Lifestyle Choices

1. Anorexia nervosa

This is an eating disorder in which a person severely restricts food intake and weighs at least 15 per cent less than her ideal weight. It usually is considered a female disorder, but anorexia nervosa occurs in men and is increasing in young boys. A person with this disorder fears being fat, and may be convinced that she is overweight despite what the scale shows or what other people say. To achieve skinniness, in addition to food restriction, she may use laxatives and exercise excessively. An anorexia sufferer is often very controlling and obsessive in other areas of her life, too. The problem usually begins in adolescence. In advanced stages of the illness, the dieting is hard to reverse. At that point, hunger may disappear completely and the pursuit of thinness becomes a way of life. Starvation causes medical complications of its own, such as thyroid problems, anaemia and joint pains. Death can occur in the most severe cases.

The causes are not clear. It is likely to be a combination of genetic and environmental factors. Some of the proposed causes include depression or anxiety or obsessive compulsive disorder, difficult family relationships, fears of adulthood and environmental pressures, such as images from glossy magazines, TV, etc.

Take charge, take care, take action

1. A mental health professional, such as a psychiatrist, psychologist or social worker, must be seen as soon as you are concerned about yourself or a loved one. The earlier it is detected the better the prognosis.
2. The health care professional will conduct a full history and assessment and will check the physical signs of starvation. Other tests may be done, including blood tests and kidney, liver and thyroid function.
3. Some people have a single, relatively brief episode whereas for others, the problem becomes chronic and the person’s condition gradually deteriorates. Anorexia is best treated with a combination of psychotherapy and medication Some people with anorexia nervosa may have to be hospitalised, either for treatment of medical complications or for treatment of the problematic behaviour related to food.

2. Bulimia nervosa

This is an eating disorder that involves binge eating: eating large quantities of food at one sitting, regardless of hunger. Most often, the condition also involves purging: the use of self-induced vomiting and/or abusing laxatives, suppositories, enemas or diuretics after a binge. Rather than purging, some people compensate for episodes of bingeing with other behaviours, such as fasting or overexercising. Bulimia mainly affects young women.

Although people with bulimia are afraid of becoming fat, most of them are of normal weight or slightly overweight. The foods on which they binge tend to be ‘comfort foods’ (sweet, pastries, ice cream etc). Like anorexia, bulimia can cause huge amounts of damage to your body. It can lead to dehydration from purging, chronic bowel problems from laxative use, tooth decay from excessive vomiting and gastrointestinal difficulties. It may even lead to permanent heart damage and death. Bulimia sufferers tend to feel very ashamed of themselves and they often show signs of addictive behaviour.

Many people with bulimia also have a history of anorexia or depression, anxiety and panic disorder. There is almost certainly a genetic predisposition to the disorder.

1. Take charge, take care, take action
2. As with anorexia, early detection is vital.
3. You must consult with a specialist, preferably a psychiatrist, who will do a full assessment and check you medically, too. Please be aware that bulimia can last for a short time or can continue for many years. Even after successful treatment, bulimia can return.
4. An eating disorder is a complex jumble of physical and emotional problems. Both must be addressed in order for treatment to work. Treatment must include psychological counselling, nutritional counselling and medication, such as antidepressants.
5. If someone you know shows signs of bulimia, contact a physician or mental health professional. Confronting someone with bulimia can be difficult. He or she may deny the problem or become defensive.

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