15 Eating Disorders

Anorexia Nervosa

Anorexia nervosa, or anorexia, is a type of eating disorder that mainly affects adolescent girls and young women. A person with this disease has an intense fear of gaining weight and limits the food she eats. She:

• Has a low body weight
• Refuses to keep a normal body weight
• Is extremely afraid of becoming fat
• Believes she is fat even when she’s very thin
• Misses three (menstrual) periods in a row (for girls/women who have started having their periods)

Anorexia affects your health because it can damage many parts of your body. A person with anorexia will have many of these signs:

• Loses a lot of weight
• Talks about weight and food all the time
• Moves food around the plate; doesn’t eat it
• Weighs food and counts calories
• Follows a strict diet
• Won’t eat in front of others
• Ignores/denies hunger
• Uses extreme measures to lose weight (self-induced vomiting, laxative abuse, diuretic abuse, diet pills, fasting, excessive exercise)
• Thinks she’s fat when she’s too thin
• Gets sick a lot
• Weighs self several times a day
• Feels depressed
• Feels irritable
• Doesn’t socialize
• Wears baggy clothes to hide appearance

Treatment

A health care team of doctors, nutritionists, and therapists will help the patient get better. They will:

• Help bring the person back to a normal weight
• Treat any psychological issues related to anorexia
• Help the person get rid of any actions or thoughts that cause the eating disorder

Some research suggests that the use of medicines—such as antidepressants, antipsychotics, or mood stabilizers—may sometimes work for anorexic patients. It is thought that these medicines help the mood and anxiety symptoms that often co-exist with anorexia. Other recent studies, however, suggest that antidepressants may not stop some patients with anorexia from relapsing. Also, no medicine has shown to work 100 percent of the time during the important first step of restoring a patient to healthy weight. So, it is not clear if and how medications can help anorexic patients get better, but research is still happening.

Some forms of psychotherapy can help make the psychological reasons for anorexia better. Psychotherapy is sometimes known as “talk therapy.” It uses different ways of communicating to change a patient’s thoughts or behavior. This kind of therapy can be useful for treating eating disorders in young patients who have not had anorexia for a long time.

Individual counseling can help someone with anorexia. If the patient is young, counseling may involve the whole family. Support groups may also be a part of treatment. In support groups, patients, and families meet and share what they’ve been through.

Some researchers point out that prescribing medicines and using psychotherapy designed just for anorexic patients works better at treating anorexia than just psychotherapy alone. Whether or not a treatment works, though, depends on the person involved and his or her situation. Unfortunately, no one kind of psychotherapy always works for treating adults with anorexia.

Bulimia Nervosa

Bulimia nervosa, or bulimia, is a type of eating disorder. Someone with bulimia eats a lot of food in a short amount of time (bingeing) and then tries to get rid of the calories by purging. Purging might be done in these ways:

• Making oneself throw up
• Taking laxatives (pills or liquids that increase how fast food moves through your body and leads to a bowel movement)

A person with bulimia may also use these ways to prevent weight gain:

• Exercising a lot (more than normal)
• Restricting her eating or not eating at all (like going without food for a day)
• Taking diuretics (pills that make you urinate)

Bulimia is more than just a problem with food. It’s a way of using food to feel in control of other feelings that may seem overwhelming. Purging and other behaviors to prevent weight gain are ways for people with bulimia to feel more in control of their lives and to ease stress and anxiety.

Unlike anorexia, when people are severely underweight, people with bulimia may be underweight, overweight, or have a normal weight. This makes it harder to know if someone has this disease. However, someone with bulimia may have these signs:

• Thinks about food a lot
• Binges (normally in secret)
• Throws up after bingeing
• Uses laxatives, diet pills, or diuretics to control weight
• Is depressed
• Is unhappy and/or thinks a lot about her body shape and weight
• Eats large amounts of food quickly
• Goes to the bathroom all the time after she eats (to throw up)
• Exercises a lot, even during bad weather, fatigue, illness, or injury
• Unusual swelling of the cheeks or jaw area
• Cuts and calluses on the back of the hands and knuckles from making herself throw up
• White enamel of teeth wears away making teeth look clear
• Doesn’t see friends or participate in activities as much
• Has rules about food — has “good” foods and “bad” foods