Disorders related to nutrition and eating behaviors

Eating disorders

They are all those that are characterized by serious alterations in nutrition and in eating behavior and that cause a significant deterioration of both physical health and psychosocial functioning.

Anorexia nervosa

The essential characteristics of this disorder are:

  • weight loss,
  • intense fear of getting fat,
  • the perceptive alteration that one has with respect to one’s own body.

The onset of this disorder is often a trigger for a stressful life event. Some people recover completely after one episode, others fluctuate during periods of improvement and relapse, and finally others have a chronic course that can last for many years. In many cases, hospitalization or admission to a specialized health and well-being center is necessary to recover weight and to better deal with medical and psychological complications.

In teenagers it can also happen that, even if the girl or boy grow taller, do not gain the weight that would be expected. To determine the right weight, thinness or insufficient weight uses a measure (the Body Mass Index) with a formula endorsed by various international organizations, including the World Health Organization (WHO). The fear of getting fat is usually not relieved by weight loss. In fact, the worry about winning becomes so continuous that it persists and may even increase when you lose weight.

Most frequent physiological alterations

Among the physiological alterations that occur, and in the case of the girls, are:

  • amenorrhea (interruption of menstruation),
  • continued behaviors such as self-induced vomiting, incorrect use of laxatives, diuretic medication and enemas, which may cause alterations in analytical results.

Most frequent psychological alterations

Many people with anorexia present:

  • depressive signs and symptoms,
  • depressed mood,
  • social isolation,
  • irritability,
  • insomnia,
  • decreased interest and sexual appetite,
  • feeling of ineffectiveness,
  • strong desire to control the environment,
  • rigid, inflexible,
  • restricted social spontaneity,
  • excessive containment of emotional expression,
  • etc.

Typology

  • Restrictive anorexia: the people affected have lost weight basically because of diets, fasts and / or excessive physical exercise,
  • Purgative anorexia: the affected individuals have lost weight basically by self-induced vomiting after binge eating or by the non-prescribed use of laxatives or diuretic medication.

Symptoms and signs of onset of anorexic disorder

  • He/she follows a diet of a very strict way with tendency to not change it, even in situations of special days (birthday, celebration of end of course, Christmas …).
  • Although weight has already been lost, the diet continues.
  • The person who loses weight usually receives admiration for at least part of their environment. This fact acts as a reinforcing mechanism to continue losing weight.
  • It begins to receive opinions of the environment in reference that the lost weight is excessive. The affected person tends to react from denial, even from anger.
  • When comments regarding thinness become general, the affected person tends to dress in wider, loose clothing in order to conceal one’s own body.
  • It has a tendency to limit until the extinction certain foods like bread, sweets, fried, etc.
  • Has a tendency to eat very badly and crumble food from the dish.
  • Has a tendency to make more meals alone and less as a family. However, you are aware of purchased family foods.
  • Low-calorie food is pending.
  • Reacts with irritability and discomfort to suggestions for ingesting higher amounts or amounts of food.
  • Weigh several times a day or after a meal.
  • Has a tendency to engage in excessive physical exercise, especially after eating.
  • Has a tendency to perform daily routines with respect to their own schedules and to react with denial and irritability responses to the proposed changes.
  • Has a tendency to want to perform various extracurricular activities, especially those related to physical or sports activities (dance, gym, dance …).
  • Has a tendency to adopt a “perfectionist” attitude with the aim that all activities carried out (school, extracurricular …) be successful.
  • Although, at least for some periods of time, the various activities that it performs may be satisfactory, the affected person is expressed with a tendency to dissatisfaction.
  • Has a tendency to refuse and deny to others feelings such as: feeling tired, going hungry, or other associated physical complications as could be, and in the case of girls, the loss of menstruation.
  • Has a tendency to isolate himself from family and friends, avoiding situations of socialization such as family celebrations, celebrations, etc.

Bulimia nervosa

The essential characteristics of this disorder are:

  • Episodes of binge eating that occur periodically.
  • Inappropriate and periodic compensatory behaviors to avoid weight gain.
  • The perception of one’s body is unduly influenced by body weight and body constitution.

Binge eating is defined as ingestion over a given period of time (about two hours) of a quantity of food that is clearly higher than most people would eat in a similar time period and in similar circumstances. An episode of binge eating is not limited to just one environment. For example, an affected person can start binge eating at a restaurant and continue eating when they get home. The fact of continually chopping food during the day in small quantities is not considered a binge.

During binge eating, the affected person may experience a sense of lack of control, which can not stop eating, and which can only be controlled if another person unexpectedly enters the same room.

Binge eating can sometimes be planned. During binges, affected people eat a remarkable amount of food and may even tend to ingest certain foods that otherwise would avoid.

People with bulimia nervosa often feel ashamed and try to hide their symptoms. That is why binges usually occur as discreetly as possible.

The triggers of a binge can be diverse: previous feelings of discomfort, stressors, restriction of diet, boredom, etc.

“Purge” behaviors refer to the bulimic person’s recurrent use of behaviors inappropriate to prevent weight gain. Vomiting, for example, is a frequent compensatory behavior. A variety of methods can be used to induce vomiting. Another purging behavior is the misuse of laxatives and diuretics. They may also be fasting one or more days, or excessive physical exercise with the goal of not gaining weight.

People with bulimia nervosa attach great importance to factors such as their weight or their body constitution. These factors will affect your self-esteem, since they are often self-rated in a high level of dissatisfaction. Not all people affected are overweight; many of them, depending on the Body Mass Index (BMI), may be within the appropriate limits.
Bulimia nervosa usually begins in adolescence and is also more prevalent in girls than in boys. Generically, bingeing behaviors usually begin during or after you have had a regimen to lose weight. In most cases, these behaviors may persist for years with periods of remission that alternate with episodes of binge eating.

Symptoms and signs of the onset of a bulimic disorder

  • Changes in customs related to food consumption occur: the refrigerator and pantry emptied more quickly. Packets of cookies, cereals, milk, etc. can disappear.
  • Initially, the amounts ingested in the context of family meals may be “normal” or not attract attention.
  • Tendency to increase the consumption of sweets, candies, chewing gum …
  • A tendency to increase the consumption of fast or prepared foods.
  • Tendency to find food remains or emboltorios in your room or camouflaged by the house.
  • Tendency to get up at night to go to the kitchen or other rooms to eat food.
  • Tendency to loneliness. The affected person may be away from home or back in their room for a long time.
  • In order to eliminate excessive intakes, the affected person may tend to perform “purgative” behaviors such as:
    • Want to go to the bathroom immediately after meals.
    • While in the bathroom, repeatedly opening faucets or pulling on the vater chain with the aim of disguising vomiting.
    • Use laxatives to experience diarrhea with a high frequency.
    • Use diuretic medication to remove more fluids.
  • Catch and hide food from home. (Sometimes also money or some valuables to buy snacks or specific foods.)
  • Use reducing creams and want to spend money on massages.
  • Tendency to oscillations in the body aspect (from thinness to overweight and vice versa).
  • Tendency to perform continuous, often strenuous physical exercise.
  • Tendency to disrupt schedules and to initiate or carry out various activities to which it does not give continuity.
  • Tendency to abuse of alcohol and other drugs.
  • Tendency to weigh and condition your mood according to the daily result of the scale.
  • Tendency to want to perform surgical interventions to remodel one or several body parts (glutes, calves, hips …).
  • Tendency to boredom often accentuated during holiday and weekend periods.
  • Tendency to enter the binge-purge cycle, resulting in changes in mood (depression, sadness, feelings of guilt …).
  • A lot of sociability, often changing friends, even emotional partners.

 Obesity

It is not considered a mental disorder. The excess of corporal fat is the result of an increase of the energetic consumption in relation to the energy that is spent. There are several predisposing factors such as: genetic, physiological, behavioral and cultural that can vary between people and that can contribute to the development of obesity. Obesity is a chronic disease that usually begins in childhood and adolescence. Apart from supposing an eating disorder, it can be a triggering factor of an eating behavior disorder. In the last decades there has been a significant growth of obesity in adults, followed more recently by a similar increase in children and adolescents, a phenomenon that has made obesity one of the most worrying public health issues today.

Most frequent physical complications

Its most negative effects can generate serious pathologies such as:

  • diabetes,
  • hypertension,
  • dyslipidemia,
  • cardiovascular complications,
  • bone and / or joint alterations,
  • apneas of the dream,
  • respiratory difficulties,
  • and even some types of cancer, such as gastrointestinal.

Most frequent psychological complications

Teens who are overweight or obese can also suffer psychological complications such as:

  • They can be ridiculed or rejected by their peers or be victims of their teasing, an issue that can lead to low self-esteem and can lead to isolation and depression.
  • They may have more difficulty integrating into a group or finding a partner.
  • They can develop serious psychological problems such as anxiety, depression or obsessive-compulsive disorders.
  • They can be sad and lonely, or even aggressive and angry with others.

People with a weight 20% higher than the midpoint of the weight scale according to the body mass index (BMI) are considered obese. (This scale relates body mass with the person’s age, height, and sex.)
It should be noted that not all obese people have a eating disorder. But overweight and obesity from childhood increase the chances of developing an eating disorder in adulthood. In this sense, a preventive program of overweight should take into account factors such as:

  • Educate from childhood in healthy nutrition habits and avoid hypocaloric diets.
  • Promote the realization of regular meals (at least breakfast, lunch, snack and dinner).
  • Do not skip meals or do them untimely.
  • To attend to the signals that our own body gives us regarding the sensations of hunger and satiety.
  • Promote eating patterns and regular and various habits in family meals.
  • Encourage physical activity and the practice of sport as another means of healthy balance.
  • Limit access to fast foods and sugary drinks.

Orthorexia

This disorder, which can become obsessive for people who suffer from it, is characterized by excessive concern for “healthy” nutrition, that is, based on ingesting basically natural products. In this case, it is not about the amount of ingested food, as with anorexia or bulimia, but about its quality. The concern to eat only certain products or perform certain diets can go so far that the affected person decides to go hungry before eating any food that is not part of the list that has decided that they are healthy. People with orthorexia tend to attach great importance to the measurements and shape of their body, as well as to perform continuous and often strenuous physical exercise. This excess of restlessness to eat healthy food and, therefore, to achieve food perfection can trigger eating disorders such as anorexia or binge eating disorder.

Pica

Its main characteristic is that the affected people tend to ingest non-nutritive and non-food substances and perform this behavior for sufficient time, with enough frequency or intensity to be subsidiary to being treated clinically.

Rumination disorder

It is mainly characterized by the fact that affected people have a tendency to regurgitate the food consumed: that is, food previously swallowed and even partially digested, is returned to the mouth apparently without effort, nausea, or malaise. Subsequently, regurgitated food may be chewed again, and spit or swallowed again.

Restrictive food intake disorder (ARFID)

Affected people, even though they have a variety and diversity of food at their disposal, have a tendency to avoid or restrict their intake, thus affecting their nutritional needs, since their energy intake is insufficient. In these cases, weight loss may occur, either affecting its increase, or the growth inherent in adolescence. Nutritional deficiency can lead to various physical health problems, as well as interference in psychosocial functioning.

Binge eating disorder

Its main characteristic is that affected people have the tendency to perform recurrent episodes of binge eating. An episode of binge eating is defined by:

  • Excessive food intake over a given period of time.
  • A feeling of lack of control over ingestion.

Vigorexia (muscle dysmorphia)

Currently the American Psychiatric Association (APA), in its fifth review (DSM-5), suggests that muscle dysmorphia, popularly known as vigorexia, is a variant, a form of body dysmorphic disorder that basically consists of concern of the person affected by the feeling that his body is too small or insufficiently muscled. Generically, people with this disorder usually have a normal or even very muscular body. They may also be concerned about areas or parts of your body such as skin, hair, etc. Most people affected tend to spend many hours in the gym and intense physical exercises to the point that injuries can often be generated. They usually make specific diets, and even self-administer anabolic androgenic steroids and other analogous substances in order to achieve more body building and body development in general. Vigorexia is more prevalent in boys than in girls, and in general, one’s awareness of illness is scarce. This disorder is usually associated with high levels of anxiety, social avoidance, depressive features, perfectionism, socialization difficulties and low self-esteem.