I have a gripe: as a psychiatrist, I just don’t care for the term “Eating Disorders.” It is just so general and does not do justice to the psychological and physical problems that often lie beneath these different and serious disorders. It really just describes the end result; a person who eats too much or too little to the extreme. Often a person may have just started out by eating smaller or larger amounts of food. But after a while, it gets beyond their control and they eat so little, or so much, that they not only pose a danger to their health but to their very life. Here are some of the most common examples:

Anorexia Nervosa – These are usually (but not always) teenage or young adult females who eat so little that they are at risk of starvation and even death. They can have low blood pressure, brittle hair, thinning bones and heart failure, among a whole host of other physical symptoms.

The real problem here is a distorted body image. Even when they have dieted, vomited, used laxatives and exercised to the point of being only skin and bones, they still see themselves as “fat.” That makes this a body image disorder, and nothing that one says or does can change their minds. Treatment is often long and very difficult, and the object is to help these people gain enough weight to keep them alive and healthy. Fortunately most actually outgrow this illness, but some can have it off and on for a lifetime. And sadly, for a few, Anorexia can actually be fatal since they never learn to accept their body as being “normal” at a weight necessary to sustain life.

Bulimia Nervosa – This is usually quite different from Anorexia. Here an individual has the sense of a loss of control. A person eats an unusually large amount of food, and then often feels guilty about it. That leads to them secretly compensating for such a huge intake by vomiting, using laxatives, fasting and/or exercising to excess. This can also lead to serious problems such as severe tooth decay, dangerous electrolyte imbalances and stomach abnormalities.

The treatment here is frequently psychotherapy and helping a person regain a sense of control, not only of eating, but of their life in general. Other psychological disorders, such as depression, can also be present and need to be addressed in order for treatment to be successful. Medications can often be very useful here.

There are other eating disorders such as Binge Eating, which is similar to Bulimia, but the person does not try to compensate for the over-eating and is often quite obese. This is also a type of loss of control where finding the underlying psychological reasons for the eating behaviors can be very useful.

Lastly, one should not forget overeating, a national health disaster. According to the National Health and Nutrition Survey of 2001-2004, two-thirds of adult Americans are overweight and one-third are obese — figures that have only gotten worse in the previous six years. Overeating can lead to diabetes, high blood pressure, heart disease, osteoarthritis, some forms of cancer and many, many other physical problems that can ultimately lead to a premature death. Here, dieting is not the answer, and it generally does not work as the weight, and often more weight than before, is almost always regained.

Leading a better lifestyle, such as eating more quality foods — including whole grains, fresh vegetables, and fruit, etc. — eating in moderation, exercise and adequate sleep can go a long way in solving this American health crisis.

National Eating Disorder Awareness Week continues through Saturday. If you would like to find out more information on Eating Disorders, I highly recommend the National Institute of Mental Health (NIMH) website at: www.nimh.nih.gov. You can also call them toll-free at 1-866-615-6464 or email them at nimhinfo@nih.gov.

Bernard Engelberg, M.D.
Cenpatico Medical Director

These are the views of  Bernard Engleberg, M.D. and not those of Cenpatico.

This entry is filed under Blog.