Dealing With Debilitating Eating Disorders

Eating disorders tend to develop in the teenage and young adult years, although it's not uncommon to see them occur at other ages as well. Most eating disorders involve focusing too much time on body shape, weight and food which then leads to dangerous eating habits and behaviours. These behaviours can then significantly impact the body's ability to receive proper nutrition and can lead to damage or injury of the digestive and cardiac systems as well as affect the mouth, teeth and bones.

Types of eating disorders

Anorexia nervosa, or simply anorexia, is potentially life-threatening and is characterized by an extremely low body weight, a distorted perception of shape or weight and an intense fear of gaining weight. These patient use extreme measures to control their weight and this will often negatively affect their quality of life and health. These measures will include excessively limiting caloric intake of food, vomiting after eating, increasing physical activities, using dietary aids or using laxatives.

Bulimia nervosa, or bulimia, is characterized by a preoccupation with weight and body shape and these patients tend to judge themselves harshly for their preconceived flaws. Here, binge eating (ingesting a lot of food over a short period of time) and purging of the ingested food occurs and it also involves a feeling of lacking control over what one eats. These patients tend to have a normal weight or be slightly overweight and they also use extreme measures such as forcing themselves to vomit, using laxatives and excessively exercising. 

Binge-eating disorder is characterized by regularly eating an excessive amount of food and then feeling a lack of control over the eating. The patient eats a lot of food or eats very quickly even when they're not hungry and may even continue eating long after they're full. After this, feelings of guilt and shame set in and this results in eating alone to hide the bingeing. These patients can have a normal weight, be overweight or even obese.

READ Binge Eating Disorder Treatment

Risk factors for developing eating disorders

The following aspects seem to identify patients which may be at high risk of developing eating disorders.

• Female gender - teenage girls and young women are more likely to develop eating disorders as opposed to their male counterparts.
• Age - these conditions tend to involve teenagers and those in their 20's in most cases.
• Mental health issues - patients with depression, obsessive-compulsive disorder or anxiety disorder are more than likely to develop eating disorders.
• Family history - patients are more likely to develop these disorders if their parents or siblings suffered from them.
• Increased physical and emotional stressors.
• Positive comments due to the results of dieting may cause some to carry on dieting excessively.
• Sportsmen and women may be encouraged to carry on losing weight which may become problematic and cause then to develop these issues.

Management Of Eating Disorders

Medications

Oral medication isn't used to directly treat an eating disorder, but rather to help control any urges to binge or purge. They can also be used to help reduce any preoccupations and obsessions with food and diet. When these obsessions are reduced, then the resulting abnormal behaviour will also be reduced.

The medications which are used are antidepressants, such as the SSRI's, or anti-anxiety medications which are used to reduce the symptoms of depression and anxiety as these can be associated with eating disorders. 

Psychotherapy

This form of management is used to help replace abnormal and unhealthy thoughts and behaviours with more acceptable ones. There are 2 forms of therapy which are incorporated in the management of eating disorders and they are as follows:

• Cognitive behaviour therapy (CBT) - this form of therapy is used to teach the patient how to monitor their eating habits and their moods, to develop skills in problem-solving and to find healthy and appropriate ways to deal and cope with stressful situations.
• Family-based therapy (FBT) - this form of therapy is an evidence-based treatment for children and teenagers where the family is involved. Here, the family members are involved in making sure that the patient follows healthy eating habits and maintains a healthy weight. It's very important that the patient's family is highly involved as their support will result in a more favourable outcome for the patient.

Anxiety reducing techniques can also help reduce stress levels, increase a sense of well-being and promote relaxation. These may include massage therapy, yoga, acupuncture, meditation, prayer and breathing exercises.

Nutritional advice and weight normalization and maintenance 

The first thing that must be achieved in patients who are underweight is to get their weight back to a healthy level. Regardless of a patient's weight, a dietitian can provide information on following a healthy diet, help design a unique eating plan to help the patient achieve their ideal weight and prescribe any necessary supplements which may be needed.

Following up with a dietitian is important so that the patient's weight is monitored, and so that they may make any adjustments to the patient's diet if needed. 

READ Binge There, Done That: Comfort Eating vs Binge Eating Disorder

Hospitalization in psychiatric or acute ward

If the eating disorder has resulted in the patient experiencing health related complications, then they may need to be hospitalized in order to manage those issues. These complications may include the following:

• Severe malnutrition.
• Multiple vitamin deficiencies.
• Digestive and/or cardiac related issues.
• Substance abuse.
• Depression and/or anxiety.
• Problems with development and growth.
• Suicidal thoughts and behaviours.
• Social and relationship problems.
• Work or school related issues.