Eating Disorders occur when eating behavior and the feelings and thoughts associated with food cause serious distress to the individual. Dieting behavior is a common stimulus for the development of eating disorders. A person's excessive obsession with food, weight and appearance can have a negative impact on their health, relationships and daily activities.
What is an Eating Disorder?
Eating Disorders are not only related to food and weight. Although physical symptoms seem to be at the forefront, it progresses with serious psychiatric problems. An eating disorder is an external solution to an internal turmoil. The causes of Eating Disorders are not known exactly. It is believed that biological and psychosocial causes play a role in the etiology. The underlying causes of Eating Disorders are associated with low self-esteem, depression, loss of control, feelings of worthlessness, identity confusion and problems in family communication.
Although it seems to affect adolescents and young women in general, people of any age and gender can have an eating disorder. According to the Academy for Eating Disorders (AED), it is estimated that 10 million women and 1 million men in the United States have eating disorders. Contrary to estimates, eating disorders in men have doubled in the last 10 years. In addition to causing significant physical health problems, eating disorders are psychiatric disorders with high morbidity and increased risk of mortality.
What are the Symptoms of an Eating Disorder?
From time to time, it may be possible to shape plates and meals according to psychological reasons and emotional states. The main symptoms for a person to be diagnosed with an eating disorder can be listed as follows:
- Excessive weight loss in a short time
- Frequent calorie counting
- Hesitation to eat in social situations and nervousness while eating
- Significant loss of vitamins
- Anxiety about weight gain and constant conversations about weight loss
- Defects on the skin and in the mouth area, especially teeth
- Excessive exercise
- Stomach disorders due to vomiting
What are the Types of Eating Disorders?
In the criteria (DSM 5) published by the American Psychiatric Association (APA: American Psychiatric Association) in 2013, Eating Disorders are finally classified as follows:
- Anorexia Nervosa
- Bulimia Nervosa
- Binge Eating Disorder
- Emotional Eating Disorder
- Unclassifiable Eating Disorders
1. Anorexia Nervosa
People with Anorexia Nervosa are generally low self-esteem, critical and perfectionistic. Although they are dangerously thin, they feel "fat" and see themselves above the desired weight when they look in the mirror. They are extremely afraid of gaining weight and being fat. In the early stages of the disease they deny that they have problems with eating behaviors, but they are obsessed with eating, food and weight control.
Some AN patients fall into a cycle of binge eating, followed by very restricted dieting and excessive exercise, self-induced vomiting or the use of laxatives and diuretics. In many cases, other psychiatric disorders such as anxiety, panic, obsessive-compulsive disorder, alcohol and substance abuse may accompany eating disorders.
What are the Diagnostic Criteria for Anorexia Nervosa?
The diagnostic criteria of the disease are as follows:
- Being less than 85% of the weight expected for physical health according to age and height or being below the expected weight during the growth process,
- Excessive fear of gaining weight or being fat, even though it is far below the expected weight,
- Disturbed thoughts and beliefs about body weight or shape, being unreasonably affected by body weight or shape in self-assessment, or denying that they are underweight,
- Over time, as the body is subjected to starvation and malnutrition, the following symptoms are observed:
What are the Symptoms of Anorexia Nervosa?
- Inability to menstruate,
- Osteoporosis or fractures due to calcium loss,
- Breakage of hair and nails,
- Skin dryness and yellowing of the skin,
- Anemia, destruction of muscle tissue, heart problems due to weakness in the heart muscle,
- Excessive constipation,
- Low blood pressure, slow breathing and low pulse rate,
- Decrease in body temperature,
- Depression, decreased perceptual ability, slowed movements.
2. Bulimia Nervosa
People with Bulimia Nervosa consume large amounts of food in recurrent bouts of eating. They often choose high-calorie foods, often high in sugar, carbohydrates and fats, and eat very quickly, sometimes swallowing food without tasting it. During eating bouts, patients feel out of control. After the seizure, they may compensate by: starving themselves, vomiting, taking large amounts of laxatives or diuretics, exercising excessively, or a combination of all of these behaviors. Because of feelings of disgust or embarrassment, the bulimic usually does his or her behavior in secret. If the patient vomits after every meal, this can lead to medical problems.
What are the Diagnostic Criteria for Bulimia Nervosa?
The diagnostic criteria of the disease are as follows:
- Recurrence of the following together:
- Consuming a larger than normal amount of food in a 2-hour period,
- Feeling of loss of control during an eating attack,
- Implementing compensatory behaviors (such as vomiting) once a week to prevent weight gain,
- Unreasonably affected by body weight or shape in self-assessment,
- Being different from an eating episode in Anorexia Nervosa.
What are the Symptoms of Bulimia Nervosa?
Symptoms of the disease include:
- Chronically red and sore throat,
- Swelling of the salivary glands in the neck and glands under the chin,
- Swelling of the cheeks and face and a "squirrel" like appearance,
- Dissolution of tooth enamel and tooth decay due to contact with stomach acids,
- Gastric valve disruption and reflux due to persistent vomiting,
- Intestinal irritation and problems due to laxative use,
- Kidney diseases caused by diuretics,
- Problems due to dehydration.
3. Binge Eating Disorder
The patient with Binge Eating Disorder loses control while eating. Unlike BN, they do not compensate for their eating behavior (such as vomiting, exercise, starvation). At the same time, the guilt, shame and distress caused by overeating cause them to go through the same eating cycle again. As a result, the weight of these patients is usually slightly above normal or much more than normal. Obese patients with Binge Eating Disorder are particularly at risk of cardiovascular disease and high blood pressure.
Diagnostic Criteria for Binge Eating Disorder
- The diagnostic criteria for the disease are:
- Experiencing binge eating episodes, accompanied by the following:
- Eating a much larger amount of food in a short period of time (e.g. every 2 hours) than any individual would eat under similar circumstances and time frame,
- Feeling of loss of control during an attack (e.g. not being able to stop eating or how much you eat)
Binge eating episodes should include at least 3 of the following:
- Eating much faster than usual,
- Don't eat until you feel uncomfortably full,
- Overeating despite not feeling physically hungry,
- Don't be ashamed of the amount of food you eat and therefore don't eat alone,
- Feeling depressed or guilty after eating,
- Binge eating episodes at least once a week for 3 months,
- Engaging in compensatory behaviors (such as vomiting, using laxatives, enemas) after a binge eating attack
4. Emotional Eating Disorder
Emotional eating disorder is a condition in which a person is constantly tempted to eat despite not being hungry due to negative emotional states. The underlying causes of this eating disorder can be many reasons such as inadequate coping mechanisms, learned behaviors, and food deprivation. If emotional eating disorder is left untreated, it can lead to serious diseases such as obesity.
What are the Symptoms of Emotional Eating Disorder?
The symptoms of the disease can be listed as follows:
- Eating too often at short intervals
- Very fast food
- Secret food
- Eating when experiencing negative emotions
- Feeling mentally well after eating
- Eating food instead of expressing anger
- In short, instead of trying to solve the problem by talking about it, the person prefers to eat. This is the main cause of emotional eating disorder.
5. Unclassifiable Eating Disorder
In anorexia nervosa the person does not eat at all, in bulimia nervosa the person overeats and then vomits the food out. In unclassifiable eating disorders, on the other hand, a person overeats but does not regurgitate; they chew the food and regurgitate it before swallowing. Abnormal eating habits such as these are defined as unclassifiable eating disorders.
What is Eating Disorder Treatment?
Eating Disorders show the inseparable integrated link between mental and physical health. In order for physical health to be sustained, the mental state must also be improved, and vice versa. Therefore, the first step in treating patients with Anorexia Nervosa is to bring the weight to a healthy level; in patients with Bulimia Nervosa, the first step is to prevent bouts of binging and purging. However, in order to make progress in this treatment, it is first necessary to resolve the underlying emotional problems that have caused or worsened the person's illness.
Psychotherapy is essential for people with eating disorders to learn about and understand the thoughts, feelings and behaviors that trigger their illness. At the same time, the use of certain medications and nutritional counseling in combination with psychotherapy has been shown to be effective in the treatment of this disorder. General Medical Care, Nutritional Counseling, Psychiatric Treatment and Psychotherapy Support Programs should be carried out together in the treatment of Eating Disorders.
