Eating Disorders

Eating disorders have become a major health problem in Western society, and there is evidence of their emergence in most parts of the world. The most common eating disorders are anorexia nervosa and bulimia nervosa, with a number of variations on these, including binge eating disorder. What they have in common, besides an excess preoccupation with weight and shape, is poor self-esteem. Indeed, they might equally be called disorders of self-esteem because self-esteem in this population is based on weight and shape.

In anorexia nervosa, people refuse to maintain a minimally normal body weight, engage in a relentless pursuit of thinness, have a distorted body image, and suffer physical side effects such as amenorrhoea (loss of menstrual cycle), poor blood circulation, low blood pressure, muscle wasting, and osteoporosis.

People with bulimia nervosa tend to maintain a normal weight, but engage in overeating (bingeing) and purging (use of laxatives, self-induced vomiting, and diuretics). Bulimia also results in serious medical complications such as cardiac abnormalities, gastro- and intestinal problems, tooth erosion, and damage to the ovaries.

Binge eating disorder is characterized by consuming an excessive amount of food, accompanied by a lack of control and marked distress, but no purging or distortion of body image.

In each of these conditions, eating gives rise to shame, disgust, fear, and self-loathing. Purging leads to a sense of relief.

Individuals with anorexia nervosa or bulimia nervosa have an intense preoccupation with shape and weight. A distorted body image is characteristic of anorexia. OSCAR BURRIEL/LATIN STOCK/SCIENCE PHOTO LIBRARY. CUSTOM MEDICAL STOCK PHOTO.

In childhood and early adolescence, other eating disorders may occur in addition to anorexia nervosa and bulimia nervosa. These include food avoidance emotional disorder (FAED) in which there is determined food avoidance but without the intense preoccupation with weight and shape seen in anorexia and bulimia; selective eating, in which there is a very limited number of foods consumed, although the total calorie intake is sufficient to maintain a normal weight; and functional dysphagia, in which the child is frightened of swallowing for fear of vomiting or choking.