Eating Disorder Questions and Answers
· What is obesity?
· Are there other types of eating disorders?
· What causes eating disorders?
· What are the medical complications of eating disorders?
· How can you tell if you have an eating disorder?
· How do you treat an eating disorder?
· How many people have eating disorders?
|1. Binge Eating Disorder|
A person who suffers from binge eating disorder periodically goes on a large binge (like with bulimia) but does not purge afterwards. They are typically at a normal weight or overweight. They often binge to hide their emotions, fill a void in their lives, or as self-punishment. To be diagnosed as binge eating, this behavior will need to occur at least twice a week for six months. Binge eating disorder is probably the most common eating disorder.
Compulsive eating and binge eating disorder are two separate conditions with a great deal in common. Compulsive overeaters generally exhibit compulsive behaviors around food, eating, and body image. Their eating behaviors can actually interfere with daily functioning. Compulsive overeaters eat for relief, comfort, and as a way of nurturing themselves. They eat because they are stressed, bored, afraid, and/or lonely. Frequently they will plan the next meal while they are eating this one. They feel they are out of control with food.
Compulsive overeaters will eat privately and surreptitiously. They feel shame about their excessive eating and about being fat or obese and will use food and eating as a way of coping with these feelings. They may seek help in many different places in an attempt to lose weight or control their weight. They may engage in strict dieting or fasting programs and community weight loss programs. Out of desperation, they may try diet pills, prescription weight loss medications, laxatives and diuretics. They have frequent weight fluctuations, often exceeding 10 pounds. Most people who are compulsive overeaters or binge eaters are overweight.
The binge eating episodes are associated with at least three of the following:
Whether a person has binge eating disorder or is a compulsive overeater, emotional pain associated with these conditions is no different. Nor are the medical complications. Both groups are at risk for:
Note: if you experience a significant number of the indicators above, call Mirasol at 888.520.1700 to see how we can help you break free from compulsive eating. Or, get help via e-mail by visiting Get Help Now or Ask the Doctor pages.
Obesity is currently defined as anyone who has a body mass index (BMI) that is 30 or greater and is considered a disease by many medical professionals who work with this population.
Some of the causes of obesity are glandular malfunctions, malnutrition, emotional tension, boredom, habit, and love of food. It has also been linked to food sensitivities or food allergies and may be the result of either binge eating disorder or compulsive eating.
Obesity results from a complex interaction between genes and the environment characterized by long-term energy imbalance. Heredity plays a primary role in the development of overweight and obesity, but lifestyle choices can be the most influential. These include lack of physical activity, a diet high in fat, sugar, and low in fiber, smoking, and stress.
Obesity develops in a society characterized by sedentary life style, mechanization, and good access to abundant food. The average American is less physically active. We are attempting to lose weight or control our weight by reducing the amount of food we eat (dieting through restriction) rather than increasing our activity levels. Americans also now consume 15-20 pounds more fat each year than we did 100 years ago. Eating fat can make you fat. So can dieting. As we've heard many times, frequent dieting is related to weight gain. A Finnish study conducted in 1999 reported that dieters were several times more likely than non-dieters to experience major weight gain (considered more than 22 pounds) during follow-up.
Fitness and Metabolic Health
Fitness is not integrally related to weight, nor should it be limited to measures of cardiorespiratory capacity and endurance, which have dominated our ideas of fitness. A person's focus on blood pressure, blood sugar, and blood cholesterol levels is in response to a different concept of fitness. The above parameters (blood pressure, blood sugar, and cholesterol levels) are the basics of a new definition of fitness which some call "metabolic fitness." Healthy bodies come in many shapes and sizes and we need to begin to view exercise and diet as more than just a means to an end (weight loss). People can be physically active, eat healthy foods, and not obsess about the numbers on the scale.
Insulin resistance is an extremely important factor when considering the health risks of obesity. It is a precursor to diabetes which is one of largest health problems facing Americans today.
Insulin is a naturally occurring hormone which is used to metabolize glucose, the body's major source of energy. When the problem is not with insulin production but with the ability to use the insulin effectively, it's known as insulin resistance.
Insulin resistance is a reduced sensitivity in the tissues of the body to the action of insulin which is to bring glucose into the tissues to be used as a major source of energy. When insulin resistance (or reduced insulin sensitivity) exists, the body will attempt to overcome this resistance by secreting even more insulin from the pancreas. When the pancreas is no longer able to sustain the increase in insulin secretion, diabetes develops. Insulin resistance describes a group of symptoms, including obesity, hypertension, lower HDL cholesterol, and high triglycerides, which can increase a person's risk for diabetes and heart disease. This group of abnormalities is interrelated. Experts state that 10-25% of the adult population may be insulin resistant.
Insulin resistance in combination with sedentary lifestyle, smoking, stress, and genetic susceptibility dramatically increases the risk for cardiovascular disease.
Treatment for obesity often consists of diet, exercise, medication, cognitive behavioral therapy — or a combination of all of the above!
Despite the well-documented success of behavioral techniques in producing temporary weight loss, treatment is typically followed by weight regain almost 90% of the time. The maintenance of treatment effects may therefore be the greatest challenge in the long-term management of obesity and weight loss and subsequent metabolic health.
To achieve long-term recovery, an intensive weight management program must be followed up with focused continuing care to provide ongoing support after treatment. Focused continuing care includes psychological support and guidance from professional trainers and a dietitians.
The key to overcoming obesity is experiencing a shift in consciousness about the relationship between weight, nutrition, metabolic fitness and body image, and making permanent changes that will and redefine the quality of our lives.
|3. Eating Disorders Not Otherwise Specified (EDNOS)|
Many patients who do not meet strict diagnostic criteria for anorexia or bulimia may be diagnosed with EDNOS ("Eating Disorder Not Otherwise Specified"). EDNOS is poorly recognized by health professionals and insurers and can include an assortment of conditions including symptoms of anorexia but regular menstrual periods or body weight, binging less than twice a week or for a duration of less than 3 months, chewing and spitting out food, or an obsession with healthy eating (orthorexia). Far more individuals suffer from EDNOS than from bulimia and anorexia combined, and the health consequences are equally serious since they involve many of the same self-harming behaviors typical of other eating disorders.
|4. What causes eating disorders?|
There is rarely a simple explanation for an eating disorder. It is an extremely complex problem and may be caused by a number of factors which may include family and cultural pressures, chronic stress and heredity. At some point in that person's life there is an event or a series of occurrences and situations which symbolizes one or more of the following scenarios:
"Why Don't You Just Stop?"
This is the question with which people with eating disorders are confronted again and again by parents, spouses, friends, and themselves. Costly experiences with programs promising an end to the food behaviors once and for all frequently lead to brief abstinence followed by devastating resumption of old and familiar patterns. Regardless of whether the person starves, binges, binges and purges, abuses laxatives, compulsively overeats, the story of a roller coaster experience with behavior changes is all too common. Until the behaviors in an eating disorder are viewed as the symptoms rather than the problem, the focus of recovery remains in the wrong place, and the person is likely to experience limited success in attempts to recover.
Most people have great difficulty understanding the function of the behaviors in an eating disorder. Why would someone starve herself to the point of death, as often happens in anorexia nervosa? Why would someone binge and then induce vomiting or painful diarrhea, as happens in bulimia nervosa? Why would someone eat so much that all she can do is lie down and fall asleep, as often happens for compulsive eaters? Why would someone maintain a body weight that is so high that she is physically uncomfortable and potentially endangering her health, as often happens in obesity?
There is rarely a simple explanation for an eating disorder. It is an extremely complex problem and may be caused by a number of factors which may include family and cultural pressures. Eating disorders may also occur as a result of psychological and interpersonal factors. Feelings of inadequacy, depression, anxiety and loneliness, difficult family and personal relationships may all play a part.
Frequently the person who has an eating disorder outwardly appears to be managing life very well. She is also a person who feels she would look better if she lost some weight, which means she could be virtually anyone in our society. At some point in that person's life there is an event or a series of occurrences and situations which symbolizes one or more of the following seven scenarios.
The common thread in all seven scenarios is that a person is experiencing emotional pain at a level of intensity that she does not know how to manage in a healthy way, mainly because she did not learn to express feelings directly while growing up. Many families are not able to model or teach how to express feelings in a way that promotes closeness, support, or resolution of conflict. So when a person who grew up lacking these skills experiences intense emotional pain, she lacks the tools to talk about it or to ask for support.
It is at this point that something very significant happens. The person begins to focus upon her body or food, looking outside rather than inside for the source and solution to the emotional pain. Once this starts, the person travels one of two paths. Following the first path, she begins to eat and finds food a source of comfort and nurturing. Food is consistent, reliable, and always there. It is something to look forward to coming home to at the end of the day as well as something to which to turn to when alone and scared. The person finds that when she eats, the pain does not hurt quite so much. This person is vulnerable to becoming overweight or obese due to compulsive eating.
Following the second path, the person begins to restrict food intake or to binge and purge and starts to lose weight. As she loses weight, people make comments like "Oh, you look so good! You've lost weight!" In a world that is very painful, suddenly there is something that feels good, brings positive attention, and is within her control. The person finds that the more she focuses on counting calories, exercising, dieting, losing weight, or purging, the less she feels the emotional pain. This person is vulnerable to developing anorexia nervosa or bulimia nervosa.
Portions of this article are reprinted from "Eating: Disorders. Nutrition Therapy in the Recovery Process" (1990) by Dan Reiff and Kim Reiff, PhD of Mercer Island, WA, published by Aspen Publishers, Inc., Aspen, CO. The portions of the article that are directly quoted have been reprinted with full consent and permission from the authors.
|5. What are the medical complications of eating disorders?|
Eating disorders have seriourefs long-term health consequences, some of which are life-threatening. The more severe or long lasting the eating disorder, the more likely you are to experience serious medical complications.
|6. How do you tell if you have an eating disorder?|
If you're concerned that you, a friend or a family member might be suffering from anorexia or bulimia nervosa, please consult this list of warning signs and symptoms.
To find out if you should seek further evaluation from a doctor, take our online Eating Disorder Quiz and get instant access to your eating disorder profile, with recommendations for additional reading and follow-up.
|7. How do you treat an eating disorder?|
Eating disorder treatment centers provide four basic levels of care: inpatient, residential, day treatment and outpatient. Finding an eating disorder treatment center that suits your needs is one of the most important decisions anyone will make! Before you decide, check out these questions to ask before you choose a treatment center.
Most eating disorder treatment programs include cognitive behavioral therapy and dialectical behavioral therapy, along with nutrition education, individualized meal plans and family therapy. At Mirasol, these well-established therapies are combined with proven alternative and experiential therapies including neurofeedback, adventure therapy, energy psychology and Oriental medicine.
|8. How many people have eating disorders?|
The South Carolina Department of Mental Health estimates that 8 million Americans (seven million women and one million men) have an eating disorder. Eating disorder statistics provided by the National Eating Disorder Association are even higher, and indicate that 10 million American women suffer from eating disorders.