EATING DISORDER

Dr. SURYAMANISports Physiotherapy(Hons.)

MEANING:

Eating disorders are potentially life-threatening psychiatric disorders, typified by severely disturbed eating behaviors and perceptual /attitudinal distortions that require clinical treatment (APA, 2000).

Individuals with clinical eating disorders engage in pathogenic eating and weight control behaviors and have distorted body cognitions and perceptions that interfere with their daily lives and have deleterious effects on their physical and psychological functioning.

EATING DISORDER

TYPES:

Acc to APA, (2000) there are three primary clinical eating disorders :

•Anorexia Nervosa (AN),

•Bulimia Nervosa (BN), and

•Eating Disorder Not Otherwise Specified (EDNOS).

Anorexia Nervosa

Features:

“The Starvation Disease”

•a refusal to maintain normal body weight for age and height

•an intense fear of weight gain despite being underweight

•disturbed perceptions of body shape and weight,

•undue influences of weight and shape on self-evaluation

•amenorrhea (in postmenarcheal women).

Bulimia Nervosa

Features:“The binge and purge disease”

• Episodes of binge eating:

(i.e., eating a large amount of food in a discrete period of time and/or feeling out of

control during the eating episode) that are followed by compensatory behaviors,

such as self-induced vomiting, diuretic or laxative use, fasting or dieting, or

excessive exercising

• a self evaluation that is strongly influenced by

body shape and weight.

Two types:

• Purging: use of vomiting or laxatives to control weight.• Non-purging: use of fasting, excessive exercise, to balance moments of

binging.

Eating Disorder Not Otherwise Specified

Eating Disorder Not Otherwise Specified is diagnosed when some, but not all, of the criteria for either Anorexia Nervosa or Bulimia Nervosa are met.

For example, a female may meet all of the criteria of AN except for menstrual dysfunction, or, despite losing a significant amount of weight, she may still be within the normal weight range. Or a male who is very dissatisfied with the size and shape of his body may engage in compensatory behaviors, such as exercising excessively or vomiting, after eating only small amounts of food.

• A combination of anorexia and bulimia

• Involves extreme dieting and purging of any food eaten

• Very serious, as with the other eating disorders, death may occur.

• Medical

• Psycological

• Behavioural

How Anorexia Affects Body

Cardiovascular & Musculoskeletal Anore

xia

• Low blood pressure (hypotension)• Diminished heart muscle size• Potentially FATAL arrhythmias

• Bradycardia (slow heart beat)

92%- osteopenia

38% -osteoporosis

•Low bone density (osteopenia)• Porous bones (osteoporosis) • Frequent stress fractures• Muscle Atrophy

Reproductive & Nervous SystemAnore

xia

•Cessation of menstrual periods (amenorrhea)•Decreased sexual interest•Congenital defects in newborns•Miscarriage- 6 times more likely

•Overall brain atrophy (shrinkage)•Increased stress hormone•Seizures•Poor concentration•Impaired memory

Headaches reported in 28% of patients

Physical & Metabolic Symptoms

Fainting/dizzy spells

PneumoniaDry skinFatigueDifficulty sleepingLanugo-fine hair

over the bodyCarotinemia—

yellowish palms or soles of feetA

nore

xia

•Hypoglycemia•Electrolyte imbalance•Low red (anemia) & white (leukopenia) blood count•Slowed metabolic rate

How Bulimia Affects Body

Cardiovascular & Musculoskeletal

• Muscle weakness• Erosion of dental enamel (if purging)• Increased susceptibility to hemorrhaging• Cardiomyopathy due to Ipecac use • Hypertension due to diet pills

Bulim

ia

Diet pills can result in high

blood pressure

Reproductive & Gastrointestinal

Miscarriage 2x as likelyImpaired fertilityIrregular periods

•Tearing or bleeding of esophagus•Constipation•Colon damage•Heartburn•Hernia•Hemorrhoids•Abdominal pain

Bulimia

Physical & Metabolic

Scars on back of handsBloodshot eyesStress-induced rashes

Kidney damage or failureDehydrationDiabetes (from binges)Abnormal growth

hormone

Bulimia

• Anxiety• Depression• Body image disturbance• Lack of confidence• Obsessive compulsive symptoms• Poor self esteem• Restless• Social withdrawal

Psycological

• Avoidance of eating situations• Body checking• Excessive weighing• Excessive exercise• Exercise despite injury• Sleep disturbance• Substance abuse• Disappear after meal• Guilt about eating

Behavioural

Famous athlete with eating disorder

player player disorder gender

1. Nadia comaneci Gymnast Anorexia & bulimia

Female

2. Mia st. john Boxer Anorexia Female

3. Bahne rabe Rower Anorexia Male

4. Cathy rigby Gymnast Bulimia Female

5. eva-maria Skater Bulimia Female

6.Zina Tennis Bulimia Male

7. helga Gymnast Anorexia Female

8. whitney Cross-country runner

Anorexia & bulimia

Female

9. Van almsick Swimmer Anorexia Female

10. Martina eberi Golfer Bulimia Male

Famous athlete died with eating disorder

name player disorder gender

Dagny knutson Swimmer Bulimia Male

Amanda beared Swimmer Bulimia Female

Heidi guenther Gymanst Anorexia Female

Bahne rabe Rower Anorexia Male

Helga brathen Gymnast Anorexia Female

DANTE