Eating Disorders

Eating Disorders

Eating disorders, eating behavior, and feelings and thoughts related to food are caused by a serious disturbance to the individual.

Diet behavior is a common stimulant that leads to the development of eating disorders. It causes the person to lose weight and to a degree of extreme obsessive-compulsive behavior, to have an adverse effect on his or her health, relationships, and daily activities.

Eating disorders are not just related to food and weight. Although physical symptoms appear to be in the foreground, they develop along with serious psychiatric problems. An eating disorder is an external solution to internal confusion.

Causes of eating disorders are not fully known. It is thought that the combination of biological and psychosocial causes play a role in the etiology.

The underlying causes of eating disorders are loosing self-esteem, depression, feeling of loss of control, worthless, identity confusion, problems in family communication.

Generally it seems to affect adolescent and young women but the person at all ages and gender may have eating disorders. According to the academy for Eating Disorders (AED), 10 million women and 1 million men are estimated to have eating disorders in the United States. Eating disorders seen in men, contrary to estimates have doubled in the last 10 years.

Eating disorders, as well as leading to significant physical health problems, along with increased morbidity are psychiatric disorders with increased risk of death.

Types Of Eating Disorders

In the criteria published by the American Psychiatric Association (APA) in 2013 (DSM 5), eating disorders have been classified as follows:

1. Anorexia Nervosa,
2. Bulimia Nervosa,
3. Binge Eating Disorder (defined for the first time),

4. Eating Disorders That Are Not Classified (EDNOS: Eating Disorder Not Otherwise Specified),

Anorexia nervosa (AN)

Anorexia nervosa patients are generally low self-confidence, critical and perfectionist people. Although they are dangerously weak, they feel "fat" and when they look in the mirror, they see themselves above the desired weight. They are extremely afraid of gaining weight and being overweight. In the early stages of the disease, they deny that they have problems with eating behavior, but food and weight control have become obsessed with them.

In some instances, patients go into an over-eating cycle and then engage in very restricted diet and exercise, self-vomiting or laxative (laxil), diuretic use behavior. In most cases, other psychiatric disorders such as anxiety, panic, obsessive-compulsive disorder, alcohol and substance abuse may be associated with eating disorders.

The diagnosis criteria of the disease are:

• According to age and height to provide physical health is expected to be less than 85% weight or growth process is expected to be under weight,
• Be extremely afraid of losing weight or being overweight, even though it is much below the expected weight,
•  Disorder in thought and belief about body weight or structure, loss of body weight or shape without reason in self-assessment, or denial although the weight is too low,

Over time, since the body is exposed to starvation and malnutrition, the following symptoms are observed:

• Not seeing menstruation,

• Bone fractures or osteoporosis due to loss of calcium,

• Breaking of hair and nails,

•Skin dryness and yellowing of the skin,

•Anemia, muscle tissue collapse, heart problems due to weakness in the heart muscle,

•Excessive constipation,

•Low blood pressure, slow breathing and low pulse rate,

•Falling in body temperature,

•Depression, decrease in perception skills, slowdown in movements

Bulimia nervosa (BN)

Bulimia nervosa patients frequently consume excessive amounts of food during recurrent eating seizures. Most of the time, sugar, carbohydrate and fat rates are high by choosing a large amount of calorie foods, eating very fast, sometimes they can swallow without tasting food. During eating bouts, patients feel out of control. After the seizure, atone for this behavior: fasting, self-Chuck, excess amounts laxative or diuretic use, excessive exercise, or is followed by a demonstration of this behavior. Because of the feeling of disgust or shame, he often secretly performs bulimic behavior. The patient vomits after each meal brings medical problems with it.

The diagnosis criteria of the disease are:

1. Frequently repete what is mention below:

• Consuming too much food in a 2-hour period of time than usual,
• Loss of control during eating attack,

2. İn order to avoid weight gain, apply compensatory behaviors (such as vomiting) once a week,
3. In the self-assessment of body weight or shape; it is affected for no reason,
4. Being different From the eating attack in the Anorexia Nervosa.

 The symptoms of the disease in the body are as follows;

• Chronic fried and sore throat,
• Swelling of the salivary glands and glands under the chin,
• Swelling of the cheeks and face, like the emergence of an image like" squirrel",

• Melting of the enamel due to acid contact and decay of the teeth,
• Upset stomach lid due to constant vomiting and reflux,
• Intestinal irritation and problems due to laxative use,
• Kidney diseases due to diuretic drugs,
• Problems related to fluid loss.

Binge Eating Disorder

The patient with binge eating disorder loses control while eating. Unlike BN, it does not compensate for eating behavior (such as vomiting, exercise, staying hungry). At the same time, the guilt, shame and distress caused by excessive eating causes them to experience the same eating cycle again. As a result, the weight of these patients is usually slightly higher than normal or more than normal. Obese patients with binge eating disorder have a risk of cardiovascular disease and high blood pressure.

The diagnosis criteria of the disease are:

1. Having binge eating attacks  and in the meanwhile, the repetition of the following together:

• Eating more food in a short time (for example, every 2 hours) than any individual can eat under similar circumstances and in a time frame,
• Feeling of loss of control during that attack (for example, you can't stop eating or how much you eat),

2. The binge eating attacks should include at least 3 of the following:

• Eating faster than usual,
• Eating until you feel unusually saturated,with Disturbing degree.
• Eating too much, even though you feel physically hungry,
• Being ashamed from the amount of food he eats, he starts eating secretly,
• Feeling depressed or guilty after eating, 

3. While 3 months of binge eating attacks, occurs at least once per a week.
4. Are there any compensatory behaviors (such as vomiting, laxative use, enema) after a binge eating attack?

Eating disorders show an inseparable link between mental and physical health. In order for physical health to be continuous, the mental state needs to be corrected, the same applies to the opposite. Therefore, the first step in treating anorexia nervosa patients is to bring the weight to a healthy level; the first step in treating bulimia nervosa patients is to prevent eating and vomiting seizures.

However, in order to take the lead in this treatment, first of all, it is necessary to solve the underlying emotional problems that cause the person to be sick or make his illness worse.

People with eating disorders, thoughts, feelings and behaviors that trigger their illness to learn and understand necessarily psychotherapy is required. At the same time, the use of some drugs along with psychotherapy and nutritional counseling has been shown to be effective in the treatment of this disease.

In the treatment of eating disorders, general medical care, nutrition counseling, psychiatric treatment and Psychotherapy support programs should be carried out together.