaction of cells in the brain centers responsible for eating behavior.
Wrong upbringing. Anorexia nervosa develops if in childhood a person did not feel unconditional approval: “No matter what happens, you’re doing great. There are mistakes, but they can be corrected.” Criticism, high demands and lack of praise did not allow the child to develop healthy self-esteem. Fighting appetite and conquering yourself in the form of refusing to eat is a perverse way to increase self-esteem.
Severe crisis adolescence . Loss of contact with parents and reluctance to move into adulthood. The thinking model is approximately this: “I am thin and small, which means I am still a child.”
Social standards. Thinness in modern society associated with beauty, health and willpower. The stereotype that it is easier for thin people to achieve success in their personal lives and careers pushes people to constantly experiment with diets and weight loss medications.
Offensive remarks about excess weight from parents, peers, teachers. Sometimes memories of mental trauma can resurface in memory years later and trigger the development of the disorder.
Some activities. Modeling, show business, dancing, athletics.
Stages of anorexia nervosa
There are three stages of development of anorexia nervosa:
Pre-anorexic stage- obsessive desire to quickly lose weight. Constant criticism of your body and appearance. The discrepancy between one’s appearance and the “ideal image” that a person has drawn in his mind, which is caused by low self-esteem. A person constantly tries various radical methods of losing weight: diets, medications, procedures, intense exercise. Duration 2-4 years.
Anorexic stage– refusal of food and weight loss. Losing weight brings satisfaction, but patients continue to consider themselves fat and refuse to eat. The patient constantly has a fear of getting better, his emotional background and vitality are reduced. The result is weight loss of 20-50% of the initial body weight. Menstrual irregularities or complete cessation of menstruation.
Cachexia stage– severe exhaustion of the body. The patient's weight is less than 50% of normal, while he continues to limit himself in food, fearing obesity. Dystrophy of the skin, skeletal muscles, and heart muscle begins. Changes occur in all internal organs. Exhaustion is accompanied by increased fatigue and inactivity.
Some researchers distinguish the elimination stage of cachexia. This is the stage of treatment, which is accompanied by anxiety associated with weight gain, unusual sensations associated with the digestion of food, which are perceived as painful. Patients continue to try to limit themselves in food. Delusional thoughts may appear: “food spoils the skin.”
Symptoms and manifestations of anorexia nervosa
Symptoms of the preanorexic stage
Dissatisfaction with your appearance. The discrepancy between the invented ideal image and the reflection in the mirror. As a rule, this coincides with the onset of puberty, when the teenager critically perceives the changes occurring in his body.
Constant struggle with excess weight. Regular attempts to lose weight by exercising and dieting.
Causes of Bulimia Nervosa
Mental illness, inherited. High need for endorphins, impaired neurotransmitter metabolism.
Metabolic disorders– known insulin resistance, impaired metabolism of fats and carbohydrates.
Excessive demands on the child in family, which cause fear of not meeting expectations and disappointing parents.
Low self-esteem. It provokes an internal conflict between the ideal idea of oneself - “what I should be” and the real situation - “what I really am.”
Loss of control over emotions. The development of bulimia is promoted by depressive moods and strong negative emotions.
Family conflicts– disruption of interaction between family members (parents, partner).
Addiction to diets and fasting. It is noted that the stricter and longer the diet, the higher the risk of failure. With systematic adherence to diets, the behavior pattern of “fasting-breakdown-cleansing” is reinforced.
Mental illnesses. Bulimia nervosa can be a symptom of epilepsy and schizophrenia.
Types of Bulimia Nervosa
Primary bulimia– uncontrollable hunger followed by bouts of gluttony and periods of purging.
Secondary bulimia, which arose on the basis of anorexia. Bouts of gluttony after prolonged refusal to eat.
Types of bulimia according to the “purification” method
Bouts of gluttony are followed by periods of “cleansing” - vomiting, taking laxatives, enemas;
Bouts of gluttony are followed by periods of strict diets and fasting.
Symptoms and manifestations of bulimia nervosa
As a rule, the onset of the disease occurs at 13-14 years of age due to dissatisfaction with one’s figure. As in the case of drug addiction, patients are obsessed with thoughts about food and fear of excess weight, while denying the existence of a problem. Most of them believe that they can return to normal eating as soon as they want.
Obsessive thoughts about food. A person constantly wants to eat. The feeling of hunger is aggravated by diets and restrictions.
Stealth. Bulimics keep their habits private, unlike anorexics who like to discuss diets.
Haste when eating. Insufficient chewing, swallowing food in chunks.
Eating large amounts of food. Bulimia sufferers specially prepare a lot of food to get the most out of their meal. This could be sweet food, favorite dishes, or vice versa, less edible food.
Artificially induced vomiting. After eating, people with bulimia often retreat to the toilet to induce vomiting. They also use laxatives or enemas to cleanse the body of what they have eaten.
Dieting. To maintain a desired weight, people with bulimia nervosa diet most of the time.
Physiological manifestations of bulimia
Weight changes. A person with bulimia may gain weight and then lose weight dramatically.
Frequent throat diseases. Frequent vomiting lead to inflammation of the mucous membrane of the throat, causing pharyngitis and sore throats. When the vocal cords are irritated, the voice becomes hoarse.
Dental problems. The acid contained in gastric juice destroys tooth enamel. This leads to caries and tooth loss.
Digestive system diseases. There is a high probability of developing gastritis, peptic ulcer of the stomach and duodenum, pain in the right hypochondrium and along the intestine.
Increased salivation and enlarged salivary glands are characteristic signs of bulimia.
Decreased vitality. Food restrictions and unhealthy image life disrupts metabolism. This is manifested by general weakness and increased fatigue during exercise.
Signs of dehydration. Flabbiness of the skin, dry mucous membranes and eyes, and infrequent urination are caused by large losses of water during vomiting and taking laxatives.
Diagnosis of bulimia nervosa
The diagnosis of bulimia nervosa is made if the following diagnostic criteria are met:
- Bouts of gluttony (consuming large amounts of food in a short period of time), recurring at least 2 times a week for 3 months;
- Loss of control over food cravings during a bout of gluttony;
- Compensatory behavior aimed at eliminating the consequences of overeating - inducing vomiting, fasting, significant physical activity;
- Excessive fear of fullness, constantly present;
Treatment for Bulimia Nervosa
Psychotherapy for bulimia nervosa
Cognitive behavioral psychotherapy. The psychologist teaches you to identify “eating disorder thoughts” and replace them with healthy attitudes. He gives the task to track in what situation obsessive thoughts about food most often appear and what feelings they cause. In the future, it is recommended to avoid these situations, for example, delegate the purchase of groceries to other family members.
Family-oriented psychotherapy. The most effective option for patients of adolescence and youth. The task of loved ones is to help strengthen self-esteem and instill proper eating habits that will help maintain normal weight without suffering from hunger.
Drug treatment for bulimia nervosa
Antidepressants third generation SSRIs increase the activity of serotonin and the transmission of impulses along the chain of nerve cells - Venlafaxine, Celexa, Fluoxetine.
Tricyclic antidepressants– Desipramine
Treatment of bulimia with antidepressants reduces the likelihood of binge eating by 50%, regardless of whether the patient is depressed or not.
Prevention of bulimia nervosa
Preventive measures are the formation in a child of adequate self-esteem, a correct attitude towards food, and the preparation of a diet that corresponds to energy costs.
Psychogenic overeating
Psychogenic overeating or compulsive overeating– an eating disorder that involves overeating in response to stress and leading to obesity. In other words, this is overeating due to nervousness. It can be a reaction to the death of a loved one, troubles at work, loneliness, illness and other psychological trauma. Binges of overeating can be rare or systematic and occur in response to any negative emotions.
This eating disorder is more common among adults, and especially people who are overweight. According to statistics, 3-5% of the adult population suffer from it.
The consequences of psychogenic overeating are obesity, diabetes, atherosclerosis, heart and joint diseases.
Causes of psychogenic overeating
Genetic predisposition. Individual genes have been identified that are responsible for overeating even in the absence of hunger, and low sensitivity to satiety. The tendency to psychogenic overeating is inherited from relatives with diabetes and obesity.
Inability to cope with negative emotions– fear, melancholy, sadness, guilt, anxiety. Eating food, especially sweet foods, quickly increases blood glucose levels. “Sweet” blood, washing the brain, promotes the production of the neurotransmitters serotonin and dopamine, which are also called pleasure hormones. As a result of eating food, the mental state temporarily improves. However, it is followed by a feeling of guilt and dissatisfaction with one’s weak will and one’s own body.
Feelings of inferiority and one’s own failure to meet other people’s expectations. These feelings are based on low self-esteem.
Psychological trauma in childhood age. It has been established that people with psychogenic overeating in childhood suffered from rough treatment by their parents, conflicts between adults, and were brought up in a family where there was a cult of food.
Social standards. Modern standards of beauty imply the absence of excess weight. People who suffer from their obesity experience a feeling of guilt and displeasure with their body. Negative emotions push them to “seize” problems, which leads to further weight gain. Thus, a vicious circle is formed.
Types and forms of psychogenic overeating
External overeating– a person eats food when it is available to him. Buys too much food, overeats when visiting, cannot stop while there is food on the table. The provoking factor is the sight and smell of food.
Emotional overeating– the cause of strong cravings for food is not hunger, but an increased level of the stress hormone – cortisol. A person overeats when experiencing negative emotions.
Symptoms and manifestations of psychogenic overeating
Uncontrollable bouts of gluttony, which are caused by stress and negative emotions, and not by hunger. Boredom is often a provoking factor, so watching TV and reading are also accompanied by eating.
Lack of power system. A person eats not according to a schedule, but according to desire. Sometimes a bout of overeating can last throughout the day. Overeating at night also happens.
During an attack, a person eats large amounts of food. He is unable to stop, despite the feeling of fullness in his stomach.
The process of eating is accompanied by pleasure, however, soon afterwards feelings of guilt and self-loathing appear. A person reproaches himself for lack of self-control. Negative emotions about one’s appearance and character weaknesses cause new bouts of overeating.
Trying to hide the amount you eat. When eating in the company of other people, a person can consume food in moderation. Left alone, the patient consumes food in large quantities, usually until everything is eaten.
Stockpiling food to eat alone. The patient tends to prepare for overeating by buying or preparing food in large quantities.
There are no attempts to cleanse the body of food. People don’t induce vomiting and don’t exhaust themselves with training. At the same time, they often try to adhere to diets, but cannot withstand the restrictions.
Despair and depression about the inability to control the amount of food eaten.
Weight gain. Within a few weeks of the onset of the disorder, significant weight gain is observed.
Diagnosis of psychogenic overeating
A diagnosis of psychogenic disorder is made if a person exhibits 3 or more signs of the disease:
- Eating large amounts of food despite not feeling hungry;
- Episodes of overeating that last a certain time (up to several hours), ending with an unpleasant feeling of fullness;
- Eating much faster than most people do;
- Feelings of guilt that arise after bouts of overeating;
- Embarrassment over eating too much, causing people to prefer to eat alone.
Treatment of psychogenic overeating
Psychotherapy for neurogenic overeating
Information psychotherapy. The psychologist explains that compulsive overeating is a complex biopsychic disorder. The reason for his development is not weak character and spoiledness. He talks about the futility of trying to diet. Instead, a rational nutrition system will be proposed. The psychologist will teach you how to keep a food diary, indicating what time and what was eaten. A psychologist helps increase motivation, which allows a person to stick to healthy system nutrition and exercise.
Cognitive therapy. It is aimed at reducing dependence on food. The psychologist’s task is to teach the patient constructive ways to deal with stress, increase stress resistance and self-control. The technique has proven itself well in cases of psychogenic overeating. Therefore, it is recommended to use it from the beginning of treatment.
Psychoanalysis. During the sessions, the psychologist helps to identify the underlying problems that caused the eating disorder. One of the main stages of treatment is accepting tormenting thoughts and speaking them out.
Group psychotherapy. When treating compulsive overeating, it is helpful to interact with people who have the same problem.
Drug treatment of neurogenic overeating
Appetite suppressants are not effective for compulsive overeating. Preference is given medicines, acting on the central nervous system.
Antidepressants. This group of drugs normalizes serotonin levels in the nervous system - Topamax.
Prevention of psychogenic overeating
Prevention of compulsive overeating is the formation of correct attitudes about nutrition - food is not a pleasure or a reward, but a necessity. It is also necessary to increase stress resistance and develop healthy eating habits - eating small portions by the hour.
Psychogenic loss of appetite
Psychogenic loss of appetite– lack of need for food due to nervous shock. Refusal to eat can be caused by stress, conflicts in the family and at work, or the loss of a loved one. The consequence of loss of appetite due to nervousness is rapid exhaustion of the body, loss of physical strength, worsening emotional state, and the development of depression.
With psychogenic loss of appetite, unlike anorexia, a person’s goal is not to fight excess weight. He does not consider himself fat and perceives his body adequately.
The prevalence among women is 2-3%. It is more common among those trying to lose weight, since at a subconscious level they have a desire to give up food.
Psychogenic disorders do not include loss of appetite due to infectious diseases and diseases of the digestive system.
Causes of psychogenic loss of appetite
Stress and strong emotional stress. Conflicts, situations that pose a threat to life or well-being, preparing for exams or reports, loss of a job, breakup of relationships.
Disturbances in hormone production due to stress. Decreased synthesis of digestive system hormones (ghrelin and insulin), which are responsible for appetite. Disturbance in the production of hormones of the hypothalamus and pituitary gland.
Disturbances in the functioning of hunger centers in the brain and spinal cord. Negative emotions and intense mental work can change how the brain works. Stress causes disturbances in the transmission of nerve impulses between appetite centers.
Depression This is one of the most common causes of loss of appetite.
Types of psychogenic loss of appetite
Primary psychogenic loss of appetite– develops immediately after stress or during severe mental or mental stress. Provokes the development of depression
Secondary psychogenic loss of appetite– develops against the background of depression and neurosis that arose after suffering psychological trauma.
Symptoms and manifestations of psychogenic loss of appetite
Lack of appetite. The person does not feel the need for food. At the same time, he may feel discomfort in the stomach caused by hunger, but not react to them.
A person deliberately forces himself to eat, despite lack of appetite. This is a favorable course of the disorder.
Refusal of food. The offer to eat is rejected on principle - this is the second possible model of behavior in this situation. She talks about severe psychological trauma.
Diagnosis of psychogenic loss of appetite
The diagnosis of “psychogenic loss of appetite” is made on the basis of complaints from the patient or his relatives, provided that the person does not have diseases of the digestive system or other causes of loss of appetite. The following are taken into account:
- Refusal of food
- Weight loss,
- Depressed mental state
- Signs of physical exhaustion.
Treatment of psychogenic loss of appetite
Psychotherapy for psychogenic loss of appetite
Cognitive behavioral therapy. At the initial stage of psychotherapy, it is necessary to minimize the consequences of mental trauma, after which treatment of the eating disorder begins. A psychologist helps to form a positive attitude towards eating.
Drug treatment psychogenic loss of appetite
Vitamin complexes with minerals to combat vitamin deficiency - Multitabs, Pikovit.
Drugs to increase appetite on plant based– wormwood tincture, plantain juice.
Nootropics to improve the functioning of the nervous system - Bifren, Glycised.
Prevention of psychogenic loss of appetite
Prevention involves increasing resistance to stress and developing healthy self-esteem and attitudes towards food.
Psychogenic vomiting
Psychogenic vomiting or nervous vomiting - a reflex eruption of stomach contents under the influence of stress. Sometimes psychogenic vomiting is not preceded by nausea. The contents of the stomach are expelled spontaneously as a result of spasm of the muscles of the abdominal wall and stomach.
Unlike bulimia, vomiting occurs unintentionally. A person does not set a goal to cleanse the stomach in order to avoid digesting food and gaining excess weight.
Isolated cases of psychogenic vomiting occurred in 10-15% of people. People with an excitable nervous system regularly face this problem. In most cases, these are children, adolescents and young women under 35 years of age. Only 1/5 of those suffering from this disorder are men.
Causes of psychogenic vomiting
Fear and anxiety. The most common reasons. In this case, vomiting occurs exclusively before a significant and exciting event.
Stress. Psychogenic vomiting is caused by acute stress, chronic stressful situations (loneliness, parental divorce), prolonged nervous tension - difficult period At work.
Excessive emotionality - a personality trait that increases the likelihood of nervous vomiting.
Increased excitability nervous system. Excitation processes predominate in the brain, which can affect the functioning of the vomiting centers located in medulla oblongata, thalamus and cortex. Excitation in this area causes morning psychogenic vomiting in children.
Hereditary predisposition. The risk of developing the disorder is higher in people whose parents suffered from motion sickness and psychogenic vomiting.
Types of psychogenic vomiting
Anxious vomiting- reaction to fear and anxiety.
Jet vomiting- appears on the basis of unpleasant associations when seeing food: pasta - worms, homemade sausage - excrement.
Hysterical vomiting– reaction to stress and associated negative emotions;
Habitual vomiting- a manifestation of the fact that a person constantly suppresses his emotions.
Symptoms and manifestations of psychogenic vomiting
- Vomiting without nausea, especially occurring on an empty stomach and not associated with poisoning, infections or diseases of the digestive system.
- Vomiting after stress or before frightening events.
- Vomiting at the sight of food that causes unpleasant associations.
- Vomiting against the background of negative emotions that a person cannot throw out.
Diagnosis of psychogenic vomiting
First, you need to be examined by a gastroenterologist to rule out diseases of the digestive system. When diagnosing nervous vomiting, the doctor pays attention to the connection of attacks with the emotional and mental state of a person, with food intake, as well as their frequency and regularity.
Treatment of psychogenic vomiting
Psychotherapy
Cognitive and behavioral therapy. The techniques used by a psychologist will help increase stress resistance and make it easier to respond to problems and conflicts.
Suggestive therapy. Its goal is to improve the functioning of the central and autonomic nervous systems. Elimination of foci of excitation in the vomiting centers.
Drug treatment
Electrolyte solutions for the correction of electrolyte disturbances. Necessary for dehydration caused by frequent bouts of vomiting - rehydron, humana electrolyte.
Antipsychotics used to treat nervous nausea and vomiting - Haloperidol, Prochlorperazine.
Antidepressants used to reduce the excitability of the nervous system - Coaxil
Prevention of psychogenic vomiting
Allotriophagy
Allotriophagy has other names - perversion of taste or perversion of appetite. This is an eating disorder in which a person has a tendency to lick or swallow inedible or inedible objects - coal, chalk, coins.
Perversion of taste is more common in low-income and dysfunctional families. Young children and pregnant women are more susceptible to it. Similar behavior occurs in mentally healthy people, as well as in autism and schizophrenia.
Perversions of appetite are a common problem among children under 3 years of age, but the older the child becomes, the less often perversions of taste occur.
Psychological trauma– separation from loved ones, pathological relationships with parents.
Boredom. This reason is typical for children. It has been established that allotriophagy occurs in children who lack toys and attention.
Hormonal changes in the body during pregnancy and adolescence.
Nutrient deficiency with improper or insufficient nutrition. For example, eating dirt may indicate a lack of iron or charcoal in the body, eating chalk - a calcium deficiency, soap - a lack of zinc.
Incorrectly formed ideas about edible and inedible. The reason may be characteristics of upbringing or cultural traditions.
Types of allotriophagy
Eating inedible objects– sand, stones, nails, paper clips, glue;
Eating inedible objects - coal, chalk, clay, animal food;
Eating raw foods - minced meat, raw dough.
Symptoms and manifestations of taste perversion
Licking and chewing. Associated with a strong desire to feel their taste.
Eating inedible substances. The goal is boredom, the desire for new experiences and sensations.
Swallowing inedible objects – caused by an inexplicable desire that a person is unable to resist.
Diagnosis of allotriophagy
The diagnosis of “allotriophagy” is made when eating inedible objects based on complaints from the patient or his relatives.
Treatment of allotriophagy
Psychotherapy
Behavioral psychotherapy. Its basic principles are to avoid situations in which there is a desire to taste inedible objects (do not play in the sandbox while eating sand). Noticing thoughts about eating and replacing them with others, as well as rewarding success for success, is a method of positive reinforcement.
Family therapy- building relationships in the family. Parents are advised to communicate more with their child. The tone should be calm and friendly. The method of isolation from stress is practiced. If possible, it is necessary to exclude all factors that overstimulate the nervous system: do not scold the child, limit time in front of the TV, tablet, phone. Keep your child busy with calm games.
Prevention of allotriophagy
Prevention of allotriophagy includes: good nutrition, varied activities and hobbies, and a friendly atmosphere in the family.
Orthorexia nervosa
Orthorexia nervosa- obsessive desire to eat right. Orthorexia differs from the desire for a healthy lifestyle by obsession; it crowds out other interests and hobbies. The topic of healthy food dominates conversations; the person actively encourages others to switch to his diet.
Orthorexia nervosa makes a person indifferent to the taste of food. Products are judged solely on their health benefits. At the same time, a person significantly limits the list of foods consumed, which can lead to a lack of nutrients. For example, vegetarians suffer from a deficiency of essential amino acids and B vitamins.
The consequences of orthorexia are: limited social circle and deficiency of vitamins and chemical elements. Restrictions in food can lead to anemia, vitamin deficiency, and changes in internal organs.
Causes of Orthorexia Nervosa
Tendency to hypochondria- fear of getting sick. Proper nutrition is an attempt to prevent disease.
Neurotic character. The development of orthorexia in mentally healthy people is facilitated by increased suggestibility and scrupulousness. In addition, an obsessive desire for healthy food can be a manifestation of neurosis obsessive states.
Heightened self-esteem. By adhering to his own nutritional system, a person feels superior to others.
Types of Orthorexia Nervosa
The most common nutritional systems that can become the basis of an eating disorder:
Veganism and vegetarianism– exclusion of animal products.
Raw food diet– refusal of food that has undergone heat treatment (frying, boiling, stewing).
Refusal of products containing GMOs. Genetically modified organisms are products with an altered genetic structure.
Symptoms and manifestations of orthorexia nervosa
Obsessive desire to consume only “healthy” foods. Moreover, the degree of usefulness is assessed subjectively. Often his interests, thoughts and conversations are limited to the topic of proper nutrition.
Limited diet. A person refuses food that is not on his list of “healthy” foods. In some cases, only a few products are included in the menu.
Cooking can be a ritual. Only the right products are used, the cutting board and knife must be ceramic, the dish must be marinated or boiled for a strictly defined period of time.
Changes in social circle. A person communicates exclusively with like-minded people who adhere to the same principles of catering. There have been cases when such people organized a commune to grow food and live separately.
Feelings of guilt that arise when consuming “harmful” foods, although in reality they do not pose a health hazard. When one’s “diet” is violated, a person experiences psychological discomfort and severe anxiety. Due to nervousness, after consuming unusual foods, nausea, vomiting, and abdominal pain may occur.
Fear of “harmful” foods can look like a phobia. In this case, they are disgusting. A person will not consume them for food, even if he is hungry and there is no other food.
Diagnosis of orthorexia nervosa
To date, the diagnosis of “orthorexia nervosa” is not included in the list of diseases.
Treatment of orthorexia nervosa
Psychotherapy is the main method of treatment. In most cases, the method of persuasion is used. A psychologist talks about the benefits of other products. When only certain foods are consumed, they, like medicine, can cause side effects: peptic ulcers from eating sour fruits, phosphate kidney stones from dairy products.
Prevention of orthorexia nervosa
Formation of rational ideas about proper nutrition in children and adults.
Selective eating disorder
Selective eating disorder– a type of eating disorder that is characterized by a refusal to consume certain foods. In this case, a person is guided not by health benefits, but by subjective criteria: color, shape, associations. When he sees these products, he experiences fear and disgust. The phobia can be triggered by the smell of this food, and even talking about it.
This disorder differs from ordinary picky eating by a large range of foods that a person cannot tolerate. This significantly impoverishes the diet, causes weight loss and complicates communication with others. For example, a person is forced to refuse business lunches or family holidays accompanied by a feast.
Selective eating disorder is a relatively rare disorder that is more susceptible to children.
Selective eating disorder can pose a health risk when most foods are excluded from a person's diet and their diet is limited to only certain foods.
Causes of selective eating disorder
Psychological injuries associated with these products.
Diseases that develop after consuming these products. Moreover, it is not necessary that the product caused poisoning or food intoxication; perhaps its consumption coincided with the onset of the disease.
Incorrect introduction of complementary foods. Often disgust and phobia are associated with foods that parents forced the child to eat against his will.
Types of Selective Eating Disorder
- Refusal of vegetables and fruits
- Avoidance of animal products
- Avoiding any solid food
Symptoms and manifestations of selective eating disorder
Fear arising from the thought, sight or smell of certain foods or dishes. These can be a variety of phobias: fear of hot or cold, round or colored foods, fear of sour, bitter, salty tastes.
Rationalization of fear. The person explains his fears: “I’m afraid to choke, choke. I'm afraid the food will stick to my throat and I won't be able to breathe. I'm afraid of getting poisoned."
Diagnosis of selective eating disorder
Selective eating disorder is a disease only if one or more of the following conditions are met:
- Refusal of a large range of products;
- The disorder negatively affects a person's health by causing vitamin or protein deficiency;
- Body weight decreases in adults, physical development slows down in children and adolescents;
- Dependence on certain foods develops;
- Fear and negative emotions associated with foods disrupt emotional well-being.
Treatment of selective eating disorder
">Behavioral therapy. During the treatment process, a person performs tasks that are aimed at getting used to the products. For example, he is asked to choose vegetables, then cook them, and in subsequent sessions they move on to tasting new dishes. Gradually, addiction sets in and the fear goes away.
Preventing selective eating disorder
Prevention is the gradual and non-violent introduction of a child or adult to a variety of dishes. Expanding its menu according to age.
Eating disorders in children
Eating disorders in infancy and childhood
Eating disorders in children early ages are widespread. To one degree or another, they are observed in 25-40% of children from 6 months to 6 years. In most cases, these are temporary phenomena that disappear with age.
Causes of eating disorders in children
- Violation of mother-child contact when little attention is paid to the child.
- The wrong type of feeding is feeding the baby while sleeping, long feedings lasting more than an hour.
- Food that is not appropriate for the child’s age does not taste good to him. Too early introduction of complementary foods and solid foods, early spoon feeding.
- Too persistent introduction of new food causes internal protest and aversion to any food.
- Psychological conflicts in the family.
- Stress – animal attack, injury, hospitalization.
- Attempts to manipulate adults in demanding children who are the center of attention of the family.
- Extreme pickiness about food.
- Curiosity. The child is interested in new tastes and new behavior patterns. If his action caused an emotional reaction from an adult, then the child will most likely repeat this action.
- Among the causes of eating disorders, we do not consider mental retardation, diseases oral cavity or digestive organs, although these diseases may have the same manifestations as eating disorders.
Types of eating disorders in children
- Refusal of food. The child refuses to open his mouth, turns away when feeding, and spits out food. This is the so-called childhood anorexia.
- Rumination disorder. Regurgitation of food followed by chewing. The baby regurgitates a small amount of food and chews it again. At the same time, he does not feel nausea or the urge to vomit.
- Perversion of taste – eating inedible objects. It is very widespread, since up to 2 years of age a child may not distinguish edible from inedible. In this regard, this behavior younger children is not considered a disorder.
Diagnosis of eating disorders in children
The described violations appear daily for a month or more, despite the parents’ attempts to change the situation.
Treatment of eating disorders in children
- The basis of treatment is psychotherapy. It includes:
- Creating a calm and friendly environment - spend more time with the child, keep him busy with quiet games and walks, and reduce watching TV.
- Eliminating situations in which eating disorders manifest themselves is not allowing them to play in the sandbox if the child eats sand.
- Adjust your diet. Feed when the child is hungry, no earlier than 4 hours after the previous feeding, exclude snacks - cookies, fruit. They are offered after the main meal.
Prevention of eating disorders in children
The child must receive food appropriate for his age. If he refuses to try new foods, then don't insist. Re-offer them in 2-3 weeks. Don't force feed. Make sure your child works up an appetite. If possible, relieve him of stress.
Eating disorders in adolescents
Eating disorders in adolescents are widespread and are associated with a variety of causes. Teenagers focus on their appearance, considering appearance and slimness the basis for success among their peers. In addition, adolescence is difficult psychologically - mood swings and changes in appearance caused by hormonal changes, separation from parents and the formation of independence, as well as instability of self-esteem create the ground for eating disorders.
Causes of eating disorders in teenagers
Disturbances in the relationship between mother and child in the first year of life. From the point of view of psychoanalysis, attention deficit and early abandonment breastfeeding cause fixation on the oral-dependent period. It is believed that this can cause eating disorders in children and adults.
Hereditary predisposition. Often, eating disorders in adolescents are caused by genetically determined characteristics of the nervous system, which are inherited from their parents.
Social factors. Statements from parents and peers about excess weight, the imposed stereotype of being thin as an essential component of success, and the desire to please members of the opposite sex push teenagers to extreme weight loss measures. Due to ignorance, teenagers do not realize the danger and harm of their actions.
Personality characteristics. Low self-esteem and uncertainty about one’s attractiveness are the main factors that form all eating disorders in adolescents.
Types of Eating Disorders in Teens
Teenage anorexia– refusal of food in order to lose weight. Teenagers consider themselves fat for no reason and actively use all means of losing weight available to them. Anorexia ranks 3rd among chronic diseases teenagers
Teenage bulimia– artificially induced vomiting to reduce food absorption. Also aims to reduce weight.
Psychogenic vomiting– unintentional vomiting associated with nervous tension, mental fatigue and stress.
Perversion of taste, perversion of appetite - the desire to taste inedible and inedible objects (lime, chalk, coal, matches), sometimes swallowing them. It is less common than other eating disorders in adolescents.
Symptoms and manifestations of eating disorders in adolescents
Symptoms of teenage anorexia
- Expressing dissatisfaction with your body, fatness, hip size, chubby cheeks.
- Refusal of high-calorie foods. Significant reduction in portions of food eaten.
- Sudden weight loss in a short period of time. Stopping growth.
- Intense exercise, other means to accelerate weight loss, appetite suppressant pills, weight loss tea.
- Depressed mood, lethargy.
- Chilliness, cold hands and feet.
- Menstrual irregularities or absence of menstruation.
Symptoms of teenage bulimia
- Alternating periods of restricting oneself in food, gluttony and “cleansing” the body.
- Careful calorie counting and selection of low-calorie foods.
- Dissatisfaction with excessive completeness. Pangs of conscience after overeating.
- The habit of seclusion after eating in order to induce vomiting and clear the stomach.
- As a rule, teenagers keep binge eating and purging secret and parents may not know about it for a long time.
- Depression, tendency to depression.
- Multiple caries, frequent throat problems, hoarseness.
- Weight changes. Stunted growth.
Symptoms of adolescent psychogenic vomiting
- Attacks of vomiting during periods of increased mental stress, worries, fear, anxiety, after stressful situations.
- Vomiting as a manifestation of protest. It can occur when a teenager is forced to do something against his will, be it traveling, studying or eating.
- Vomiting as a way to attract the attention of adults.
- Increased excitability of the nervous system, manifested by excessive emotionality, anger, and tearfulness for minor reasons.
- The attacks are not associated with food intake, poisoning or diseases of the digestive system.
Symptoms of teenage taste perversion
The diagnosis for a teenager is made based on information collected during a survey of the child and his relatives. In this case, it is necessary to examine the general condition of the body in order to identify disorders in the organs caused by an eating disorder. The examination includes:
- Blood, urine, stool tests;
- Ultrasound of the abdominal organs;
- Gastroscopy and other studies (if necessary).
Treatment of eating disorders in adolescents
Diet becomes the basis of treatment. Food is given in small portions 5-6 times a day. At first, the calorie content of the daily diet is 500 kcal, gradually increasing it to the age norm.
Psychotherapy
Family therapy plays a leading role in the treatment of adolescents, since support and good relationships within the family are the basis for successful treatment. The psychologist gives advice on how to improve relationships with a teenager and between other family members.
Behavioral therapy is aimed at changing thinking patterns, developing a healthy attitude towards your body and food, and increasing self-esteem. The psychologist will tell the teenager how to change his thinking and behavior in order to get rid of an eating disorder. A change of environment and social circle is recommended. Treatment in a sanatorium gives good results.
Suggestive and hypnotherapy. Suggestion in a state of half-asleep helps to remove a negative attitude towards treatment and food.
Drug treatment of eating disorders in adolescents
Treatment begins with restoring the functions of internal organs. Gradually return the teenager to a normal diet.
Antidepressants, tranquilizers and antipsychotics are prescribed only in cases where the disorder does not respond to other treatment methods.
Prevention of eating disorders in adolescents
- It is important to avoid heavy stress on the nervous system. Significant training loads and a large number of additional tasks cause overwork of the nervous system and foci of excited neurons in different parts of the brain.
- Balanced diet. The menu should include tasty and varied dishes. The amount of food should meet the needs of the teenager and ensure normal growth and development.
- Food should not be a reward or the main source of pleasure.
- It is necessary to support a teenager to develop adequate self-esteem.
Eating disorders are psychological illnesses characterized by abnormal eating habits, which may include insufficient or overconsumption food to the detriment of physical and mental health. and are the most common forms of eating disorders. Other types of eating disorders include binge eating disorder and other eating and eating disorders. Bulimia nervosa is a disorder characterized by compulsive overeating and purging. This may include forced vomiting, excessive exercise, and the use of diuretics, enemas, and laxatives. Anorexia nervosa is characterized by excessive food restriction to the point of self-exhaustion and large weight loss, which often causes women who have begun to menstruate to stop their menstrual cycle, a phenomenon known as amenorrhea, although some women who have other criteria for anorexia nervosa according to the Diagnostic and Statistical Manual of Mental Disorders , 5th edition, are still noticing some menstrual activity. This version of the Guide identifies two subtypes of anorexia nervosa—the restrictive type and the purging type. Patients with the restrictive type of anorexia nervosa lose weight by restricting food intake and sometimes excessive exercise, while patients with the purging type overeat and/or compensate for weight gain with a form of cleansing. The difference between purging anorexia nervosa and bulimia nervosa is the patient's body weight. In anorexia, patients feel well at a normal body weight, whereas in bulimia, patients may have a body weight that ranges from normal to overweight and obese. While these disorders were originally thought to be specific to women (estimated at 5-10 million people in the UK), eating disorders also affect men. It is estimated that 10–15% of patients with eating disorders are men (Gorgan, 1999) (an estimated 1 million men in the UK suffer from these disorders). Although the incidence of eating disorders is increasing worldwide in both men and women, there is evidence to suggest that women in the Western world have the greatest risk of developing such disorders, and the degree of Europeanization increases the risk. About half of Americans personally know someone with an eating disorder. The ability to understand the central processes of appetite, as well as knowledge of the study of brain function, has increased significantly since the discovery of leptin. Eating behavior involves interrelated incentive, homeostatic, and self-regulatory control processes that are key components of eating disorders. The exact cause of eating disorders is not fully understood, but there is supporting evidence that it may be associated with other diseases and conditions. The cultural idealization of thinness and youth has contributed to the development of eating disorders in various sectors of society. One study found that girls with attention deficit hyperactivity disorder are more likely to develop eating disorders than girls without the disorder. Another study suggests that women with post-traumatic stress disorder, especially sexually related, are most likely to develop anorexia nervosa. One study found that female adoptees were more likely to develop bulimia nervosa. Some researchers suggest that peer pressure and idealized body shapes presented in the media are also a significant factor. Some studies indicate that for certain people there are genetic reasons possible susceptibility to developing eating disorders. Recent studies have found evidence of a correlation between patients with bulimia nervosa and substance abuse disorders psychoactive substances. In addition, patients with eating disorders typically have anxiety disorders and personality disorders, which may have a cognitive component of inappropriate hunger, which can cause various feelings of psychological stress that contribute to hunger. While appropriate treatment can be very effective for many patients suffering from specific types of eating disorders, the consequences of eating disorders can be severe, including death(due to direct medical influence of disordered eating behavior or associated conditions such as suicidal ideation).
Classification
Disorders currently approved in medical guidelines
These eating disorders are listed as mental disorders in standard medical manuals such as the International Classification of Diseases, 10th Revision and/or the Diagnostic and Statistical Manual of Mental Disorders, 5th Revision.
Disorders not currently included in standard medical guidelines
Causes
There are many causes of eating disorders, including biological, psychological and/or abnormalities environment. Many patients with eating disorders also suffer from body dysmorphic disorder, which alters the patient's self-image. Studies have found that a large proportion of patients diagnosed with body dysmorphic disorder also had some type of eating disorder, with 15% of patients having either anorexia nervosa or bulimia nervosa. This connection between body dysmorphic disorder and anorexia comes from the fact that both body dysmorphic disorder and anorexia are characterized by a preoccupation with physical appearance and body image disturbance. There are also many other possibilities such as environment, social issues and interpersonal problems that can contribute and stimulate the development of these diseases. The media is also often blamed for the increase in eating disorders due to the media promoting an ideal image of a physically thin person, such as models and celebrities, who motivate or even coerce the audience to try to achieve the same result themselves. The media has been accused of distorting reality in the sense that people portrayed in the media are either naturally thin and thus not representative of the norm, or are abnormally thin by striving to look like an ideal image through excessive exercise. While recent findings have described the causes of eating disorders as primarily psychological, environmental, and sociocultural, new research has provided evidence that the genetic/hereditary aspect of the causes of eating disorders is predominant.
Biological reasons
Leptin and Ghrelin: Leptin is a hormone produced primarily by fat cells in the body that has an inhibitory effect on appetite by inducing a feeling of fullness. Ghrelin is an appetite-inducing hormone produced in the stomach and upper small intestine. The levels of both hormones in the blood are an important indicator in weight control. Often associated with obesity, both hormones and their respective actions have been implicated in the pathophysiology of anorexia nervosa and bulimia nervosa. Leptin may also be used to differentiate between the innate leanness of healthy individuals with a low body mass index and those with anorexia nervosa.
Gut Bacteria and the Immune System: Research has shown that most patients with anorexia nervosa and bulimia have elevated levels of autoimmune antibodies, which affect hormones and neuropeptides that regulate appetite control and response to stress. There may be a direct correlation between the level of autoimmune antibodies and associated subjective symptoms. The latest study found that the autoimmune antibodies that reacted with alpha-melanocyte-stimulating hormone were actually produced against ClpB, a protein produced by a certain gut bacterium, such as Escherichia coli. The ClpB protein has been identified as a conformational mimetic antigen of alpha-melanocyte-stimulating hormone. In patients with eating disorders, plasma levels of anti-ClpB immunoglobulin-G and immunoglobulin-M correlated with the patient's psychological traits.
Infections: PANDAS (abbreviation for “pediatric autoimmune neuropsychiatric diseases associated with streptococcal infection”, English). Children with PANDAS "have obsessive-compulsive disorder (OCD) and/or tic disorders such as Tourette's syndrome and whose symptoms worsen following infections such as strep throat and scarlet fever" (data National Institute mental health). There is a possibility that PANDAS in some cases may be a precipitating factor in the development of anorexia nervosa.
Focal lesions: Studies have noted that focal lesions in the right frontal lobe or temporal lobe of the brain can cause pathological symptoms of eating disorders.
Tumors: Tumors in various parts of the brain have been implicated in the development of abnormal eating patterns.
Brain calcification: Study presents a case in which primary calcification of the right thalamus may have contributed to the development of anorexia nervosa.
Somatosensory projection: is a model of the body located in the somatosensory cortex, first described by the famous neurosurgeon Wilder Penfield. The illustration was originally titled "Penfield's Homunculus", homunculus meaning little man, little man. “In normal development, this projection should represent the passage of the organism through the pubertal growth spurt. However, in anorexia nervosa, it is suggested that there is a lack of plasticity in this area, which can lead to poor sensory processing and disturbances in body image” (Bryan Lask, also proposed by V. S. Ramachandran).
Obstetric complications: Studies have been conducted that have shown that maternal smoking, obstetric and perinatal complications such as maternal anemia, very preterm birth (less than 32 weeks), small for gestational age birth, neonatal heart problems, preeclampsia, placental infarction and the development of a cephalohematoma at birth increases the child's risk of developing either anorexia nervosa or bulimia nervosa. Some such developmental risks, as in the case of placental infarction, maternal anemia and heart problems, may cause intrauterine hypoxia, umbilical cord entrapment or umbilical cord prolapse and may cause ischemia leading to damage to the brain, prefrontal cortex in the fetus, the newborn with This is highly susceptible to damage, as it has been noted that the result of oxygen deprivation may contribute to executive dysfunction, attention deficit hyperactivity disorder and may influence personality traits associated with eating disorders and related disorders such as impulsivity, mental rigidity and obsessions. The problem of perinatal brain injury regarding the impact on society and on affected individuals and their families is extraordinary (Yafeng Dong, Ph.D.).
Symptom of exhaustion: Evidence suggests that symptoms of eating disorders are actual symptoms of exhaustion itself rather than a mental disorder. In a study of 36 healthy young men who underwent therapeutic fasting, the men soon began to experience symptoms commonly seen in patients with eating disorders. In this study, healthy men ate about half the food they were used to eating and soon developed symptoms and patterns (preoccupation with food and eating, ritualistic eating, worsening cognitive function, other physiological changes such as decreased body temperature) that are characteristic symptoms of anorexia nervosa. The men in the study also developed pathological hoarding and compulsive collecting even though they despised it, revealing a possible link between eating disorders and obsessive-compulsive disorder.
Genetic causes: Numerous studies suggest that there is a likely genetic predisposition to eating disorders as a result of Mendelian inheritance. It has also been demonstrated that eating disorders can run in families. Recent studies involving twins have found minor examples of genetic variation when considering different criteria for anorexia nervosa and bulimia nervosa as endophenotypes of the disease as a whole. In another recent study involving couples and families, researchers found genetic connection on chromosome 1, which may be found in multiple family members of a patient with anorexia nervosa, indicating an inheritance pattern found between family members or other individuals with preliminary diagnosis eating disorder. The study found that a patient who is an immediate family member of a person who has suffered or is currently suffering from an eating disorder is 7 to 12 times more likely to suffer from an eating disorder. Twin studies have also shown that at least some of the susceptibility to developing eating disorders may be inherited, and there is sufficient evidence to demonstrate that there is a genetic locus responsible for susceptibility to developing anorexia nervosa.
Epigenetics: Epigenetic mechanisms are the means by which environmental effects alter gene expression through methods such as DNA methylation; they are independent of and do not change the underlying DNA sequence. They are inherited, but can also occur throughout life and are potentially reversible. Dysregulation of dopaminergic neurotransmission through epigenetic mechanisms has contributed to various eating disorders. One study found that "epigenetic mechanisms may contribute to known changes in atrial natriuretic peptide homeostasis in women with eating disorders."
Biochemical causes: Eating behavior is a complex process regulated by the neuroendocrine system, the main component of which is the hypothalamic-pituitary-adrenal axis. Dysregulation of the hypothalamic-pituitary-adrenal axis has been associated with eating disorders such as irregular production, levels or transmission of certain neurotransmitters, hormones or neuropeptides and amino acids such as homocysteine, which have been found to have elevated levels in anorexia nervosa and bulimia nervosa, as well as depression .
Psychological reasons
Eating disorders are classified as Axis I disorders in the Diagnostic and Statistical Manual of Mental Disorders, 4th Revision (DSM-IV), published by the American Psychiatric Association. There are various other psychological problems that may contribute to the development of eating disorders, some meeting criteria for a separate Axis I diagnosis or personality disorders that fall under Axis II and are thus considered comorbid with the diagnosed eating disorder. Axis II disorders are divided into 3 groups: A, B and C. The cause-and-effect relationship between personality disorders and eating disorders is not fully understood. Some patients have a pre-existing disorder, which may increase susceptibility to developing eating disorders. Some people develop them immediately. The severity and type of eating disorder symptoms have been noted to influence comorbidities. The Diagnostic and Statistical Manual of Mental Disorders, 4th Edition should not be used by lay people for self-diagnosis, even when used by professionals, there has been considerable debate regarding the diagnostic criteria used for various diagnoses, including eating disorders. There were contradictions in various publications Manuals, including the latest 5th edition dated May 2013.
Problems of attentional deviation in the cognitive process
Attentional bias may influence eating disorders. Many studies have been conducted to test this theory (Shafran, Lee, Cooper, Palmer, & Fairburn (2007), Veenstra and de Jong (2012) and Smeets, Jansen, & Roefs (2005)).
Evidence of the influence of attentional bias on the development of eating disorders
Shafran, Lee, Cooper, Palmer, and Fairburn (2007) conducted a study examining the influence of attentional bias on the development of eating disorders in women with anorexia, bulimia, and other eating disorders compared to controls and found that patients with eating disorders were more likely to identified “bad” eating scenarios than “good” ones.
Attentional deviation in anorexia nervosa
A study examining a more specific area of eating disorders was carried out by Veenstra and de Jong (2012). He found that patients in both the control and eating disorder groups showed attentional bias towards high-fat foods and a negative eating picture. Patients with eating disorders showed a greater attentional bias toward foods that are perceived as “bad.” This study hypothesized that negative attentional bias may facilitate restricted eating in patients with eating disorders.
Deviation of attention due to dissatisfaction with one's own body
Smeets, Jansen, and Roefs (2005) examined body dissatisfaction and its relationship with attentional bias and found that induced bias for unattractive body parts caused participants to feel worse about themselves and their body satisfaction decreased, and vice versa when a positive bias was introduced. .
Character traits
There are various childhood personality traits associated with the development of eating disorders. During puberty, these traits may be enhanced by various physiological and cultural factors, such as hormonal changes associated with puberty, stress associated with the approach of maturity, and sociocultural influences and subjective expectations, especially in areas that relate to body image. Many character traits have a genetic component and are highly inherited. Maladaptation of certain specific traits can result from hypoxic or traumatic brain injury, neurodegenerative diseases such as Parkinson's disease, neurotoxicity such as lead exposure, bacterial infections such as Lyme disease or viral infections, such as Toxoplasma, as well as hormonal influences. While research using various imaging techniques such as functional magnetic resonance imaging is ongoing, it has been noted that these traits originate in different areas of the brain, such as the amygdala and prefrontal cortex. Eating behavior has been noted to be influenced by disturbances in the prefrontal cortex and executive functioning system.
Environmental influence
Child abuse
Child abuse, which includes physical, psychological and sexual abuse and neglect, has been shown in numerous studies to be a precipitating factor in a wide range of mental disorders, including eating disorders. Abused children may develop eating disorders in an attempt to gain some sense of control or comfort, or they may be exposed to unhealthy or insufficient diets. Child abuse and neglect cause profound changes in the physiology and neurochemistry of the developing brain. Children in government care, orphanages, or foster care are particularly susceptible to developing eating disorders. In a study in New Zealand, 25% of participants in foster care developed eating disorders (Tarren-Sweeney M. 2006). An unbalanced home environment negatively affects emotional condition child, even in the absence of overt abuse or neglectful behavior, the stress of an unstable home situation can contribute to the development of eating disorders.
Social isolation
Social isolation has harmful effects on a person's physical and emotional well-being. Socially isolated individuals have a higher mortality rate, in general, compared to individuals who have social relations. This effect on mortality is significantly increased in persons with pre-existing medical and psychiatric disorders, and has been particularly noted in coronary artery disease. “The magnitude of the risk associated with social isolation is comparable to cigarette smoking and other major biomedical and psychological risk factors” (Brummett et al.). Social isolation can be stressful in itself, causing depression and anxiety. In an attempt to eliminate these unpleasant sensations, a person may begin to experience emotional overeating, in which food serves as a source of pleasure. Thus, the associated loneliness with social isolation and unavoidable stressors are also implicated as triggering factors in the development of binge eating disorder. Waller, Kennerley, and Ohanian (2007) argue that purifying and restrictive types are strategies for suppressing emotions, but they are used only in different time. For example, food restriction is used to suppress emotional activation, whereas binge-vomiting is used after emotional activation.
Parental influence
Parental influence has been shown to be an intrinsic component of the development of eating behavior in children. This influence is expressed and shaped by a wide variety of factors, such as family genetic predisposition, dietary choices according to cultural or ethnic preferences, parental body measurements and eating behavior, degree of involvement and expectations of children's eating behavior, and personal relationships between parents and children. This complements the general psychosocial climate of the family and the presence or absence of a stable child-rearing environment. It has been noted that parental maladjustment plays an important role in the development of eating disorders in children. In more subtle aspects of parental influence, it has been noted that eating behavior is established in early childhood, and that children should be allowed to decide when their appetite is satisfied as early as two years of age. A direct link has been shown between obesity and parental pressure to eat more. Forced dieting tactics have been shown to be ineffective in controlling a child's eating behavior. Affect and attention have been shown to influence a child's degree of pickiness and acceptance of a wider variety of foods. Heald Bruch, a pioneer in the field of eating disorder research, says anorexia nervosa often occurs in girls who excel academically, are obedient and always try to please their parents. Their parents tend to be overly controlling and fail to encourage emotional expression, suppressing their daughters' acceptance own feelings and desires. Teenage girls in their overbearing families do not have the ability to be independent from their families and to realize their needs, which often leads to open disobedience. Controlling what they eat can help people feel more confident because it gives them a sense of control.
Peer pressure
Various studies, such as one conducted by McKnight researchers, have suggested that peer pressure has a significant contribution to body image issues and attitudes toward food among adolescent and young adult participants up to approximately 23 years of age. Eleanor Mackie and co-authors Annette M. La Greca of the University of Miami conducted a study of 236 adolescent girls from public high schools in southeast Florida. "Teenage girls' concerns about their weight, how they appear to others, and their feelings that their peers would like to see them thinner are significantly associated with their weight control behavior," says psychologist Eleanor Mackie, of the National Health Institute. Pediatric Center in Washington, DC, the main author of the study. - “This is really important.” According to one study, 40% of girls aged 9-10 years are already trying to lose weight. It is noted that such a diet is influenced by the behavior of peers, so many of them who are on a diet also claim that their friends are also on a diet. The number of friends who diet and the number of friends who pressure them to diet also plays a significant role in their own choices. Elite athletes have a significantly higher rate of eating disorders. Female athletes in sports such as gymnastics, ballet, diving, etc. are at the highest risk among all athletes. Women are more likely than men to develop eating disorders between the ages of 13 and 30. 0–15% of those with bulimia and anorexia are men[citation needed].
Cultural pressure
This is the cultural emphasis on thinness that predominantly dominates Western society. There is an unrealistic stereotype about beauty and the ideal figure presented by the media, fashion and entertainment industries. “Cultural pressure on men and women to be ‘perfect’ is an important predisposing factor in the development of eating disorders.” Further, when women of all races base their self-worth on what is considered a culturally ideal body, the incidence of eating disorders increases. Such disorders are becoming more prevalent in non-Western countries where being thin is not seen as an ideal, showing that social and cultural pressures are not the only causes of eating disorders. For example, research on anorexia in non-Western regions of the world indicates that these disorders are not only “culturally determined”, as previously thought. However, studies examining bulimia rates suggest that it may be culturally related. In non-Western countries, bulimia is less common than anorexia, but it can be said that these non-Western countries studied are likely or definitely influenced or pressured by Western culture and ideology. Socioeconomic status has also been examined as a risk factor for the development of eating disorders, suggesting that having more resources allows a person to make more active dietary choices and reduce body weight. Some studies have also shown a relationship between increases in body dissatisfaction and increases in socioeconomic status. However, after achieving high socioeconomic status, the relationship weakens and in some cases disappears. The media plays a big role in how people see themselves. Countless advertisements in magazines and the image of very thin celebrities on television, such as Lindsay Lohan, Nicole Richie and Mary Kate Olsen, receive a lot of attention. Society has taught people that the approval of others must be obtained at any cost. Unfortunately, this has led to the belief that in order to meet the demands of society, one must act in a certain way. Television beauty pageants such as the Miss America pageant promote the idea that beauty is what contestants judge it to be based on their own opinions. In addition to considering socioeconomic status, the world of sports appears as a cultural risk factor. Athletics and eating disorders tend to go hand in hand, especially in sports where weight is a competing factor. Gymnastics, horse racing, wrestling, bodybuilding and dancing are just a few categories of sports in which performance depends on weight. Eating disorders among competitive individuals, especially women, often result in weight-related physical and biological changes that often mask the prepubertal period. Often, as women's bodies change, they lose their competitive edge, forcing them to resort to extreme means to maintain a more youthful figure. Men often experience overeating followed by exercise, focusing on building muscle rather than losing fat mass, but this goal of gaining muscle weight is as much an eating disorder as an obsession with being thin. The following statistics, taken from Susan Nolen-Hoeksema's book, Normal (Pathological) Psychology, show the calculated percentage of athletes who have eating disorders by sport.
Aesthetic sports (dancing, figure skating, gymnastics) – 35%
Weight sports (judo, wrestling) – 29%
Strength sports (cycling, swimming, running) – 20%
Technical sports (golf, high jump) – 14%
Ball games (volleyball, football) – 12%
While most of these athletes maintain eating disorders to maintain a competitive edge, others use exercise as a way to maintain weight and body measurements. This is as serious as regulating your competition food intake. Although there is mixed evidence showing that certain athletes face the problem of eating disorders, research shows that, despite the level of competition, all athletes are at increased risk for developing eating disorders compared to non-athletes, especially those who participate in sports in which being thin matters. Social pressure is also noted within the homosexual community. Homosexual men are at increased risk of developing eating disorder symptoms than heterosexual men. In gay culture, a muscular body provides advantages in social and sexual attractiveness, as well as power. This pressure and the idea that another gay man may desire a thinner or more muscular partner can possibly lead to an eating disorder. The more symptoms of an eating disorder are experienced, the greater the patient's problem with how others will perceive him and the more frequent and debilitating physical activity. High levels of body dissatisfaction are also associated with extrinsic motivation for exercise and older age; however, the image of a thin and muscular body is more prevalent among younger than older homosexuals. It is important to be aware of some of the limitations and challenges of many studies that attempt to examine the role of culture, ethnicity, and socioeconomic status. For those new to the field, most cross-cultural studies use definitions from the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Revised, which has been criticized for reflecting Western cultural biases. Thus, assessments and surveys may not be sufficient to identify some of the cultural differences associated with various disorders. Also, when looking at patients from areas of potential Western cultural influence, some studies have attempted to measure the extent to which a person has adapted to popular culture or remained faithful to the traditional cultural values of their region. Finally, most cross-cultural studies of eating disorders and psychological disorders about self-image was conducted in Western countries and not in the countries or regions of the study. While there are many factors that influence a person's body image, the media plays a big role. Along with the media, the influence of parents, peers and self-belief also play a significant role in a person's vision of himself. The way media presents images can have a lasting effect on a person's perception of their own body. Eating disorders are a worldwide problem, and while women are more susceptible to eating disorders, they affect both sexes (Schwitzer 2012). The media has an influence on the development of eating disorders by reporting positively or negatively, so they have a responsibility to warn audiences when presenting images that represent the ideal that many are trying to achieve through eating behavior change.
Symptoms of complications
Some of the physical symptoms of eating disorders are weakness, fatigue, sensitivity to cold, decreased beard growth in men, decreased erection upon awakening, decreased libido, weight loss, and decreased growth. Unexplained hoarseness may be a symptom of an underlying eating disorder due to acid reflux, or the release of acidic stomach contents into the larynx and esophagus. Patients who vomit, such as those with purging-type anorexia nervosa or purging-type bulimia nervosa, are at risk for developing acid reflux. Polycystic ovary syndrome is the most common endocrine disorder among women. Often associated with obesity, it can also occur in patients of normal weight. PCOS has been linked to binge eating disorder and bulimia.
Subculture of anorexia propaganda
Men
Evidence to date suggests that gender discrimination among medical practitioners means that men are less likely to be diagnosed with bulimia or anorexia, despite identical behaviour. Men are more likely to be diagnosed with depression due to changes in appetite than with a primary diagnosis of an eating disorder. Using the Canadian research examples below, it is possible to discover more detailed problems that men face with eating disorders. Until recently, eating disorders were characterized as almost exclusively female disorders (Maine and Bunnell 2008). Most early academic knowledge during the early 1990s. have tended to dismiss the prevalence in men as being largely, if not entirely, irrelevant compared to such disorders in women (Weltzin et al. 2005). Only recently have sociologists and feminists expanded the scope of eating disorders to identify the unique challenges men with eating disorders face. Eating disorders are the third most common chronic illness in adolescent boys (NEDIC, 2006). Using currently available data, it is estimated that 3% of men will experience an eating disorder in their lifetime (Health Canada, 2002). Not only are the rates of eating disorders increasing among women, but men are also more concerned about their appearance than ever before. Health Canada (2002) found that nearly one in two girls and one in five boys by age 10 are either dieting or want to lose weight. Since 1987, hospitalizations for eating disorders have increased overall by 34% among boys under 15 years of age and by 29% among boys aged 15 to 24 years (Health Canada, 2002). In Canada, the rate of age segregation of hospital patients with eating disorders was highest among men in British Columbia (15.9 per 100,000) and New Brunswick (15.1 per 100,000) and lowest in Saskatchewan (8.6 ) and Alberta (8.6 per 100,000) (Health Canada, 2002). Part of the task of determining the prevalence of eating disorders in men is under-researched and has few statistics that are current or relevant. Recent work by Schoen and Schoen (2008) suggests that the same prevailing social factors were responsible for the increase in eating disorders among women in the late 1980s. , may also be veiled by public opinion about the similar susceptibility of men. As a result, male eating disorders and prevalence have been underreported or misdiagnosed. Particularly recent attention has been drawn to the gendered nature of diagnosis and different presentation methods in men; Diagnostic criteria that focus on weight loss, fear of getting fat, and physical symptoms such as amenorrhea cannot be applied to men with eating disorders, many of whom engage in excessive exercise and value muscularity and self-determination rather than absolute weight loss; men resent certain terms, such as “fear of getting fat,” which they see as instilling insecurity and stripping away masculinity (Derenne and Beresin, 2006). As a result of these preliminary attempts to express eating disorders in men using the language and concepts of disparate disorders in women, there is a significant lack of data on the prevalence, incidence, and burden of the disease in men, and most of the available data are difficult to estimate, poorly reported, or simply flawed. The message that there is no ideal body shape, figure or weight that every person should strive to achieve is still disproportionately targeted at women, and those events that include men still prominently celebrate gender presentation (e.g. the ribbon symbol ), further creating a barrier to access for men with eating disorders (Maine and Bunnell, 2008). Male body image is not as homogeneous in the media (i.e., the range of “acceptable” male physical attributes is wider) but instead focuses on perceived or perceived masculinity (Gaughen, 2004, 7 and Maine and Bunnell, 2008). More acutely than ever, there is a lack of consensus in the literature regarding unique risk factors for gay or bisexual men; The US Center for Population Research in LGBT Health notes the prevalence in the LGBT population to be approximately twice the national average for women and approximately 3.5 times higher for men. However, a similar study (Feldman and Meyer, 2007) failed to explain the processing of these results, and a subsequent study (Hatzenbuehler et al., 2009) suggests that members of the LGBT community are somewhat protected from the prevalence of psychiatric illnesses, including including eating disorders. As mentioned above, a distinct lack of research continues to pose a barrier to reaching a broad conclusion on this topic. A 2014 report in Salon estimated 42 percent of men with eating disorders identified as gay or bisexual. Current treatment for men with eating disorders occurs in the same environment as for women. Men living in isolated, rural or small communities who experience physical abuse, which sometimes leads to the development of eating disorders, face barriers to treatment, as well as additional stereotypes that they suffer from a “female” disease ( data from Health Canada, 2002). Health Canada (2011 report) also states that integrated treatment approaches for domestic violence and eating disorders are likely to become increasingly rare as the resources required to ensure availability of services, appropriate health care, sufficient staff, shelters and space transitional and psychological counseling on underlying violence is no longer available. Many cases in Canada are referred to as US treatment data due to a lack of appropriate services offered (Vitiello and Lederhendler 2000). For example, in one case, a patient with anorexia nervosa initially admitted to a children's hospital in Toronto was subsequently advised to transfer to a hospital in Arizona (Jones, 2007). In 2006, the province of Ontario alone referred 45 patients (36 of them male) to the United States for eating disorder treatment at a total cost of US$3,719,440 (Jones, 2007), a decision motivated by the lack of specialized facilities locally. Speaking from a feminist perspective, Maine and Bunnell (2008) proposed a unique approach to managing eating disorders in men. They call for counseling that focuses on how the patient responds to pressures and expectations, rather than addressing the individual pathology of disordered eating behavior. Current treatment shows some success in this regard (Health Canada, 2011), but patient-based review and feedback are lacking. Physical symptom monitoring, behavioral and cognitive therapy, body image therapy, nutritional counseling, education and drug treatment are currently available in some form if needed, although all of these programs are provided regardless of the patient's gender (Department of Health, 2002 and Maine and Bunnell, 2008). Up to 20% of patients with eating disorders eventually die from their disease, and another 15% resort to suicide. When accessed to treatment, 75–80% of adolescent girls recover, but less than 50% of boys recover (Macleans, 2005). Moreover, there are some limitations in data collection since most studies are based on case reports, which makes it difficult to report the results to the general population. Patients with eating disorders require a wide range of treatments for physical complications and psychological problems amounting to approximately US$1,600 per day (Timothy and Cameron 2005, 100). Treatment of patients diagnosed after hospitalization based on their condition is more expensive (approximately three times the cost) and also less effective, with a corresponding reduction of more than 20% in women and 40% in men (Macleans, 2005). There are many societal, family and individual factors that can influence the development of an eating disorder. People who struggle with their identity and self-image may be at risk, as can those who have experienced a traumatic event (Mental Illness in Canada Report, 2002). In addition, many patients with eating disorders report a sense of powerlessness in their socioeconomic environment and see diet, exercise, and cleansing as a means of gaining greater control over their lives. The traditional approach (Trebay, 2008 and Derenne and Beresin, 2006) to understand the underlying causes of eating disorders focuses on the role of the media and sociocultural pressures; the idealization of being thin (for women) and muscular (for men) often goes beyond mere body image. The media implicitly implies that not only are people with “ideal” bodies likely to be more confident, successful, healthy, and happy, but that being thin is associated with positive character traits such as reliability, solidity, and integrity (Harvey and Robinson, 2003). Traditional views of eating disorders reflect a generalized media image in which thin and attractive people are not only the most successful and desirable members of the community, but that they are the only members of the community who can be attractive and desirable. From this perspective, society is focused on appearance; Body image has become central to young people's sense of self-esteem and self-worth, which overshadows qualities and achievements in other aspects of life (Maine and Bunnell, 2008). Adolescents may associate success or acceptance by their peers with achieving the "ideal" physical standards portrayed in the media. As a result, during a period in which children and adolescents become significantly more exposed to prevailing cultural norms, boys and girls are at risk of developing distorted images of themselves and their bodies (Andersen and Homan, 1997). When desired body image goals are not achieved, they may experience feelings of failure, which contribute to further declines in self-esteem, confidence, and increased body dissatisfaction. Some also suffer from psychological and mental health conditions such as shame, failure, deprivation and unsustainable diet (Maine and Bunnell, 2008). Eating disorders can make a person feel tired and depressed, have decreased mental function and concentration, and can lead to malnutrition with risks to bone health, physical growth, and brain development. There are also increased risks osteoporosis and reproductive problems, weakening immune system, decreased heart rate, blood pressure and also a decrease in metabolic rate (NEDIC, 2006). In addition, patients with eating disorders have the third highest risk of self-abuse and suicide, with rates 13.6 and 9.8 times higher than the Canadian average, respectively (Löwe et al., 2001).
Psychopathology
The psychopathology of eating disorders centers around body image disturbances, such as problems with weight and body shape; In this case, the following is observed: self-esteem is too dependent on the weight and shape of the body; fear of gaining weight even if you are underweight; denial of the severity of symptoms and distorted vision of the body.
Diagnostics
The initial diagnosis should be made by a qualified physician. “History is the most powerful tool for diagnosing eating disorders” (American Family Medicine). There are many medical conditions that mask eating disorders and co-occurring mental disorders. All organic disorders should be examined before a diagnosis of an eating disorder or other mental disorder is made. Eating disorders have become more visible over the past 30 years, and it is unclear whether changes in presentation reflect a true increase in incidence. Anorexia nervosa and bulimia nervosa are the most clearly defined subgroups of a broader range of eating disorders. Many patients present with a subthreshold expression of two main diagnoses: other disorders with varying presentation and symptoms.
Medical factors
The diagnostic examination usually includes a complete medical and psychosocial history and then an appropriate and standardized approach to diagnosis. Neuroimaging using functional magnetic resonance imaging, magnetic resonance imaging, PET, and gamma-ray imaging have been used to identify cases in which focal lesions, tumors, or other organic conditions were either the sole causative or contributing factor in the development of eating disorders. “Right frontal intracerebral lesions, with their close interaction with the limbic system, may be the cause of eating disorders, therefore, we recommend performing cranial MRI in all patients with suspected eating disorders” (Trummer M. et al. 2002); “Intracranial pathology should also be considered even with a definite diagnosis of early-onset anorexia nervosa. Second, neuroimaging plays an important role in the diagnosis of early-onset anorexia nervosa from a clinical and research perspective” (O'Brien et al. 2001).
Psychological factors
After examining the organic causes and the physician's initial diagnosis of an eating disorder, a trained psychiatrist helps evaluate and prescribe treatment for the underlying psychological components of the eating disorder and any associated psychological conditions. The doctor conducts a clinical interview and may perform various psychometric tests. Some are general in nature, while others are designed specifically for use in the assessment of eating disorders. Some of general tests that can be used are the Hamilton Depression Rating Scale and the Beck Depression Rating Scale. A longitudinal study notes that the chance of young adult women developing bulimia increases due to ongoing psychological pressures, but as a person ages and matures, their emotional problems change or resolve and the symptoms then subside.
Differential diagnosis
There are many conditions that can be misdiagnosed as a primary mental disorder, complicating or delaying treatment. They may have a synergistic effect on diseases that mask eating disorders or on properly diagnosed eating disorders.
Psychological disorders that may resemble or accompany an eating disorder:
Prevention
Prevention aims to promote healthy development before the onset of eating disorders. It also aims to identify eating disorders early, before treatment is still appropriate. Children aged 5-7 years are aware of cultural messages regarding body image and diet. Prevention consists of highlighting these problems. The following topics should be discussed with children (and also young people).
The Internet and modern technologies present new opportunities for prevention. Online programs have the potential to increase the use of prevention programs. Development and practice of application of preventive programs using online resources makes it possible to convey information to many people at minimal cost. This approach can also make prevention programs rational.
Forecast
Treatment
Treatment varies depending on the type and severity of the eating disorder, and several treatment options are typically used. However, there is a lack of reliable supporting data on treatments and controls, the current understanding of which is based mainly on clinical experience. Therefore, before treatment, the family physician will play an important role in the early treatment of patients with eating disorders who are unwilling to see a psychiatrist, and much of the success will depend on the attempt to establish a good relationship with the patient and family during primary treatment. Some of the treatment methods are:
There are several studies examining the cost-effectiveness of various treatment regimens. Treatment can be expensive due to limitations in insurance coverage for treatment, so people hospitalized with anorexia nervosa may be discharged underweight, leading to relapse and readmission.
results
The final assessments are complicated by the heterogeneous criteria used for various studies, but for anorexia nervosa, bulimia nervosa and binge eating disorder, it is generally accepted that the percentage of complete recovery is 50-85% with the majority of patients experiencing at least partial remission.
Epidemiology
Eating disorders cause approximately 7,000 deaths per year as of 2010, making it the mental illness with the highest mortality rate.
Feminist literature and theory
Economic aspects
Total spending in the United States for inpatient treatment for eating disorders has increased from $165 million in 1999–2000. to US$277 million in 2008-2009, an increase of 68%. Average costs per eating disorder patient increased 29% over ten years, from $7,300 to $9,400.
Over the course of the decade, hospitalizations for patients with eating disorders increased across all age groups. The greatest increase was in the group of patients 45-65 years old (88% increase), followed by hospitalizations in patients under 12 years of age (72% increase).
The majority of patients with eating disorders are women. In 2008-2009 88% of cases involved women, 12% – men. The report also noted a 53% increase in hospital admissions for men with a primary diagnosis of an eating disorder, from 10 to 12% over ten years.
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List of used literature:
Hudson, JI; Hiripi, E; Pope, H. G. Jr.; Kessler, R. C. (2007). "The Prevalence and Correlates of Eating Disorders in the National Comorbidity Survey Replication.” Biological Psychiatry 61(3):348–58. doi:10.1016/j.biopsych.2006.03.040. PMC 1892232. PMID 16815322.
Yale, Susan Nolen-Hoeksema, (2014). Abnormal psychology (6th ed.). New York, NY: McGraw Hill Education. pp. 340–341. ISBN 978-0-07-803538-8.
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Eating disorders (ED)- these are diseases characterized by unhealthy eating behavior, which is based on concern for one's own weight and appearance.
Eating disorders can involve inappropriate or excessive food consumption, which can ultimately significantly impair an individual's well-being. The most common forms of eating disorders (EDs) are anorexia, bulimia and compulsive overeating- all of them are found in both women and men.
Eating disorders can develop at any stage of life, but, as a rule, are more often formed and manifested in adolescence or early age. The right therapy can be very effective in treating many types of eating disorders.
If eating disorders are not treated and left without proper attention, the symptoms and consequences can be very disastrous, lead to the destruction of health and even lead to the death of the patient. Eating disorders are often accompanied by mental disorders, such as anxiety disorders, depression, neurosis, substance abuse and/or alcohol abuse.
Types of Eating Disorders. RPP is:
The three most common types of eating disorders are:
- Bulimia - This eating disorder is characterized by frequent overeating, accompanied by “compensatory” behavior - induced vomiting, excessive physical activity and abuse of laxatives and diuretics. Men and women suffering from Bulimia may fear weight gain and feel dissatisfied with the size and shape of their own body. Binging and purging tend to happen in secret, creating feelings of shame, guilt and lack of control. Side effects of bulimia include problems with gastrointestinal tract, severe dehydration and heart problems caused by electrolyte imbalances.
Causes of Eating Disorders
The exact cause of eating disorder has not yet been officially confirmed. Anna Vladimirovna Nazarenko, head of the Eating Behavior Recovery Clinic, based on more than 15 years of practical experience, believes that one of the common reasons is the individual peculiarity of the aesthetic perception of the individual, which is embedded in us even before birth. In simple terms, the main reason is the desire to be thin and beautiful from an aesthetic point of view, as an individual personality trait. The type of eating disorder a patient develops depends on psychological characteristics and external social factors.
Examples of psychological characteristics:
- Negative perception of one's own body;
- Low self-esteem.
Examples of social factors:
- Dysfunctional family dynamics;
- Profession and occupation that promote weight loss, for example, ballet and modeling;
- Aesthetically oriented sports that promote a muscular, toned body;
- Examples:
- Body-building;
- Ballet;
- Gymnastics;
- Struggle;
- Long distance running;
- Family and childhood trauma;
- Cultural pressure and/or pressure from peers and/or friends and colleagues;
- Difficult experiences or life problems.
At the moment, not a single study has been conducted in the field of eating disorders and not a single evidence has been found in favor of the theory of genetic predisposition to an eating disorder. The only thing that has been reliably proven is that the risk of developing bulimia is higher if someone in the family has an addiction (alcohol, drugs or bulimia).
Signs and Symptoms of an eating disorder
A man or woman with an eating disorder may exhibit a range of signs and symptoms, such as:
Treatment of eating disorders in 2019
Given the severity and complexity of these diseases, patients require comprehensive treatment under the supervision of a team of different specialists specializing in the treatment of eating disorders. Here, too, everything depends on the level of personality destruction. Specialists include: a professional eating disorder specialist, a psychotherapist, in some cases a gastroenterologist, an internist and a neurologist.
At the moment, in Israel and Russia they are mainly used outdated methods of inpatient treatment with antidepressants, which destroy the liver and kidneys, have a short-term effect. The patient is constantly in a inhibited state and the psychotherapist does not have the opportunity to effectively work and conduct personality psychotherapy in this patient’s state. This condition only helps doctors in the hospital feed the patient and has a short-term effect, i.e. gives a short time of remission, but does not provide a long-term sustainable and successful final recovery, since it is necessary to work with the patient through awareness. As practice shows, the latest PSYCHOTHERAPY indicates that the best method of treating eating disorder is outpatient treatment and psychotherapy without hospitalization and antidepressants (the only exception may be cases of acute anorexia, when we are talking about life and death).
To solve many of the problems that a man or woman faces in restoring their health and well-being, individual treatment plans. Treatment of eating disorder usually takes place under the supervision of one or more specialists (psychologist, neurologist, etc.):
- Medical supervision and care. The biggest challenge in treating eating disorders is addressing any health problems that may have resulted from disordered eating;
- Nutrition: We are talking about restoring and stabilizing a healthy weight, normalizing eating habits and developing an individual nutrition plan;
- Psychotherapy: Various shapes Psychotherapy (individual, family or group) can help address the underlying causes of eating disorders. Psychotherapy is a fundamental part of treatment because it can help the patient survive traumatic life events and learn how to properly express their emotions, communicate and maintain healthy relationships with others;
- Medications: Some medications can be very effective in relieving symptoms of depression or anxiety that may occur with an eating disorder or in reducing binge eating and purging.
Depending on the severity of the eating disorder, different levels of treatment may be recommended for the patient, ranging from outpatient support groups to inpatient treatment centers. In any case, the patient first of all needs to recognize the presence of an eating disorder and seek help from specialists.
Stories of girls cured from eating disorders
Key Points About Eating Disorders
- Anorexia kills. This disease actually has the highest mortality rate of any mental disorder. The media often reports celebrity deaths from anorexia. Perhaps the first such case was the death of Karen Carpenter in the early eighties. The singer suffered from anorexia and abused emetics. She ultimately died of heart failure. Many years later, her sad experience was repeated by Christina Renee Henrich, a world famous gymnast who died in 1994.
- "Female Athlete Syndrome" is a dangerous disease that can leave professional athletes at risk of serious health problems for life. Their coaches, friends and family should support them and help prevent them from developing an eating disorder.
- Major changes in life can trigger the development of eating disorder. Starting university studies is no exception. A young man or woman leaves home, leaves friends and family behind to venture into the unknown. For some, college can be much more difficult emotionally than for others. The beginning of adulthood can be a serious psychological shock and, unfortunately, being a student can trigger the development of an eating disorder.
- Eating disorders are believed to be more common among wealthy women with good education who belong to a high socio-economic class. Eating disorders are also often considered to be a uniquely “European” disease and are therefore rarely seen in other ethnic groups. However, this is all a big misconception. In fact, eating disorders have existed for quite a long time in many cultures and ethnic groups. And this is further proof that there are no barriers or restrictions for eating disorders. Men, women, Europeans, African-Americans, residents of the Caucasus, Kazakhstan, etc. can become victims of eating disorders. For example, in the Anna Nazarenko Eating Behavior Recovery Clinic, the second place in terms of the number of requests belongs to Kazakhstan, the third place is shared by Belarus and Ukraine, and the first place belongs to Russia.
- According to the National Eating Disorders Association, lesbian, gay, bisexual and transgender people (and other members of the LGBT community) are at higher risk of developing eating disorders, including anorexia and bulimia. Single gay and bisexual men are more likely to suffer from anorexia (because they are forced to maintain thinness as a competitive advantage), while gay and bisexual men in relationships are more likely to suffer from bulimia. Lesbian and bisexual women with eating disorders are not much different from heterosexual women with eating disorders, but lesbian and bisexual women are more likely to have mental health disorders.
- In pursuit of the ideal. Ballerinas work hard to succeed in their profession, but as a result, they often become victims of eating disorders. It's no secret that ballet dancers often suffer from eating disorders, and this is understandable, since during training and rehearsals in front of a large mirror they have to compare themselves with their competitors. Moreover, professional ballet itself promotes unhealthy thinness.
- Does vegetarianism contribute to the development of eating disorders? Currently, about five percent of Americans consider themselves vegetarians (they exclude meat and animal products from their diet). This percentage does not take into account those who consider themselves “quasi-vegetarians” (people who eat some animal products but whose diet is mostly plant-based). Vegetarianism is much more common among those who suffer from eating disorders. About half of patients struggling with an eating disorder practice some form of vegetarian diet.
- The most serious complications resulting from eating disorders are malnutrition or an unstable heartbeat. However, a number of complications associated with eating disorders can have serious long-term consequences for the patient's health, even if they are not obvious and practically do not manifest themselves. Bone loss, or osteoporosis, is a silent but very serious disease that often affects patients with anorexia.
- Due to the huge number
