Categories
Depression Eating Disorders

Eating Disorders: The Consequences

Eating disorders are a set of widespread and life threatening conditions.  According to a new study published in Biological Psychiatry based on the largest national sample of U.S. adults of 36,309 people, around “0.8 percent of adults will be affected by anorexia nervosa in their lifetime; 0.28 percent will be affected by bulimia nervosa; and 0.85 percent will be affected by binge eating disorder” (Udo & Grilo, 2018).  Furthermore, eating disorders affect people of every age, sex, gender, race, ethnicity, and socioeconomic group and could have severe consequences on a person’s emotional and physical health (“Risk Factors”, 2018).

Eating disorders affect every organ system in a person’s body, including the brain.  Because of this there are many health consequences associated with having an eating disorder.  By consuming fewer calories, the body starts to break down muscle and tissue for fuel. Due to this, the heart has fewer cells and less fuel to pump blood with and pulse and blood pressure begin to drop and the risk of heart failure increases (“Health Consequences”, 2018).  In the case of orally purging the body of food, the body is losing electrolytes which “can lead to irregular heartbeats and possible heart failure and death” (“Health Consequences”, 2018). Not only does purging cause electrolyte imbalances in the body, it has severe consequences on the gastrointestinal system.  Purging can lead to a deteriorated esophagus and stomach problems such as blocked intestines from undigested food, bacterial infections, constipation, intestinal perforation and in severe cases stomach ruptures (“Health Consequences”, 2018). In addition, purging and malnutrition can cause of pancreatitis or an inflammation of the pancreas (“Health Consequences”, 2018).

Neurologically, due to the restriction of calories in the body, the brain will not receive enough nutrients to function and could lead to a toxic cycle of obsessing about food and difficulties concentrating (“Health Consequences”, 2018).  Furthermore, not eating enough can create difficulties falling or staying asleep, numbness and tingling in the extremities of the body due to damage to the neuronal insulations, seizures and muscle cramps due to electrolyte imbalance, and fainting or dizziness (“Health Consequences”, 2018).  Even more alarming, in the endocrine system sex hormones decrease and can increase bone loss and starvation can cause high cholesterol levels (“Health Consequences”, 2018).

However, the consequences of eating disorders are not merely confined to the physical body.  There are many cognitive and emotional effects associated with restrained eating. People suffering from eating disorders have their cognitive performance and function disrupted by thoughts of food and/or weight (Polivy, 1996).  People with a history of dieting were also found to have more difficulty concentrating than their peers and experience feelings of irritability and negative emotionality and heightened affective responsiveness (Polivy, 1996). Self-harm, suicide attempts and death constitutes as some of the highly associated risks with eating disorders (Keski-Rahkonen & Mustelin, 2016) .  

In fact, according the the National Association of Anorexia Nervosa and Associated Disorders, eating disorders have the highest mortality rate of any mental illness.  One in five people with anorexia die by suicide (“Eating Disorder Statistics”, n.d.). This statistic does not include those that die due to pure self-starvation. The Standard Mortality Ratio, how likely one is to die over the study period compared to same aged peers of the general population, is 5.86 times more likely for people suffering from anorexia nervosa and 1.93 times more likely for people suffering from bulimia nervosa (“Eating Disorder Statistics”, n.d.).  

As eating disorders are complex in nature, the risk factors of eating disorders involves an interaction between a range of biological, psychological and sociocultural factors (“Risk Factors”, 2018). Eating disorders are extremely prevalent and consequential and with more information, education, and funding for research there can be more support for those fighters and survivors of eating disorders.   

References

Eating Disorder Statistics • National Association of Anorexia Nervosa and Associated Disorders.

(n.d.). Retrieved February 10, 2019, from

https://anad.org/education-and-awareness/about-eating-disorders/eating-disorders-statistics/

Health Consequences. (2018, February 22). Retrieved February 10, 2019, from

https://www.nationaleatingdisorders.org/health-consequences

Keski-Rahkonen, A. & Mustelin, L. (2016). Epidemiology of eating disorders in Europe. Current

Opinion in Psychiatry, 29(6), 340–345. doi: 10.1097/YCO.0000000000000278.

Polivy, J. (1996). Psychological Consequences of Food Restriction. Journal of the American

Dietetic Association,96(6), 589-592. doi:https://doi.org/10.1016/S0002-8223(96)00161-7

Risk Factors. (2018, August 03). Retrieved February 10, 2019, from

https://www.nationaleatingdisorders.org/risk-factors

Udo, T., & Grilo, C. M. (2018). Prevalence and Correlates of DSM-5–Defined Eating Disorders

in a Nationally Representative Sample of U.S. Adults. Biological Psychiatry,84(5),

345-354. doi:https://doi.org/10.1016/j.biopsych.2018.03.014

 

Categories
Eating Disorders

Eating Disorders Are Taking a Bite Out of Children

December 9, 2015. While many of us were counting the days until winter vacation, British teenager,  Pippa ‘Pip’ McManus was counting her last breaths, before jumping in front of a train, ending her three-year battle with anorexia (Scapens & Abbit, 2017). She was 15 years old.

Pip’s struggles with anorexia began when she was just 12. According to her mother, Pip was initially obsessed with looking at herself in the mirror and asking if she looked fat. While her parents initially overlooked this behavior, Pip’s preoccupation with her diet and exercise, followed by her drastic weight loss eventually pushed them to admit her to the Priory Hospital Altrincham, which specializes in the treatment of mental disorders. Despite receiving professional help, Pip’s condition only worsened over time and she eventually succumbed to her disorder. Around the time of her death, Pippa weighed 55 pounds (“Priory’s care plan for anorexic teen Pippa McManus “inadequate,’” 2017).

Although we often associate eating disorders with women in their late teens and twenties, a study conducted by the Agency for Healthcare Research and Quality revealed that “hospitalizations for eating disorders in children under 12 increased by 119% between 1999 and 2006” (Harb, 2012). In a 2012 CNN article by Cindy Harb, psychologist Dina Zeckhausen links the rise in childhood eating disorders to the increased focus on obesity and diets.

Additionally, Zeckhausen states that children who are vulnerable to eating disorders often display a shared set of traits including: “high anxiety, perfectionism and obsessive-compulsive tendencies” (2012). Zeckhausen also states that children with troubled home and/or school lives are most likely to develop an eating disorder because they see food as one of the only aspects of life under their control. Zeckhausen’s statement is further explained by a University of Rochester Medical Center article on anorexia, which notes that individuals with eating disorders view calorie-control as a way of reducing stress, anxiety and helps in attaining a sense of control and accomplishment through visible weight loss (University of Rochester Medical Center [URMC], n.d.).

In response to childhood eating disorders, numerous incentives have emerged across the globe. For instance, Australian Federal Health Minister, Greg Hunt, recently enforced a policy requiring teachers, school counselors, and coaches to receive training in detecting signs of eating disorders. Additionally, he increased funding for the Ed Hope national helpline and the Butterfly Foundation, both of which are dedicated to helping individuals overcome their eating disorders (Brennan, 2017).

Similarly, many schools throughout the United States have sought to help students through in-school counseling as well as awareness and prevention programs (Olivero, 2015). Additionally, in a 2015 U.S. News article, Magaly Olivero provides suggestions for possible in-school initiatives, including: educating school staff on signs of eating disorders and broadening health curriculums and anti-bullying campaigns to address body-image issues and eating disorders.

The increase in childhood eating disorders depicts the importance of raising awareness on body-image issues among not only adults, but also children, as the future of the world’s youth is dependent upon it.

References:

Anorexia Nervosa. (n.d.). Retrieved September 25, 2017, from https://www.urmc.rochester.edu/childrens-hospital/adolescent/eating-disorders/teens/anorexia-nervosa.aspx

Brennan, R. (2017, September 18). First National Policy for Treatment of Eating Disorders Announced. Retrieved September 19, 2017, from http://www.dailytelegraph.com.au/news/nsw/first-national-policy-for-treatment-of-eating-disorders-announced/news-story/ef8f025b9fd376774d79f94962cf884f

Harb, C. (2012, August 22). Child eating disorders on the rise. Retrieved September 18, 2017, from http://www.cnn.com/2012/08/22/health/child-eating-disorders/index.html

Olivero, M. (2015, February 23). Tackling Eating Disorders With School-Based Initiatives. Retrieved September 25, 2017, from https://health.usnews.com/health-news/health-wellness/articles/2015/02/23/tackling-eating-disorders-with-school-based-initiativeshttp://www.bbc.com/news/uk-england-manchester-39781995

Priory’s care plan for anorexic teen Pippa McManus ‘inadequate’. (2017, May 2). Retrieved September 24, 2017, from http://www.bbc.com/news/uk-england-manchester-39781995

Scapens, A., & Abbit, B. (2017, May 3). The devastating last words of a teenager whose discharge from the Priory ‘was not done well enough’. Retrieved September 18, 2017, from http://www.manchestereveningnews.co.uk/news/greater-manchester-news/pip-mcmanus-anorexia-inquest-stockport-12975723

Categories
Eating Disorders

A Victim of Anorexia: How to Tell

As outlined by DSM-5 guidelines, anorexia nervosa includes restrictive energy intake even lower than daily requirements, extreme fear of gaining weight or becoming fat, and denial of increasingly lower body weight. What does a victim of anorexia look like and how can you tell?

Easy. Look at what is on magazine covers, television screens, and fashion runways: a severely underweight, starving young woman.What is more shocking is that over 1 million women in the United States suffer from anorexia in their lifetime, with 1 in 5 anorexia deaths resulting from suicide (Arcelus et al. 2011; Hudson et al. 2007). While database statistics can better represent an affected population, popular media continues to emphasize that most people who suffer from anorexia are women, women who are young, white, and middle-to-upper class. Elders, minority groups, men, gender non-conforming, the poor–all silently suffering, and current statistics are not enough to emphasize the prevalence of anorexia in these subgroups of society.

Still trying to figure out how to tell if someone is a victim of anorexia? In a world domineered by Western culture, the face is a young white woman. A mere Google search shows you almost nothing else. If other subgroups are affected by this mental disorder, why are we only beaming our eyes towards one angle and averting all other angles?

Media. One of the most influential powers of Western society, media comes in a variety of flavors, from television to Internet to the radio. In between all the sitcoms, news, and movies, commercials can subliminally speak to our hidden insecurities and inner fears, particularly those that target women’s physical appearance. What we do not realize is that others that are not directly targeted are also deeply affected.

TJ’s “nine-year nightmare” ended at the age of 22, when he died in the middle of doing sit-ups. The 2015 tragedy flooded news stations and circulated on the Internet, claiming that he was the “New Face of Anorexia.” TJ, a young white college-student with excellent grades, dreams, and manners did not “want to be skinny. He wanted to have muscles. He wanted to have a six-pack, like the health magazine covers that he had, about 100 of those under his bed. He wanted to be quicker and faster and stronger, and look good,” his mother, Susan, explained. People might be quick to blame Susan for her lack of intervention, but she did monitor him for years until he went off to college. He began lying to her because he was afraid of showing weakness or worry and giving up on his goal. TJ’s demise can be perfectly attributed to the influence of media, those magazines eventually convincing him that he had to be muscular and thin or that he would not be considered a man.

On the other hand, Ahani Ortega, a 25-year-old Latina woman, had found herself trapped in the shadows of the “white anorexia.” Ortega shares with us that as part of her traditional Mexican lifestyle, her family would only eat two meals a day, and skipping meals was even easier at her California high school because no one was watching. Her anorexia escalated into self-harm and bulimia, and at the age of 15, she was hospitalized for overdosing on diet pills and nearly suffering a stroke. She began group therapy, but she was the only Latina “in a room full of white girls.” Her group therapy failed, and her doctors then diagnosed her with EDNOS (eating disorder not otherwise specified) because she did not meet the standards for anorexia, bulimia, or binge eating disorder. Surprisingly, EDNOS is the most common diagnosis in Latina women because like Ortega, many are not focused maintaining “the perfect thin,” defined as curvy, but not too much; thus, because anorexia’s diagnostic requirement is a “preoccupation with thinness,” she fell away from the possibility of receiving the treatment appropriate for her.

Darcy, too, found herself battling with anorexia after her husband died. She stopped eating, dropped fifty pounds, and, one day, the 66-year-old widow living in an “active retirement community” found herself hospitalized after a fainting spell on the golf course. The events leading up to her collapse were a mix of her depression, other women complimenting her on her figure the more weight she lost, and her own desire to lose her “chubby belly,” although she was a 5-foot-5, 90-pound woman. Who was telling her that she was “chubby,” and who knew that she was no longer eating?

More advertisements portray what young white women should represent, but nobody talks about TJ’s starving himself to death, Anahi’s misdiagnosis because she is Latina, or Darcy’s mid-life struggle with her husband’s sudden passing. Nobody talks because the facts are wrong. Most statistics we have are recorded based on self-reported questionnaires, with questions that target specific populations and create the young white woman bias we see (Streigel-Moore and Franko, 2003).

Given what I have discussed in previous other articles I have published about eating disorders, you can recognize that the experiences of eating disorders are spectral and range from one extreme to the other. To solve part of the bias portrayed in the media, Favaro et al. 2004 suggests to conduct personal interviews across several communities; furthermore, population-based data are needed to ascertain the prevalence in not only anorexia nervosa, but also bulimia nervosa and binge eating disorder (Favaro et al. 2004). From these interviews, we will be better able to assort the data on age-of-onset, duration of the illness, and association with sociodemographic factors (e.g. race, gender, class).

Note that many of the sources in this article date back to approximately ten or more years ago, which demonstrates the evident knowledge gap in anorexia prevalence, pathology, and treatment. On the greener side of research, data analyzed from the National Comorbidity Survey Replication (NCS-R) by Hudson et al. 2007 identifies a wider range of factors to consider, such as the association of anorexia with other mental disorders, the degree of disability, and the history of mental health treatment (Hudson et al. 2007). Other work contributed to the National Institutes of Mental Health (NIMH) reveals that researchers have found that, on the whole, eating disorders are caused by “a complex interaction of genetic, biological, behavioral, psychological, and social factors.” Just from these studies alone, we can start to understand that anorexia does not look the same for every person who lives with the illness.

We like to think that we know the in’s and out’s of anorexia, but we only know what anorexia should look like because the media tells us what to believe. As serious as anorexia nervosa is, a black cloud of social issues still hovers over the mental disorder. Media portrayal of positive body image, self-love and acceptance, and mental health wellness and awareness can lead to profound changes in how we view others and ourselves. TJ, Ahani, and Darcy did not get the help they needed when they were most vulnerable, all because they were not young white women, but emphasizing the level of destruction that a disorder such as anorexia can sustain on an individual can aid in the advocacy of urgent intervention, treatment, and management.

As Gayle Brooks, vice president and chief clinical officer of the Renfrew Center, the country’s first residential treatment facility for eating disorders, says, “When eating disorders were first being recognized, people seeking treatment were young white girls, so the belief developed early that nobody else suffers from them. When that became the core of our understanding, we stopped looking at diversity being an issue. We missed a lot.”

If you or someone you know is struggling with an eating disorder, the National Eating Disorders Association has useful information and resources. Do not hesitate to get help.

References:

American Psychiatric Association. (2013). Feeding and Eating Disorders. Retrieved from http://dsm.psychiatryonline.org/doi/full/10.1176/appi.books.9780890425596.dsm10

Arcelus J, Mitchell AJ, Wales J, Nielsen S. (2011). Mortality Rates in Patients With Anorexia Nervosa and Other Eating Disorders: A Meta-analysis of 36 Studies. Arch Gen Psychiatry, 68(7):724-731.doi:10.1001/archgenpsychiatry.2011.74

Cartwright, Martina M. (2013). Does Grandma Have an Eating Disorder? Psychology Today. Retrieved from https://www.psychologytoday.com/blog/food-thought/201310/does-grandma-have-eating-disorder

Favaro A, Ferrara S, Santonastaso P. (2004). The Spectrum of Eating Disorders in Young Women: A Prevalence Study in a General Population Sample. Psychosom Med, (65):701–708.

George, J. B. E., & Franko, D. L. (2010). Cultural Issues in Eating Pathology and Body Image Among Children and Adolescents. Journal of Pediatric Psychology, 35(3), 231-242. doi: 10.1093/jpepsy/jsp064

Hudson, J. I., Hiripi, E., Pope, H. G., & Kessler, R. C. (2007). The Prevalence and Correlates of Eating Disorders in the National Comorbidity Survey Replication. Biological Psychiatry, 61(3), 348–358. http://doi.org/10.1016/j.biopsych.2006.03.040

Kloepfer, Chivon. (2015). Friends for Life: Nine-Year Nightmare. WLNS 6 News. Retrieved from http://wlns.com/2015/11/23/friends-for-life-nine-year-nightmare/

Konstantinovsky, Michelle. (2014). Eating Disorders Do Not Discriminate. Slate. Retrieved from http://www.slate.com/articles/double_x/doublex/2014/03/eating_disorders_and_women_of_color_anorexia_and_bulimia_are_not_just_white.html

National Association of Anorexia Nervosa and Associated Disorders. (2016). Eating Disorder Statistics. Retrieved from http://www.anad.org/get-information/about-eating-disorders/eating-disorders-statistics/

National Institutes of Mental Health. (2016). Eating Disorders. Retrieved from https://www.nimh.nih.gov/health/topics/eating-disorders/index.shtml