The Underlying Causes of Eating Disorders

The Underlying Causes of Eating Disorders : 

The Underlying Causes of Eating Disorders A Study of the Traits Associated with Anorexia Nervosa, Bulimia Nervosa and Binge Eating Disorder lisa lahey, B.Ed.

The History of Bulimia Nervosa and Binge Eating Disorder : 

Read A Brief History of Eating Disorders Eating disorders originate as far back as ancient times. Both bulimia and anorexia nervosa were observed by doctors and philosophers in the first century. In Ancient Greece people attended feasts where they gorged themselves at banquets then retreated to purging rooms to vomit. This behaviour was not abnormal for its time. These early rituals may have been the beginnings of bulimia nervosa and binge eating disorder. The History of Bulimia Nervosa and Binge Eating Disorder

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Ancient Egyptians drew hieroglyphics depicting their use of monthly purges to avoid illness. Persian medical manuscripts and Chinese scrolls also describe illnesses that are very similar to modern eating disorders. Tribal lore from Africa details stories of adults who fasted during times of extreme and then continued to fast and were in danger of dying after the famine was over.

CARLA: A CASE STUDY OF BULIMIA NERVOSA : 

CARLA: A CASE STUDY OF BULIMIA NERVOSA Carla was a 15-year-old Caucasian female diagnosed with bulimia, depression and obsessive compulsive disorder. Carla was of average height and above average weight for age. Carla’s body dissatisfaction intensified with pressure from her school coach, peers, and family about her weight. Read CyberEd – Bulimia Case Study

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, Her girlfriends at school told her that she could lose weight by using laxatives and vomiting after food consumption. Carla and her friends planned purging activities and food binges together. Carla lost 14 pounds in four weeks. Unaware of her food addiction, her family and coach expressed great pride in her weight loss.

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Within a year Carla was bingeing and purging as much as five times daily averaging 3,000 calories at each binge. It became difficult for Carla to focus on her school work and she withdrew from social activities. Her boyfriend recognized these changes and insisted she talk to the school nurse. Carla refused. At the same time, Carla’s girlfriends became concerned about her condition. They pleaded with Carla to talk with the nurse. Carla finally agreed.

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INTERVENTION Carla was scheduled for further evaluation with a dentist, psychologist physician dietitian The school nurse noted physical findings including: enlargement of the parotid glands blood shot eyes callused knuckles on Carla's hands. recent fluctuations in Carla's weight

Bulimia Facts : 

Bulimia nervosa is defined as two or more episodes of binge eating every week for 3 months + and inappropriate ways of avoiding weight gain. A binge consists of rapid ingestion of large amounts of food during a specific period of time that is much more than the average person would consume. In addition, the individual has a sense of being unable to control the bingeing. Bulimia Facts Watch Youtube Video Bulimia Nervosa

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Watch Youtube Video Eating Disorders Documentary Part 1 – Sequence 1-MPEG-4 Lan Streaming 5% to 8% of all girls will develop bulimia. Bulimia also has two subtypes: purging type, where the individual uses self-induced vomiting, laxatives, diuretics, or enemas. The nonpurging type where the individual uses other types of inappropriate methods to rid the body of calories such as excessive exercise or fasting.

The Dangers of Bulimia Nervosa : 

The Dangers of Bulimia Nervosa Fluid and electrolyte imbalances.Abnormal heart rhythmsKidney dysfunction leading to kidney failure.Irritation to the pharynx, esophagus, and salivary glands.Erosion of teeth and dental caries.Use of laxatives causes injury to the intestinal tract.

What Are Electrolytes? : 

What Are Electrolytes? What Are Electrolytes?Electrolytes are the salts in your body. The most common salts are sodium, potassium, and chloride. Electrolytes acquire the capacity to conduct electricity. The balance of electrolytes in the human body is essential for the normal functioning of organs and cells. A decrease in sodium results in kidney disease and heart failure. A decrease in potassium results in profound effects to the nervous system. A decrease in chloride can result in death. Read Electrolytes

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Watch Youtube Video Eating Disorders Part 1

Bulimia: Princess Diana: Eating Disorder : 

Bulimia: Princess Diana: Eating Disorder Princess Diana came forward about her eating disorder in the 1990s. She admitted her bulimia began after people on television criticized her as “pudgy”. Her admission prompted thousands of women to report their own bulimia and seek treatment. Read Bulimia: The Princess Diana Eating Disorder

Art Therapy and Bulimia Nervosa : 

Art Therapy and Bulimia Nervosa Art therapy plays an important role in the treatment of BN. This chart reveals clinical samples of self-portraits by bulimics. Women with distorted body images to varying degrees portray themselves as either the subclinical BN or full-blown syndrome. The basic model is an anatomical artist’s rendering. Control groups of women without BN generally drew themselves as the basic model or the sample labelled controls.

The History of Anorexia Nervosa : 

The History of Anorexia Nervosa Anorexia Nervosa means “the nervous loss of appetite”. It is not a sufficient description but it was diagnosed centuries ago when little was known about it. The history of anorexia nervosa begins with descriptions and case studies as far back as the 14th and 15th centuries: 1556: Mary, Queen of Scots 1613: Jane Balan – the “French fasting girl of Confolens” 1347: St Catherine of Siena Watch Youtube Video Wasting Away

Mary Queen of Scots : 

Mary Queen of Scots In Medieval times self-starvation was termed ANOREXIA MIRABILIS (miraculously inspired loss of appetite).  Mary Queen of Scots was the first cousin of Queen Elizabeth I. Mary gained the throne of Scotland in 1542 at the age of 6 days, 3 months after her father’s death. Mary was convicted of treason against the Queen and was eventually put to death.

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Mary’s doctors documented an “unnamed illness” when she was a teenager that some historians now believe to have been anorexia nervosa. Her condition was described as involving weight loss, uneven appetite, vomiting and diarrhoea, pallor, fainting fits and breathing difficulties. Watch Youtube Video Eating Disorders Part 2

Divine Inspiration? Breatharians : 

Divine Inspiration? Breatharians A woman who calls herself Jasmuheen claims to be a Breatharian, subsisting on light energy rather than food or drink. She claims not to have eaten in years. Her book “Living in Light” has sold worldwide and thousands of people claim to have become Breatharians. Jasmuheen claims that her work “colleague” is a man named St Germain who lived centuries ago and that it is through him she acquired the ability to live off of light energy. They communicate via cosmic telephone. Read Helthnut’s Blog Breatharian’s Living (and dying) on Air and Prayer Watch Living on Air

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60 Minutes UK tested Jasmuheen by installing her in a hotel for a 7-day experiment without food or water. After 4 days Jasmuheen was extremely gaunt, barely coherent and dehydrated. A medical doctor insisted Jasmuheen was near death and 60 Minutes stopped the experiment. Although the failed experiment should have revealed to people that Jasmuheen is clearly a fraud her devoted followers continue to believe in her and thousands of people attend her motivational speeches.

Catherine of Siena : 

Catherine of Siena Catherine was considered a tertiary in the Roman Catholic Church. She was a layman, meaning she did not live within the religious community, but she wore the religious habit and was devoted to good works in the name of Christianity. She took a vow of chastity. Her older sister Bonaventura died in childbirth and her parents insisted that Catherine marry Bonaventura’s husband.

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In protest of her parent’s demand Catherine undertook a massive fast, something she had learned from Bonaventura. Bonaventura undertook a fast to force her husband to treat her with respect. This taught Catherine the power of fasting in close relationships. Watch Youtube Video Anorexia’s Childhood Roots (CBS News)

Recovery from Anorexia in Medieval Women : 

There is also evidence of “recovery” in medieval women. Medieval women displaying anorexic behaviours would enter a convent where in their late 20-30’s, would “recover” and become active in affairs, often being elected to convent’s head.  St. Clare of Assisi was known to have recovered from her illness and explicitly backed away from earlier excesses.  Princess Agnes in Prague founded a convent on the model of the Poor Ladies of Assisi in 1234. She fasted so excessively that St. Clare felt obliged to warn her against going to extremes. Recovery from Anorexia in Medieval Women

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The first formal description and diagnosis of anorexia as a medical condition occurred in England during the 1680's. Dr. Richard Morton of London described his twenty-year-old patient in 1686 as "a skeleton clad with skin". In his work, "A Treatise of Consumption" he suggested that sadness ate away at her. She reportedly died two years later. Read Richard Morton (physician) Early Descriptions of Anorexia

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ANOREXIA NERVOSA – CASE STUDY OF LISA: A 10-YEAR-OLD GIRL Lisa was a 10-year-old female with mixed Caucasian and Native-American ethnicity. Lisa began the school year as a somewhat overweight, cheerful child with dark hair and bright green eyes. Over time Lisa's mood and appearance changed dramatically. Lisa stayed in the classroom at recess and read, her social contacts with female peers lessened, and Lisa no longer ate lunch. She was observed giving most of her lunch away and nibbling at a small piece of fruit or vegetable. Read Case Study: Eating disorder in a 10-year-old girl

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The teacher estimated that Lisa lost between 20 and 30 lbs in 10 weeks. Her clothes didn’t fit, her hair appeared dry and straw-like. Since Lisa lost between 20 and 30 lbs, bulimia nervosa was ruled out as her diagnosis. Lisa's mother agreed to meet with Lisa’s teacher but noted she was pleased Lisa lost some weight since "she was getting a little fat." Watch Youtube Video Eating Disorders Part 3

Lisa: Case Study of a 10-Year Old Girl : 

Lisa: Case Study of a 10-Year Old Girl The mother's statement that she was pleased with Lisa's weight loss might have set up an adversarial relationship with the teacher. The teacher received help from the CNS to understand the mother's position before meeting with her. It was possible for instance that Lisa's mother had an eating disorder herself and didn’t recognize the seriousness of Lisa's problem.

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Other psychiatric issues such as body dysmorphic disorder needed to be ruled out. The CNS met with Lisa to assess the situation and planned a strategy for treatment. In BDD body image distortions include feeling fat, but usually without weight loss.

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Jennifer is 20 years old and very attractive. From an early age she prided herself on her figure. She watched her diet and exercised daily. She has always been thin, but has never been satisfied with her weight or appearance. She is 5’ 6” and weighs 85 lbs. Jennifer is unaware of the fact that she is undernourished and sees no problem with her appearance or weight. JENNIFER Watch Youtube Video Anorexia’s Living Face (CBS News)

LEARNED BEHAVIOURS : 

LEARNED BEHAVIOURS Learned behaviour has a great deal to do with Jennifer’s anorexia. Many young women develop anorexia as a result of our society’s obsession with thinness. Many women are anorexic based on the eating patterns they develop trying to accomplish unrealistic weight goals. Fashion models, long distance runners, women athletes and dancers commonly have anorexia-like traits. Watch Youtube Video Victoria Beckham - Parkinson - BBC

PHYSICAL DANGERS OF ANOREXIA : 

Heart - pumps less efficiently, muscles become weak and thin. In extreme cases heart failure occurs leading to death. Thyroid - hormones become abnormal Diarrhea - occurs as the lining of the digestive tract slows. Reduced levels of Protein. An increase in fine body hair, skin dryness and deceased skin temperatures Brain activity becomes abnormal. Loss of sleep and feeling of fatigue. PHYSICAL DANGERS OF ANOREXIA Watch Youtube Video Eating Disorders Part 4

Anorexia Facts : 

Anorexia Facts The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders provides four main criteria for the diagnosis of anorexia nervosa: The individual is unwilling to gain weight at a weight considered the normal minimum Weight has fallen to 15% below the normal range for the individual The individual has an extreme fear of being fat Disturbances in body image related to either weight or shape of body are present Watch Youtube Video Anorexia Quotes

Anorexia Demographics : 

1% to 6% of all teenage and college-age women develop anorexia. People with anorexia nervosa are introverted, constricted, obsessional, compulsive, and reticent. Female adolescents with anorexia are likely to be self-regulating, more socially conscientious and conforming, more interpersonally inhibited, and less emotionally demonstrative than non-anorectic females. Anorexia Demographics

A Disturbing Profile : 

A Disturbing Profile The anorectic person uses self-starvation as a form of self-punishment, with the goal of pleasing the internalized parent who has harsh restrictions. Most anorectics are well-behaved, perfectionists, straight A students, and obsessive worriers. Some are responding to their developing bodies and issues of sexuality. Fast and self-starvation allow the anorectic to gain a sense of control over herself and others. Watch Youtube Video Anorexia Bulimia - Commercial

Brittany Murphy: An Anorexia Casualty : 

Brittany Murphy: An Anorexia Casualty At 32 actress Brittany Murphy was found dead in her home due to complications from anorexia nervosa. The official cause of her death was cardiac arrest. Iron-deficiency anemia and multiple drug intoxication were factors in her death. Coroner reports did not confirm her eating disorder but it was rumoured that she took appetite suppressants. Her physical transformation was startling. Murphy originally was a robust healthy young woman who regressed to an emaciated version of her earlier self.

Causes of Eating Disorders – Binge Eating Disorder : 

Causes of Eating Disorders – Binge Eating Disorder Binge Eating Disorder (BED) was first described in 1959 by psychiatrist Albert Stunkard as "Night Eating Syndrome" (NES). Later the term "Binge Eating Disorder" was coined to describe the same binging-type eating without the nocturnal component. BED often leads to obesity but it can occur in normal weight individuals. Watch Youtube Video Binge Eating Disorder

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There may be a genetic inheritance factor involved in BED independent of other obesity risks. There is also a higher incidence of psychiatric comorbidity with another mental condition, such as Borderline Personality Disorder. The percentage of individuals with BED and a comorbid psychiatric disorder is 78.9%. Watch Youtube Video Binge Eating Disorder Binge Eating Disorder is much more common than anorexia nervosa or bulimia nervosa. It is the most common eating disorder.

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Binge eating disorder is more common among competitive athletes such as swimmers or gymnasts whose bodies are regularly on public display. Affected athletes in these sports tend to compare their own bodies in a negative way with those of their teammates. View Youtube Video Health & Nutrition: What is Binge Eating Disorder?

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Victoria Beckham: Binge Eating Spice Girl Victoria Beckham was criticized about her weight most of her life, long before she became a Spice Girl. Here a satirical cartoon compares her to Jack Skellington, a cartoon character in the Tim Burton film The Nightmare Before Christmas.

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“Inappropriate advertising contributes to many kids' ills, from obesity to anorexia, to drinking booze and having sex too soon, and Congress should crack down on it.” The American Academy of Pediatrics Read Children and Eating Disorders “There's been a lot of debate about the role of faulty parenting and dysfunctional family environments in relation to eating disorders.” Lifestyle - Yahoo “The average age of anorexia sufferers is dropping rapidly (as young as elementary school), with peak onset among girls ages 11-13.” A-Better-Child.org Read Pediatricians say ads contribute to eating disorders, alcoholism Watch Youtube Video Binge Eating Disorder Part 2

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EATING DISORDERS NOT SPECIFIED Eating disorders not otherwise specified (EDNOS) can refer to a number of disorders: A female individual who suffers from anorexia but still has her period Someone who may still be an "average healthy weight" but who has anorexic thought patterns and behaviours The sufferer equally participates in some anorexic as well as bulimic behaviours (sometimes referred to as purge-type anorexia) Read Eating Disorders Not Otherwise Specified Explained

Causes of Eating Disorders: Sexual Abuse : 

Causes of Eating Disorders: Sexual Abuse A reaction to sexual abuse during childhood and adolescence for many young women is an eating disorder. The disorder gives the victim a sense of control over her own body, a power she lacked during the abuse. A link has been established between sex abuse and bulimia but not anorexia. Read Coping with Life: Childhood sexual abuse shows link to bulimia

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Girls who were sexually abused before the age of 16 are at high risk for developing an eating disorder. Even their own children are considered to be at risk for developing either anorexia or bulimia by association. Obesity may also be caused by sex abuse. Some women develop bulimia and gain extreme weight in order to render themselves unattractive to men and avoid male attention. Read BBC NEWS/Health: Abuse Triggers Eating Disorders

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Women, Sexual Abuse and Eating Disorders Read Far-Reaching Effects of Sexual Abuse Females who have been sexually abused report frequent body dissatisfaction, self-consciousness, and less satisfaction with themselves in their relationships. They also are less comfortable having sex with the lights on and are uncomfortable undressing in front of their sexual partner. They are less likely to use contraception regularly than those without a history of sexual abuse.

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Online Support Group for Bulimic Victims of Childhood Sexual Abuse Read Is there a connection between eating disorders and sexual abuse? Sexual Abuse Stats Over 80% of all child abuse cases are perpetrated by a parent or stepparent. Over 80% of abuse cases involve a parent or step-parent. Over 80% of abuse cases involve a parent or step-parent. Over 80% of abuse cases involve a parent or step-parent. Over 80% of abuse cases involve a parent or step-parent. Over 80% of abuse cases involve a parent or step-parent. Almost 50% of abused children are between the ages of 5 - 11 ¼ of all girls are sexually assaulted before the age of 18. 50 – 80% of all abuse goes unreported.

Children and Eating Disorders : 

Children and Eating Disorders Signs and Symptoms: Depression Intense fear of becoming fat Cessation of menstruation Extreme concern with body shape Sore throat from vomiting Refusal to maintain a healthy body weight

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Epigenetic mechanisms are a means by which environmental effects alter gene expression. They are heritable, but also may occur throughout the lifespan. Dysregulation of dopamine neurotransmission due to epigenetic mechanisms has been implicated in eating disorders. These changes may last for a person’s lifetime or even span generations. Read Eating Disorders - PediaView Causes of Eating Disorders - Epigenetics

Causes of Eating Disorders - Genetics : 

Causes of Eating Disorders - Genetics Mendelian Inheritance relates the transmission of hereditary characteristics from parents to their offspring. A Mendelian disorder  is a genetic disease showing a Mendelian pattern caused by a single mutation in the structure of DNA, which causes a single defect with pathologic consequences, in this case the development of eating disorders.

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Causes of Eating Disorders - Biochemical Eating behaviour is a complex process controlled by the neuroendocrine system irregularities in the manufacture, amount or transmission of certain neurotransmitters, hormones or neuropeptides and amino acids. Serotonin in particular has an inhibitory effect on eating behaviour. Dopamine is a neurotransmitter which regulates the rewarding property of food.

Causes of Eating Disorders – Immune System : 

The immune system of the majority of patients with anorexia and bulimia nervosa has elevated levels of autoantibodies that affect hormones and neuropeptides which regulate appetite control. There may be a direct correlation between autoantibody levels and associated psychological traits. Causes of Eating Disorders – Immune System

Causes of Eating Disorders - PANDAS : 

Causes of Eating Disorders - PANDAS PANDAS is an acronym for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections. Children with PANDAS "have obsessive-compulsive disorder (OCD) and/or tic disorders such as Tourette syndrome. There is a possibility that PANDAS may be a factor in the development of anorexia nervosa in some cases.

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Causes of Eating Disorders - Lesions Lesions are any abnormal tissue found on or in an organism, usually damaged by disease or trauma. Studies have shown that lesions to the right frontal lobe or temporal lobe of the brain can cause the pathological symptoms of an eating disorder.

Causes of Eating Disorders – Brain Tumours : 

Causes of Eating Disorders – Brain Tumours Tumors in various regions of the brain have been implicated in the development of abnormal eating patterns. These findings challenge the traditional view that eating disorders are linked to hypothalamic disturbance. The findings also suggest a major role of frontotemporal circuits with right hemispheric predominance in the pathogenesis of eating disorders.

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Maternal smoking, obstetric and perinatal complications such as maternal anemia, very pre-term birth (32<wks.), being born small for gestational age, and neonatal cardiac problems at birth increase the risk factor for developing either anorexia nervosa or bulimia nervosa. Causes of Eating Disorders – Obstetric Complications

Co-morbidity: Anxiety and Eating Disorders : 

Co-morbidity: Anxiety and Eating Disorders Psychiatric disorders such as anxiety disorders, affective disorders, and personality disorders often coexist with anorexia nervosa and bulimia nervosa.  Anxiety is defined as �”a mood state characterized by negative affect and symptoms of tension in which a person anticipates future danger or misfortune. ” Generalized anxiety disorder is characterized by intense, uncontrollable, chronic worry with physical symptoms of tenseness, irritability, and restlessness.

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Gema, a 37-year old housewife began restricting food from an early age.  She was diagnosed with panic disorder with agoraphobia, her bulimia  ceased, and she began restricting her food intake.  She dieted because she believed that her weight caused herself and her husband marital discord. She developed a fear of choking and became so panicked she could not leave her  home.  She believed eating caused her panic so she restricted her food intake more.  Avoiding eating created an illusion of control for Gema. PANIC DISORDER AND ANOREXIA: A CASE STUDY Watch Youtube Video Saving Julia Part 1 of 2

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For practitioners, the importance of Gema’s case was if a person had a panic disorder with difficulty swallowing or a fear of choking, that person should be evaluated for an eating disorder.  The patient might need to be treated  simultaneously for an eating disorder and an anxiety disorder. Eating-disordered patients who  attempt to alleviate panic with food often worsen both the panic and eating  disorder symptomatology.

Eating Disorders and Depression : 

Eating Disorders and Depression Read Anorexia Nervosa and Major Depression: Shared Genetic and Environmental Risk Associations between anorexia nervosa and affective disorders have often been suggested. The first-degree relatives of anorexia nervosa patients with current nonbipolar major depression have a higher rate of depression than the relatives of anorexic patients without current depression. Decreases in eating disorder symptomatology following antidepressant treatment may be related to changes in depressive symptoms. Watch Youtube Video Saving Julia Part 2 of 2

Treatment for Anorexia and Bulimia Nervosa : 

Treatment for Anorexia and Bulimia Nervosa Several approaches are used in treating anorexia and bulimia nervosa, therapy in particular. Treatments include: Anti-depressants Recreational Therapy Assertiveness Training Sexuality Group Cognitive Behaviour Therapy Nutritional Counseling Obesity medication Anti-psychotic medication Inpatient Care After Treatment

Medical Drugs for Bulimia Nervosa : 

Medical Drugs for Bulimia Nervosa Fluoxetine (Prozac) has been found to be effective with moderate to severe bulimia nervosa. Prozac significantly reduces the number of binge eating and vomiting episodes weekly. A decrease by 50% has been observed in clinical trials with patients with purge-type BN. Read Fluoxetine Full Prescribing Information Watch Youtube Video Prozac – A Beginner’s Guide

Naltrexone and Anorexia Nervosa : 

The drug naltrexone hydrochloride, used to treat narcotic addiction and alcoholism has shown promise in treating anorexia nervosa. The positive effects in treating anorexia may be due to a change in baseline levels of some hypothalamic, pituitary, adrenal, or gonadal hormones. Naltrexone and Anorexia Nervosa

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There is no cure for anorexia, bulimia or binge eating. Cognitive behaviour and other forms of therapy seem to be the most reliable form of control for these eating disorders. But sufferers tend to struggle all of their lives against the affliction. They also must take vigilant care of their bodies due to complications from the long-term effects of bulimia and anorexia nervosa.