CARE GUIDE Eating Disorders

Eating Disorders

Eating disorders are a set of serious conditions where a skewed perception of body image leads to a preoccupation with food. They can cause nutritional deficits and become so extreme as to be life-threatening. The most common eating disorders are anorexia nervosa, bulimia nervosa and binge eating disorder.

This condition is characterized by limiting food intake and self-starvation. Symptoms of anorexia nervosa include:

  • Distorted body image
  • Denial of hunger signs and refusal to eat
  • Food preoccupation and calorie counting
  • Insomnia
  • Extreme exercise
  • Irritability
  • Appearing emotionless
  • Social withdrawal
  • Menstrual irregularity
  • Irregular heartbeat
  • Dry skin
  • Abdominal pain
  • Constipation
  • Dehydration
  • Low blood pressure
  • Feeling cold

This condition is characterized by cycles of bingeing and purging—where large quantities of food are consumed over a short time frame and then vomiting is induced to rid the body of the excess calories. Symptoms of bulimia nervosa include:

  • Self-induced vomiting; relaxed gag reflex
  • Overeating to the level of pain or discomfort, often with foods high in fat or calories
  • Use of laxatives
  • Negative/distorted body image
  • Low self-esteem
  • Bathroom visits during or after meals
  • Poor condition of teeth and gums
  • Sores in mouth and throat
  • Dehydration
  • Irregular heartbeat
  • Menstrual irregularities

This condition is characterized by excessive eating without purging afterward. Guilt or shame over eating habits causes the person to eat more, even when he or she is not hungry. Symptoms of binge eating disorder include:

  • Eating faster than normal
  • Consuming food to the level of pain or discomfort
  • Eating alone or in secret
  • Low self-esteem
  • Feeling guilty about the quantity of food consumed

Doctors and Specialists

Treatment for an eating disorder is best accomplished with a team approach, where the patient sees several doctors and specialists who are each focused on a different aspect of care. Those providers may include:

Psychologist: Provides therapy for individuals through counseling and teaching the patient techniques for controlling stress or mood problems. Also, eating disorders are often accompanied by feelings of anxiety, guilt and frustration, which must be addressed along with a skewed perception of body image.

Psychiatrist: A medical doctor who focuses on disorders of the mind and mood. This doctor may prescribe medications in addition to psychotherapy if eating problems are found to accompany obsessive-compulsive disorders or other associated mental conditions.

Nurse practitioner:A nurse who focuses on prevention, wellness and education of patients about health conditions and treatment choices.

Nutritionist: A professional who formulates diet plans for both healthy and compromised individuals. He or she also offers advice on vitamins and supplements to promote good health. Since those with eating disorders often have accompanying vitamin or protein deficiencies, diet plans are crucial.

Endocrinologist: A physician who deals with hormonal system disorders such as thyroid imbalances, diabetes and pituitary problems. A hormonal imbalance can cause dramatic weight loss or fluctuations and abnormal eating patterns.

Internist: A physician who focuses on the diagnosis, treatment and prevention of adult illness.

General practitioner: A doctor who specializes in the diagnosis, treatment and prevent of illness in all age categories.

Preparing for Your Appointment

On the day of the appointment, bring the following information:

  • Past medical conditions and infections
  • Past surgeries with dates
  • All recent laboratory test results and x-ray reports
  • List of all medications currently being taken, including supplements, herbs and vitamins
  • List of any symptoms experienced, even those that seem unrelated to eating disorders
  • History of weight fluctuations
  • Menstrual history
  • Any recent life changes or major stress

You’ll probably have questions for the doctor about eating disorders. Review this list of common concerns before the appointment, or print it out to bring with you.

Questions About My Diagnosis

  • Is this condition lifelong or can it be just a reaction to current stress?
  • Will this condition resolve if the stress is resolved?
  • Are there other conditions that may be causing these symptoms?
  • Can this be a normal step in growth and development?
  • Are there diagnostic tests that I will need to take?

Questions About My Treatment

  • Will I need to gain weight as part of the treatment?
  • Must I see a psychologist/psychiatrist for treatment?
  • Will I need treatment long-term or temporarily? Can I be cured?
  • Do I need to switch the type of job that I do?
  • Are there medications that I need? What are the effects?

Questions About My Lifestyle and Family

  • Is there a family tendency toward this problem? What can I do to prevent my children from getting this?
  • Will my periods become regular?
  • Will I become more fertile now? What contraception should I use?
  • Can I still exercise? What exercises are advised?
  • Are there forums or websites about eating disorders that you recommend? Are there support groups in the area? Do you have printed material o r brochures that I can take with me?

Tests and Diagnosis

Diagnosing an eating disorder starts with a review of the patient’s eating habits, behavior and image perception. A psychological exam is often performed, using the Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association.

Additional tests are usually run to identify related complications or conditions that may be causing or contributing to the eating disorder itself. These exams include:

  • Complete blood count: (CBC): The CBC is a blood test done to check for anemia, which can cause abnormal food cravings or eating disorders. Anemia can also be caused by poor diet, which is common in those with eating disorders.
  • SMA18: This blood test measures electrolytes, proteins, and liver and kidney function.
  • Thyroid panel: This blood test looks for problems with thyroid function, which affects metabolism and can cause abnormal weight loss or gain.
  • Liver function test: This blood test measures the health of the liver.
  • Kidney function test: This blood test measures the health of the kidneys.
  • Urinalysis: This urine test measures the health of the urinary tract and system.
  • Chest x-ray: This x-ray test is done to rule out pneumonia or other lung disorders.
  • Electrocardiogram (EKG): This test is done to look for problems affecting the electrical activity of the heart.

Medications and Treatment

Treatment of eating disorders may include a combination of nutritional education programs, psychotherapy and medications. If the condition becomes life-threatening, hospitalization may become necessary.

While there are no drugs specific to the treatment of eating disorders, antidepressants and anti-anxiety drugs can alleviate the stress, depression and anxiety that can trigger eating problems. In addition, medications for obsessive-compulsive disorder have been found to help with eating disorders, especially bulimia.

Diet plans for healthy eating encourages better food choices and eating habits.

For children and teens suffering from eating disorders, support from family members can help with weight restoration, making healthier food choices, and dealing with daily stress.

Individual or group therapy can help those with eating disorders learn to substitute healthy habits for unhealthy ones. Psychotherapy can lead to better coping skills, healthier relationships and enhanced problem-solving strategies.

Stress reduction is helpful in managing eating disorders. Activities like acupuncture, massage, yoga, or meditation can help to promote relaxation and wellness.