Eating disorders are serious medical illnesses
Eating disorders are serious medical illnesses marked by severe disturbances to a person’s eating behaviors (National Institute of Mental Health, 2018). The most common eating disorders are anorexia nervosa and bulimia. Sometimes these can be difficult to treat as it is associated with medical and mental comorbidities. There may even be a genetic component to these disorders. Anorexia has the highest mortality rate of all the mental health conditions, with a 5-year mortality rate of 15% to 20% (Burns, 2017). These disorders affect women more than men.
It can be somewhat difficult to diagnose an eating disorder because some of the signs and symptoms can just be normal patters of an adolescent female. This is because these girls may not be happy with their body image. People with anorexia will deny themselves food to the point of self-starvation as they obsess about weight loss. The emotional symptoms of anorexia include irritability, social withdrawal, lack of mood or emotion, not able to understand the seriousness of the situation, fear of eating in public and obsessions with food and exercise (National Alliance on Mental Illness, 2018). People living with bulimia will feel out of control when binging on very large amounts of food during short periods of time, and then desperately try to rid themselves of the extra calories using forced vomiting, abusing laxatives or excessive exercise. The emotional symptoms of bulimia include low self-esteem overly linked to body image, feelings of being out of control, feeling guilty or shameful about eating and withdrawal from friends and family (National Alliance on Mental Illness, 2018).
ANOREXIA NERVOSA
Dramatic weight loss
Dresses in layers to hide weight loss or stay warm
Preoccupation with weight, food, calories, fat grams, and dieting. Makes frequent comments about feeling “fat.’
Resists or is unable to maintain a body weight appropriate for their age, height, and build
Maintains an excessive, rigid exercise regime – despite weather, fatigue, illness, or injury
BULIMIA NERVOSA
Evidence of binge eating, including disappearance of large amounts of food in short periods of time or lots of empty wrappers and containers indicating consumption of large amounts of food
Evidence of purging behaviors, including frequent trips to the bathroom after meals, signs and/or smells of vomiting, presence of wrappers or packages of laxatives or diuretics
Drinks excessive amounts of water or non-caloric beverages, and/or uses excessive amounts of mouthwash, mints, and gum
Has calluses on the back of the hands and knuckles from self- induced vomiting
Dental problems, such as enamel erosion, cavities, discoloration of teeth from vomiting, and tooth sensitivity
Some possible differential diagnoses include IBS, peptic ulcer disease, OCD, substance abuse disorder and major depression. Some lab tests may be done to see how severe of an electrolyte imbalance a patient may have. CBC, Chem 8, thyroid studies, FSH, ECG and bone density are some tests that may be ordered.
Once the patient and family admit that there is a problem treatment can begin. Nutritional rehabilitation, pharmacotherapeutics, and therapy. Sometimes inpatient management is necessary to achieve recovery. The primary care provider should be there to screen for an eating disorder Monitoring weight gain, and complications are especially important. Death is the biggest complication of an eating disorder.
It can be somewhat difficult to diagnose an eating disorder because some of the signs and symptoms can just be normal patters of an adolescent female. This is because these girls may not be happy with their body image. People with anorexia will deny themselves food to the point of self-starvation as they obsess about weight loss. The emotional symptoms of anorexia include irritability, social withdrawal, lack of mood or emotion, not able to understand the seriousness of the situation, fear of eating in public and obsessions with food and exercise (National Alliance on Mental Illness, 2018). People living with bulimia will feel out of control when binging on very large amounts of food during short periods of time, and then desperately try to rid themselves of the extra calories using forced vomiting, abusing laxatives or excessive exercise. The emotional symptoms of bulimia include low self-esteem overly linked to body image, feelings of being out of control, feeling guilty or shameful about eating and withdrawal from friends and family (National Alliance on Mental Illness, 2018).
ANOREXIA NERVOSA
Dramatic weight loss
Dresses in layers to hide weight loss or stay warm
Preoccupation with weight, food, calories, fat grams, and dieting. Makes frequent comments about feeling “fat.’
Resists or is unable to maintain a body weight appropriate for their age, height, and build
Maintains an excessive, rigid exercise regime – despite weather, fatigue, illness, or injury
BULIMIA NERVOSA
Evidence of binge eating, including disappearance of large amounts of food in short periods of time or lots of empty wrappers and containers indicating consumption of large amounts of food
Evidence of purging behaviors, including frequent trips to the bathroom after meals, signs and/or smells of vomiting, presence of wrappers or packages of laxatives or diuretics
Drinks excessive amounts of water or non-caloric beverages, and/or uses excessive amounts of mouthwash, mints, and gum
Has calluses on the back of the hands and knuckles from self- induced vomiting
Dental problems, such as enamel erosion, cavities, discoloration of teeth from vomiting, and tooth sensitivity
Some possible differential diagnoses include IBS, peptic ulcer disease, OCD, substance abuse disorder and major depression. Some lab tests may be done to see how severe of an electrolyte imbalance a patient may have. CBC, Chem 8, thyroid studies, FSH, ECG and bone density are some tests that may be ordered.
Once the patient and family admit that there is a problem treatment can begin. Nutritional rehabilitation, pharmacotherapeutics, and therapy. Sometimes inpatient management is necessary to achieve recovery. The primary care provider should be there to screen for an eating disorder Monitoring weight gain, and complications are especially important. Death is the biggest complication of an eating disorder.
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