Eating Disorders

Food is energy! It is the sole reason (you can always argue with that) for what we all are working! Some people eat more than others; some, even more! Some of them suffer from eating disorders which may not get noticed. Let us know more about common eating disorders.

 

Types: The major eating disorders prevalent among adolescents are :
1.Anorexia nervosa
2.Bulimia nervosa
3.Binge eating disorder

 

1. Anorexia nervosa: It is generally present among early to middle aged adolescent white girls with above average intelligence,pursuit for thinness and disorder of anxiety and mood swings. These people do excessive dieting and  exercising.
2. Bulimia nervosa: It is seen in later adolescent age with eating and vomiting cycle and excessive use of laxatives as they do not count calories and emit out everything. They have an impulsive personality with borderline personality disorder, along with depression and mood swings.
3. Binge eating disorders: These kind of individuals have no record of calories and type of food. They eat large amount at a time at continuous intervals.
Why? These disorders are due to complex interplay of culture,ethnicity, gender,peer and family. In pursuit of perfect body and structure people often neglect their own body and lead to many complications.
Implications: No organ is spared, but most effected organs are heart, brain, gonads and bones.
  • Heart :  These disorders lead to disturbances in heart rhythm and rate which result in abrupt increase and decrease in heart rate, known as arrhythmias, and they may become a cause of sudden death!
  • Brain: It leads to problem in thermo-regulation of body, satiety and sleep.
  • Gonadal dysfunction: both in male and females. In females, it can lead to amenorrhea while in males, erectile dysfunction may happen.
  • Bones: It leads to decrease in bone mineral density, and therefore, weak bones .

 

Treatment: Multidisciplinary approach is the mode of treatment which include
  • Nurturtant: The doctor has to be nurturtant and make the patient accept the disorder and also counselling of parents and child so that there is no blame and guilt game.
  • Authoritative: Doctor needs to be authoritative for monitoring patient physical status, setting limitations on behaviour and treating patient’s health.
  • Biopsychosocial: to resolve issues related to self esteem, family, peer and school.
  • Reinforcement: Child should be given external rewards (compliments ) for following therapy.
  • Nutrition and physical activity
  • Weight Management: In patients with anorexia nervosa, weight has to be increased by 0.5- 1lb/week and increase energy intake by 100-200 kcal every few days till 4000 kcal/day reached.
  • Counselling: Along with active nutrition therapy, these people need to be counselled properly as they are people with all or none thinking, leading to over-generalizations and jumping to catastrophic conclusions! They also think that their body is governed by rules which do not apply to others, hence they choose foods by self imposed restrictions.
  • Diet should have 15-20% protein,50-55% carbohydrate and fat 25-30% with calcium and vitamin D. All patients with eating disorders should be given 3 meals and one snack distributed evenly. Breakfast should be the main priority as its mostly eliminated by anorexia nervosa and avoided in bulimia.
  • Exercise: They should be advised exercise, but not more than 30 minutes.
  • Monitoring of daily calorie intake/activity/emotional state.
  • Reference to a mental health facility for behavior therapy.
Eat a well balanced diet, be aware, and watch this space for more health tips!