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What is an eating disorder? Well, one of the many definitions for an eating disorder is any range of psychological disorders characterized by disturbed eating habits; which include anorexia nervosa (AN), bulimia nervous (BN) and binge-eating disorder. (CITE). All eating disorders have similar characteristics. This could be a fear of becoming fat, food, weight or calories. The reason why I want to focus on this population is that eating disorders are a significant problem during the adolescent years affecting up to 5% of adolescent girls (Golden et al., 2003).
Someone suffering from an eating disorder has a very unhealthy relationship with food that is prying into many areas of their everyday life. An individual may eat little to no food, eat unreasonably massive amounts of food, be infatuated with thoughts of food or exercise, and have a distorted body image. The Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-V) recognizes four main eating disorders: anorexia nervosa, bulimia nervosa, binge eating disorder, and eating disorder not otherwise specified (EDNOS). (CITE DSM-5).The signs of an eating disorder will vary and may include refusal to eat, extreme exercise, social withdrawal, self-induced vomiting or binge eating.
Many families that have a family member that suffers from an eating disorder also have an increased risk of depression, obesity, substance abuse or consuming too much food. People that suffer from eating disorders may struggle socially, physically and or mentally, there are also many symptoms and signs to watch for. (article 7)
Causes of Eating Disorders:
Eating Disorders are complex disorders, influenced by a façade of factors. Thought the exact cause of eating disorders is unknown, it is generally believed that a combination of biological, psychological and/or environmental abnormalities contribute to the development of these illnesses. (Cite Article 4)
When it comes to biological factors some include; certain people may have irregular hormone functions that increase their risk of developing eating disorders. Genetics (the tie between eating disorders and one’s genes is still being heavily researched, but we know that genetics is a part of the story). And lastly, there are nutritional deficiencies; which is an inadequate supply of essential nutrients in diet resulting in malnutrition or disease. (Mayo Clinic)
Some of the psychological factors or emotional health include people with a negative body image. They may have low self-esteem, perfectionism impulsive behavior and troubled relationships with friends and loved ones. (Article 4)
Environmental factors or social factors that would contribute to the occurrence of eating disorders are dysfunctional family dynamic, professions and careers that promote being thin and weight loss, such modeling. Aesthetically oriented sports, where an emphasis is placed on maintaining a lean body for enhanced performance. Family and childhood traumas: childhood sexual abuse, severe trauma and cultural and/or peer pressure among friends and co-workers. (Article 6)
Signs and Symptoms: (CITIE Article)
Symptoms may vary depending on the type of eating disorder. A man or a woman suffering from an eating disorder may reveal several signs and symptoms that are both the same and different.
Anorexia is possible life-threatening eating disorder characterized by an atypically low body weight, intense fear of gaining weight and one-sided perception of weight or shape. People that suffer from anorexia use dangerous efforts to control their weight and shape, which often knowingly interferes with their lifestyle. Obsession with calories and fat contents of food or use other methods to lose weight; such as having engaging in formalized eating patterns, including, cutting food into tiny pieces, eating alone, and/or hiding food. (Cite article 5)
Bulimia is a serious, theoretically life-threatening eating disorder. When you have bulimia, you have episodes of bingeing and purging that involve feeling a lack of control over your eating. Many people with bulimia also restrict their eating during the day, which often leads to more binge eating and purging (Cite article 3). During these episodes, bulimics typically eat a large amount of food in a short time, and then try to rid of the extra calories in an unhealthy way. Because of guilt, shame and an intense fear of weight gain from overeating, they may force vomiting (purging bulimia), exercise too much, or use other methods, such as laxatives, to get rid of the calories (no purging bulimia). Even if you are bulimic, you’re undoubtedly preoccupied with weight and body shape and may judge severely and harshly for self-perceived flaws. Bulimic may be at a normal weight or even a bit overweight. (Cite article 4)
When it comes to a binge-eating disorder, many regularly eat too much food (binge) and feel a lack of control over eating. Eating quickly or eat more food than intended, even when not hungry, and may continue eating even long after becoming uncomfortably full. After a binge, there may feeling of guilty, disgusted or ashamed by the behavior displayed and the amount of food eaten (Cite Article 2). Many will try to but do not try to compensate for this behavior with excessive exercise or purging, as someone with bulimia or anorexia might. Embarrassment can lead to eating alone to hide bingeing. A new round of bingeing usually occurs at least once a week. Many may be normal weight, overweight or obese (Cite article 1)
Treatment of an eating disorder generally includes a team approach. The team typically includes medical providers, mental health providers and dietitians; all with experience in eating disorders. Many of the treatments are based around your specific type of eating disorder. However, in general, it typically includes psychotherapy, nutrition education and medication thorough being either an outpatient, or inpatient and if your life is at risk the possibility of being hospitalized. (CITIE ARTICLE 2). Psychotherapy, also known as talk therapy can help learn how to replace unhealthy habits with healthy ones. Psychotherapy can also help to improve the relationships and moods. Psychotherapy can include both Cognitive Behavioral therapy and Family Based Therapy. (Cite Article 3)
Cognitive Behavioral Therapy
Cognitive Behavioral Therapy (CBT) is applicable to all eating disorders but has been most intensively studied in the treatment of bulimia nervosa (BN). CBT is designed to alter abnormal attitudes about body shape and weight. (CITE ARTICLE 1) CBT is effective in reducing all core features of BN and shows good maintenance of therapeutic improvement.
Family Based Therapy
Family Based Therapy (FBT) is an evidence-based treatment for children and over teenagers dealing with eating disorders. The family is involved in making sure that the child or other family member follow healthy-eating patterns and maintains a healthy body image and weight. (Cite article 1)
The goals of this form of treatment include restoring a normal weight and maintaining that weight, managing physiologic abnormalities, reducing the comorbid psychiatric symptoms such as depression, and changing the fundamental thoughts that are underlying the anorexia. Bulimics require similar medical management with the goal of the treatment being the restoration of a normalized eating pattern free of the binge and/or purge cycle. (Article 6)
For the patient with anorexia nervosa (AN) who have had repeated hospitalizations, a partial hospitalization treatment plan is recommended. The partial hospitalization treatment should follow a group treatment model and should include nutritional counseling, meal planning and additional groups such as social skills training. For a patient with BN who are in transition from inpatient to outpatient treatment or those whose bingeing and purging have begun to interfere with their functioning may be treated in partial hospitalization. (Article 3)
The criteria need for hospitalization for both anorexia and bulimia include unstable medical conditions. Weight loss of 10% to 15% or more normal for relapse only or 16% to 20% or more if it is a patients’ first episode. (Cite article 1). The inpatient hospitalization beings with a full evaluation, including a psychiatric and medical evaluation.
Patients with anorexia are fed initially with supplemental liquid feedings 6 times a day until they are within at least 10% of their goal weight. Patients who refuse the feedings consistently and do not gain weight are given feeing through nasal gastric tubes (Mayo Clinic).
Bulimic patients being with food trays. The goal for both anorectics and bulimics is self-regulated weight maintenance. This is done through letting the patient self-selecting meals after a period of weight maintenance within their range. Both the bulimic and the anorectic are participants in response prevention techniques intended to prevent any purging behavior. (John Hopkins)
Future Practitioner Helping Individual with Eating Disorders from Empowerment and Strength Perspectives
The empowerment perspective and the strength-based approach work together. In social service work, the strengths-based approach involves helpers highlighting the client’s strengths and not their shortfalls. There are different ways to empower clients; and how empowerment can benefit the clients and social services workers attitudes, relationships etc. Social workers need to be aware and practice methods for empowerment effectively to be able to believe in their client’s strengths, abilities, and dreams. (Cite empowerment article). Empowerment does not give people power, people already have plenty of power. Empowerment is defined as letting this power out. It encourages people to gain the skills and knowledge that will allow them to overcome obstacles in life or work environment and eventually help them develop strengths within themselves or in the society (Cite Theo class).