Individuals with eating disorders are obsessed with food, body image, and weight loss. They may have severely limited food choices, employ bizarre eating rituals, excessively drink fluids and chew gum, and avoid eating with others. Depending on the severity and duration of their illness, they may display physical symptoms such as weight loss; amenorrhea; loss of interest in sex; low blood pressure; depressed body temperature; chronic, unexplained vomiting; and the growth of soft, fine hair on the body and face.
There are various types of eating disorders, each with its own physical, psychological, and behavioral manifestations. They are classified into four distinct diagnostic categories by the American Psychiatric Association: anorexia nervosa, bulimia nervosa, binge eating disorder, and eating disorder not otherwise specified.
Anorexia nervosa. Clinically, anorexia nervosa is diagnosed as intentional weight loss of 15 percent or more of normal body weight. The anorexic displays an inordinate fear of weight gain or becoming fat, even though he or she may be extremely thin. Food intake is strictly limited, often to the point of life-threatening starvation. Sufferers may be unaware of or in denial of their weight loss, and may therefore resist treatment.
Peak ages of onset are between 12 and 13 and at age 17. Among women of menstruating age, menstruation ceases due to weight-related declines in female hormones.
This illness has two subtypes: the restricting type, in which weight loss is achieved solely via reduction in food intake, and the binge eating/purging type, in which anorexic behavior is accompanied by recurrent episodes of binge eating or purging.
Bulimia nervosa. Bulimia nervosa is characterized by repeated episodes of bingeing followed by compensatory behaviors to prevent weight gain. Compensatory behaviors include vomiting, diuretic and laxative abuse, fasting, or excessive exercise. Like the anorexic, the typical bulimic has an unusual concern about body weight and weight loss. Unlike the anorexic, he or she is acutely aware of this condition and has a greater sense of guilt and loss of self control.
Bulimia typically develops during the late teens and early twenties. In contrast to the typically emaciated anorexic, most bulimics are of normal body weight, although weight may fluctuate frequently. Physically, the bulimic may have symptoms such as erosion of tooth enamel, swollen salivary glands, potassium depletion, bruised knuckles, and irritation of the esophagus.
To qualify for a clinical diagnosis of bulimia nervosa, binge eating and related compensatory behaviors must take place at least two times a week for a minimum of three months. Sufferers are classified into one of two subtypes: the purging type, which employs laxatives, diuretics, or self-induced vomiting to compensate for bingeing, or the nonpurging type, which relies on behaviors such as excessive exercising or fasting to offset binges.
Binge eating disorder. Binge eating disorder is characterized by eating binges that are not followed by compensatory methods. This condition, which frequently appears in late adolescence or the early twenties, affects between 15 and 50 percent of individuals participating in diet programs and often develops after substantial diet-related weight loss. Of those affected, 50 percent are male.
Binge eating disorder is diagnosed when an individual recurrently (at least twice a week for a six month period) indulges in bingeing behavior. A clinical diagnosis also requires three or more of the following behaviors: (1) eating at an unusually rapid pace, (2) eating until uncomfortably full, (3) eating large quantities of food in the absence of physical hunger, (4) eating alone out psychological: related to thoughts, feelings, and personal experiences behavioral: related to behavior, in contrast to medical or other types of interventions anorexia nervosa: refusal to maintain body weight at or above what is considered normal for height and age bulimia: uncontrolled episodes of eating (bingeing) usually followed by self-induced vomiting (purging)
binge: uncontrolled indulgence eating disorder: behavioral disorder involving excess consumption, avoidance of consumption, self-induced vomiting, or other food-related aberrant behavior hormone: molecules produced by one set of cells that influence the function of another set of cells diuretic: substance that depletes the body of water depression: mood disorder characterized by apathy, restlessness, and negative thoughts of shame, and (5) feelings of self-disgust, guilt, or depression subsequent to bingeing episodes.
Eating disorder not otherwise specified. The category eating disorder not otherwise specified (EDNOS) is used to diagnose individuals whose eating disorders are equally as serious as anorexia nervosa, bulimia nervosa, or binge eating disorder, but do not meet all of the diagnostic criteria for these illnesses. An example of EDNOS might be a female who fulfills all of the criteria for anorexia but is still having regular menstrual periods, or an individual with all of the signs of bulimia who binges and purges less than twice a week.
biological: related to living organisms stress: heightened state of nervousness or unease nutrition: the maintenance of health through proper eating, or the study of same serotonin: chemical used by nerve cells to communicate with one another neurotransmitter: molecule released by one nerve cell to stimulate or inhibit another
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