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Advicenators discussion: Eating Disorders/ Dieting
karenR wrote Thursday April 23 2009, 7:10 am:
EATING DISORDERS OVERVIEW:
An eating disorder is a disturbance in eating behavior that compromises a person's physical and psychological health. Anorexia nervosa and Bulimia are chronic problems in which there is a preoccupation with food, eating and weight loss.
Eating disorders are a very dangerous type of illness no matter who you are. Men also get eating disorders, and more young men are coming forward and admitting their obsessions with their weight and food.
Anorexia Nervosa
Anorexia nervosa was first described in scientific literature over 100 years ago in England. Descriptions of self-starvation have even been found in medieval writings. Anorexia is not a new syndrome that the media has created, but has certainly influenced. Anorexia nervosa is a self-starvation syndrome in which a person willingly loses an excessive amount of weight (20 percent or more of their original body weight), shows muscle wasting, suffers from body image disturbances and experiences intense fears about becoming fat, no matter how thin the individual becomes. The term "anorexia," literally meaning "loss of appetite," is deceiving, since hunger is felt by the anorexic person. In the case of anorexia, the hunger pains are denied. Despite their refusal to eat, people with anorexia become obsessed with food, often fantasizing about it, reading recipes or cookbooks and often preparing large meals for others.
Anorexia is still more prevalent in young women than in young men. The disorder typically begins in tween or teenage girls who are either overweight or perceive themselves that way. An interest in weight reduction becomes an obsession with severely restricted caloric intact and, often excessive physical exercise. Teasing by peers or parents can also play a role in the fear of becoming overweight.
Many teenagers who suffer from anorexia have a fear of becoming an adult, and so try to maintain the figure of a child. Low self-esteem, feelings of shame and guilt, and problems with drug and or alcohol abuse may also contribute to this disorder.
Complications
Many organ systems are affected by the malnutrition that occurs in people with anorexia. The severity of the abnormalities tends to be related to the degree of malnutrition and reversed with re-feeding. The most frequent complication of anorexia is amenorrhoea (cessation of menstruation) and the loss of secondary sex characteristics with the decreased levels of estrogen that anorexia nervosa causes. Other complications include constipation, cold intolerance, slow heart rate, low blood pressure, decreased heart size, irregular heart beat, dry skin and hair loss. Unexpected sudden deaths have been recorded. The risk of death appears to increase as weight drops to less than 35 to 40 percent of ideal weight. It is believed that these deaths are due to heart failure.
Treatment
The most difficult part of treating the anorexic person is the inability of the person to realize that there is indeed a problem. Anorexia is a form of starvation and is very serious. It can lead to death if left untreated.
Research suggests that anorexics can achieve weight gain by way of treatment, although they may never reach ideal weight. Frequently their abnormal eating patterns of avoiding high-calorie foods continues. There is no preferred single form of treatment. Psychological interventions are often helpful. Initially, anorexia was thought to be a psychological problem, but in the past several years scientists have discovered that people with eating disorders have a chemical imbalance in the brain similar to those found in people with depression.
Bulimia
Bulimia is an eating disorder that has several distinctive behaviors, feeling and thoughts. Bulimia (a term that literally means "ox hunger") is characterized by secretive episodes or "binges" of eating large quantities of high-calorie, high-carbohydrate, easy-to-eat foods such as ice cream, cookies or donuts. There are also periods of severe food restriction by way of dieting or vomiting to prevent weight gain. The purging behaviors are what distinguish it from anorexia. Purging behaviors include self-induced vomiting, use of diuretics, use of laxatives to induce diarrhea and/or obsessive exercise.
People who experience the binge-purge syndrome are usually women in their late teens through the mid-thirties. Their weights may fluctuate, but not to the dangerous low levels seen in people with anorexia nervosa. The thoughts and feelings of people with bulimia range from fear of not being able to stop eating to a concern about gaining too much weight. They also experience feelings of sadness, anger, guilt, shame and low self esteem. In contrast to anorexic persons, who turn away from food when facing problems, bulimic persons turn towards food. Also unlike anorexic persons, they do recognize that their behavior is abnormal.
People with bulimia nervosa tend to lead secret lives, hiding their abnormal eating habits. In a single binge they can consume foods supplying 10,000 to 15,000 calories or more. The binge usually occurs in several stages: anticipation and planning, anxiety, urgency to begin, rapid and uncontrollable consumption of food, relief and relaxation, disappointment and finally shame.
Complications
The complications of binge-purge syndrome include those resulting from overeating, self-induced vomiting, and diuretic and laxative abuse. Among the complications of binge-purge syndrome are dental disorders, body fluid disorders and salivary gland problems. Dental abnormalities, such as sensitive teeth, dental decay and gum disease occur from the frequent vomiting. This is due to the high acid content of vomit, it eats away at the tooth enamel and sometimes teeth are lost as a result. Use of laxatives changes normal bowel patterns. Diuretics can throw off a person's acid-base balance.
Self-induced vomiting can lead to swelling of salivary glands, electrolyte and mineral disturbances, and enamel erosion in teeth. Laxative abuse can lead to long lasting disruptions of normal bowel functioning. Complications such as tearing the esophagus, rupturing the stomach and developing life-threatening irregularities of the heart rhythm may also result.
Treatment
The treatment requires a team of experienced clinicians. Therapists aim to reduce the number of binge-purge episodes by improving self-acceptance, decreasing concern about body weight and altering abnormal attitudes. The primary goal of therapy for this syndrome is to establish a regular healthful eating pattern. Unlike those who suffer with anorexia nervosa, the person with bulimia is upset by the behaviors they are exhibiting and by the thoughts that they experience. This makes them more likely to accept help for their disorder. People who have been successfully treated for bulimia seem to have benefited from making meal plans, avoiding sugary or binge foods, exercising regularly, finding alternative activities, and going through behavioral or traditional psychotherapy.
Summary
The most crucial thing about treating eating disorders is to recognize and address the problem as soon as possible. Unhealthy eating patterns become harder to break the longer a person takes part in them. If you or someone you know has an eating disorder, get help. Anorexia and bulimia can do a lot of damage to the body and mind if left untreated. Remember, they can both kill. Even if a person recovers fully from this disorder, serious permanent damage may have already been done to the body. The scope of related problems associated with eating disorders highlights the need for prompt treatment and intervention.
For sufferers: Admitting you have an eating or body image problem that requires treatment is difficult. Taking those first steps to seeking help can be filled with fear and anxiety, but also hope. Finding and getting the right help is essential. There are a variety of treatment options available: individual therapy, group therapy, nutritional support, psychiatric care, outpatient, inpatient and even residential treatment facilities.
REF:[Link](Mouse over link to see full location)
karenR wrote Thursday April 23 2009, 7:13 am:
ANOREXIA NERVOSA
The actual criteria for anorexia nervosa are found in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV).
There are four basic criteria for the diagnosis of anorexia nervosa that are characteristic:
1. The refusal to maintain body weight at or above a minimally normal weight for age and height. Body weight less than 85% of the expected weight is considered minimal.
2. An intense fear of gaining weight or becoming fat, even though the person is underweight.
3. Self-perception that is grossly distorted and weight loss that is not acknowledged.
4. In women who have already begun their menstrual cycle, at least three consecutive periods are missed (amenorrhea), or menstrual periods occur only after a hormone is administered.
The DSM-IV further identifies two subtypes of anorexia nervosa. In the binge-eating/purging type, the individual regularly engages in binge eating or purging behavior which involves self-induced vomiting or the misuse of laxatives, diuretics, or enemas during the current episode of anorexia. In the restricting type, the individual severely restricts food intake but does not engage in the behaviors seen in the binge eating type.
REF:[Link](Mouse over link to see full location)
karenR wrote Thursday April 23 2009, 7:14 am:
What are anorexia symptoms and signs (psychological and behavioral)?
Anorexia can have dangerous psychological and behavioral effects on all aspects of an individual's life and can affect other family members as well.
* The individual can become seriously underweight, which can lead to depression and social withdrawal.
* The individual can become irritable and easily upset and have difficulty interacting with others.
* Sleep can become disrupted and lead to fatigue during the day.
* Attention and concentration can decrease.
* Most individuals with anorexia become obsessed with food and thoughts of food. They think about it constantly and become compulsive about eating rituals. They may collect recipes, cut their food into tiny pieces, prepare elaborate calorie-laden meals for other people, or hoard food. Additionally, they may exhibit other obsessions and/or compulsions related to food, weight, or body shape that meet the diagnostic criteria for an obsessive compulsive disorder.
* Other psychiatric problems are also common in people with anorexia nervosa, including affective (mood) disorders, anxiety disorders, and personality disorders.
* Generally, individuals with anorexia are compliant. Sometimes, they are overly compliant, to the extent that they lack adequate self-perception. They are eager to please and strive for perfection. They usually do well in school and may often overextend themselves in a variety of activities. The families of anorexics often appear to be "perfect." Physical appearances are important to them. Performance in other areas is stressed as well, and they are often high achievers.
* While control and perfection are critical issues for individuals with anorexia, aspects of their life other than their eating habits are often found to be out of control as well. Many have, or have had at some point in their lives, addictions to alcohol, drugs, or gambling. Compulsions involving sex, exercising, housework, and shopping are not uncommon. In particular, people with anorexia often exercise compulsively to speed the weight-loss process.
All of these features can negatively affect one's daily activities. Diminished interest in previously preferred activities can result. Some individuals also have symptoms that meet the diagnostic criteria for a major depressive disorder.
REF: [Link](Mouse over link to see full location)
karenR wrote Thursday April 23 2009, 7:16 am:
What are anorexia symptoms and signs (physical)?
Most of the medical complications of anorexia nervosa result from starvation. Few organs are spared the progressive deterioration brought about by anorexia.
* Heart and circulatory system: Although not life-threatening, an abnormally slow heart rate (bradycardia) and unusually low blood pressure (hypotension) are frequent manifestations of starvation and are commonly associated with anorexia. Of greater significance are disturbances in the heart rhythm (arrhythmia). A reduction in the work capacity of the heart is associated with severe weight loss and starvation.
* Gastrointestinal complications are also associated with anorexia. Constipation and abdominal pain are the most common symptoms. The rate at which food is absorbed into the body is slowed down. Starvation and overuse of laxatives can seriously disrupt the body's normal functions involved in the elimination process. While liver function is generally found to be normal, there is evidence of changes in enzyme levels and overall damage to the liver.
* The glandular (endocrine) system in the body is profoundly affected by anorexia. The complex physical and chemical processes involved in the maintenance of life can be disrupted, with serious consequences. Disturbances in the menstrual cycle are frequent and can affect not only fertility but also bone density, which is very important to a woman's health as she ages. Hormonal imbalances are found in men with anorexia as well. Continual restrictive eating can trick the thyroid into thinking that the body is starving, causing it to slow down in an attempt to preserve calories.
* Kidney (renal) function may appear normal. However, there are significant changes in kidney function in many people with anorexia, resulting in potassium deficiency, increased urination, or decreased urination.
* Anorexics who use a large quantity of laxatives or who frequently vomit are at great risk for electrolyte imbalance, which can have life-threatening consequences.
* Anemia is frequently found in anorexic patients. Suppressed immunity and a high risk for infection are suspected, but not clinically proven.
* Physical symptoms, other than the obvious loss of weight, can be seen. Anorexia can cause dry, flaky skin that takes on a yellow tinge. Fine, downy hair grows on the face, back, arms, and legs. Despite this new hair growth, loss of hair on the head is not uncommon. Nails can become brittle. Frequent vomiting can erode dental enamel and eventually lead to tooth loss.
REF:[Link](Mouse over link to see full location)
karenR wrote Thursday April 23 2009, 7:17 am:
How is anorexia treated?
Anorexia may be treated in an outpatient setting, or hospitalization may be necessary. For an individual with severe weight loss that has impaired organ function, hospital treatment must initially focus on correction of malnutrition, and intravenous feeding may be required. A gain of between one to three pounds per week is a safe an attainable goal when malnutrition must be corrected.
The overall treatment of anorexia, however, must focus on more than weight gain. There are a variety of treatment approaches dependent upon the resources available to the individual. Because of increasing insurance restrictions, many patients find that a short hospitalization followed by a day treatment program is an effective alternative to longer inpatient programs. Most individuals, however, initially seek outpatient treatment involving psychological as well as medical intervention.
Different kinds of psychological therapy have been employed to treat people with anorexia. Individual therapy, cognitive behavior therapy, group therapy, and family therapy have all been successful in treatment of anorexia. Those with anorexia can be treated by a medical doctor, a clinical psychologist, or both, depending upon the progression of the disorder. A psychiatrist with both medical and psychological training is perhaps the best treatment provider. An appropriate treatment approach addresses underlying issues of control and self-perception. Family dynamics are explored, and often the family is included in the treatment plan. Nutritional education provides a healthy alternative to weight management for the patient. Group counseling or support groups often assist the individual in the recovery process. The ultimate goal of treatment should be for the individual to accept herself/himself and lead a physically and emotionally healthy life.
While no medications have been identified that can definitively reduce the compulsion to starve themselves, some of the selective serotonin reuptake inhibitor (SSRI) antidepressant drugs have been shown to be helpful in weight maintenance after weight has been gained, and in controlling mood and anxiety symptoms that may be associated with the condition.
REF:[Link](Mouse over link to see full location)
karenR wrote Thursday April 23 2009, 7:18 am:
What is the prognosis (outcome) of anorexia?
Anorexia is among the psychiatric conditions with the highest mortality rate, with an estimated 6% of anorexia victims dying from complications of the disease. The most common causes of death in people with anorexia are medical complications of the condition including cardiac arrest and electrolyte imbalances. Suicide is also a cause of death in people with anorexia.
Early diagnosis and treatment can improve the overall prognosis in an individual with anorexia. With appropriate treatment, about half of those affected will make a full recovery. Some people experience a fluctuating pattern of weight gain followed by a relapse, while others experience a progressively deteriorating course of the illness over many years and still others never fully recover. It is estimated that about 20% of people with anorexia remain chronically ill from the condition.
As with many other addictions, it takes a day-to-day effort to control the urge to relapse. Many individuals will require ongoing treatment for anorexia over several years, and some may require treatment over their entire lifetime.
Anorexia Nervosa At A Glance
* Anorexia nervosa is an eating disorder and, more importantly, a psychological disorder.
* The cause of anorexia has not been definitively established, but self-esteem and self-image issues, family dynamics, societal pressures, and even genetic factors may each play a role.
* Anorexia affects females far more often than males and is most common in adolescent females.
* The disorder affects about 1% of adolescent girls in the U.S.
* People with anorexia tend to show compulsive behaviors and may become obsessed with food.
* The extreme dieting and weight loss can lead to a potentially fatal degree of malnutrition.
* Other possible consequences of anorexia include heart-rhythm disturbances, digestive abnormalities, anemia, and hormonal and electrolyte imbalances.
* The treatment of anorexia must focus on more than just weight gain.
* The prognosis of anorexia is variable, with some people making a full recovery. Others experience a fluctuating pattern of weight gain followed by a relapse, or a progressively deteriorating course over many years.
* As with many other addictions, it takes a day-to-day effort to control the urge to relapse, and treatment may be needed on a long-term basis.
REF:[Link](Mouse over link to see full location)
karenR wrote Thursday April 23 2009, 7:20 am:
What is bulimia?
Bulimia, also called bulimia nervosa, is an eating disorder. Bulimia is characterized by episodes of secretive excessive eating (bingeing) followed by inappropriate methods of weight control, such as self-induced vomiting (purging), abuse of laxatives and diuretics, or excessive exercise. Like anorexia, bulimia is a psychological disorder. It is another condition that goes beyond out-of-control dieting. The cycle of overeating and purging can quickly become an obsession similar to an addiction to drugs or other substances. The disorder generally occurs after a variety of unsuccessful attempts at dieting.
Bulimia is estimated to affect between 3% of all women in the U.S. at some point in their lifetime. About 6% of teen girls and 5% of college-aged females are believed to suffer from bulimia. These numbers are somewhat lower than earlier estimates of the prevalence of bulimia due to the precise criteria now established for the diagnosis (see below). Approximately 10% of identified bulimic patients are men. Bulimics are also susceptible to other compulsions, affective disorders, or addictions. Twenty to 40% of women with bulimia also have a history of problems related to drug or alcohol use, suggesting that many affected women may have difficulties with control of behavioral impulses.
Unlike anorexics, bulimics experience significant weight fluctuations, but their weight loss is usually not as severe or obvious as anorexics. The long-term prognosis for bulimics is slightly better than for anorexics, and the recovery rate is felt to be higher. However, many bulimics continue to retain slightly abnormal eating and dieting behaviors even after the recovery period.
The secrecy of bulimia stems from the shame that bulimics often attach to the disorder. Binge eating is not triggered by intense hunger. It is a response to depression, stress, or other feelings related to body weight, shape, or food. Binge eating often brings on a feeling of calm or happiness (euphoria), but the self-loathing because of the overeating soon replaces the short-lived euphoria.
Often, the individual will feel an impairment or loss of control during the binge eating and the purging becomes a way of regaining control. Not all bulimics engage in self-induced vomiting or the misuse of laxatives, diuretics, or enemas during the current episode. Some may fast for days following a binge episode. Others may resort to excessive exercise as a method to regain their control and rid their body of the possible weight gained during the binge. Excessive exercise is that which interferes with normal daily activities or when it occurs at inappropriate times or in inappropriate settings, or when it continues despite illness or injury.
REF:[Link](Mouse over link to see full location)
karenR wrote Thursday April 23 2009, 7:21 am:
What causes bulimia?
As with anorexia, there is currently no definite known cause of bulimia. Because of the complexity of the disorder, researchers within the medical and psychological fields continue to explore its dynamics.
Bulimia is generally felt to begin with a dissatisfaction of the person's body. The individual may actually be underweight, but when the person looks in a mirror they see a distorted image and feel heavier than they really are. At first, this distorted body image leads to dieting. As the body image in the mirror continues to be seen as larger than it actually is, the dieting escalates and can lead to bulimic practices.
In certain neurological or medical conditions, there can be disturbed eating behavior, but the essential psychological feature of bulimia, the extreme concern with body shape and weight, is not present. For example, overeating is a common feature in depression, however, these individuals do not engage in inappropriate weight-loss behaviors and are not overly concerned with body image and weight loss as is characteristic of the person with bulimia.
Organic causes for bulimia are being investigated. There is evidence that bulimia and other eating disorders may be related to abnormalities in levels of chemical messengers (neurotransmitters) within the brain, specifically the neurotransmitter serotonin. Other studies of people with bulimia have found alterations in metabolic rate, decreased perceptions of satiety, and abnormal neuroendocrine regulation (the process by which the nervous system interacts with production of hormones and hormone-like substances).
REF: [Link](Mouse over link to see full location)
karenR wrote Thursday April 23 2009, 7:22 am:
How is bulimia diagnosed?
As with anorexia, denial and secrecy complicate the diagnosis of bulimia. The individual usually does not come to the attention of the practitioner until an associated medical condition or serious psychological problem manifests itself. Truthful disclosure of behaviors is critical for an accurate diagnosis. The actual criteria for bulimia nervosa are found in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). There are five basic criteria in the diagnosis of bulimia:
1. Recurrent episodes of binge eating. This is characterized by eating within a two-hour period an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances.
2. A sense of lack of control over the eating during the episode, or a feeling that one cannot stop eating.
3. In addition to the binge eating, there is an inappropriate compensatory behavior in order to prevent weight gain. These behaviors can include self-induced vomiting, misuse of laxatives, diuretics, enemas or other medications, fasting, or excessive exercise.
4. Both the binge eating and the compensatory behaviors must occur at least two times per week for three months and must not occur exclusively during episodes of anorexia.
5. Finally, there is dissatisfaction with body shape and/or weight.
The DSM-IV also identifies two subtypes of bulimia nervosa. The purging type regularly engages in self-induced vomiting or the misuse of laxatives, diuretics, or enemas. The nonpurging type engages in other inappropriate compensatory behaviors, such as fasting or excessive exercise, rather than purging methods.
What are signs that may suggest a person has bulimia?
It is not always possible to tell whether a person has bulimia. Those affected may be overweight, underweight, or of normal body weight. However, some warning signs may be present, although these do not confirm the diagnosis of bulimia:
* going to the bathroom after every meal (to induce vomiting)
* compulsive or excessive exercising
* physical signs arising from excessive vomiting such as swollen cheeks or jaws, broken blood vessels in the eyes, or teeth that appear clear due to damage to tooth enamel
* excessive preoccupation with body image or weight
REF: [Link](Mouse over link to see full location)
karenR wrote Thursday April 23 2009, 7:23 am:
What medical complications and long-term effects can bulimia have?
The medical complications that result from bulimia are generally due to continual bingeing and purging. The type of purging behavior used can have varied effects on different body systems.
Self-induced vomiting can result in oral complications. Repeated exposure to acidic gastric contents can erode tooth enamel, increase dental cavities, and create a sensitivity to hot or cold food. Swelling and soreness in the salivary glands (such as the parotid glands in the cheeks) from repeated vomiting can also be a concern.
The esophagus and the colon are the areas most affected by bulimic behaviors. Repeated vomiting can result in ulcers, ruptures, or strictures of the esophagus. Acid that backs up from the stomach (reflux) can also become a problem.
As with anorexia nervosa and other eating disorders, irregular menstrual periods or amenorrhea (the absence of menstrual periods) may result from malnutrition or weight fluctuations associated with bulimia.
There are a number of intestinal and systemic complications. The misuse of diuretics can create an abnormal buildup of fluid (edema). Continual use of laxatives can result in dependency on them and can cause the normal elimination process to become dysfunctional. Loss of normal colonic function can necessitate surgical intervention in some cases. Restoration of normal bowel function may take weeks after the misuse has been discontinued. The misuse of diuretics and laxatives combined can place the bulimic at great risk for electrolyte imbalance, which can have life-threatening consequences. The complex physical and chemical processes involved in the maintenance of life can be disrupted with serious consequences by the continuation of bulimic and purging behaviors. Additional complications can affect an unborn fetus of a practicing bulimic or the infant of an active bulimic mother. Psychological problems can escalate to serious levels if untreated and interfere with the restoration of normal body functions.
REF: [Link](Mouse over link to see full location)
karenR wrote Thursday April 23 2009, 7:24 am:
How is bulimia treated?
Patients with bulimia present a variety of medical and psychological complications which are usually considered to be reversible through a multidisciplinary treatment approach. Treatment can be managed by either a physician, psychiatrist, or in some cases, a clinical psychologist. The extent of the medical complications generally dictates the primary treatment manager. A psychiatrist, with both medical and psychological training, is perhaps the optimum treatment manager.
A number of antidepressant medications have been shown to be beneficial in the treatment of bulimia. Several studies have demonstrated that fluoxetine (Prozac), a member of the selective serotonin reuptake inhibitor (SSRI) class of antidepressants, has been effective in the treatment of bulimia. And the U.S. Food and Drug Administration has approved fluoxetine for the treatment of bulimia.
Other types of antidepressants, including the monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants, and buspirone (Buspar) have all been shown to decrease bingeing and vomiting in people suffering from bulimia. However, the SSRIs remain the first choice for treatment due to their relative safety and low incidence of side effects.
Other drugs are currently under investigation as possible treatments for bulimia. Examples are the antiepileptic drug topiramate and the serotonin antagonist ondansetron.
Some patients may require hospitalization due to the extent of the medical or psychological complications. Others may seek outpatient programs. Still others may require only weekly counseling and monitoring by a practitioner. Stabilization of the patient's physical condition will be the immediate goal if the individual is in a life-threatening state. The primary goals of treatment should address both physical and psychological needs of the patient in order to restore physical health and normal eating patterns. The patient needs to identify internal feelings and distorted beliefs that led to the disorder initially. An appropriate treatment approach addresses underlying issues of control, self-perception, and family dynamics. Nutritional education and behavior management provides the patient with healthy alternatives to weight management. Group counseling or support groups can assist the patient in the recovery process as well.
The ultimate goal should be for the patient to accept herself/himself and lead a physically and emotionally healthy life. Restoration of physical and mental health will probably take time, and results will be gradual. Patience is a vital part of the recovery process. A positive attitude coupled with much effort on the part of the affected individual is another integral component to a successful recovery.
Bulimia At A Glance
* Bulimia (also called bulimia nervosa) is a psychological eating disorder.
* Bulimia is felt to be related to a person's dissatisfaction with their own body image, although the exact cause is not known.
* Bulimia is diagnosed according to defined criteria.
* There are two types of bulimia: the purging and nonpurging types.
* The purging type regularly engages in self-induced vomiting or the misuse of laxatives, diuretics, or enemas.
* The nonpurging type engages in other inappropriate behaviors such as fasting or excessive exercise, rather than purging.
* Bulimia can have serious medical complications.
* The successful treatment of bulimia is often multidisciplinary involving both medical and psychological approaches.
* The goals of treatment are to restore physical health and normal eating patterns.
REF:[Link](Mouse over link to see full location)
karenR wrote Thursday April 23 2009, 7:28 am:
BINGE EATING DISORDER
How do I know if I have binge eating disorder?
Most of us overeat from time to time, and some of us often feel we have eaten more than we should have. Eating a lot of food does not necessarily mean that you have binge eating disorder. Experts generally agree that most people with serious binge eating problems often eat an unusually large amount of food and feel their eating is out of control. People with binge eating disorder also may:
* eat much more quickly than usual during binge episodes
* eat until they are uncomfortably full
* eat large amounts of food even when they are not really hungry
* eat alone because they are embarrassed about the amount of food they eat
* feel disgusted, depressed, or guilty after overeating.
Binge eating also occurs in another eating disorder called bulimia nervosa. Persons with bulimia nervosa, however, usually purge, fast, or do strenuous exercise after they binge eat. Purging means vomiting or using a lot of diuretics (water pills) or laxatives to keep from gaining weight. Fasting is not eating for at least 24 hours. Strenuous exercise, in this case, means exercising for more than an hour just to keep from gaining weight after binge eating. Purging, fasting, and overexercising are dangerous ways to try to control your weight.
How common is binge eating disorder, and who is at risk?
Binge eating disorder is probably the most common eating disorder. Most people with this problem are either overweight or obese,* but normal-weight people also can have the disorder.
About 2 percent of all adults in the United States (as many as 4 million Americans) have binge eating disorder. About 10 to 15 percent of people who are mildly obese and who try to lose weight on their own or through commercial weight-loss programs have binge eating disorder. The disorder is even more common in people who are severely obese.
Binge eating disorder is a little more common in women than in men; three women for every two men have it. The disorder affects blacks as often as whites. No one knows how often it affects people in other ethnic groups.
People who are obese and have binge eating disorder often became overweight at a younger age than those without the disorder. They might also lose and gain back weight (yo-yo diet) more often.
* The 1998 NIH Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults define overweight as a body mass index (BMI) of 25 to 29.9 and obesity as a BMI of 30 or more. BMI is calculated by dividing weight (in kilograms) by height (in meters) squared.
What are the complications of binge eating disorder?
People with binge eating disorder are usually very upset by their binge eating and may become depressed. Research has shown that people with binge eating disorder report more health problems, stress, trouble sleeping, and suicidal thoughts than people without an eating disorder do. People with binge eating disorder often feel bad about themselves and may miss work, school, or social activities to binge eat.
People with binge eating disorder may gain weight. Weight gain can lead to obesity, and obesity puts people at risk for many health problems, including
* type 2 diabetes
* high blood pressure
* high blood cholesterol levels
* gallbladder disease
* heart disease
* certain types of cancer.
Most people who binge eat, whether they are obese or not, feel ashamed and try to hide their problem. Often they become so good at hiding it that even close friends and family members do not know they binge eat.
REF: [Link](Mouse over link to see full location)
karenR wrote Thursday April 23 2009, 7:28 am:
BINGE EATING DISORDER
How do I know if I have binge eating disorder?
Most of us overeat from time to time, and some of us often feel we have eaten more than we should have. Eating a lot of food does not necessarily mean that you have binge eating disorder. Experts generally agree that most people with serious binge eating problems often eat an unusually large amount of food and feel their eating is out of control. People with binge eating disorder also may:
* eat much more quickly than usual during binge episodes
* eat until they are uncomfortably full
* eat large amounts of food even when they are not really hungry
* eat alone because they are embarrassed about the amount of food they eat
* feel disgusted, depressed, or guilty after overeating.
Binge eating also occurs in another eating disorder called bulimia nervosa. Persons with bulimia nervosa, however, usually purge, fast, or do strenuous exercise after they binge eat. Purging means vomiting or using a lot of diuretics (water pills) or laxatives to keep from gaining weight. Fasting is not eating for at least 24 hours. Strenuous exercise, in this case, means exercising for more than an hour just to keep from gaining weight after binge eating. Purging, fasting, and overexercising are dangerous ways to try to control your weight.
How common is binge eating disorder, and who is at risk?
Binge eating disorder is probably the most common eating disorder. Most people with this problem are either overweight or obese,* but normal-weight people also can have the disorder.
About 2 percent of all adults in the United States (as many as 4 million Americans) have binge eating disorder. About 10 to 15 percent of people who are mildly obese and who try to lose weight on their own or through commercial weight-loss programs have binge eating disorder. The disorder is even more common in people who are severely obese.
Binge eating disorder is a little more common in women than in men; three women for every two men have it. The disorder affects blacks as often as whites. No one knows how often it affects people in other ethnic groups.
People who are obese and have binge eating disorder often became overweight at a younger age than those without the disorder. They might also lose and gain back weight (yo-yo diet) more often.
* The 1998 NIH Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults define overweight as a body mass index (BMI) of 25 to 29.9 and obesity as a BMI of 30 or more. BMI is calculated by dividing weight (in kilograms) by height (in meters) squared.
What are the complications of binge eating disorder?
People with binge eating disorder are usually very upset by their binge eating and may become depressed. Research has shown that people with binge eating disorder report more health problems, stress, trouble sleeping, and suicidal thoughts than people without an eating disorder do. People with binge eating disorder often feel bad about themselves and may miss work, school, or social activities to binge eat.
People with binge eating disorder may gain weight. Weight gain can lead to obesity, and obesity puts people at risk for many health problems, including
* type 2 diabetes
* high blood pressure
* high blood cholesterol levels
* gallbladder disease
* heart disease
* certain types of cancer.
Most people who binge eat, whether they are obese or not, feel ashamed and try to hide their problem. Often they become so good at hiding it that even close friends and family members do not know they binge eat.
REF: [Link](Mouse over link to see full location)
karenR wrote Thursday April 23 2009, 7:32 am:
Healthy Diet
For Teenagers
Health Problems Related to Diet
At least 6 health problems have been proven to relate to diet:
1. Iron deficiency anemia
The body needs iron to build red blood cells. This type of anemia usually occurs between 6 months and 2 years of age. It can also occur in adolescents, especially in girls with heavy menstrual periods. Many teens have no symptoms. If they do, the most common symptoms are fatigue, shortness of breath, and poor endurance.
2. Overweight
Obesity is one of the most common nutritional problems in this country. Obesity is also one of the most important contributing factors in heart disease, hypertension, and some cancers.
3. Tooth decay
Tooth decay is more likely if you have a lot of sugar in your diet. (Poor toothbrushing habits also contribute to tooth decay.)
4. Intestinal symptoms
Too little fiber in the diet can cause intestinal problems such as constipation, abdominal discomfort, appendicitis, gallstones, and some intestinal cancers.
5. Coronary artery disease
A lot of animal fat (especially cholesterol) in the diet contributes to coronary artery disease. This disease is less common among vegetarians.
6. High blood pressure
High blood pressure is mainly due to narrowed arteries from a high fat diet. An increased amount of salt or a decreased amount of calcium in the diet contributes to high blood pressure in some susceptible persons. Most people, however, get rid of extra salt through their kidneys and don't develop high blood pressure.
Recommendations for a Healthy Diet
* Learn the 5 basic food groups. Food can be divided into 5 basic groups: milk products, meat/eggs, grains, fruits, and vegetables. The USDA revised the Dietary Guidelines for Americans in 2005. The recommended servings per day as listed are for teens and adults.
o milk products (milk, cheese, yogurt, ice cream) 2 to 3 servings per day (8 ounces is 1 serving)
o meat/eggs (red meats, poultry, fish, and eggs) 2 servings per day (5 ounces per day total)
o grains (breads, cereals, rice, pasta) 6 to 11 servings per day (1 slice of bread is 1 serving)
o fruits (juice or solid fruit) 2 to 4 servings per day (1/2 cup is 1 serving)
o vegetables (juice or vegetables): 3 to 5 servings per day (1/2 cup is 1 serving)
20% of a healthy diet should consist of milk, meat and eggs, and 80% should be vegetables, fruits, and grains. (Fiber is found in grains, fruits, and vegetables.)
* Eat 3 meals a day.
Breakfast is essential. Skipping breakfast can compromise performance at school. If you are on a weight loss diet, you should know that skipping breakfast usually doesn't lead to weight loss. All meals should contain fruits or vegetables, as well as grains. Meat or milk should be included in 2 of the meals.
Eating snacks is largely a habit. Snacks are unnecessary for good nutrition but harmless unless you are overweight. If you like snacks, try to eat more fruits, vegetables, and grains.
* Decrease the amount of fat (meat and milk products) in the diet.
Americans eat excessive amounts of meat and dairy products.
To decrease the amount of fat in the diet, follow these guidelines:
o Remember that one serving of meat per day is adequate for normal growth and development. (Don't eat meat more than twice a day.)
o Eat more fish and poultry and fewer red meats, since the latter have the highest cholesterol levels. Lean red meats are lean ground beef, pork loin, veal, and lamb.
o Trim fat off meats and the skin from poultry.
o Don't eat bacon, sausages, spareribs, pastrami, and other meats that have a high fat content. Cut back on hot dogs, lunch meats, and corned beef.
o Limit the number of eggs to 3 or 4 per week. (Eggs have the highest cholesterol content of any of the commonly eaten foods. The cholesterol in one egg is equivalent to the cholesterol in 14 ounces of beef, 1-and-1/2 quarts of whole milk, or 1 quart of ice cream.)
o Drink 1% or 2% milk or skim milk instead of whole milk.
o Decrease the amount of milk you drink to 2 or 3 cups per day. (Drink water to satisfy thirst.)
On the other hand, some teenage girls may need to consume adequate milk products (the equivalent of 3 glasses of milk) to lay down the bone mass required to prevent osteoporosis later in life.
o Eat a vegetable oil spread with no trans fats instead of butter.
o Keep in mind that red meat may be hard to give up because of the widespread misconception that red meat helps to build muscle mass and strength. Other foods such as fish, chicken, and beans also have lots of protein.
* Increase the amount of fruits, vegetables, and grains in your diet.
Follow these guidelines:
o Eat at least 8 servings (4 cups total) of fruits and vegetables per day. (50% of Americans eat only 1 fruit or vegetable per day.)
o Try to eat a fruit at every meal.
o Eat more fruits as dessert and snacks.
o Start every day with a glass of fruit juice. (Caution: Limit fruit juices to 2 cups per day to prevent diarrhea.)
o Since fruits and vegetables are interchangeable, you don't have to eat vegetables you don't like.
o Eat more soups.
o Eat more cereals for breakfast.
o Use more whole-grain bread in making sandwiches.
* Include an adequate amount of iron in the diet.
Throughout our lives we need adequate iron in our diets to prevent anemia. Everyone should know which foods are good sources of iron. Red meats, fish, and poultry are best. Having 2 servings per day of these foods will provide adequate iron. Although liver is a good source of iron, it contains 16 times more cholesterol than beef and should be avoided. Adequate iron is also found in iron-enriched cereals, beans of all types, peanut butter, raisins, prune juice, sweet potatoes, spinach, and egg yolks. The iron in these foods is better absorbed if the meal also contains fruit juice or meat.
* Avoid excessive salt.
Salt is not usually harmful for people without high blood pressure. However, to discourage a taste for excessive salt, remove the salt shaker from the dinner table. Use other herbs and spices instead of salt. Eat salty foods such as potato chips and pretzels sparingly.
* Avoid excessive pure sugars.
Sweets are not harmful, but they should be eaten in moderation. Most humans are born with a "sweet tooth." They seek out and enjoy candy, soft drinks, and desserts. The main side effect of eating candy is tooth decay if the teeth are not brushed afterward. Eating food with a lot of sugar ("a sugar binge") can cause jitters, sweating, dizziness, sleepiness, and intense hunger 2 to 3 hours later. This temporary reaction is not harmful and can be relieved by eating some food. A love of sweets is not related to obesity (if the total calories per day are normal) or hyperactivity. A high amount of sugar in the diet has not been correlated with coronary artery disease or cancer.
* Know what to eat before exercise.
Eating meat does not improve athletic performance. The best foods to eat before prolonged exercise are complex carbohydrates (starches). These include bread, pasta (noodles), potatoes, and rice. You should eat these foods 3 to 4 hours before the athletic event so they have passed out of the stomach.
It is important to drink water up to the time of the activity and every 20 to 30 minutes during the activity.
REF: [Link](Mouse over link to see full location)
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