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Eating Disorders

Anorexia Nervosa and Bulimia Nervosa

Anorexia Nervosa is a disorder characterized by self-starvation and an irrational fear of being fat.  It usually begins in the preteen to young adult years and strikes ten times more females than males. These individuals appear to have taken a normal desire to be thin and dieting to an extreme, and continue to lose weight until they are 20% lower than normal for their age and height. Often there is excessive exercise and extreme preoccupation with body size, calories, and fat grams.  This is one of the few psychological disorders that can be fatal.  It is estimated that 6% of all victims die from medical complications, and many more suffer serious effects of malnutrition. 

Individuals with Bulimia Nervosa also have an extreme fear of being fat and use extreme and unhealthy means to avoid it. This disorder is characterized by cycles of compulsive eating of large amounts of food in short periods of time (bingeing), followed by either self-induced vomiting or use of laxatives, diuretics, over-exercising or fasting (purging). The bulimic usually hides both bingeing and purging behavior, is filled with shame and guilt and is often depressed.  They may experience rapid weight gains and loses, and will usually either be near normal weight or slightly overweight. Medical problems are likely but not obvious, are usually due to the purging behavior, and can include cardiac arrest from acute dehydration.  Chronic constipation from laxative abuse, and deteriorating dental health are also common.

Eating Disorders strike more than 1 in every 10 high school students, and the incidence has increased over the last decade. If untreated, the symptoms usually continue and worsen over a period of years.  Early treatment is the most effective, and may  be accomplished in office visits, without the need for hospitalization. The goals of treatment include anxiety management, development of more realistic and positive body image, and more normal and healthy eating and exercise habits. Psychologists usually work with physicians and nutritionists, and often with family members, in treating individuals with eating disorders.  Although they often resist treatment at first, most patients realize that their disorder is controlling them and disrupting their lives and health.  This is the first step to recovery.