A mix of genetics, environment and social factors play a role in the development of eating disorders. Some people with eating disorders may use extreme measures to limit food intake or food groups when they feel like other aspects of their lives are hard to manage. An obsession with food becomes an unhealthy way of coping with painful emotions or feelings. Thus, eating disorders are more about finding healthy way to manage your emotions than about food.
Specific symptoms of eating disorders vary by type. It may be difficult to spot an eating disorder as it often mimics dieting. Or, a person struggling with an eating disorder may be reluctant to share their eating concerns. If you or a loved one has an eating disorder, you may notice these general changes:
Healthcare providers, such as physicians and mental health professionals, diagnose eating disorders. Your primary care provider may review symptoms, perform a physical examination and order blood tests. A mental health counselor, such as a psychologist or psychiatrist, conducts a psychological evaluation to learn more about your eating behaviors and beliefs.
If eating disorders run in your family, being aware of the warning signs is a good first step to catching the problem early. Prompt treatment can break unhealthy eating patterns before they become harder to overcome. You can also reduce the risks of an eating disorder by getting treatment for problems like depression, anxiety and OCD.
Eating disorders disrupt eating behavior with excessive concern about body weight that impairs physical health or psychosocial functioning. To avoid the high morbidity and mortality associated with this condition, it must be promptly diagnosed and treated. This activity reviews the evaluation and treatment of eating disorders and highlights the interprofessional team's role in evaluating and treating patients with this condition.
Objectives:Describe the etiology and risk factors for eating disorders.Review eight categories in feeding and eating disorders mentioned in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).Summarize the complications of eating disorders.Outline some interprofessional strategies that can improve care delivery and better manage patients who present with eating disorders.Access free multiple choice questions on this topic.
One in eight youngsters may have at least one eating disorder by twenty years of age. Approximately 5 million Americans are affected by eating disorders every year. Although eating disorders can affect people of all ages and both genders, they are often reported in adolescents and young women. The anorexia nervosa and bulimia nervosa are approximately 0.3% and 1% among adolescent females respectively. The prevalence of eating disorders is generally higher in young women except for binge eating disorder, which is more common in men and older individuals.
The terminology EDNOS (Eating disorder - not otherwise specified) in DSM-IV is changed to the Other Specified Feeding and Eating Disorder (OSFED) in DSM 5. It includes purging disorder, night eating syndrome, atypical anorexia nervosa, and subclinical bulimia nervosa / binge eating disorder. These eating disorders share the same concern about eating, body shape, and weight and have disordered eating behavior. Avoidant restrictive food intake disorder, pica disorder, and rumination disorder are not included in this subsection because weight and shape concerns are not a feature in these disorders. Many people with an atypical eating disorder will later develop a typical eating disorder.
There is a wide variation in how eating disorders are managed. Treatments are frequently multi-faceted, with psychotherapy and pharmacotherapy. It is crucial to seek treatment early for eating disorders. The management approach is tailored to patient's needs and may comprise one or more of the following:
For all eating disorders, psycho-behavioral therapy can be provided on an outpatient basis. People with severe symptoms or not improving with outpatient care may be treated as inpatient service.
Many medical conditions can mimic eating disorders. Chronic infectious disease, malabsorptive disorders, malignant conditions, immune deficiency, endocrine disorders like diabetes mellitus, hyperthyroidism, or Addison's disease should be ruled out before labeling it as an eating disorder. Intense fear of gaining weight and distorted body will be the hallmark findings in eating disorders, which help rule out the other medical conditions mentioned above.
Obsessive-compulsive disorder, affective disorders, major depression, anxiety disorders, and drug abuse are often present as comorbid psychiatric conditions along with eating disorders. A high index of suspicion is necessary to detect comorbid psychiatric conditions.
Personality disorders also are shared with eating disorders. Dramatic or erratic personality is associated with Bulimia nervosa, and avoidant or anxious personality disorder is associated with anorexia nervosa.
The prognosis for persons with eating disorders is variable. The long-term prognosis is better with Bulimia nervosa when compared to anorexia nervosa. The binge eating and purging behaviors, duration of more than six years, lower body mass index, low motivation, unstable personality, concurrent depression, higher body image concerns, and dysfunctional relationships are consistently associated with poor treatment outcomes in all eating disorders.
A major challenge in treatment outcomes among individuals with eating disorders is a delay in seeking health care due to low levels of health literacy, stigma, poor affordability, and poor psychotherapy access. Recovery from bulimia nervosa occurs earlier than anorexia nervosa. The majority of individuals with bulimia nervosa recover within 9 to 10 years, but only 50% of individuals with Anorexia nervosa recover within 9-10 years. The mortality rate in Anorexia nervosa is higher than other types of eating disorders and is the highest mortality rate of any psychiatric disorders.
The prevention of eating disorders is a vital public health issue. Universal prevention programs targeting national, community, or school level aim to promote general well being and decrease the risk of eating disorders. Educational programs targeting eating disorders, body image perception, and obesity can be implemented in the school curriculum.
When a person is diagnosed with an eating disorder, it is crucial to educate patients and families about the course, prognosis, and management of eating disorders. Family members like parents should always be included in the management process to facilitate meal planning or limit setting, particularly useful while managing young children and adolescents.
The coordinated interprofessional team effort involving a clinician, a nutritionist, a psychotherapist, a psychiatrist, nurses, exercise therapist, occupational therapist, pharmacist, and social worker enhances patient care in eating disorders. Early treatment and aggressive multidisciplinary interventions increase the chances of success and lower the likelihood of relapse. Eating disorders cause a substantial economic burden on healthcare resources. Efficient use of available healthcare resources potentially reduces costs to the healthcare system and society. Primary care physicians are vital in recognizing and offering early intervention in eating disorders. Family involvement plays an important role, particularly in the younger patient.
A person with an eating disorder may experience long-term impairment to social and functional roles, and the impact may include psychiatric and behavioural problems, medical complications, social isolation, disability and an increased risk of death as a result of medical complications or suicide. Suicide is a major cause of mortality for people with eating disorders. Suicide is up to 31 times more likely to occur for someone with anorexia nervosa and 7.5 times higher for someone with bulimia nervosa than the general population.2
The mortality rate for people with eating disorders is up to six times higher than that for people without eating disorders. The increased risk of premature death exists for all types of eating disorders, however people living with anorexia nervosa have the highest mortality rate of all psychiatric conditions due to both psychological and physiological complications.3
Eating disorders are classified into different types, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), Fifth Edition. Classifications are made based on the presenting symptoms and how often these occur, and include:
Eating disorders can occur in people of all ages and genders, across all socioeconomic groups, and from any cultural background. Approximately one million Australians are living with an eating disorder in any given year; that is, 4% of the population. (1)Many more people experience disordered eating (i. e.
Eating disorders are medical conditions; they are not a lifestyle choice. They affect your body's ability to get proper nutrition. This can lead to health issues, such as heart and kidney problems, or sometimes even death. But there are treatments that can help.
The exact cause of eating disorders is unknown. Researchers believe that eating disorders are caused by a complex interaction of factors. These include genetic, biological, behavioral, psychological, and social factors.
Anyone can develop an eating disorder, but they are more common in women. Eating disorders frequently appear during the teen years or young adulthood. But people can also develop them during childhood or later in life.
Treatment plans for eating disorders are tailored to individual needs. You will likely have a team of providers helping you, including doctors, nutritionists, nurses, and therapists. The treatments may include:
If you believe that you or someone you know has an eating disorder, it is important to seek professional assessment and support. The Syracuse University Eating Disorder Treatment Team can be accessed by calling the Barnes Center at The Arch at 315.443.8000. 041b061a72