Eating Disorders - suicide in slow-motion
Within the last few years, the previously unheard-of eating disorders
of Bulimia Nervosa and Anorexia Nervosa have received widespread
press coverage and public attention as the magnitude of this problem
that affects both teens and adults has grown.
the causes are not clear, worrying numbers of people -- most of
them young women -- develop potentially life-threatening eating
disorders. People with bulimia, known as bulimics, indulge in
bingeing (episodes of eating large amounts of food) and purging
(expelling food by vomiting or using laxatives). People with anorexia,
whom doctors refer to as anorectics, severely limit their food
of those who are anorexic also have bulimic symptoms. In 1994,
about 9,000 people were admitted to hospital and diagnosed with
bulimia while about 8,000 were diagnosed with anorexia (estimates
by the National Center for Health Statistics). Studies have indicated
that by their college freshman year, 4.5 to 18 percent of women
and 0.4 percent of men have a history of bulimia and that as many
as 1 in 100 females between the ages of 12 and 18 have anorexia.
90-95 percent of bulimia and anorexia cases are women and while
people of all races develop the disorders, the overwhelming majority
of those diagnosed are white.
most cases, professional help is needed for people to stop their
anorexic or bulimic behaviour. Otherwise, the problem may become
chronic and cause serious health problems, even death. Sometimes,
anti-depressants are prescribed to people with these eating disorders
and in 1996, the FDA added the treatment of bulimia to the indications
for the antidepressant Prozac (fluoxetine).
American Anorexia/Bulimia Association says that about 1,000 women
die of anorexia each year. More specifically, the National Center
for Health Statistics reports that "anorexia" or "anorexia nervosa"
was the underlying cause of death noted on 101 death certificates
in 1994 and was mentioned as one of multiple causes of death on
another 2,657 death certificates. That year, bulimia was noted
as the underlying cause of death on two death certificates and
mentioned as one of several causes on 64 others.
about the causes of bulimia and anorexia abound. One of them is
that the "ideal" portrayed by magazines, movies and television
makes some young women feel abnormally pressured to be as thin.
The fact that the skinny "waif"-look continues to be highly fashionable,
Barbie dolls have literally impossible vital statistics and celebrities
like Cher are having ribs removed to achieve an hourglass figure
all seems to support this theory.
theory is that abnormalities in key chemical messengers in the
brain may encourage the development or persistence of these disorders.
Once begun, the cycles of bingeing and purging (often together
with a strict diet) spiral out of control easily. Despite most
cases of bulimia developing during the teens or early 20s, many
bulimics conceal their symptoms successfully, usually avoiding
treatment until middle-age. Actress Jane Fonda revealed that she
had hidden her bulimia from age 12 until finally recovering at
age 35, reporting that she had binged and purged up to 20 times
daily! The late Princess Diana also confessed to being a secret
bulimic, saying her disorder was a manifestation of her need for
attention and help.
bulimics appear healthy and successful (perfectionist), with nearly
normal weight. In reality, however, they often suffer from low
self-esteem and depression. Bulimics may also exhibit other compulsive
behaviour - one doctor reports that a third of his bulimic patients
regularly engage in shoplifting while another quarter have abused
or been addicted to alcohol at one time or another.
normal food intake for women and teenagers is 2,000 to 3,000 calories
daily. Bulimic binges, however, average about 3,400 calories in
fifteen minutes, according to one study. Extreme cases have bulimics
consuming up to 20,000 calories in binges lasting 8 hours. Some
resort to stealing food or money to support their obsession, which
may cost up to $50 a day.
Bulimics purge to lose the weight gained during binges by vomiting,
(by self-induced gagging or with an emetic, a substance which
causes vomiting) or by using laxatives (50-100 tablets at a time),
diuretics (drugs that increase urination), or enemas. Periods
of fasting or vigorous exercise often occur between binges.
purging quickly upsets the body's balance of sodium, potassium
and other chemicals. This may lead to fatigue, seizures, irregular
heartbeat and thinner bones. Repeated vomiting can damage the
stomach and oesophagus (the tube that carries food to the stomach),
make the gums recede and erode tooth enamel (some patients lose
all their teeth prematurely. Other side effects include skin rashes,
broken blood vessels in the face and irregular menstrual cycles.
Anorexia can develop at any age, from 5 to 60, although it most
commonly develops among teenagers and the occurrence of 8-11 year
olds developing the disorder is increasing. Anorexia may be limited
to one episode accompanied by large weight loss within a few months
followed by recovery, or it may begin gradually and persist for
years. The illness may swing between improving and getting worse,
or it may just become steadily more severe.
An anorectic's pre-occupation with food is usually accompanied
by habits such as moving food about the plate, cutting it into
tiny pieces to prolong eating and not eating with the family.
Excessive exercise is also another common symptom.
weight-obsessed anorectics, normal fold of flesh are regarded
as "fat" which must be eliminated, fuelled by a compulsive fear
of becoming fat. After the normal fat padding is lost, sitting
or lying down brings discomfort and not rest, making sleep difficult.
As the disorder progresses, victims may withdraw from loved ones
and become increasingly isolated.
with starvation, the body slows down or stops various processes.
Blood pressure and body temperature falls, breathing rate slows,
menstruation stops (or never begins, in the case of pre-teen girls)
and the thyroid gland (which regulates growth) displays reduced
activity. The skin becomes dry while hair and nails become brittle.
Light-headedness, cold-intolerance, constipation and joint swelling
are other common symptoms. Soft hair called lanugo forms on the
skin for warmth. An extreme imbalance of body chemical may even
cause heart failure.
anorectics also have bulimia, the effects are even worse. The
late recording artist Karen Carpenter, an anorectic who used syrup
of ipecac to induce vomiting, died after a build-up of the drug
irreversibly damaged her heart.
Getting treated early is vital. The longer either disorder lasts,
the greater and less reversible the damage becomes.
family is often asked to help in the treatment, which might include
psychotherapy, nutrition counselling, behaviour modification and
self-help groups. Therapy is usually on an out-patient basis and
normally lasts a year or more, unless life-threatening physical
symptoms or severe psychological problems demand hospitalisation.
are presently no drugs approved specifically for bulimia or anorexia
but several are being investigated for this use and among them
are several anti-depressants. If you think a friend or family
member is suffering from bulimia or anorexia, point out in a caring,
non-judgemental way the behaviour you have observed and encourage
the person to seek medical help.
you think you may be suffering from either of these disorders
yourself, keep in mind that you are not alone and that this is
a health problem that requires professional help.As
a first step, talk to your parents, family doctor, religious counsellor,
school counsellor or nurse.
is Bulimia Nervosa and Anorexia Nervosa?
According to the American Psychiatric Association, a person must
display all of the specific symptoms of that disorder in order
to be diagnosed as either bulimic or anorectic.
· Refusal to maintain weigh that's over the lowest weight considered
normal for age and height
· Intense fear of gaining weight or becoming fat, even though
· Distorted body image
· In women, three consecutive missed menstrual periods without
· Recurrent episodes of binge eating (minimum average of two binge-eating
episodes a week for at least three months)
· A feeling of lack of control over eating during the binges
· Regular use of one or more of the following to prevent weight
gain: self-induced vomiting, use of laxatives or diuretics, strict
dieting or fasting, or vigorous exercise
· Persistent over-concern with body shape and weight
based on "On the teen scene: Eating disorders require medical
attention", by Dixie Farley FDA Consumer March 1992 (Permission
granted, e-mail message + public domain notification on website)
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