What are eating disorders?
Each year, millions of people in the United States are affected
by serious and sometimes life-threatening eating disorders. The
vast majority -- more than 90 percent -- of those afflicted with
eating disorders are adolescent and young adult women. One reason
that women in this age group are particularly vulnerable to eating
disorders is their tendency to go on strict diets to achieve an
"ideal" figure. Researchers have found that such stringent dieting
can play a key role in triggering eating disorders.
Approximately 1 percent of adolescent girls develop anorexia
nervosa, a dangerous condition in which they can literally starve
themselves to death. Another 2-3 percent of young women develop
bulimia nervosa, a destructive pattern of excessive overeating
followed by vomiting or other "purging" behaviors to control their
weight. These eating disorders also occur in men and older women,
but much less frequently.
The consequences of eating disorders can be severe. For example,
one in ten cases of anorexia nervosa leads to death from
starvation, cardiac arrest, other medical complications, or
suicide. Fortunately, increasing awareness of the dangers of eating
disorders -- sparked by medical studies and extensive media
coverage of the illness -- has led many people to seek help.
Nevertheless, some people with eating disorders refuse to admit
that they have a problem and do not get treatment. Family members
and friends can help recognize the problem and encourage the person
to seek treatment.
What are the medical complications of eating
Medical complications can frequently be a result of eating
disorders. Individuals with eating disorders who use drugs to
stimulate vomiting, bowel movements, or urination may be in
considerable danger, because this practice increases the risk of
In patients with anorexia, starvation can damage vital organs
such as the brain and heart. To protect itself, the body shifts
into "slow gear": monthly menstrual periods stop, breathing pulse
and blood pressure rates drop, and thyroid function slows. Nails
and hair become brittle; the skin dries, yellows, and becomes
covered with soft hair called lanugo. Excessive thirst and frequent
urination may occur. Dehydration contributes to constipation, and
reduced body fat leads to lowered body temperature and the
inability to withstand cold.
Mild anemia, swollen joints, reduced muscle mass, and
light-headedness also commonly occur in anorexia. If the disorder
becomes severe, patients may lose calcium from their bones, making
them brittle and prone to breakage. They may also experience
irregular heart rhythms and heart failure. In some patients, the
brain shrinks, causing personality changes. Fortunately, this
condition can be reversed when normal weight is reestablished.
Scientists have found that many patients with anorexia also
suffer from other psychiatric illnesses. While the majority have
co-occurring clinical depression, others suffer from anxiety,
personality or substance abuse disorders, and many are at risk for
suicide. Obsessive-compulsive disorder (OCD), an illness
characterized by repetitive thoughts and behaviors, can also
accompany anorexia. Individuals with anorexia are typically
compliant in personality but may have sudden outbursts of hostility
and anger or become socially withdrawn.
Bulimia nervosa patients -- even those of normal weight -- can
severely damage their bodies by frequent binge eating and purging.
In rare instances, binge eating causes the stomach to rupture;
purging may result in heart failure due to loss of vital minerals
such as potassium. Vomiting causes other less deadly, but serious,
problems -- the acid in vomit wears down the outer layer of the
teeth and can cause scarring on the backs of hands when fingers are
pushed down the throat to induce vomiting. Further, the esophagus
becomes inflamed and glands near the cheeks become swollen. As in
anorexia, bulimia may lead to irregular menstrual periods. Interest
in sex may also diminish.
Some individuals with bulimia struggle with addictions including
abuse of drugs and alcohol, and compulsive stealing. Like
individuals with anorexia, many people with bulimia suffer from
clinical depression, anxiety, OCD, and other psychiatric illnesses.
These problems, combined with their impulsive tendencies, place
them at higher risk for suicidal behavior.
People with binge eating disorder are usually overweight so they
are prone to the serious medical problems associated with obesity,
such as high cholesterol, high blood pressure, and diabetes. Obese
individuals also have a higher risk for gallbladder disease, heart
disease, and some types of cancer. Individuals with binge eating
disorder also have high rates of co-occurring psychiatric illnesses
-- especially depression.
What causes eating disorders?
In trying to understand the causes of eating disorders,
scientists have studied the personalities, genetics, environments,
and biochemistry of people with these illnesses. As is often the
case, the more that is learned, the more complex the roots of
eating disorders appear.