Task 4:
Tema interés: Bulimia and Anorexia:
Introduction
We all have different eating habits. There are a large number of “eating styles” which can allow us to stay healthy. However, there are some which are driven by an intense fear of becoming fat and which actually damage our health. These are called “eating disorders” and involve:
- eating too much
- eating too little
- using harmful ways to get rid of calories.
In fact, the 'eating disorders' usually involve a lot more than eating behaviour, so that people affected by them are constantly worrying about how to avoid taking in calories or how to 'burn off' or how to get rid of them. They also find themselves checking their weight and appearance all the time, avoid seeing themselves in mirrors or being in photographs to reassure themselves that their weight has not increased.
This leaflet deals with two eating disorders - Anorexia Nervosa and Bulimia Nervosa. It describes the two disorders separately, however
- the symptoms of anorexia and bulimia are often mixed
- people may also move from bulimia to anorexic, or you may start with anorexic symptoms, but later develop the symptoms of bulimia.
Who gets eating disorders?
Girls and women are 10 times more likely than boys and men to suffer from anorexia or bulimia. However, eating disorders do seem to be getting more common in boys and men - they are more likely to develop their disorder in association with over-exercise and to want to be of a muscular build rather than a very skinny one.
Anorexia Nervosa
What are the signs?
You find that you:
- worry more and more about your weight
- eat less and less - calerie counting
- exercise more and more, to burn off calories
- can't stop yourself from wanting to lose weight, even when you are well below a safe weight for your age and height
- smoke more or chew gum to keep your weight down
- obsessively check your weight, shape or reflection in mirrors
- withdraw from social situations which may involve eating
- wearing baggy clothes to hide one's body
- water loading before being weighed
- excluding certain food groups and making foods "good" and "bad"
- avoiding mealtimes, especially at school
- lose interest in sex
- In girls or women - monthly menstrual periods become irregular or stop.
- In men or boys - erections and wet dreams stop, testicles shrink.
Some people notice that they have developed other obsessive difficulties, such as having to stick to rigid routines and times, or perhaps fears of 'contamination', a need to study or work all the time, or difficulty in spending money appropriately.
When does it start?
We now know that people of any age can have anorexia, but it commonly starts in the teenage years. It affects around:
- 1 fifteen-year-old girl in every 150
- 1 fifteen-year-old boy in every 1000.
What happens?
- You take in very few calories every day. You eat "healthily" - fruit, vegetables and salads - but they don't give your body enough energy.
- You may also exercise, use slimming pills, or smoke more to keep your weight down.
- You don't want to allow yourself to eat, but you buy food and cook for other people.
- You still get as hungry as ever, in fact you find you can't stop thinking about food.
- You become more afraid of putting on weight, and more determined to keep your weight well below what is normal.
- Your family may be the first to notice your thinness and weight loss.
- You may find yourself not able to tell other people the true amount you are eating and how much weight you are losing.
- You may also make your self sick if you eat anything you did not plan to allow yourself, particularly if you lose control of your eating and find yourself bingeing. However, this is known as 'anorexia, binge-purge subtype' rather than bulimia nervosa. Bulimia nervosa sufferers are by definition in the normal weight range.
Bulimia Nervosa
What are the signs?
You find that you:
- worry more and more about your weight
- binge eat (see below)
- make yourself vomit and/or use laxatives or other ways to get rid of calories
- have irregular menstrual periods
- feel tired
- feel guilty
- stay a normal weight, in spite of your efforts to diet.
When does it start?
Bulimia Nervosa often starts in the mid-teens. However, people can be unwell for several years before they feel able to ask for help. People most often seek help when their life changes - the start of a new relationship or having to live with other people for the first time.
About 4 out of every 100 women suffers from bulimia at some time in their lives, rather fewer men.
Bingeing
- You raid the fridge or go out and buy lots of fattening foods that you would normally avoid.
- You then eat it all, quickly, usually in secret.
- You might get through packets of biscuits, several boxes of chocolates and a number of cakes in just a couple of hours.
- You may even take someone else’s food, or shoplift, to satisfy the urge to binge.
- Binges may begin as a planned meal, but because you have been restricting what you eat, you find that a normal meal doesn't satisfy you so that you can't stop eating.
- Afterwards you feel stuffed and bloated – and probably guilty and depressed. You try to get rid of the food you have eaten by making yourself sick, or by purging with laxatives. It is very uncomfortable and tiring, but you find yourself trapped in a routine of binge eating, and vomiting and/or purging.
Binge Eating Disorder
This is a pattern of behaviour that has recently been recognised. It involves dieting and binge eating, but not vomiting. It is very distressing, but is usually more responsive to therapy. Sufferers are more likely to become overweight.
How can anorexia and bulimia affect you?
If you aren't getting enough calories, you may:
Psychological symptoms
- Sleep badly.
- Find it difficult to concentrate or think clearly about anything other than food or calories.
- Feel depressed.
- Lose interest in other people.
- Become obsessive about food and eating (and sometimes other things such as washing, cleaning or tidiness).
Physical symptoms
- Find it harder to eat because your stomach has shrunk.
- Feel tired, weak and cold as your body's metabolism slows down.
- Become constipated.
- Notice changes in your hair and skin. Some people's head hair falls out, but they grow downy hair on other parts of the body. Skin becomes dry and you can have pressure sores.
- Not grow to your full height, or lose height with a 'bowed over' appearance.
- Get brittle bones which break easily.
- Be unable to get pregnant.
- Damage your liver, particularly if you drink alcohol.
- In extreme cases, you may die. Anorexia Nervosa has the highest death rate of any psychological disorder.
If you vomit, you may:
- lose the enamel on your teeth (it is dissolved by the stomach acid in your vomit)
- get a puffy face (the salivary glands in your cheeks swell up)
- notice your heart beating irregularly - palpitations (vomiting disturbs the balance of salts in your blood)
- feel weak
- feel tired all the time
- experience huge weight swings (see below)
- damage your kidneys
- have epileptic fits
- be unable to get pregnant.
If you use a lot of laxatives, you may:
- have persistent stomach pain
- get swollen fingers
- find that you can't go to the toilet any more without using laxatives (using laxatives all the time can damage the muscles in your bowel)
- have huge weight swings. You lose lots of fluid when you purge, but take it all in again when you drink water afterwards (no calories are lost using laxatives).
What causes eating disorders?
There is no simple answer, but these ideas have all been suggested as explanations:
- Genetics: There is a lot of evidence that eating disorders run in families even where the sufferers don't necessarily live together, and that certain genes make people more vulnerable, not only to eating disorders, but to related conditions.
- Lack of an “off” switch: Most of us can only diet so much before our body tells us that it is time to start eating again. Some people with anorexia may not have this same body "switch" and can keep their body weight dangerously low for a long time.
- Control: It can be very satisfying to diet. Most of us know the feeling of achievement when the scales tell us that we have lost a couple of pounds. It is good to feel that we can control ourselves in a clear, visible way. It may be that your weight is the only part of your life over which you feel you do have any control.
- Puberty: Anorexia can reverse some of the physical changes of becoming an adult – pubic and facial hair in men, breasts and menstrual periods in women. This may help to put off the demands of getting older, particularly sexual ones.
- Social pressure: Our social surroundings powerfully influence our behaviour. Societies which don’t value thinness have fewer eating disorders. Places where thinness is valued, such as ballet schools, have more eating disorders. ‘Thin is beautiful’ in Western culture. Television, newspapers and magazines show pictures of idealised, artificially slim people. For someone with a negative body image, gyms and health clubs can also reinforce this perception. So, at some time or other, most of us try to diet. Some of us can diet too much, but for a person who may be at risk of developing an eating disorder, this can make dieting dangerous and the person may develop anorexia.
- Family: Eating is an important part of our lives with other people. Accepting food gives pleasure and refusing it will often upset someone. This is particularly true within families. Saying “no” to food may be the only way you feel you can express your feelings, or have any say in family affairs. Open and honest communication between the carer and the sufferer is essential. It is also important not to be too judgemental. On the other hand, loving families often try to protect you from the consequences of an eating disorder, and this can mean that the eating disorder can go on longer.
- Depression: Most of us have eaten for comfort when we have been upset, or even just bored. People with bulimia are often depressed, and it may be that binges start off as a way of coping with feelings of unhappiness. Unfortunately, vomiting and using laxatives can leave you feeling just as bad.
- Low self-esteem: People with anorexia and bulimia often don’t think much of themselves, and compare themselves unfavourably to other people. Losing weight can be a way of trying to get a sense of respect and self-worth.
- Emotional distress: We all react differently when bad things happen, or when our lives change. Anorexia and bulimia have been related to:
- life difficulties
- sexual abuse
- physical illness
- upsetting events - a death or the break-up of a relationship
- important events - marriage or leaving home.
- The vicious circle : An eating disorder can continue even when the original stress or reason for it has passed. Once your stomach has shrunk, it can feel uncomfortable and frightening to eat.
- Physical causes: Some doctors think that there may be a physical cause that we don't yet understand.
- Certain illnesses and treatments: There is a relatively high incidence of anorexia in people who suffer from diabetes, Cystic Fibrosis or other illness where diet has to be monitored and without adequate treatment, weight is lost. It can be tempting to neglect your health in order to lose some weight, and this is particularly dangerous.
Produced by the Royal College of Psychiatrists' Public Education Editorial Sub-Committee.
- Series Editor: Dr Philip Timms
- Expert review: Susan Ringwood from B-eat and Dr Jane Morris
- Service User and Carer input: Veronica Kamerling, Vanessa Harris and Henrietta Wood
This leaflet reflects the best available evidence available at the time of writing.
© August 2014. Due for review: August 2016.
Royal College of Psychiatrists. This Leaflet may be downloaded, printed out, photocopied and distributed free of charge as long as the Royal College of Psychiatrists is properly credited and no profit is gained from its use. Permission to reproduce it in any other way must be obtained from
permissions@rcpsych.ac.uk. The College does not allow reposting of its Leaflets on other sites, but allows them to be linked to directly.
fuente: http://www.rcpsych.ac.uk/healthadvice/problemsdisorders/anorexiaandbulimia.aspx.
Referencia:
- Fecha de escrito y autor:1
- Fecha del texto: es la misma fecha del punto anterior, (está válido hasta el 2016).
- Autores que aparecen en el texto: 3
Síntesis no lingüística:
Anorexia and Bulimia
Readable and well-researched information for the public
For anyone who is worried about themselves, a friend or a relative.
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