Monday Medical: Eating disorders affect everyone
Yampa Valley Medical Center hosts health program Wednesday
January 22, 2012
Eating disorders are serious and complicated mental illnesses with significant and, at times, life-threatening physical and psychological consequences, regardless of the individual's weight.
The spectrum of eating disorders includes anorexia nervosa, bulimia nervosa, binge eating disorder and eating disorders not otherwise specified.
Anorexia involves a distorted body image with a fear of and refusal to gain weight resulting in severe eating restrictions and dramatic weight loss.
In contrast, patients with bulimia may not lose weight but engage in frequent binge eating followed by attempts to get rid of the food through self-induced vomiting, laxatives, diuretics or exercise.
Anorexia nervosa carries the highest mortality rate of any psychiatric disorder. In females ages 15 to 24, anorexia causes 12 times more deaths than all other causes.
Anorexia is considered to be the third most common chronic illness among adolescents. Although the majority of patients who come to medical attention for eating disorders are women and girls, eating disorders are equal-opportunity illnesses that affect females and males, adults, adolescents and children as well as people of all ethnicities, socioeconomic backgrounds, body shapes, sizes and weights.
The puzzle of why an eating disorder affects one individual over another is a complex interplay between genetic and environmental factors. Research on the risk of developing anorexia suggests that 40 to 50 percent is genetic and 50 to 60 percent is psychosocial. In fact, anorexia nervosa is as inheritable as schizophrenia and bipolar disorder.
Eating disorders are mental illnesses not choices. Additionally, many individuals affected by eating disorders also are affected by a secondary psychiatric condition such as depression and anxiety.
While society and environment do not cause eating disorders, they may create an atmosphere that encourages development of a disorder.
In our obsession with perfection, we convey societal and familial messages about health, weight and priorities that stand in opposition to acknowledging one's own values and nurturing intuitive eating, self-care and compassion for oneself and others.
Eating disorder patients often remark that their behaviors initially were triggered by a simple comment about their weight, what they ate or their level of activity.
Eating disorders are about feelings and not primarily about food.
The eating disorder provides a coping mechanism to maintain a sense of control in the face of anxiety, change or conflict. An individual who develops an eating disorder initially may choose to modify his/her relationship with food but eventually feels sustained and driven by the eating disorder as an entity in and of itself.
Recognizing the warning signs of an eating disorder is of tremendous importance as the affected individual does not typically seek help independently. In children or adolescents, a delay in attaining expected growth or development should be evaluated.
Dramatic weight loss, denying hunger/making excuses for skipping meals, preoccupation with weight/food/calories/fat, rigid food or exercise rituals, disappearance of large amounts of food in short periods of time, or frequent trips to the bathroom after meals should prompt concern from family members and friends.
Overcoming an eating disorder is a complicated task that begins with recognition. It requires the active involvement of the patient, family members, a medical doctor and/or psychiatrist, nutritionist and psychotherapist.
There are medical, nutrition and psychotherapy resources available in Steamboat Springs. With early detection, it is possible for a patient to recover without inpatient or residential therapy.
If you know someone who you are concerned may be suffering from an eating disorder, voice your concern as a personal worry for them and offer support in helping them to locate treatment. If they are children or adolescents outside of your family, share your concerns with their families.
The best indicator for successful and prolonged recovery from an eating disorder is early and comprehensive intervention.
Lisa Harner, M.D., is a board-certified family medicine physician at Yampa Valley Medical Associates.