Families often experience
enormous stress when facing the fact that their loved ones
are suffering from an eating disorder. Guilt, despair, fear,
distress, anger, confusion, frustration, helplessness, shame
and a sense of loss are the common negative emotions reported
by families. Most families do not know what they should
do, who they can turn to and how to cope with eating disorders
that have taken control of their lives. If you are the family
member of a sufferer, this programme can offer you useful
information and suggestions about what you can do to help
the person you care about and also to look after yourself.
This program contains
family education materials which help you to gain control
over eating disorders. Family
members use this program will also be able to
chat with other families whose members or relatives are
having eating disorders. This enables the sharing of experience
and enhances mutual support. The resources of this programme
will provide you with information about the professional
health services on eating disorders and useful references.
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The
facts about eating disorders |
Eating disorders are illnesses of the body
and mind. They involve disturbances in eating habits and
excessive concerns about body weight and shape. They affect
the physical health, thinking, attitudes, feelings, emotions,
social relationship and quality of life of the sufferers
of different gender, age group, nationalities, social classes
and cultures. Female adolescents and young women are the
most at risk. An increasing number of young men are reported
to have the disorders. There are multiple factors contributing
to the cause of the disorders, such as, dieting, genetics
and biological factors, personality, low self-esteem, depression,
family factors, peer influence, cultural factors, chronic
illness and stressful life events. Eating disorders may
occur with mood disorders, anxiety disorders, personality
disorders, adjustment problems, and substance abuse. Though
family problems can be the cause of the disorders ˇ§ families
are not to be blamed ˇ¨ for the disorders. The disorders
usually involve a combination of biological and sociocultural
factors triggered by stress, and most families have tried
their very best to do what they can. So don't blame yourself
for causing the disorders.
Common risk factors
for developing an eating disorder
- Dieting
- Low self-esteem
- Feelings of lack of control
- History of being teased as
overweight
- People's comment on the need
to lose weight
- Over emphasis on body image
- Perfectionism/ high achievers
- Fear of the responsibilities
of adulthood
- Participation in sports of
activities that discriminates against people with a heavy build
- Personal or family history
of obesity
- Personal or family history
of depression
- Family history of an eating
disorder
- Gay orientation in males
- History of abuse
- History of family conflict
or excessive parental expectation
- Culture which places a high
value on external appearance or thinness
- Psychological stress(e.g.
major life changes, relationship breakdown)
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Common eating disorders:
(A)
Anorexia nervosa |
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It is a potentially
life-threatening illness because of the various
medical and psychological complications it can cause
to the sufferers. The affected individuals starve
themselves in order to become thinner. They have
an intense fear of gaining weight and a distorted
view of their body image. They view themselves as
fat despite being grossly underweight. The eating
disorder is often used as a mean to cope with negative
emotions. It may give a person a sense of control
and mastery over her / his life.
Doctors diagnose a person with
anorexia nervosa based on all of the following criteria:
- Restriction of energy intake relative to requirements leading to a significantly low body weight in the context of age, sex, developmental trajectory, and physical health.
- Intense fear of gaining weight or of becoming fat, or persistent behavior that interferes with weight gain, even though at a significantly low weight.
- Disturbance in the way in which one's body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or persistent lack of recognition of the seriousness of the current low body weight.
There are two recognized types
of anorexia nervosa:
- Restricting
Type
During the last 3 months, the individual has not engaged in recurrent episodes of binge eating or purging behavior (i.e. self-induced vomiting or the misuse of laxatives, diuretics or enemas). Weight loss is accomplished primarily through dieting, fasting and/or excessive exercise.
- Binge-eating
/ Purging type
During the last 3 months, the individual has engaged in recurrent episodes of binge eating or purging behavior (i.e. self-induced vomiting or the misuse of laxatives, diuretics or enemas).
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|
(B) Bulimia
nervosa |
It
is a serious eating disorder in which the affected
individuals consume an enormous amount of food in
a short period of time uncontrollably followed by
self-induced vomiting, use of laxatives or diuretics,
excessive exercise, or fasting. People with bulimia
nervosa are very concerned about their body shape
and weight. They fear gaining weight but they are
often unsuccessful in losing weight. They are usually
of normal weight or slightly overweight. Some of
them have anorexia nervosa before the occurrence
of bulimia nervosa. The binges in bulimia nervosa
occur as a way to fulfill the suffererˇ¦s emotional
needs and their loneliness but soon after they would
develop feelings of guilt. Their attempt of inducing
vomiting following a binge further increases their
feelings of shame. Bingeing and purging can happen
in repeated cycles and are ways sufferers cope with
stress or deal with emotions and disappointments.
Doctors diagnose a person
with bulimia nervosa based on all of the following
criteria:
- Rapid consumption of a large amount
of food in a discrete period of time
- A feeling of lack of control over
eating behavior during the eating binges
- Recurrent inappropriate compensatory
behavior in order to prevent weight gain, such
as self-induced vomiting, use of laxatives or
diuretics, strict dieting or fasting, or vigorous
exercise
- The binge eating and inappropriate
compensatory behaviors both occur, on average,
at least once a week for three months
- Self-evaluation is unduly influenced
by body shape and weight
- The disturbance does not occur exclusively during episodes of anorexia nervosa
There are two recognized types
of bulimia nervosa:
- Purging
Type
The affected person has regularly
engaged in self-induced vomiting or the misuse
of laxatives, diuretics, or enemas
- Nonpurging
Type
The affected person has used
other inappropriate compensatory behaviors, such
as fasting or excessive exercise, but has not
regularly engaged in self-induced vomiting or
the misuse of laxatives, diuretics, or enemas
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| C) Binge eating
disorder
|
People
with binge-eating disorder have frequent episodes
of binge eating with an inability to stop. Unlike
people with bulimia nervosa, they do not engage
in compensatory behaviors to prevent weight gain.
Overweight happens in about 50% of people with a
binge-eating disorder. Food is used by the sufferer
to cope with strong emotions and problems. Dangerous
complications can result from binge-eating, such
as diabetes, a high blood pressure, high cholesterol
level, gallbladder disease, heart disease, and certain
types of cancer.
Doctors diagnose a person with
binge-eating based on all of the following criteria:
- Rapid consumption of a large amount
of food in a discrete period of time
- A feeling of lack of control over
one's eating behavior during the eating binges
- The binge-eating episodes are associated
with three or more of the following:
- Eating much more rapidly than
normal
- Eating until feeling uncomfortably
full
- Eating large amounts of food when
not feeling hungry
- Eating alone because of being
embarrassed by how much one is eating
- Feeling disgusted with oneself,
depressed, or very guilty after overeating
- Feeling of distress regarding binge-eating
- The binge-eating occurs, on average,
at least once a week for 3 months
- The binge-eating is not associated
with the recurrent use of inappropriate compensatory
behaviors
(e.g.
purging, fasting, excessive exercise)
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| D) Other specified feeding and eating disorder |
The affected person will have disordered patterns of eating, and a preoccupation with thoughts of food and body weight which interferes with his/ her daily life. The symptoms of the disorders, however, do not meet all the criteria of anorexia nervosa, bulimia nervosa or binge-eating disorder. The person may be anorexic but her current weight is still within or above the normal range. The person could be bulimic but her binge-eating behavior occurs less than once a week or for a duration of less than three months. Some people with the disorders could have recurrent purging behavior to influence weight or shape in the absence of binge eating or recurrent episodes of night eating, as manifested by eating after awakening from sleep or by excessive food consumption after the evening meal. |
Physical complications
associated with eating disorders
Anorexia nervosa
- Growth delay in children and teenagers
- Heart problems
(e.g.
smaller and weaker heart, slow heart rate, low blood pressure,
cardiac arrhythmia)
- Absent menstruation
- Osteoporosis
- Anaemia
- Muscle weakness
- Dehydration and potential risk of kidney
problems and kidney failure
- Delayed emptying of the stomach
- Constipation
- Dry skin
- Dry hair and hair loss
- Decreased immunity
- Metabolic problems
(e.g.
low blood glucose level, decreased metabolic rate, low
body temperature)
- Obstetric problems
(e.g.
increased risk of infertility and obstetric complication)
Bulimia nervosa
- Electrolyte disturbance from purging and
leading to a low potassium level, cardiac arrhythmia and
heart failure
- Gastrointestinal problems(e.g.
constipation or diarrhea)
- Tears or rupture of the esophagus from repeated
vomiting
- Dental caries from exposure to gastric acid
caused by vomiting
Binge-eating
disorder
- High blood pressure
- Elevated cholesterol level
- Heart problems
- Joint problems
- Diabetes
Psychological
complications associated with eating disorders
- Low self-esteem(e.g.
in bulimia and binge-eating disorder)
- Development of obsessions, compulsions and
rituals in anorexia nervosa
- Depression
- Anxiety
- Mood disturbance
- Suicidal thoughts and feelings
- Drug and alcohol abuse
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