Encyclopedia of Health and Medicine

E–I
eating disorders Psychologic conditions in
which the person restricts food intake because of
the belief that he or she is overweight. Eating disorders
affect 10 times as many girls and women as
boys and men. There are two main types of eating
disorder: anorexia nervosa and bulimia nervosa.
Anorexia nervosa With anorexia nervosa, the
person avoids eating, eats only very small
amounts of certain foods, vomits after eating, or
excessively uses laxatives and diuretics to reduce
body weight. Some people who have anorexia
nervosa also exercise compulsively and excessively
to further drive down body weight. The person
weighs herself numerous times each day, often
following obsessive rituals (such as spitting or urinating
before stepping on the scale, completely
undressing, or taking off jewelry) to obtain the
lowest weight possible. Even when weight reaches
an unhealthy low, the person still believes she is
overweight.
Bulimia nervosa In bulimia the person compulsively
binges (eats excessive amounts of food in
a short period of time), then compensates through
inappropriate behaviors, such as induced vomiting
or excessive laxative use, to eliminate the food.
People who have bulimia often remain at normal
weight or slightly below because they do consume
calories during binging episodes, though believe
they are excessively overweight.
Symptoms and Diagnostic Path
Because eating disorders incorporate secretive
behaviors, symptoms may be subtle until weight
loss (in anorexia particularly) is severe. Indications
of an eating disorder include
• moving food around on the plate but not eating
any of it
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• self-proclaimed weight “problems” though
excessively thin
• delayed or irregular MENSTRUATION
• going to the bathroom during or immediately
after meals
• supplies of laxatives, diuretics, and enemas
• damaged tooth enamel (from vomiting)
The diagnostic path includes a comprehensive
physical examination to detect signs of malnourishment
or damage to the body resulting from
prolonged inadequate nutrition. The KIDNEYS and
HEART are most vulnerable to such damage.
Treatment Options and Outlook
The standard of care for treatment is a three-level
approach:
• restoring body weight to a healthy range,
which may require nutritional support or supplementation
as well as supervised meals
• PSYCHOTHERAPY
• ANTIDEPRESSANT MEDICATIONS, usually selective
serotonin reuptake inhibitors (SSRIs)
Treatment for anorexia is often a long-term
process; treatment for bulimia tends to be more
effective. Some people recover fully, though many
deal with eating issues for most of their lives. SUD-
DEN CARDIAC DEATH remains a lifelong risk in people
who have anorexia.
Risk Factors and Preventive Measures
Researchers do not know what causes eating disorders
though believe they result from an interplay
of genetic and environmental or psychosocial
factors such as family relationships and self-