Eating disorder
An eating disorder is a mental disorder defined by abnormal eating behaviors that adversely affect a person's physical or mental health.[1] Types of eating disorders include binge eating disorder, where the patient eats a large amount in a short period of time; anorexia nervosa, where the person has an intense fear of gaining weight and restricts food or overexercises to manage this fear; bulimia nervosa, where individuals eat a large quantity (binging) then try to rid themselves of the food (purging); pica, where the patient eats non-food items; rumination syndrome, where the patient regurgitates undigested or minimally digested food; avoidant/restrictive food intake disorder (ARFID), where people have a reduced or selective food intake due to some psychological reasons; and a group of other specified feeding or eating disorders.[1] Anxiety disorders, depression and substance abuse are common among people with eating disorders.[2] These disorders do not include obesity.[1] People often experience comorbidity between an eating disorder and OCD. It is estimated 20–60% of patients with an ED have a history of OCD.[9]
Eating disorder
Anxiety disorders, depression, substance abuse,[2] arrhythmia, heart failure and other heart problems, acid reflux (gastroesophageal reflux disease or GERD), gastrointestinal problems, low blood pressure (hypotension), organ failure and brain damage, osteoporosis and tooth damage, severe dehydration and constipation, stopped menstrual cycles (amenorrhea), infertility, stroke[3]
Unclear[4]
Gastrointestinal disorders, history of sexual abuse, being a dancer or gymnast[5][6][7][8]
Counseling, proper diet, normal amount of exercise, medications[2]
The causes of eating disorders are not clear, although both biological and environmental factors appear to play a role.[2][4] Cultural idealization of thinness is believed to contribute to some eating disorders.[4] Individuals who have experienced sexual abuse are also more likely to develop eating disorders.[7] Some disorders such as pica and rumination disorder occur more often in people with intellectual disabilities.[1]
Treatment can be effective for many eating disorders.[2] Treatment varies by disorder and may involve counseling, dietary advice, reducing excessive exercise, and the reduction of efforts to eliminate food.[2] Medications may be used to help with some of the associated symptoms.[2] Hospitalization may be needed in more serious cases.[2] About 70% of people with anorexia and 50% of people with bulimia recover within five years.[10] Only 10% of people with eating disorders receive treatment, and of those, approximately 80% do not receive the proper care. Many are sent home weeks earlier than the recommended stay and are not provided with the necessary treatment.[11] Recovery from binge eating disorder is less clear and estimated at 20% to 60%.[10] Both anorexia and bulimia increase the risk of death.[10] When people experience comorbidity with an eating disorder and OCD, certain aspects of treatment can be negatively impacted. OCD can make it harder to recover from obsession over weight and shape, body dissatisfaction, and body checking.[12] This is in part because ED cognitions serve a similar purpose to OCD obsessions and compulsions (e.g., safety behaviors as temporary relief from anxiety).[13] Research shows OCD does not have an impact on the BMI of patients during treatment.[12]
Estimates of the prevalence of eating disorders vary widely, reflecting differences in gender, age, and culture as well as methods used for diagnosis and measurement.[14][15][16]
In the developed world, anorexia affects about 0.4% and bulimia affects about 1.3% of young women in a given year.[1] Binge eating disorder affects about 1.6% of women and 0.8% of men in a given year.[1] According to one analysis, the percent of women who will have anorexia at some point in their lives may be up to 4%, or up to 2% for bulimia and binge eating disorders.[10] Rates of eating disorders appear to be lower in less developed countries.[17] Anorexia and bulimia occur nearly ten times more often in females than males.[1] The typical onset of eating disorders is in late childhood to early adulthood.[2] Rates of other eating disorders are not clear.[1]
Classification[edit]
ICD and DSM diagnoses[edit]
These eating disorders are specified as mental disorders in standard medical manuals, including the ICD-10 and the DSM-5.
Prevention aims to promote a healthy development before the occurrence of eating disorders. It also intends early identification of an eating disorder before it is too late to treat. Children as young as ages 5–7 are aware of the cultural messages regarding body image and dieting.[274] Prevention comes in bringing these issues to the light. The following topics can be discussed with young children (as well as teens and young adults).
Internet and modern technologies provide new opportunities for prevention. Online programs have the potential to increase the use of prevention programs.[279] The development and practice of prevention programs via online sources make it possible to reach a wide range of people at minimal cost.[280] Such an approach can also make prevention programs to be sustainable.
Parents can do a lot for their children at a young age to impede them from ever seeing themselves in the eyes of an eating disorder. The parents who are actively engaged in their children's lives' often contribute to fostering a stronger sense of self-love in them.
Evolutionary perspective[edit]
Evolutionary psychiatry as an emerging scientific discipline has been studying mental disorders from an evolutionary perspective. If eating disorders have evolutionary functions or if they are new modern "lifestyle" problems is still debated.[360][361][362]