Exit

Health Condition

Eating Disorders

About This Condition

Eating disorders are complex conditions involving psychological factors and nutritional deficiencies. The term eating disorders includes anorexia nervosa, bulimia, and binge-eating.

The psychological factors may include an inability to cope with stress, problems with family and other relationships, feelings of deprivation, and experiences of physical, sexual, or emotional abuse. Psychotherapy is an essential part of the treatment for eating disorders, along with nutrition counseling and medical care as needed.1

A person with anorexia does not eat enough to maintain a healthy weight; she views herself as overweight and is anxious about gaining weight. Anorexia typically begins in early adolescence, mainly among girls, though the numbers of boys developing this condition is increasing. People with anorexia weigh less than 85% of the normal weight for their age and height. Excessive exercise, vomiting, and abuse of laxatives and/or diuretics may also occur. Severe anorexia can be life threatening.

Bulimia, also known as bingeing and purging, is more common than anorexia, and usually affects teenage girls and women in their twenties. It involves a recurring, emotionally driven cycle of compulsive consumption of large quantities of high-calorie food in a short period of time, followed by induced vomiting. Some individuals also use laxatives, drugs that induce vomiting, diuretics, or excessive exercise in an attempt to purge. About 50% of anorexics also purge, and both bulimia and anorexia can coexist in the same person.2 Unlike those with anorexia, some people affected by bulimia maintain normal or even excessive body weight.

Binge-eating disorder is similar to bulimia but no purging is done. It is more common than either bulimia or anorexia nervosa, and people with binge-eating disorder are usually overweight.3

Symptoms

People with eating disorders may have a preoccupation with weight and food, anxiety about their body image, and/or a feeling that they lose control over how much they eat. They may also exercise compulsively and, in women, experience missed menstrual periods. They may also frequently use laxatives, diet pills, and medicines designed to induce vomiting or reduce fluid retention.

Other Therapies

Treatment for eating disorders also includes psychological counseling, such as cognitive-behavioral, interpersonal, psychodynamic, and family therapy.

References

1. Zerbe KJ. Anorexia nervosa and bulimia nervosa. When the pursuit of bodily ‘perfection' becomes a killer. Postgrad Med 1996;99:161-4, 167-9 [review].

2. Garner DM, Garner MV, Rosen LW. Anorexia nervosa “restricters who purge”: implications for subtyping anorexia nervosa. Int J Eat Disord 1993;13:171-85.

3. Spitzer RL, Yanovski S, Wadden T, et al. Binge eating disorder: its further validation in a multisite study. Int J Eat Disord 1993;13:137-53.

4. Thibault L, Roberge AG. The nutritional status of subjects with anorexia nervosa. Int J Vitam Nutr Res 1987;57:447-52.

5. Abou-Saleh MT, Coppen A. The biology of folate in depression: implications for nutritional hypotheses of the psychoses. J Psychiatr Res 1986;20:91-101 [review].

6. Beaumont PJ, Chambers TL, Rouse L, Abraham SF. The diet composition and nutritional knowledge of patients with anorexia nervosa. J Hum Nutr 1981;35:265-73.

7. Rock CL, Vasantharajan S. Vitamin status of eating disorder patients: relationship to clinical indices and effect of treatment. Int J Eat Disord 1995;18:257-62.

8. Langan SM, Farrell PM. Vitamin E, vitamin A and essential fatty acid status of patients hospitalized for anorexia nervosa. Am J Clin Nutr 1985;41:1054-60.

9. Ceci F, Cangiano C, Cairella M, et al. The effects of oral 5-hydroxytryptophan administration on feeding behavior in obese adult female subjects.J Neural Transm 1989;76(2):109-17.

10. Cangiano C, Ceci F, Cascino A, et al. Eating behavior and adherence to dietary prescriptions in obese adult subjects treated with 5-hydroxytryptophan. Am J Clin Nutr 1992;56:863-7.

11. Cangiano C, Laviano A, Del Ben M, et al. Effects of oral 5-hydroxy-tryptophan on energy intake and macronutrient selection in non-insulin dependent diabetic patients. Int J Obes Relat Metab Disord 1998;22:648-54.

12. Peterson CB, Mitchell JE. Psychosocial and pharmacological treatment of eating disorders: a review of research findings. J Clin Psychol 1999;55:685-97 [review].

13. Mitchell JE, Raymond N, Specker S. A review of the controlled trials of pharmacotherapy and psychotherapy in the treatment of bulimia nervosa. Int J Eat Disord 1993;14:229-47 [review].

14. Thackwray DE, Smith MC, Bodfish JW, Meyers AW. A comparison of behavioral and cognitive-behavioral interventions for bulimia nervosa. J Consult Clin Psychol 1993;61:639-45.

15. Agras WS. Nonpharmacologic treatments of bulimia nervosa. J Clin Psychiatry 1991;52 Suppl:29-33 [review].

16. Fairburn CG, Norman PA, Welch SL, et al. A prospective study of outcome in bulimia nervosa and the long-term effects of three psychological treatments. Arch Gen Psychiatry 1995;52:304-12.

17. Peterson CB, Mitchell JE, Engbloom S, et al. Group cognitive-behavioral treatment of binge eating disorder: a comparison of therapist-led versus self-help formats. Int J Eat Disord 1998;24:125-36.

18. Wilfley DE, Agras WS, Telch CF, et al. Group cognitive-behavioral therapy and group interpersonal psychotherapy for the nonpurging bulimic individual: a controlled comparison. J Consult Clin Psychol 1993;61:296-305.

19. Carter JC, Fairburn CG. Cognitive-behavioral self-help for binge eating disorder: a controlled effectiveness study. J Consult Clin Psychol 1998;66:616-23.

20. Pike KM. Long-term course of anorexia nervosa: response, relapse, remission, and recovery. Clin Psychol Rev 1998;18:447-75 [review].

21. Eisler I, Dare C, Russell GF, et al. Family and individual therapy in anorexia nervosa. A 5-year follow-up. Arch Gen Psychiatry 1997;54:1025-30.

22. Gowers S, Norton K, Halek C, Crisp AH. Outcome of outpatient psychotherapy in a random allocation treatment study of anorexia nervosa. Int J Eat Disord 1994;15:165-77.

23. Treasure J, Todd G, Brolly M, et al. A pilot study of a randomised trial of cognitive analytical therapy vs educational behavioral therapy for adult anorexia nervosa. Behav Res Ther 1995;33:363-7.

24. Robin AL, Siegel PT, Koepke T, et al. Family therapy versus individual therapy for adolescent females with anorexia nervosa. J Dev Behav Pediatr 1994;15:111-6.

25. Drewnowski A, Halmi KA, Pierce B, et al. Taste and eating disorders. Am J Clin Nutr 1987;46:442-50.

26. Casper RC, Pandy GN, Jaspan JB, Rubenstein AH. Hormone and metabolite plasma levels after oral glucose in bulimia and healthy controls. Biol Psychiatry 1988;24:663-74.

27. van der Ster Wallin G, Norring C, Holmgren S. Binge eating versus nonpurged eating in bulimics: is there a carbohydrate craving after all? Acta Psychiatr Scand 1994;89:376-81.

28. Blouin AG, Blouin J, Bushnik T, et al. A double-blind placebo-controlled glucose challenge in bulimia nervosa: psychological effects. Biol Psychiatry 1993;33:160-8.

29. Johnson WG, Jarrell MP, Chupurdia KM, Williamson DA. Repeated binge/purge cycles in bulimia nervosa: role of glucose and insulin. Int J Eat Disord 1994;15:331-41.

30. Drewnowski A, Halmi KA, Pierce B, et al. Taste and eating disorders. Am J Clin Nutr 1987;46:442-50.

31. Casper RC, Pandy GN, Jaspan JB, Rubenstein AH. Hormone and metabolite plasma levels after oral glucose in bulimia and healthy controls. Biol Psychiatry 1988;24:663-74.

32. van der Ster Wallin G, Norring C, Holmgren S. Binge eating versus nonpurged eating in bulimics: is there a carbohydrate craving after all? Acta Psychiatr Scand 1994;89:376-81.

33. Blouin AG, Blouin J, Bushnik T, et al. A double-blind placebo-controlled glucose challenge in bulimia nervosa: psychological effects. Biol Psychiatry 1993;33:160-8.

34. Johnson WG, Jarrell MP, Chupurdia KM, Williamson DA. Repeated binge/purge cycles in bulimia nervosa: role of glucose and insulin. Int J Eat Disord 1994;15:331-41.

35. Davis C, Katzman DK, Kaptein S, et al. The prevalence of high-level exercise disorders: etiological implications. Compr Psychiatry 1997;38:321-6.

36. Davis C, Kennedy SH, Ravelski E, Dionne M. The role of physical activity in the development and maintenance of eating disorders. Psychol Med 1994;24:957-67.

Copyright © 2018 Healthnotes, Inc. All rights reserved. www.healthnotes.com

Learn more about Healthnotes, the company.

The information presented by Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires December 2018.

Drugs used to treat EATING DISORDERS. Select drug name to view medication information and pricing