Anorexia nervosa and bulimia nervosa are the two most common eating disorders. People with anorexia nervosa are usually underweight, anxious, maintain rigid rules, exercise excessively, and constantly see themselves as grossly overweight. People with bulimia nervosa, however, have varied weights that often fall within the normal range. Their eating habits usually consist of eating binges followed by an action to counteract the binge, such as self-induced vomiting, using laxatives or diuretics, exercising excessively, or starving themselves.
Eating disorders have multiple physical and mental side effects that include lightheadedness, mood swings, anxiety, depression, constantly feeling cold, and finding it hard to concentrate. Long term effects include fertility problems, osteoporosis, and death. The mortality rate of those with an eating disorder is about 10 percent.
The causes of eating disorders are a likely combination of genetic and environmental factors. Often times anxiety, depression, and the pursuit of perfection can be passed down genetically through the family. This, combined with the pressure society puts on young women to be small, can cause them to seek unhealthy, alternative ways to quickly lose weight. Although people diagnosed with an eating disorder are most often women in their upper teens, anorexia nervosa and bulimia nervosa can affect both males and females, as young as age 12 and as old as age 50.
Anorexia is often considered more serious than bulimia because it is the hardest to treat and, according to some researchers, has a higher mortality rate. Many researchers, however, are putting eating disorder classifications into question. Sixty percent of patients suffer from a sub-threshold eating disorder, which means they do not meet the strict diagnostic criteria for anorexia nervosa or bulimia nervosa. They may not binge or purge as often, or even show a low weight. Due to the perceived lower severity, these patients are often overlooked by clinicians. Our research, however, shows that the mortality rate of these sub-threshold eating disorder patients may be as high as the rates in other groupings.
Treating eating disorders can be difficult. The cornerstone of any treatment is nutrition: reestablishing good eating habits. Psychotherapy and sometimes medication can also be used for treatment, though they do not work for as many people as we would like. The key to being able to treat and prevent eating disorders lies within the understanding of the underlying processes. Using this approach as our foundation, my colleagues and I at the University of Minnesota Medical School are currently working on a study that focuses on anorexia nervosa. Using palm-top computers, we are able to study the daily thoughts, feelings, and mental states of patients. This project, and others like it, will allow us to more accurately capture symptoms and better understand the illness so that we can develop more effective treatments for patients.
Scott Crow is associate professor in the University of Minnesota Medical School's
Department of Psychiatry.
Health Talk & You is an educational service of the University of Minnesota. Advice presented should not take the place of an examination by a health-care professional. For more health-related information, go to
http://www.healthtalk.umn.edu/. For comments or questions about Health Talk & You e-mail
buss@umn.edu.
