Eating disorders

An eating disorder is a compulsion in which the main problem is a person eats in a way which disturbs their physical health. The eating may be too excessive (compulsive over-eating), too limited (restricting), may include normal eating punctuated with episodes of purging, may include cycles of binging and purging, or may encompass the ingesting of non-foods. The best-known eating disorders are Anorexia nervosa, Bulimia nervosa, and Pica.

Types
PsychInfo, a major academic database in psychology and psychiatry, lists:


 * Anorexia nervosa
 * Beriberi
 * Binge eating disorder
 * Bulimia nervosa
 * Hyperplasia
 * Kleine-Levin syndrome
 * Rumination
 * Obesity as a result of eating disorders
 * Pica

Over 50% of the sufferers of an eating disorder also have a comorbid diagnosis of severe mental depression. The American Psychiatric Association lists eating disorders and severe depression as primary diagnoses.

Some psychologists also classify a syndrome called orthorexia as an eating disorder, or, more properly, "disordered eating" - the person is overly obsessed with the consumption of what they see as the 'right' foods for them (vegan, raw foods, etc), to the point that their nutrition and quality of life suffers. In addition, some individuals have food phobias about what they can and cannot eat, which some also call an eating disorder. Another condition that is somewhat qualitatively different from those previously mentioned is pica, or the habitual ingestion of inedibles, such as dirt, wood, hair, etc. This is a condition particularly prevalent in children.

Pathogenesis
Psychologists prefer to class the other syndromes as "mental disorders", referring to the mental health model, which views the syndrome as caused by something largely outside human will, or, more properly, a compulsion. Some eating problems, such as chronic overeating, are not always regarded as mental disorders, but as a lack of self-control, as the idea of "compulsion" suggests.

Eating disorders are said to "interfere" with normal food consumption and be the antecendent for more serious health problems. Patients diagnosed with Bulimia nervosa and Anorexia nervosa have a mortality rate of between 5% and 12% per decade, which is a higher mortality rate than any other mental illness (Agras 2004).

People whose eating is disordered often experience psychological decompensation, typically becoming obsessed with food, diet and, most often with Anorexia nervosa and Bulimia, body image. Clinically, the distortion of body image is called body dysmorphia. The overall health of the individual is at extreme risk due to malnutrition, as well as more indirect effects such as, heart arythmia, and even heart failure, an increase in hypertension (high blood pressure), electrolyte imbalances, cognitive deficits, and esophogeal difficulties.

In the prevailing psychological view, patients with an eating disorder are seen as victims rather than as conscious actors. Again, the compusive aspects of the disorder are referenced here. Their suffering is not seen as self-inflicted, but as the result of a disease process. Most people with an eating disorder attempt to hide their abnormal behaviour from others. They do not accept the diagnosis, and will refuse treatment. As the treatments prescribed for eating disorders can take decades, mental health advocates warn that early "identification" of these disorders (and diagnosis of the syndrome as being caused by mental illness) may be the difference between life and death for the patient.

There are many variations of Anorexia and Bulimia. An anorectic may himself/herself eat, but severely restrict the amount and/or specific foods he/she eats; or the eating pattern can progress to the point of literally starving consuming nothing. There are other forms of purging besides vomiting: such as compulsive exercise and laxatives. Often times sufferers fall under the category of "eating disorder not otherwise specified" (EDNOS) in which the eating disorder patterns vary; for example someone with EDNOS might fluctuate between compulsively eating and starving and occasionally purge.

Women account for 90% of eating disorder cases. Not too long ago, this disease was considered typical of the Caucasian upper-middle class. In recent years, researchers have noted an increase in the Asian and Hispanic populations, as well as in men. In addition, although this disorder is most prevalent in young teens, the clinical community has, in recent years, seen an increase in the disease within the older female population.

Journal references

 * An excellent current article on the consequences of eating disorders, the costs to families and institutions.
 * Abstract: In a prospective long-term follow-up of 84 patients 21 years after first hospitalisation for anorexia nervosa, we found that 50.6% had achieved a full recovery, 10.4% still met full diagnostic criteria for anorexia nervosa, and 15.6% had died from causes related to anorexia nervosa. Predictors of outcome included physical, social, and psychological variables.
 * Abstract: In a prospective long-term follow-up of 84 patients 21 years after first hospitalisation for anorexia nervosa, we found that 50.6% had achieved a full recovery, 10.4% still met full diagnostic criteria for anorexia nervosa, and 15.6% had died from causes related to anorexia nervosa. Predictors of outcome included physical, social, and psychological variables.
 * Abstract: In a prospective long-term follow-up of 84 patients 21 years after first hospitalisation for anorexia nervosa, we found that 50.6% had achieved a full recovery, 10.4% still met full diagnostic criteria for anorexia nervosa, and 15.6% had died from causes related to anorexia nervosa. Predictors of outcome included physical, social, and psychological variables.
 * Abstract: In a prospective long-term follow-up of 84 patients 21 years after first hospitalisation for anorexia nervosa, we found that 50.6% had achieved a full recovery, 10.4% still met full diagnostic criteria for anorexia nervosa, and 15.6% had died from causes related to anorexia nervosa. Predictors of outcome included physical, social, and psychological variables.
 * Abstract: In a prospective long-term follow-up of 84 patients 21 years after first hospitalisation for anorexia nervosa, we found that 50.6% had achieved a full recovery, 10.4% still met full diagnostic criteria for anorexia nervosa, and 15.6% had died from causes related to anorexia nervosa. Predictors of outcome included physical, social, and psychological variables.