What Are The Complications Of Treating Anorexia Nervosa
The most serious complication of treating anorexia is a condition called refeeding syndrome. This life-threatening condition can occur when a seriously malnourished person begins to receive nutrition again. Basically, the body cannot properly restart the metabolism process.
Patients experiencing refeeding syndrome can develop:
- Whole body swelling
Abnormal laboratory signs include low phosphate levels , low blood sugar levels, , low potassium level , low magnesium level , and low sodium level .
Patients who have one or more of the following risk factors for developing refeeding syndrome may need to be treated in the hospital:
- Are severely malnourished
- Have had little or no calorie intake for more than 10 days
- Have a history of refeeding syndrome
- Have lost a lot of weight in a very short period of time
- Drink significant amounts of alcohol
- Have a history of misusing laxatives, diet pills, diuretics, or insulin
- Have abnormal electrolytes before starting refeeding
When Should A Person Seek Help
If a serious physical illness is present , the individual should get prompt medical care. However, eating disorders are not necessarily dependent upon a persons weight. In fact, even larger bodied people who have recently lost weight can have anorexia. If you suspect that you or someone you know has an eating disorder, seek help immediately. Eating disorders can become increasingly dangerous the longer they go untreated. In severe cases, eating disorders can be fatal.
What Insurance Does The Hospital Take
If you are being admitted to one of our hospital-based programs, both Inpatient and Partial Hospitalization, our business office will verify your benefits beforehand, and the admissions coordinator will contact you with information about your coverage. Admission to our program in the Johns Hopkins Hospital Department of Psychiatry qualifies as a mental health hospitalization and will be authorized under the mental health portion of your insurance, not the medical portion. Please see the Admissions page for more information.
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Sexual Abuse And Eating Disorders: Whats The Connection
What is the connection between sexual abuse and developing an eating disorder? Why does bingeing, purging, starving and chronic dieting become a solution for the abuse?
Abuse shatters the sacred innocence of a child and often becomes a primary trigger for an eating disorder. The survivor of sexual abuse becomes plagued with confusion, guilt, shame, fear, anxiety, self-punishment, and rage. She seeks the soothing comfort, protection, and anesthesia that food offers. Food, after all, is the most available, legal, socially sanctioned, cheapest mood altering drug on the market! And emotional eating is a mood altering behavior that can help detour, divert, and distract a person from inner pain.
Barbara describes, My fathers best friend molested me in our garage starting when I was seven. I was filled with such anxiety that I began gorging on everything that wasnt tied down. I gained 30 pounds by the time I was 11 which my mother attributed to my eating too much pizza at the school cafeteria.
Amber was abused by an older cousin who said it was a game of doctor. Overeating and laxatives became my way to rid myself of the pain and confusion. I realized I was trying to evacuate my cousin out of my body through those laxatives.
In addition to falling prey to eating disorders, all survivors of sexual abuse are vulnerable to depression, substance abuse, post traumatic stress disorder, and a profound mistrust of intimacy.
What Are The Warning Signs Of Eating Disorders In Older People
Due to the common misconception that eating disorders primarily occur in younger people, it is not unheard of for the early warning signs of an eating disorder in an older person to be overlooked or mistaken for another illness by people close to the person, sometimes even doctors.
Signs to look out for:
- Weight changes – Has the individual lost/gained weight for a seemingly unexplained reason?
- Preferring to eat in private – Is the individual turning down meal invitations?
- Feeling the cold more – Is the person complaining about feeling cold more often? Has their heating bill gone up?
- Behavioural changes – Has the individual being disappearing to the bathroom straight after meals?
- An increase in their food bill – Have you noticed that the individual is spending more on food?
- Hair loss – Is the individuals hair looking noticeably thinner?
- Medical problems – Has the individual been having medical problems with their heart, oral health or gastrointestinal problems?
- References to being unhappy with their weight and the way that they look – Are they refusing to have photos taken due to thinking they look ‘fat’?
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Has The Prevalence Of Eating Disorders Increased Over Time
Although eating disorders have existed throughout human history, they seem to be growing more widespread today. One large review study found that 3.5 percent of people suffered from an eating disorder in the years 2000 to 2006, yet nearly 8 percent suffered from one in the years 2013 to 2018.
A particularly unsettling trend is that anorexia may be increasing among children. One recent study found that anorexia had increased among 8- to 12-year-olds in the past decade, which is consistent with other research showing that the age of onset for anorexia may be decreasing.
Did You Choose Your Eating Disorder
It is hard for people to understand that eating disorders are not a choice, they are not a lifestyle. Someone with an eating disorder is not trying to garner attention they are not choosing to battle a life-altering mental health condition.
Eating disorders are an illness that takes control over someone as they struggle with disordered beliefs about their weight and shape, lack of self-esteem, and the constant societal emphasis placed on body image. Anorexia, bulimia, and binge eating disorder are only some of the eating disorders affecting someones physical and mental health and lead to severe consequences.
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Eating Disorders And People At Higher Weight
People at higher weight or living in a larger body is not an eating disorder or mental disorder. Language is important as labels can be stigmatising. While there is not one universally agreed-upon term for people at higher weights, the terms people at higher weight or living in a larger body are used to replace the terms overweight or obesity here as many people with a lived experience have indicated this as their preference.
Body diversity is a fact of life and eating disorders can occur across the weight spectrum. An eating disorder diagnosis may be missed for individuals at higher weight as the perceived traditional stereotype of a person with an eating disorder is not observed. Weight stigma may also be experienced.
People at a higher weight are at increased risk of disordered eating compared with the general population, while individuals who use unhealthy weight control practices are at increased risk of being at a higher weight. Eating disorder risk factors are shared by people of all body sizes, including individual factors such as dieting, unhealthy weight-control behaviours, weight and shape concerns, and self-esteem issues. Other risk factors include social factors, such as parental and peer weight and shape-related behaviours, and societal factors, such as sociocultural norms, media exposure and weight discrimination. In addition, weight stigma experienced by people at higher weight increases the risk of developing an eating disorder.
How Do I Know If I Need Inpatient Treatment
If you think you have an eating disorder, if your symptoms have persisted or worsened despite attempts at outpatient treatment, or if you feel constantly preoccupied by thoughts of food and weight, then a good place to start is with a comprehensive evaluation in our Consultation Clinic. To safely provide the best possible care during the COVID pandemic, we have expanded our outpatient telemedicine services to include remote clinical consultation and outpatient visits with our eating disorders doctors by videolink across multiple states. Video visits allow patients to connect face-to-face in real time without leaving their home by using their smartphone, tablet or computer. Virtual connections are secure and HIPAA compliant.
You will be seen by a psychiatrist who will perform a thorough review of your history and symptoms, medical tests and past treatment. We recommend you forward any past treatment records ahead of your appointment for the doctor to review. Whenever possible we ask that you attend the consultation with a close family member or significant other, since we believe family support and involvement is very important when you are struggling with an eating disorder. The doctor will also be interested in any medical or psychiatric problems you may have besides the eating disorder.
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Questions To Ask Your Doctor
Asking questions and providing information to your doctor or health care provider can improve your care. Talking with your doctor builds trust and leads to better results, quality, safety, and satisfaction. Visit the Agency for Healthcare Research and Quality website for tips at www.ahrq.gov/patients-consumers.
More information about finding a health care provider or treatment for mental disorders is available on our Finding Help for Mental Illness webpage, available at .
Getting Help For An Eating Disorder
If you think you may have an eating disorder, see a GP as soon as you can.
A GP will ask about your eating habits and how you’re feeling, plus check your overall health and weight.
They may refer you to an eating disorder specialist or team of specialists.
It can be very hard to admit you have a problem and ask for help. It may make things easier if you bring a friend or loved one with you to your appointment.
You can also talk in confidence to an adviser from eating disorders charity Beat by calling their adult helpline on 0808 801 0677 or youth helpline on 0808 801 0711.
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Eating Disorders And Suicide Risk
Information presented in this article may be triggering to some people. If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 1-800-273-8255 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.
For more mental health resources, see our National Helpline Database.
Eating disorders can be painful illnesses, at times robbing their victims of their health, happiness, social life, and occupational achievements. It is accordingly no surprise that suicide is a major cause of death for people with eating disorders.
Although medical complications related to malnutrition are the leading cause of death among individuals with anorexia nervosa, suicide is believed to follow closely behind. Suicidal behavior is elevated in patients with anorexia nervosa, bulimia nervosa, and binge eating disorder, the three eating disorders that have been most studied.
Eating disorders have the highest mortality rate of any mental disorder. While studies have shown varying results, patients with eating disorders appear to be between 1.5 and 14 times more likely than same-aged peers to die. Mortality rates are the highest for patients with anorexia nervosa but are high for any person with an eating disorder.
Getting Help For Someone Else
It can be difficult to know what to do if you’re worried that someone has an eating disorder.
They may not realise they have an eating disorder. They may also deny it, or be secretive and defensive about their eating or weight.
Let them know you’re worried about them and encourage them to see a GP. You could offer to go along with them.
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What Are The Symptoms And Behaviors Of People With Anorexia Nervosa
Physical signs and symptoms include:
- Significant weight loss over several weeks or months
- Unexplained change in growth curve or body mass index
- Feeling tired
- Bluish or purple coloring of the hands and feet
Emotional and behavioral symptoms include:
- Binge eating or purging behavior
- Continuing to diet even when thin or when weight is very low
- Having an unusual interest in food, calories, fat grams and dieting
- Sudden change in eating behavior becoming a vegetarian/vegan interest in certain food types or certain food groups, or eliminating certain food types or food groups
- Intense fear of gaining weight
- Strange eating habits or routines, such as eating in secret, eating foods in a certain order, rearranging foods on a plate
- Feeling fat, even if underweight
- Inability to realistically assess ones own body weight
- Striving for perfection and being very self-critical
- Undue influence of body weight or shape on self-esteem
- Depression, anxiety, or irritability
- Withdrawal from friends and social events
- Inability to describe ones emotions
- Doesnt enjoy life thoughts of self-harm or suicide
What Can I Do About It
It’s very important to get help for an eating disorder because bingeing, purging and/or severely limiting how much food you eat can cause a lot of serious health problems such as bone loss, kidney problems, or heart problems, which can be life threatening. But eating disorders are treatable and many people recover with treatment. Treatment for an eating disorder often includes support from a few different professionals. Regular medical check-ups are also important to treat physical health problems. The earlier someone seeks help for their eating disorder, the better the outcomes.
The following are common treatments for eating disorders:
PsychotherapyPsychotherapy is a very important part of treatment. Psychotherapies for eating disorders include:
Nutritional helpA registered dietitian can help you learn about food and help you create healthy meal plans.
Support groupsSupport groups for yourself or your loved ones can help you see that you aren’t alone. You can learn new ways of coping and find support from others.
HospitalizationIf you start to develop serious health problems, you may need to be treated in the hospital.
MedicationSome antidepressants may help treat bulimia and binge-eating disorder. Other medications may be prescribed to help treat eating disorders or other mental illnesses that go along with an eating disorder.
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How Eating Disorders Became A White Women Problem
Radical thinness was so de rigueur that a 1993People cover story dubbed it the waif wave. Kate Moss was the movements poster child, but others repping the fad included casts of hit series like Friends and Ally McBeal, who seemed to be battling one another for peak slimness.
Despite the popularity of the skin-and-bones look, when celebrities admitted to eating disorders, they were censured. When beloved Princess Diana spoke about her bulimia, she received little sympathy from her family. Her husbands response was to gesture toward her plate and ask, Is that going to reappear later? Critics called pop star Fiona Apple Kate Moss with songs, emaciated and too thin, even though she admitted to starving herself to cope with the trauma of being raped.
That women suffering from eating disorders were insulted is no surprise. But the waif wave coincided with a new social awareness of the connection between extreme thinness and a diagnosis an eating disorder. Before, skinniness was a marker of a svelte womans ability to control her body better than her peers. Now it was a symptom of a sickness.
Women of color were practically absent from these representations. They were assumed to not suffer from eating disorders because they reportedly had better body attitudes than their white peers. That same study revealed that 70 percent of black girls were satisfied with their bodies, but coverage of it downplayed the statistic that more than half of them dieted.
Being Involved In Physical Sports
Its not uncommon for people to enjoy competitive sports. Whether its running, dancing or gymnastics doesnt matter. The pressure that comes along with needing to be great can often be daunting.
Some people will starve themselves to perform better. They feel that an extra ten pounds off their frame will improve their game. It can especially be a problem if there are others with the perfect body who seem to excel at their sport.
This poor self-image must be dealt with as it can ruin this and many other aspects of a persons life.
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How Is Anorexia Nervosa Treated
The goals of treatment are to stabilize weight loss, begin nutrition rehabilitation to restore weight, eliminate binge eating/purging behaviors and other ritualistic eating patterns, treat emotional issues such as low self-esteem, correct distorted thinking patterns, and develop long-term behavioral changes.
Treatment options will vary depending on the individuals needs. Treatment most often involves a combination of the following strategies:
This is a type of individual counseling that focuses on changing the thinking and behavior of a person with an eating disorder. Treatment includes practical techniques for developing healthy attitudes toward food and weight, as well as approaches for changing the way the person responds to difficult situations. There are several types of psychotherapy including:
The antipsychotic olanzapine may be helpful for weight gain. Although there is no clear evidence that antidepressant medications can help individuals gain weight, some doctors may prescribe these drugs to help control anxiety and depression associated with an eating disorder.
This strategy is designed to teach a healthy approach to food and weight, to help restore normal eating patterns, and to teach the importance of nutrition and a balanced diet.
Group and/or family therapy
I Saw A Lot Of Blogs About Females And Eating Disorders But Nothing Pointed To Males
Priyesh Vyas, 25, from Kent, looks back on the years he suffered with bulimia and explains how guilt and secrecy defined his battle with the condition
I was bulimic between the ages of 15 and 18. I had a relapse at 21 as well. It was probably down to more than one factor, but exam stress and social media pressure didnt help.
Men have more pressure in looking a certain way in this day and age. I cant pinpoint an exact time when it started it was a gradual thing. There would be times when Id be at school, eat lunch and purge it out in the toilets without anyone knowing.
Its such a secretive eating disorder. No one can physically see it because your weight fluctuates so much. People just cant tell. I would often have balanced meals not junk food or anything bad but Id feel guilty and purge it out. After eating a meal, Id feel like Id put on weight instantly that I wouldnt burn all the calories that Id just consumed.
I was a keen cricketer and there would be instances when Id be playing cricket and Id be bulimic in the middle of a match. There would be points where I would go the whole day without being bulimic and days when Id purge out all my meals thats the nature of the eating disorder.
No one knew until I was caught by a schoolteacher. The teacher had suspicions because I was going to the toilet so often. One time they found me after I had thrown up and told my parents. I felt embarrassed that my secret had suddenly been exposed.
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