Eating disorders (ED) are psychogenically caused pathological syndromes that are associated with eating disorders. Among the most common disorders, it is necessary to note anorexia, bulimia, psychogenic overeating, and orthorexia.
It is important to note that eating disorders are mental disorders, as they are primarily associated with impaired perception of body image and associated psychological problems (anxiety, depression, PTSD or others). The development of eating disorders can be influenced by one or more factors, among which the following should be noted:
• Social influence. Advertising, fashion magazines, clothing brands, movie and show business stars often promote thinness and slimness as synonymous with beauty and success. But for many girls and women, thinness is unattainable, which results in dissatisfaction with oneself and appearance.
• Psychological reasons. Perfectionism, low self-esteem, anxiety, depression and other psychological disorders can lead to eating disorders.
• Adolescence. According to statistics, anorexia and bulimia very often occur in adolescence due to body changes, hormonal surges, and emotional lability.
• Profession. Several professions (ballerina, model, actress, dancer, athlete) have a number of fairly strict requirements for appearance. Therefore, some occupations have an increased risk of developing an eating disorder.
• Family problems and conflicts. Divorce, conflicts with children or a spouse can lead a person to seek solace in food.
• Stressful situation. Moving, changing your country of residence, changing jobs or schools, the death of a loved one, an accident, or experiencing an acute stressful situation can also trigger an eating disorder.
• Biological reasons. Several studies show that in people with eating disorders, there is an imbalance of neurotransmitters.
Next, we will look at the most common eating disorders.
Anorexia nervosa statistically occurs in approximately 0.5-1% of young women. Moreover, compared to men, women are diagnosed with anorexia almost 10 times more often. A person suffering from anorexia seems fat and ugly, which means that no one needs him, no one can love him. He can stand in front of the mirror for hours, looking at folds of fat on his sides or cellulite and hating himself and his body. The problem is that a person suffering from anorexia cannot objectively assess the state of his body.
Such a person thinks mainly about food - he is afraid of gaining weight, so he is scrupulous about what he eats. Sometimes the entire daily diet of an anorexic patient may consist of an apple and a cup of coffee. Patients may also abuse diuretics and laxatives.
Anorexia is a deadly condition because crash diets lead to a lack of vitamins, minerals and nutrients that are important for the normal functioning of the body. If a body mass index is below 15, a few countries require mandatory emergency hospitalization, as there is a high risk of developing multiple organ failure.
Signs of anorexia:
• Extremely low weight support
• Fear of gaining weight
• Control and counting of calories
• Refusal to eat
• Exhausting physical training
• Menstrual irregularities
• Brittle hair and nails
• Dry and dull skin
• Frequently weighing yourself, looking at yourself in the mirror
Treatment of anorexia
If the body mass index (BMI) is above 15, outpatient treatment for anorexia is possible. If the BMI is below 15, inpatient treatment is indicated, which includes specialized nutrition and long-term psychological work. The basis of treatment is psychotherapy, and it is quite long-term. At the beginning of treatment, the intensity of psychotherapy is quite high (2-3 times a week), then the number of sessions can be reduced to 1 per day. Psychotherapeutic work with parents is also often required.
This psychological disorder is characterized by frequent bouts of binge eating, when a person can eat a large amount of food, mostly high calorie, in a short period of time. At the same time, the person cannot stop; it seems to him that he is losing control. After an attack of overeating, he is tormented by a feeling of shame and remorse. He promises himself next time to give up the cake or eat only one piece of candy, but when he eats one piece of chocolate, the whole bar follows, followed by a sausage sandwich and cutlet. It turns out to be a vicious circle, from which, as it seems to a person, there is no way out.
Behind compulsive overeating are psychological problems - loneliness, depression, anxiety, fear, internal tension, stressful situations, low self-esteem. As with anorexia, the thoughts of a person suffering from overeating revolve around food.
Compulsive overeating leads to weight gain and the development of many associated diseases, such as cardiovascular disorders, diabetes, and hormonal imbalances.
Signs of compulsive overeating:
• Attacks of uncontrolled eating
• Feelings of anger and shame after overeating
• Preference for dining alone
• Attempts to hide bouts of overeating
• Weight gain
Treatment of compulsive overeating
This disorder is treated with psychotherapy. The treatment method is selected individually. As with any eating disorder, binge eating disorder requires long-term psychotherapeutic work.
The symptoms of bulimia are like those of compulsive overeating disorder, with one difference being the presence of compensatory behavior. A person with bulimia also suffers from bouts of uncontrollable overeating and is also tormented by feelings of shame and anger after attacks. But because of the fear of gaining weight and gaining weight, a person goes to the toilet and induces vomiting, or takes laxatives or diuretics.
The causes of bulimia are also psychological in nature: depression, PTSD, anxiety, suppressed feelings of anger, tension that is difficult to cope with. Moreover, unlike compulsive overeating, people with bulimia’s weight practically does not change - it either remains at the same level, or can fluctuate in one direction or another with minor changes.
Signs of bulimia:
• Attacks of uncontrolled eating
• Feelings of anger and shame after overeating
• Attempts to hide bouts of overeating
• Compensatory behavior – inducing vomiting, taking diuretics or laxatives
• Swelling on the face
• Teeth marks on the hand
• Voice change
• Throat damage
• Damage to tooth enamel
Treatment for bulimia
For bulimia, the main treatment is psychotherapy. In some cases, symptomatic treatment may be prescribed - for example, antidepressants if there are signs of depression, anxiolytics if there is anxiety. Psychotherapy is required for quite a long time.
This is a recently discovered disorder, which is associated with the patient’s obsessive desire to eat only proper and healthy food. Most often, this disorder is observed in athletes and people who take excessive care of their health. A person with such a disorder avoids any food that is incorrect in his understanding - fatty meat, baked goods, gluten, processed foods or foods with dyes and preservatives. There is currently no official diagnosis for orthorexia, but many experts use the term to describe the disorder.
A person with orthorexia also thinks about food all the time, about how healthy it is; the taste properties of food are often neglected, and preference is given to one or another food solely on the basis of its health benefits. If a person has consumed a product that he considers unhealthy, he experiences feelings of guilt, anxiety, and anger.
Signs of orthorexia:
• Exclusion of an entire group of products due to their harmfulness (canned food, sweets, gluten, yeast, processed foods)
• Strict adherence to one or another diet (paleo diet, veganism, raw food diet)
• Dividing products into good and bad without exceptions
• The emergence of anxiety, guilt if suddenly he ate some product that is not healthy
• Sometimes a feeling of fear or phobia of prohibited foods
• Careful menu planning
• Control of the cooking process
• Avoiding eating bad foods even if you feel hungry
• Exercising for long periods of time if a person suddenly eats a prohibited product
• Refusal to eat in a restaurant or cafe
Such strict adherence to the rules and consumption of certain products imposes certain restrictions on human functioning. He may refuse to meet with friends or go on visits. In some cases, strict diets lead to a person not receiving enough important microelements and vitamins.
Treatment of orthorexia
Treatment for orthorexia is primarily psychotherapeutic. Various techniques can be used in each specific case. Virtual reality techniques can also be used: with the help of VR glasses, the patient is simulated the situation of dining in a restaurant, he overcomes his fear of food that is dangerous from his point of view.
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