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Eating Disorder(EDO)
Classification and external resources
ICD-10	F50.
ICD-9	307.5
MeSH	D001068

An eating disorder is a condition which affects an individuals eating habits, either as a result of their own doing (self-inflicted), or as a bodily reaction to the consumption of food. Eating disorders can range from mild mental anguish to life-threatening conditions, and can affect every aspect of an individuals daily life. According to the authors of Surviving an Eating Disorder, "feelings about work, school, relationships, day-to-day activities and one's experience of emotional well being are determined by what has or has not been eaten or by a number on a scale."^[1] Anorexia nervosa and bulimia nervosa are the most common eating disorders generally recognized by medical classification schemes,^[2] with a significant diagnostic overlap between the two.^[3] Together, they affect an estimated 5-7% of females in the United States during their lifetimes^[4] and "approximately 10% of eating disordered individuals coming to the attention of mental health professionals are male".^[5] There are several other eating disorders which are prevalent amongst certain demographics that are being investigated and defined - Rumination syndrome, Compulsive overeating, and Selective eating disorder.

Contents 1 Causes 1.1 Environmental 1.2 Biological 1.3 Developmental etiology 1.4 Trauma 2 Gender differences 3 Diagnosis 4 Symptoms 4.1 Anorexia nervosa / Bulimia nervosa 4.2 Compulsive overeating / Binge eating disorder 5 See also 6 Notes 7 References 8 External links

[edit] Causes

[edit] Environmental

Family and friends are very influential when it comes to eating disorders. The media may be a significant influence on eating disorders through its impact on values, norms, and image standards accepted by modern society.^[6] The media sends a message that "thin is beautiful" in their choice of fashion models, which many young girls want to emulate.^[7] Both society’s exposure to media and eating disorders have grown immensely over the past decade. Researchers and clinicians are concerned about the relationship between these two phenomena and finding ways to reduce the negative influence thin-ideal media has on women’s body perception and susceptibility to eating disorders. The dieting industry makes billions of dollars each year by consumers continually buying products in an effort to be the ideal weight. Hollywood displays an unrealistic standard of beauty that makes the public feel incredibly inadequate and dissatisfied and forces people to strive for an unattainable appearance. People, such as teachers or counselors, who work closely with young women and men and who come into contact with them regularly are in a position to detect warning signs and possible eating disordered symptoms. Teachers have a particularly important role in detecting eating disorders and changes in behavior in students, as they see them everyday and are able to monitor changes frequently. A resource for teachers to reference in maintaining the health of students, as far as eating disorderes are concerned, can be found at: http://www.something-fishy.org/isf/signssymptoms.php Teachers should also be aware of unhealthy messages sent by classmates about appearance preferences and ideal images of beauty, and these messages should be addressed and corrected. ^[8] This takes an enormous toll on one's self-esteem and can easily lead to dieting behaviors, disordered eating, body shame, and ultimately an eating disorder.^[7] The surrounding culture in which an adolescent is raised greatly affects how they feel they are supposed to look, potentially contributing to an eating disorder. It has been discovered that a chemical imbalance in the brain may be linked to why some people have anorexia and others don’t. The most dangerous part of certain eating disorders is that people who have them “see themselves as overweight even though they are dangerously thin” (National Institute of Health). This fact alone suggests that the person cannot help but see themselves as overweight. Their brain is possibly distorting their image while everyone else is seeing how they really look. Bulimics very often binge and then purge because they feel guilty for eating so much food, even if they are a “weight around their normal weight range” (National Institute of Health). ^[7]

[edit] Biological

Patients with severe obsessive compulsive disorder, depression or bulimia were all found to have abnormally low serotonin levels.^[9] Neurotransmitters such as serotonin, dopamine and norepinephrine are secreted by the intestines and central nervous system during digestion.^[10]

Researchers have also found low cholecystokinin levels in bulimics. Cholecystokinin is a hormone that causes one to feel full and decreases eating. Low levels of this hormone are likely to cause a lack of satiative feedback when eating, which can lead to overeating. Another explanation researchers found for overeating is abnormalities in the neuromodulator peptides, neuropeptide Y and peptide YY. Both of these peptides increase eating and work with another peptide called leptin. Leptin is released by fat cells and is known to decrease eating. Research found the majority of people who overate produced normal amounts of leptin but they might have complications with the blood-brain barrier preventing an optimal amount to reach the brain.^[10]

Cortisol is a hormone released by the adrenal cortex which promotes blood sugar and increases metabolism.^[10] High levels of cortisol were found in people with eating disorders. This imbalance may be caused by a problem in or around the hypothalamus.^[11] A study in London at Maudsley Hospital found that anorexics were found to have a large variation of serotonin receptors and a high level of serotonin.^[12]

Many of these chemicals and hormones are associated with the hypothalamus in the brain.^[13] Damage to the hypothalamus can result in abnormalities in temperature regulation, eating, drinking, sexual behavior, fighting, and activity level. Uher & Treasure (2005) performed a study researching brain lesions effects on eating disorders. They evaluated 54 formally published cases of eating disorders and brain damage. They found many correlations between eating disorders and damage to the hypothalamus. People with brain lesions in the hypothalamus had abnormal eating behaviors; unprovoked and self induced vomiting, over concern with becoming fat, cheating with eating, frequent sleepiness, depression, obsessive compulsive behavior and diabetes insipidus.^[14]

While scientists have determined that there are possible biochemical or biological causes leading to eating disorders because certain chemicals which control hunger, appetite or digestions are out of balance, experts such as Dr. Edward J. Cumella, executive director of the Remuda Treatment Programs, states that there are three components to eating disorders: 1. The genetic component; 2. The unique environmental factors, such as personal experiences; and 3) The shared environmental factors, such as culture. According to Dr. Cumella, "Some people are born with a predisposition to having an eating disorder and there are genetic markers that can push a person in the direction of anorexia or bulimia...but it does not guarantee that a person will automatically suffer from an eating disorder. The environment - a person's life experience - still has to pull the trigger."^[15]

[edit] Developmental etiology

Research from a family systems perspective indicates that eating disorders stem from both the adolescent's difficulty in separating from over-controlling parents, and disturbed patterns of communication. When parents are critical and unaffectionate, their children are more prone to becoming self-destructive and self-critical, and have difficulty developing the skills to engage in self-care giving behaviors. Such developmental failures in early relationships with others, particularly maternal empathy, impairs the development of an internal sense of self and leads to an over-dependence on the environment. When coping strategies have not been developed in the family system, food and drugs serve as a substitute.^[16]

[edit] Trauma

Eating disorders should also be understood in the context of experienced trauma, with many eating problems beginning as survival strategies rather than vanity or obsession with appearance. According to sociologist Becky Thompson, eating disorders stemming from women of varying socio-economic status, sexual orientation and race, and finds that eating disorders and a disconnected relationship with one's body is commonly a response to environmental stresses, including sexual, physical, and emotional abuse, racism, and poverty. This reality is further detrimental for women of color and other minority women, since they are forced to live in a culture that embraces a narrowly defined conception of beauty: "people furthest from the dominant ideal of beauty, specifically women of color, may suffer the psychological effects of low self-esteem, poor body image, and eating disorders."^[17]

[edit] Gender differences

"Frequent dieting and trying to look like persons in the media were independent predictors of binge eating in females of all ages. In males, negative comments about weight by fathers was predictive of starting to binge at least weekly."^[18]

Exercise addiction is common in men and women, especially in those who suffer from eating disorders and obsessive-compulsive disorder. It is the result of a fear of becoming fat, and allowing their need to stay fit to overtake their lives. Exercise addicts are risking their health in order to get a "runner's high". ^[19] They are in search of the ideal body type and place the importance of exercise above the needs of their children, parents, friends and health.

In male and female sports there are different reasons to lose weight.^{[citation needed]} For a female many of the eating disorders are for more dancing related sports such as poms, cheerleading, and many other forms of competitive forms of dance.^{[citation needed]} While in many male predominant sports it is also necessary such as wrestling, mixed martial arts, and sports where weigh-ins are necessary.^{[citation needed]} This puts a lot of stress on the male to make the cut leading to many of the eating disorders such as bulimia and anorexia nervosa.^{[original research?]}

Education sources that we depend on don't always give us the accurate information on eating disorders. Eating disorders affect women and men but we don't recognize that fact.^{[original research?]} Men may suffer from different forms of eating disorders than women.^{[citation needed]} They may not starve themselves^{[original research?]} but sometimes they use drugs to bulk up. They have the pressure of being "strong, bulk, hot".^{[dubious – discuss][original research?]}"A survey published in Psychology Today reported that only 15% of men said that they are unhappy with their weight. Increasingly, men feel the same pressure that women feel to be attractive and slender. If these trends continue, the incidence rate for eating disorders among men will increase" (Pipher 16).

Pipher, Mary. Hunger pains: The moderns woman's tragic quest for thinness. New York: Ballantine Books, 1995.

[edit] Diagnosis

This section requires expansion.

Clinically, eating disorders are evaluated using instruments such as the Questionnaire of Eating and Weight Patterns (QEWP), which has specialized versions for adolescents and parents (QEWP-A, and QEWP-P). In addition to evaluating eating patterns, these tests also diagnose depression.^[20]

[edit] Symptoms

[edit] Anorexia nervosa / Bulimia nervosa

The most visible symptom is the extreme weight loss in a short period of time. Oral symptoms include generalized mucosal redness oral ulcerations and loss of tooth material especially due to erosion caused by acidic vomiting. This erosion is especially seen on the palatal surface of the maxillary anterior teeth, and occlusal surface of mandibular molars the mandibular incisors are spared of erosive lesions as they are covered by the tongue during bouts of vomiting. The patient may also present with traumatic lesion on the uvula due to damage caused by the fingers while inducing vomiting similar lesion can be found on the corresponding finger.

[edit] Compulsive overeating / Binge eating disorder

Noticeable symptoms include rapid weight gain or the onset of obesity, significantly decreased mobility due to increased body weight, as well as excessive perspiration and/or shortness of breath. Other symptoms include isolation, self-loathing, and poor sleeping patterns or insomnia.

[edit] See also

• Organic feeding disorders

[edit] Notes

[edit] References

[edit] External links

• BALANCE eating disorder center
• F.E.A.S.T -- Families Empowered and Supporting Treatment of Eating Disorders
• National Association of Anorexia Nervosa and Associated Disorders
• National Eating Disorders Association

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