Eating Disorders are a group of serious psychiatric conditions characterized by distorted perception of our body shape and weight (e.g. worrying that we are too fat or our weight is too high). This leads to abnormal eating behaviours (e.g. eating a lot less, starving oneself, choosing low calorie foods), and engaging in excessive exercise and other ways to lose weight.
Eating disorders are particularly dangerous psychiatric conditions because they often occur in teenage years and can lead to many different medical complications, some of which could even be life-threatening. However, family members may not notice it until much later. In the developing young person, eating disorders can lead to stunted growth and affect many different parts of the body such as the brain, bones, teeth, heart and digestive system, literally from head to toe.
Complications of eating disorders
- Memory problems, delayed reaction times, fainting spells, seizures. The brain can literally shrink from a lack of nutrition.
- Depression, anxiety disorders, irritability, changes to one’s personality.
- Dental caries because saliva production which is crucial for oral health is reduced
- Enlargement of salivary glands in the cheeks
- Dangerously low heart rate, irregular heart beat, weakness of heart muscles causing heart failure
- Shrinkage of the stomach. Purging food can lead to erosions of the esophagus.
- Self-induced vomiting can also lead to dangerous disturbances to mineral salts such as potassium levels in the blood. This can cause heart rhythm problems.
- Poor bone health, Osteoporosis and fractures.
- Loss of muscle mass
- Thinning of the skin, increased risk of bruising due to low platelet levels
- Anaemia which is a low red blood cell count and can lead to shortness of breath and giddiness
- Weakened immunity resulting in frequent cough and cold infections
- Thyroid hormone disturbances
- Menstrual cycle disturbances can lead to subfertility or infertility in future. Menses may even cease completely.
- Beyond medical complications, eating disorders often damage family relationships, friendships and may lead to recurrent absences from work or school due to the repeated hospitalizations.
- Having parents or siblings with eating disorders
- Female gender
- Perfectionist personality
- Childhood trauma such as abuse or neglect
TypesThe common types of eating disorder are:
- Anorexia nervosa – Despite an abnormally low body weight, the person has an intense fear of weight gain and a distorted perception of their weight and body shape. People with anorexia nervosa resort to extreme measures to lose weight. They may refusing high calorie foods (fried food, desserts and meat) or starve themselves for long periods of time. They may engage in excessive exercise. Some may make themselves vomit and abuse slimming pills, laxatives, diuretics or illicit drugs in a bid to lose even more weight.
- Bulimia nervosa – Sufferers have a distorted view of their weight and body shape as well. But unlike in anorexia nervosa, their weight is still normal. They often skip meals to lose weight, and then end up losing control and binge-eat when intense hunger takes over. The binging episodes leads to strong feelings of guilt and shame, which then perpetuates the vicious cycle of starvation followed by binges. Some may self-induce to vomit after binge-eating while others may exercise excessively or skip meals.
- Binge-eating disorder –This is characterized by episodes of binge-eating (over-eating significantly with a loss of control, often leading to feelings of guilt, shame and disgust). Unlike in bulimia nervosa, there are no behaviours to lose weight. Sufferers do not typically skip meals, self-induce vomit or exercise excessively. Hence they are likely to be overweight.
- Family-Based Therapy has been scientifically proven to help and is in fact the gold standard intervention to help teenagers beat their eating disorder. Parents learn to take back control of the young person’s eating habits. When the body weight and eating patterns improve, parents can then hand back control to the teenager gradually. Hence, the family plays an extremely important role in the young person’s recovery.
- Other types of therapy include Cognitive Behavioural Therapy and Adolescent-Focused Therapy. Medications may not be as helpful in anorexia nervosa but they could be helpful for bulimia nervosa and binge-eating disorder. The psychiatrist may involve a dietician, physiotherapist or occupational therapist to help the patient holistically. It is important to find a psychiatrist or psychologist who is trained in the treatment of eating disorders to ensure better health outcomes.