roe_oh asked:


My mom found out about my bulimia but simply does not understand. She’s convinced that I am just depressed but I am not. I am not sad, I go out with my friends, I don’t want to die. I explained this to her but she still thinks I am.
My dad does not know about my eating disorder yet. I need my dad to support me and help me get treatment for this. But I don’t know how to do this since he is male and might not understand as well.

Roy

Samson Omotosho, PhD, APRN/PMHN asked:


Helping Those With Eating Disorders

Dr. Samson Omotosho, PhD, APRN/PMHN

Definition: An eating disorder is a maladaptive response due to inability to regulate eating habits and the tendency to overuse or under use food. It is more common in females. The problem may be characterized by an imbalance in the eating pattern, an excessive or inadequate caloric intake or an inappropriate body weight for the individual’s age and height. Types of Eating Disorders: Bulimia Nervosa, Anorexia Nervosa, Binge Eating Disorder, and Night Eating Syndrome.

 Bulimia Nervosa: This is an eating disorder characterized by uncontrollable binge eating, alternating with vomiting or dieting. Most (90%) of bulimia nervosa is found in females. It occurs in 2.5% of the population. The age of onset is 15-18 years. About 72% of patients recover. Early detection and treatment of the illness improves chances of recovery. It is mostly found in normal weight persons. The patient may, in addition, have anorexia nervosa.

 Anorexia Nervosa: This is an eating disorder in which the person experiences hunger but refuses to eat because of a distorted body image and false perception of fatness, leading to starvation. It occurs in about 1% of the population. The onset may be at any age, mostly 13-20 years. Mostly (90%) occurs in females. About 72% of patients recover and about 5% die. Alcohol use increases mortality from anorexia nervosa.

 Binge Eating Disorder (BED): This is an eating disorder in which the person rapidly consumes large quantities of food without any attempt to control weight gain. It is found in about 3% of the population. About 30% of obese persons have this disorder. Therefore, clinicians want to assess obese persons for BED.

Night Eating Syndrome (NES): This is a severe eating problem in which the person experiences anorexia in the morning, depression in the evening, insomnia at night and multiple awakenings to eat at night. About 1.5% of the population has NES. 8% of obese persons have NES.

Possible Factors: There has been a genetic link to eating disorders. Other factors include disorder in the appetite regulation center in the brain (hypothalamus); low serotonin and high dopamine levels in the brain; the individual’s psychological makeup such as being a perfectionist, impulsive, or rigidity; early separation problems; low self esteem; high sense of shame and guilt; compulsion and obsession; environmental factors; multiple childhood illnesses or surgeries; parental separation; deaths in the family; parental overemphasis on athletics and slimness; parental disapproval of overweight persons in the presence of the child; skipping meals; preoccupation with wanting to be a model, poor nutritional habits; societal value of thinness; school’s emphasis on weight and size; occupations such as dancing, acting, modeling, and fashion that emphasize body weight and size; mass media reinforcement of the thinness culture; 

What to look for: Look for any of the factors listed above. Do or suggest a full physical assessment. Check for the individuals’ satisfaction with their eating pattern; if they ever eat in secret; actual weight versus desired weight; food avoidances, including restrictions, dieting, and fasting; use of laxatives, diuretics, diet pills, and purging; compulsive exercise patterns; frequency, timing, and preferences about eating. Assessment for Binging: Check for consumption of hundreds or thousands of calories in one sitting; excessive intake and loss of control in eating; secretive consumption of food; eating accompanied with sense of shame; history of unsuccessful dieting in the past. Binging may range form occasional to more than ten times per day. Assessment for Anorexia Nervosa: Look for fasting and restriction of calorie intake to 200-700/day while patient yet perceives her intake as adequate; the design of limited unbalanced diet for self; insistence on particular choice of food repeatedly; insistence on a particular eating time, order, and pattern; bizarre food preferences; avoidance of fatty foods; prolonged fasting; obsession with food, cooking, and food-related jobs. Assessment for Bulimia: Look for forced vomiting, excessive exercise, and the use of diet pills, diuretics, laxatives, steroids, insulin, cocaine, heroine, thyroid hormones, nicotine, hallucinogens, antidepressants, benzodiazepines, and analgesics.

Complications: For Anorexia nervosa: starvation, scanty menstruation, osteoporosis, cold intolerance, fast heartbeat, low blood pressure, constipation, electrolyte imbalance, and leg edema (swelling). Bulimia Nervosa: low blood potassium, muscle weakness, irregular heartbeat, stomach and intestinal problems, dental enamel erosion, and parotid enlargement. Binging – obesity, hypertension, diabetes mellitus. For any form of eating disorder, there may also be accompanying depression, anxiety, substance abuse, and personality disorders.

Other Considerations: Persons with eating disorders are very susceptible to life stressors. Anorexia nervosa is thought to be as a result of the individual’s difficulty in controlling some aspects of the individual’s life or fears (aspects such as maturity, independence, failure, sexuality, and parental demand). Individuals with anorexia are usually angry about concern from others and frequently use denial as a defense mechanism. Bulimia patients use avoidance, isolation of affect and intellectualization mostly.

Help and Treatment: Success in helping actually depends on the patient’s motivation. So, assess the level of motivation of the individual for help and treatment. Ask her to rate her desire for help and treatment on a scale of 1 to 10. Formulate a helper-patient contract and help protocol and gain patient’s commitment. The protocol should specify patient and expectations and responsibilities about meals, weighing, timing of meals, amount of drinking water, vital signs, bathroom privileges, close observation, diet foods, and food substitutions. Graduate the patient’s independence over meal selection and scheduling. Stabilize patient’s nutritional status. Motivate anorexic and bulimic patient to stop trying to lose weight. Motivate her to gain weight. Contract with her to gain at least 1lb per week. Counsel her about healthy eating patterns. Help her to graduate her exercise and focus on fitness. Provide cognitive behavioral therapy (CBT). The CBT should train her in cue avoidance and response change; challenging faulty thoughts, feelings, and assumptions, and finding alternative problem-solving and decision-making responses in high-risk situations. Reinforce her compliance with the contract. Use dance, movement therapy, imagery, relaxation, working with mirrors and depicting the self through art to help her with body image distortion. With patient’s consent, involve chosen family members in planning and intervention. Help family to respect patient’s individuality. Motivate them to serve as support system to the patient. Use group therapy for reality testing, support, peer communication, social alliance, and expression of feelings. Medications are not usually very useful for eating disorders. Antipsychotics, antidepressant and mood stabilizers provide very little benefit.

Check out the following websites:

www.nationaleatingdisorders.org

www.nimh.nih.gov/health/publications/eating-disorders/

Dr. Samson Omotosho

CEO, Futurefocus Wealth Builders. www.futurefocusbiz.com

 

References:

Copstead, L. C., & Banasik, J. L. (2005). Pathophysiology (3rd ed.). St. Louis, MO: Elsevier Saunders.

Stuart, G. W. & Laraia, M. T. (2005). Principles and practice of psychiatric nursing (8th ed.). St. Louis, MO: Elsevier Mosby.

Varcarolis, E. (2006). Foundations of psychiatric mental health nursing: A clinical approach (5th ed.). Philadelphia: W.B. Saunders.

Williams, P. M., Goodie, J., & Motsinger, C. (2008). Treating eating disorders in primary care. American Family Physician 77(2), 187-195.

 

 



Nicholas

meggers asked:


I have serious health issues i know. Im actually pretty skinny, but i binge and purge uncontrollably. My life is surrounded by this disorder and i **** it and want it to stop. i say that every morning or everytime i am eating well and healthy then once i have a little splurge of something that i consider forbidden, i go nuts!! and this happens everyday, sometime 4 times a day. i eat sooo much, like 7 meals in one. it is discusting and i cant act normal where do i start!

Minnie

Jerry Cahill asked:


Adolescence can be a very stressful time when people begin gaining independence and discovering who they are. The teen years are when people establish new friendships and also when they find that their body has begun to develop. When a person enters puberty, it can be a very stressful, confusing and frightening period.

A lucky few can make the transition from childhood to adulthood with no major problems. However, many who may develop a teen eating disorder as a way to cope with these changing times.

A teen eating disorder may cause someone to worry that the weight that he or she is gaining will become permanent. This can cause panic and desperate efforts to prevent or shed any weight gain. Teens may be ignorant of the fact that these physical changes will ease with time and that their weight will stabilize without the need for dieting. The teen eating disorder may also be attributed to going through puberty which is a testing time, especially if the teenager also has to undergo sexual advances.

In addition, teens may be under great pressure to perform and excel. Pressure to conform to society’s ‘ideal’ body image may lead to eating disorders. Teens see touched up pictures of models and assume they must look the same way. In an effort to become thin, teens may develop anorexia, bulemia, or other eating disorders. Many teens think that being thin leads to happiness, which can be a strong factor in eating disorders.

Another important factor that may contribute to a teen eating disorder is the home environment. Teens who are subject to emotional, physical, or sexual abuse may develop eating disorders to have control over some aspect of their lives. Teen eating disorders may also help block out painful feelings.

Schools and families can play an active role in preventing teen eating disorders. By teaching teens and families about the warning signs and problems with eating disorders, we may be able to prevent or quickly treat cases of anorexia, bulemia, and other eating disorders. Educators can also be trained to build self-esteem and show teens that they don’t have to develop an eating disorder to be successful or beautiful. Through education, prevention, and good treatment, we can get a handle on teen eating disorders.

One Common disorder is Bulimia Eating Disorder. A bulimia eating disorder is a particular kind of eating disorder in which a person eats large amounts of food in a relatively short time of time, and then purges it back up later on. Purging can be done in several methods, including: producing oneself throw up; and taking laxatives, pills, or liquids that increase how fast food moves throughout your body and leads to a bowel movement.



Ashley

kew_816 asked:


I have taken several tests online and have also talked to a therapist and I have several features of an eating disorder. I was wondering where I would go to receive a full evaluation by a professional. Any ideas? Has anyone received one? What should I expect?

Jack

/\/\ontage asked:


She lost her Kaiser intensive outpatient food group clinic insurance so she lost the connections she established there. Recently she got a job related to modeling that seems to push her food disorder problem into a bad direction as it upsets her for various reasons, for example she is expected to look good for work and that means not eating, restricting, or binge/purge. What is helpful in this type of situation? Please, help me out here.

Pedro

Jyoti asked:


Eating disorder is getting prevalent in the cities of today. We may call it as psychiatric disorder. It is caused mostly by no regular exercise, no control over consumption of food and eating junk foods containing high calories and cholesterol. Because of these habits people also suffer some serious problems like blood pressure, diabetes other than eating disorder.



Most of the people assume that eating disorders occurs in peoples with excessive weight only but the fact is average weight people can also face these types of problem. Depression can also lead to eating diseases; in fact it is the main cause of binge eating disorder.

Symptoms of Eating Disorders:

Eating disorders are prevalent in many types –



Binge eating disorder

Compulsive overeating

Blumia

Anorexia nervosa

Diabulmia

Night eating syndrome

Orthorexia nervosa

Pica

Rumination

Starvation diet

Anorexia



The most common are:

Binge eating disorder: – Can’t stop to eat, eat without checking there profit and loss Because of this behavior people also suffer some serious problems like eating disorder.



Eats until physically uncomfortable

Periodically does not exercise to control over consumption of food

Often eats alone during periods of normal eating, owing to feelings of embarrassment about food

Eats an unusually large amount of food at one time — more than a normal person would eat in the same amount of time.

Eats much more quickly during binge episodes than during normal eating episodes

Eats large amounts of food even when they are not really hungry

Usually eats alone during binge eating episodes in order to avoid discovery of the disorder

Feels disgusted, depressed, or guilty after binge eating



Compulsive overeating – Overeating or addiction of over eating is called compulsive overeating. People suffering from their abnormal eating, feels uncomfortable in society. Compulsive Overeater is at risk for a heart attack, high blood-pressure and cholesterol, kidney disease and/or failure, arthritis and bone deterioration, and stroke.

Bulimia :- Bulimia nervosa, known as bulimia, is an eating disorder and psychological condition in which the subject engages in recurrent binge eating followed by feelings of guilt, depression, and self-condemnation and intentional purging to compensate for the excessive eating, usually to prevent weight gain. Purging can take the form of vomiting, fasting, inappropriate use of laxatives, enemas, diuretics or other medication, or excessive physical exercise.

Night eating syndrome: – Night eating syndrome is an eating disorder this is an ongoing, persistent behavior, unlike the occasional late snack or skipped meal that most people have from time to time. In fact, people with this disorder are often unaware of their nocturnal meals, although some feel they won’t be able to sleep without eating first.

Eating Disorder Prevention Tips



Make your whole life better through food and eating

Dieting is about losing some weight in a healthy way so how you feel on the outside will match how good you already feel inside.

Convinced your self-esteem is hinged on what you weigh and how you look.

Attempt to control your weight a bit better

Control your life and emotions through food/lack of food — and are a huge neon sign saying “look how out of control I really feel”

Everything gets going in life — stress, coping, pain, anger, acceptance, validation, confusion, fear — cleverly hidden behind phrases like “I’m just on a diet”





Suzanne

eliy asked:


Hi, I’m a 17 year old girl and i have recently started dieting. i have become obsessed with counting calories and paranoid with what i eat and gaining weight. this is putting so much unnecessary stress on me. i am becoming more depressed and feeling guilty about food. i am afraid of developing an eating disorder. I’m planning to see my doctor but wonder if any one has advice for me or can tell me if I’m headed towrds an eating disorder.

Claudia

Jillard asked:


I’m struggling with an eating disorder and I’ve been searching for a good website with advice and support, but so far I can’t find any. Or if anyone reading this can try to talk to me, I would really appreciate it. I talk to my family and friends, but it’s hard to be open with them.

Kimberly

Keith George asked:


Anorexia is an eating disorder where people starve themselves and treatment of anorexia is difficult, because people with this disease believe there is nothing wrong with them. Anorexia is one type of eating disorder and another is bulimia. Both are applicable to men but much more common for women. Preteens, girls especially, can develop a serious eating disorder. Eating disorders may begin in children as young as 8 years old.

People with eating disorders really do harmful things to their bodies because of their obsession about their weight. The most widely and rapidly spreading eating disorder is compulsive overeating or binge eating disorder. There are three types of eating disorders: anorexia nervosa, bulimia nervosa, and ED-NOS (Eating Disorders Not Otherwise Specified). Anorexia is a mental illness, it usually is about a control issue.

If you are on this web site then you probably already know what anorexia is. In one example anorexia is described as a way of gaining attention. It is for sure a condition that leads to problems with eating. The most common form of anorexia is simply satiation following the consumption of food. Central to persons in this condition is an abnormal fear of gaining weight.

If you are suffering from most of the symptons of anorexia, but not really severely or really that noticably, you need medical help anyway. There are also some very unusual symptons like pregnancy symptons. Angina symptons can also be common. Primarily though is the sudden interest in weight loss, food, calories etc. You can have The Eating Attitudes Test which gives an index of the symptons of anorexia nervosa.

There are many treatment centers for persons with eating disorder, but enough. So although eating disorders are rampant in our society, yet few states in the nation have adequate programs or services to combat anorexia nervosa and bulimia. As up to 10 million teens develop eating disorders, abnormal attitudes and behaviors with foods, which include anorexia nervosa or bulimia nervosa. Eating disorders that are literally killing youngsters and adults.

To get a proper treatment you should search for institutions with an Eating Disorders Intensive Counseling Treatment Program to treat these eating disorders. Some also offer Specialized Adolescent Eating Disorder Programs including help for their parents.

In spite of all the treatment availbable there remain a small number, usually girls, who die from this condition despite energetic and expert treatment.

The sooner the treatment is started, the better the chance of recovery. Remember you can make a difference by helping a friend confront her illness and seek treatment. Successful treatment of anorexia requires that the patients symptoms be egodystonic enough for the patient to be motivated to do something about them.

What is appropriate treatment when a person with an eating disorder is also a substance abuser. Some commentators have spoken out against psychiatric treatment of anorexia nervosa in general and, in particular, against compulsory treatment. Treatment of anorexia nervosa is often quite complicated the patient must want to change and must have family and friends to help them.

The motivation for anorexia is the mirror, how do I look. So the best you can say to a person with anorexia is “You don’t look healthy”.



Esther