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| Eating disorder Classification & external resources | |
| ICD-10 | F50. |
|---|---|
| ICD-9 | 307.5 |
| MeSH | D001068 |
An eating disorder is a compulsion to eat, or avoid eating, that negatively affects one\'s physical and mental health. Anorexia nervosa and bulimia nervosa are the most common eating disorders generally recognized by medical classification schemesICD-10: Behavioural syndromes associated with physiological disturbances and physical factors. World Health Organization (2006-04-05). Retrieved on 2007-03-08..; together they affect an estimated 5-7% of females in the United States during their lifetimes."Practice guidelines for the treatment of patients with eating disorders", American Journal of Psychiatry (American Psychiatric Association) 157 (1): 1-39, January 2000.
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Anorexia nervosa is deliberate and sustained weight loss driven by a fear of becoming overweight and a distorted body image. It is not to be confused with anorexia, which is its symptomatic general loss of appetite or disinterest in food. DSM-IV characterizes anorexia nervosa as:
Anorexia can be life-threatening as victims commonly refuse to eat and drastically lose weight which causes the lack of nutrients within their body. Anorexics are commonly perfectionists, driven to succeed; yet they set unattainable standards of performance for themselves. When they fail to meet these standards, they look for a part of their lives they can control; food and weight become that “control” for them. Low self-esteem and constant self-criticism cause anorexics to constantly fear losing control, and even consuming a small amount of food could be considered a loss of control. One thousand women die of anorexia nervosa each year, and millions more suffer from the destructive physical complications.
Bulimia nervosa is a cyclical and recurring pattern of binge eating (uncontrolled bursts of overeating) followed by guilt, self-recrimination and overcompensatory behaviour such as crash dieting, overexercising and purging to compensate for the excessive caloric intake.
Bulimics often have "binge food," which is the food they typically consume during binges. Some describe their binge episodes as a physical high they feel, numbing out, going into auto-pilot, losing all control, immediate comfort, etc. The reasoning or triggers behind a binge may serve different purposes for different people. This binge episode leads the individual to feel guilt, shame, embarrassment, and complete failure. Bulimics try to regain control of themselves and the situation by purging the food–making up for their mistake. This leads to feeling famished and empty again, and therefore, another uncontrollable binge, followed by feeling powerless, and the vicious binge/purge cycle continues. Bulimics have extreme eating and exercising habits, instead of demonstrating moderation. This compulsive behavior is often echoed in similar destructive behavior such as sexual promiscuity, pathological lying, and shoplifting. Some bulimics not only struggle with the eating disorder, but these other harmful behaviors as well.
The media may be a significant influence on eating disorders through its impact on values, norms, and image standards accepted by modern society Harrison, K & Cantor, J (1997), "The relationship between media consumption and eating disorders", Journal of Communication (Oxford University Press) 47 (1): 40-68. Both society’s exposure to media and eating disorders have grown immensely over the past decade. Researchers and clinicians are concerned about the relationship between these two phenomena and finding ways to reduce the negative influence thin-ideal media has on women’s body perception and susceptibility to eating disorders. The dieting industry makes billions of dollars each year by consumers continually buying products in an effort to be the ideal weight. Hollywood displays an unrealistic standard of beauty that makes the public feel incredibly inadequate and dissatisfied and forces people to strive for an unattainable appearance. This takes an enormous toll on one\'s self-esteem and can easily lead to dieting behaviors, disordered eating, body shame, and ultimately an eating disorder.
Patients with severe obsessive compulsive disorder, depression or bulimia patients were all found to have abnormally low serotonin levels.Long, Phillip W (1993). Eating Disorders. National Institute of Mental Health. Retrieved on 2006-03-03. Neurotransmitters such as serotonin, dopamine and norepinephrine are secreted by the intestines and central nervous system during digestion.Kalat, James W (2006). Biological Psychology, 8th, Houston: Wadsworth Publishing. ISBN 0495090794.
Researchers have also found low cholecystokinin levels in bulimics. Cholecystokinin is a hormone that causes one to feel full and decreases eating. Low levels of this hormone are likely to cause a lack of satiative feedback when eating, which can lead to overeating. Another explanation researchers found for overeating is abnormalities in the neuromodulator peptides, neuropeptide Y and peptide YY. Both of these peptides increase eating and work with another peptide called leptin. Leptin is released by fat cells and is known to decrease eating. Research found the majority of people who overate produced normal amounts of leptin but they might have complications with the blood-brain barrier preventing an optimal amount to reach the brain.
Cortisol is a hormone released by the adrenal cortex which promotes blood sugar and increases metabolism . High levels of cortisol were found in people with eating disorders. This imbalance may be caused by a problem in or around the hypothalamus Long, Phillip W. (1993). Eating Disorders. Retrieved March 3, 2006, from the National Institute of Mental Health website: http://www.mentalhealth.com/book/p45-eat1.html. A study in London at Maudsley Hospital found that anorexics were found to have a large variation of serotonin receptors and a high level of serotonin Yager, Joel & Anderson, Arnold E. (2005). Anorexia Nervosa. The New England Journal of Medicine, 353 (14), 1481-1488, Retrieved March 3, 2006, from Ovid web: http://mutex.gmu.edu:2076/gw1/ovidweb.cgi
Many of these chemicals and hormones are associated with the hypothalamus in the brain Uher, R., & Treasure, J. (2005). Brain Lesions and Eating Disorders. Journal of Neurology, Neurosurgery, & Psychiatry, 76 (6). June 2005, pp 852-857..Damage to the hypothalamus can result in abnormalities in temperature regulation, eating, drinking, sexual behavior, fighting, and activity level. Uher & Treasure (2005) performed a study researching brain lesions effects on eating disorders. They evaluated 54 formally published cases of eating disorders and brain damage. They found many correlations between eating disorders and damage to the hypothalamus. People with brain lesions in the hypothalamus had abnormal eating behaviors; unprovoked and self induced vomiting, over concern with becoming fat, cheating with eating, frequent sleepiness, depression, obsessive compulsive behavior and diabetes insipidus.Uher, R & Treasure, J (June 2005), "Brain Lesions and Eating Disorders", Journal of Neurology, Neurosurgery & Psychiatry 76 (6): 852-857
Research from a family systems perspective indicates that eating disorders stem from both the adolescent\'s difficulty in separating from over-controlling parents, and disturbed patterns of communication. When parents are critical and unaffectionate, their children are more prone to becoming self-destructive and self-critical, and have difficulty developing the skills to engage in self-care giving behaviors. Such developmental failures in early relationships with others, particularly maternal empathy, impairs the development of an internal sense of self and leads to an over-dependence on the environment. When coping strategies have not been developed in the family system, food and drugs serve as a substitute.Weiner, Sydell (1998), "The Addiction of Overeating: Self-Help Groups as Treatment Models", Journal of Clinical Psychology 54 (2): 163-167, ISSN 0021-9762
Eating disorders should also be understood in the context of experienced trauma, with many eating problems beginning as survival strategies rather than vanity or obsession with appearance. According to sociologist Becky Thompson, eating disorders stemming from women of varying socio-economic status, sexual orientation and race, and finds that eating disorders and a disconnected relationship with ones body is commonly a response to environmental stresses, including sexual, physical, and emotional abuse, racism, and poverty. This reality is further detrimental for women of color and other minority women, since they are forced to live in a culture that embraces a narrowly defined conception of beauty: "people furthest from the dominant ideal of beauty, specifically women of color, may suffer the psychological effects of low self-esteem, poor body image, and eating disorders."Hall, C. I. (1995), "Asian Eyes: Body Image and Eating Disorders of Asian and Asian-American Women", Eating Disorders (Taylor & Francis) 3 (1): 8-19 For minority women, being part of multiple subordinate groups, often silenced by mainstream media and culture, compounds the likelihood that injustice and oppression will be played out within the body, as social injustice is internalized and eating disorders develop as a way to cope with the stress.
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