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Eating disorders are abnormal eating behaviors, which include anorexia and bulimia. Anorexia is defined as the refusal to reach or to keep a weight that is considered to be the minimum required for a person’s height and age. Bulimia is an eating pattern of repeated occurrences of binge eating followed by attempts to keep from gaining weight.
The characteristics associated with eating disorders include the following:
Yes, if a person has an eating disorder, it is more likely that a close relative has had an eating disorder, mood disorder, or substance abuse disorder.
Females are much more likely to have eating disorders than males. In the United States young women may have a greater tendency to develop eating disorders because American culture encourages females to be thin.
Eating disorders are usually diagnosed in adolescence or early adulthood. However, it is not unusual for someone who is twenty to thirty (20 – 30) years of age to suffer from an eating disorder.
It is estimated that three percent (3%) of the young female population has some form of eating disorder.
Individuals with eating problems often attempt to keep this information secret from parents or friends. Therefore, other family members or friends must sometimes bring a young person’s abnormal eating behavior to their parents’ attention, or they must talk directly with the individual about these issues. The individual can then be encouraged to seek proper professional help.
A mental health professional makes a diagnosis of an eating disorder by taking a careful personal history from the client/patient and other available family members. It is important that the therapist learn the details of that person’s life. No laboratory tests are required to make a diagnosis of an eating disorder. However, in addition to the personal history, anorexia is diagnosed by obtaining body weight. A person must lose at least fifteen percent (15%) of her ideal weight in order to be diagnosed with anorexia. A growing child can be anorexic if he/she fails to attain eighty-five percent (85%) of the ideal body weight.
Bulimia is also diagnosed by personal history. There must be a history of binge eating which takes place inside of a two hour period. Following the episode of binge eating, the individual must attempt to prevent weight gain. Behaviors associated with the prevention of weight gain include vomiting, the overuse of laxatives, diuretics or enemas, excessive exercise, and prolonged fasting.
It is very important not to overlook a physical illness that might mimic or contribute to an eating disorder. If there is any question that the individual might have a physical problem, the mental health professional should recommend a complete physical examination by a medical doctor. Laboratory tests might be necessary as a part of the physical workup.
The treatment for eating disorders includes individual and/or group psychotherapy. Therapy focuses on education about the harmful effects of starvation, purging behaviors, and excessive exercise. Therapy also aims to improve the individual’s self-esteem and acceptance of a healthy body image. The use of medication may be helpful to control symptoms of obsessions, compulsions, anxiety, and depression which are often associated with the eating disorders.
The course of eating disorders varies widely. Some people have only one brief episode of anorexia. Others may struggle with the illness for decades. Many people have mild forms of anorexia or bulimia that never come to the attention of treatment providers. At the other extreme, some individuals with anorexia starve themselves to the point where their lives become threatened, and they need to be hospitalized for acute care. About five percent (5%) of those with anorexia die of complications associated with this illness.
If you, a friend, or a family member would like more information and you have a therapist or a physician, please discuss your concerns with that person.
Developed by John L. Miller, MD