Health Services
Self Care

Anorexia Nervosa & Bulimia Nervosa

Description
Eating disorders are complex psychological and behavioral disorders which occur in susceptible persons, usually during periods of physical and/or psychological growth or change. The anxiety produced during these developmental periods is sometimes dealt with through abnormal eating behaviors and/or dieting. These disorders are an attempt by individuals to gain control and adapt to the circumstances of their lives, and are reinforced by current sociocultural standards of thinness (especially for women). Eating disorders cover a spectrum from self-imposed starvation (anorexia nervosa), binge eating with purging (bulimia nervosa), to compulsive over-eating.

The prevalence of eating disorders is difficult to document. Many individuals display some of the behaviors of an eating disorder but do not fill all of the diagnostic criteria. However, it is believed that bulimia occurs in up to 2-3% of the population, and anorexia occurs in approximately 1%. People who are at the greatest risk for developing an eating disorder include women, athletes, people involved in the performing arts, and models.

Symptoms
The diagnosis of anorexia nervosa is based on the following criteria: refusal to maintain normal body weight, with a loss of 15% or more of body weight; severe distortion of body image; absence of menses for at least 3 consecutive cycles; extreme fear of fatness and gaining weight. Individuals with anorexia nervosa are relatively easy to identify because of their emaciated bodies. Other characteristics may include:

• Purposely avoiding eating situations.
• Playing with, hoarding, or concealing food, but not eating.
• Maintaining extremely rigid eating patterns.
• Expressing intense interest in weight loss, checking weight frequently.
• Engaging in intense long-term and continuous physical activity.
• Complaining of coldness, wearing layers of clothes.

If left untreated, anorexia nervosa may cause abnormal heartbeat, anemias, osteoporosis, blood vitamin and mineral abnormalities, disruption of menstrual cycle, dehydration, constipation, abnormal heartbeat, and possible death, often from cardiac arrest.

The clinical diagnosis of bulimia nervosa is based on the following criteria: recurring episodes of bingeing (eating excessively large amounts of food in a relatively short period of time), a feeling of lack of control during bingeing, use of vomiting, laxatives, diuretics, fasting or strict dieting and/or exercising, and an over concern with body weight and shape.

The body appearance of a person with bulimia nervosa may be normal, over- or under-weight, making the condition difficult to identify. Some typical behaviors and symptoms of a person with this disorder are:

• Disappearing to the bathroom after eating.
• Hearing the sounds of vomiting or smelling vomit in the bathroom.
• Finding laxative, Ipecac, and/or diuretics containers in the trash.
• Puffy face and/or red eyes, especially after eating.
• Bad breath, teeth problems (due to the effect of stomach acid on tooth enamel).

If left untreated, bulimia nervosa can cause blood vitamin and mineral abnormalities, disruption of menstrual cycle, dehydration, tooth enamel erosion, sore throat, gastritis, abnormal heartbeat, and possible death.

Treatment
Eating disorders are treatable with proper intervention. This may involve medical evaluation, nutrition guidance, and if possible, family counseling. Therapy is the core treatment, since an understanding of the psychological issues that lead to the maladaptive eating behavior is important. Learning to understand and manage feelings, improving self-esteem, and improving personal relationships are very important as well. The majority of individuals can be successfully treated.

More Information/Questions
Messiah  students may contact Counseling Services at 796-5357 or the Health Center at 691-6035 for help and information. Students may make an appointment with a registered dietitian by calling 691-6035.