In recent years, two extreme forms of eating disorders have gained increasing attention : anorexia nervosa and bulimia. These conditions are not yet fully understood, but let`s take a brief look at what is known about them.
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| Anorexia Nervosa |
Anorexia Nervosa
At the extreme end of the weight-control spectrum is a disorder in which people severely limit the amount they eat, virtually starving themselves. This condition is called anorexia (loss of appetite) nervosa (nervous or psychogenic). It occurs almost exclusively among preadolescent and adolescent girls or young women, and it has been increasing in frequency in the past decade.
Most anorexics are people who come from upper or middle-class homes, and who may have seemed like model children before they developed the disorder. In the typical case, the young girl suddenly becomes obsessed with the idea that she is fat. She begins to diet, often following a fad diet. For some reason, even as she begins to lose weight seriously, she still feels fat and begins to starve herself. Eventually she begins to look like a skeleton, sometimes losing more than a third of her body weight. She may avoid food altogether, or she may seem to take a perverse pleasure in it preparing gourmet meals for the rest of the family, for example, but eating nothing herself. Or she may occasionally gorge herself on a huge meal and then immediately make herself vomit it all. If her strange eating habits are questioned, she will typically deny that there is anything wrong with her behavior. Eventually, she may grow negative, passive, and apathetic. Left untreated, up to 10 percent of anorexics eventually die of starvation.
Why should an apparently healthy, welladjusted person decide to starve herself in such a bizarre and tragic way? Unfortunately, no one has yet been able to answer this question; the precise cause of anorexia nervosa remains a mystery. Occasionally, the disorder is seen in connection with mental illness, such as schizophrenia. Cases of this kind are known as secondary anorexia nervosa. Primary anorexia nervosa, in which the disorder does not seem to be produced by obvious mental illness, is a more puzzling problem. The consensus is that anorexia nervosa has a psychological cause, but researchers disagree over what this cause is.
Some experts suggest that anorexics may have abnormal fears of their approaching womanhood. In losing so much weight, the girls lose their feminine curves, stop menstruating, and begin to look like little girls again.
Specialists in treating anorexia feel strongly that both psychological and medical treatment are imperative. Tube feeding and a high calorie diet may be necessary at the start: Not only is the anorexic`s weight dangerously low, it is also impossible for her to reason effectively when her thinking processes have been disrupted by chronic malnutrition. Treatment is not easy. Until the anorexic is able to establish a more realistic outlook on her situation, therapy results in little more than cycles of remission and relapse.
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| Bulimia Nervosa |
Bulimia
Bulimia, a pattern involving eating binges followed by vomiting purges, is considered a type of anorexia nervosa. Typically, the bulimia sufferer is a woman in her early twenties, college educated, single and white. Like anorexics, bulimics “are usually perfectionists....but they tend to be older, of near-normal weight, with healthy, outgoing appearances.
Bulimia is not just eating a lot, or “pigging out”; there is a distinct pattern to the bulimic`s binges. The bulimic typically eats secretly, consuming an enormous amount of food at one sitting. The urge that drives such eating is clearly something beyond simple hunger. Commonly, a binge will follow one “slip” from a self-imposed diet : The bulimic will eat one favorite forbidden food-a brownie, a piece of pecan pie-and then feel compelled to consume virtually every bit of food in sight. Then comes the need to vomit or to take quantities of laxatives to make sure that the food doesn`t stay in the body to produce weight gain.
What causes bulimia ? As with anorexia, the condition is not fully understood. Psychiatrists who have studied bulimics agree that they have an abnormal fear of becoming fat. The onset of bulimia usually occurs during adolescence, when staying slim seems to be the one way to please overly critical parents. The binge-purge syndrome can over time be very harmful. Potassium depletion, urinary tract infections, kidney failure, weight loss, ulcers, and hernias are all possible side effects. Curing bulimia is difficult because the disease is still so poorly understood, but the number of treatment programs is growing.
References :
Jane E. Brody, ‘Anorexia Nervosa, an Ailment Rising Among Teen-Age Girls, Is Yielding to a New Therapy, New York Times, July 14, 1982.
“Anorexia : The Starving-Disease Epidemic”, U.S. News and World Report, August 30, 1982.
Sadrudin Bhanji, “Anorexia Nervosa : Physicians and Psychiatrists Opinions and Practice”, Journal of Psychosomatic Research 23, 1979.
Anorexia : The Starving-Disease Epidemic.
Paul E. Garfinkel, Harvey Moldofsky, and David M. Garner, “The Heterogenety of Anorexia Nervosa”, Archives of General Psychiatry 37, September, 1980.
Marvin R Levy, Mark Dignan, Janet H Shirreffs, Essentials of Life & Health, Fourth Edition, Random House, New York, 1984.
“The Binge-Purge Syndrome”, Newsweek, November 2, 1982.
