EATING DISORDERS

Also called: Anorexia nervosa, Binge eating, Bulimia, Pica.

     
Summary
What are eating disorders?

Eating disorders are serious mental health disorders. They involve severe problems with
your thoughts about food and eating behaviors. You may eat much less or much more than
you need.

Eating disorders are medical conditions; they are not a lifestyle choice. They affect your
body's ability to get proper nutrition. This can lead to health issues, such
as heart and kidney problems, or sometimes even death. But there are treatments that can
help. They also involve extreme concern about your shape and weight.

What are the types of eating disorders?

Common types of eating disorders include throw up: vomitar

 Binge-eating, which is out-of-control eating. People with binge-eating disorder keep eating
even after they are full. They often eat until they feel very uncomfortable. Afterward, they
usually have feelings of guilt, shame, and distress. Eating too much too often can lead to
weight gain and obesity. Binge-eating disorder is the most common eating disorder in the
U.S.
Women are more likely than men to have eating disorders. They usually start in the teenage
years and often occur along with depression, anxiety disorders, and substance abuse.
 Bulimia nervosa. People with bulimia nervosa also have periods of binge-eating. But
afterwards, they purge, by making themselves throw up or using laxatives. They may also
over-exercise or fast. People with bulimia nervosa may be slightly underweight, normal
weight, or overweight.
 Anorexia nervosa. People with anorexia nervosa avoid food, severely restrict food, or eat
very small quantities of only certain foods. They may see themselves as overweight, even
when they are dangerously underweight. Anorexia nervosa is the least common of the three
eating disorders, but it is often the most serious. It has the highest death rate of any mental
disorder.
Anorexia nervosa, in which you become too thin, but you do not eat enough because you
think you are fat.
 What causes eating disorders?

The exact cause of eating disorders is unknown. Researchers believe that eating disorders are
caused by a complex interaction of factors. These include genetic, biological, behavioral,
psychological, and social factors. Genes and hormones may play a role. Social attitudes that
promote very thin body types may also be involved.
Who is at risk for eating disorders?

Anyone can develop an eating disorder, but they are more common in women. Eating
disorders frequently appear during the teen years or young adulthood( adultez). But people
can also develop them during childhood ( infancia-niñez) or later in life.

What are the symptoms of eating disorders?

The symptoms of eating disorders vary, depending on the disorder:

The symptoms of binge-eating include

 Eating unusually large amounts of food in a specific amount of time, such as a 2-hour
period
 Eating even when you're full or not hungry
 Eating fast during binge episodes
 Eating until you're uncomfortably ( incomodamente) full
 Eating alone or in secret to avoid embarrassment
 Feeling distressed ( angustiado), ashamed (avergozado), or guilty( culpable) about your
eating
 Frequently dieting, possibly without weight loss.

The symptoms of bulimia nervosa include the same symptoms as binge-eating, plus trying
to (get rid of – deshacerse de) he food or weight after binging by

 Purging, making yourself throw up or using laxatives or enemas to speed up(acelerar) the
movement of food through your body
 Doing intensive and excessive exercise
 Fasting (ayuno)
Over time, bulimia nervosa can cause health problems such as

 Chronically inflamed and sore throat

 Swollen salivary glands in the neck and jaw area
 Worn tooth enamel and increasingly sensitive and decaying teeth. This is caused by the
exposure to stomach acid every time you throw up.
 GERD – Gastroesophageal Reflux Disease - (acid reflux) and other gastrointestinal
problems
 Severe dehydration from purging.
 Electrolyte imbalance, which could be too low or too high levels of sodium, calcium,
potassium and other minerals. This can lead to a stroke or heart attack.

The symptoms of anorexia nervosa include

 Eating very little, to the point of starving(hambre extrema) yourself

 Intensive and excessive exercise
 Extreme thinness(delgadez)
 Intense fear of gaining weight
 Distorted body image - seeing yourself as overweight even when you are severely
underweight
Over time, anorexia nervosa can cause health problems such as

 Thinning of the bones (osteopenia or osteoporosis)

 Mild anemia (anemia moderada)
 Muscle wasting and weakness
 Thin, brittle(quebradiza) hair and nails
 Dry, blotchy(llena de manchas) , or yellowish skin
 Growth of fine hair all over the body
 Severe constipation
 Low blood pressure
 Slowed breathing and pulse.
 Feeling cold all the time because of a drop in internal body temperature
 Feeling faint (mareo todo da vueltas), dizzy( , or weak
 Feeling tired all the time
 Infertility
 Damage to the structure and function of the heart
 Brain damage
 Multi-organ failure
Anorexia nervosa can be fatal. Some people with this disorder die of complications from
starvation, and others die of suicide.
Some people with eating disorders may also have other mental disorders (such
as depression or anxiety) or problems with substance abuse.
RISK FACTORS OF ANOREXIA INCLUDE

 Being more worried about, or paying more attention to, weight and shape.
 Having an anxiety disorder as a child
 Having a negative self-image
 Having eating problems during infancy or early childhood
 Having certain social or cultural ideas about health and beauty
 Trying to be perfect or overly focused on rules.

Treatment for Anorexia Nervosa

The biggest challenge in treating anorexia nervosa is helping the person recognize that they
have an illness. Most people with anorexia deny that they have an eating disorder. They
often seek treatment only when their condition is serious.

Goals of treatment is to restore normal body weight and eating habits. A weight gain of 1 to
3 pounds per week is considered a safe goal.

Different programs have been designed to treat anorexia. These may include any of the
following measures:

 Increasing social activities

 Reducing the amount of physical activities
 Using schedules(horarios) for eating

If a person has lost a lot of weight – being below 70% of their ideal weight for their age and
height. They need to be hospitalized because of their severe and life-threatening
malnutrition, the person may need to be fed through a vein or stomach tube.
Weight loss continues, even with treatment.
Medical complications, such as heart problems, confusion, or low potassium (K) levels
develop.
The person has severe depression or thinks about committing suicide.

Care providers who are usually involved in this program include:

Nurse practitioners
Physicians
Physician assistants
Dietitians
Mental health care providers

Treatment is often very difficult. People and their families must work hard. Many therapies
may be tried until the disorder is under control.
 Many people drop out( dejar) programs if they have unrealistic hopes of being “cured” with
therapy alone.

How are eating disorders diagnosed?

Because eating disorders can be so serious, it is important to seek(buscar) help if you or a

loved one thinks that you might have a problem. To make a diagnosis, your health care
provider

 Will take a medical history and ask about your symptoms. It is important to be honest about
your eating and exercise behaviors so your provider can help you.
 Will do a physical exam
 May do blood or urine tests to rule out other possible causes of your symptoms
 May do other tests to see whether you have any other health problems caused by the eating
disorder. These can include kidney function tests and an electrocardiogram (EKG or ECG).

What are the treatments for eating disorders?

Treatment plans for eating disorders are tailored (adaptar) to individual needs. You will
likely have a team of providers helping you, including doctors, nutritionists, nurses, and
therapists. The treatments may include.

 Individual, group, and/or family psychotherapy. Individual therapy may include

cognitive behavioral approaches(enfoques), which help you to identify and change negative
and unhelpful thoughts. It also helps you build coping(arreglarselas,afrontar)
skills(habilidades) and change behavioral patterns.
 Medical care and monitoring, including care for the complications that eating disorders
can cause
 Nutrition counseling. Doctors, nurses, and counselors will help you eat healthy to reach
and maintain a healthy weight.
 Medicines, such as antidepressants, antipsychotics, or mood stabilizers, may help treat
some eating disorders. The medicines can also help with the depression and anxiety
symptoms that often go along with eating disorders.
Some people with serious eating disorders may need to be in a hospital or in a residential
treatment program. Residential treatment programs combine housing(caseros) and
treatment services.

NIH: National Institute of Mental Health

PICA
Pica is a pattern of eating non-food materials, such as dirt or paper.

CAUSES

Pica is seen more in young children than adults. Up to(hasta) one third of children of ages 1 to 6
have these eating behaviors. It is unclear how many children with pica intentionally consume dirt
(geophagy-comer cosas de la tierra ).

Pica can also occur during pregnancy. In some cases, a lack of certain nutrients, such as iron (Fe)
and zinc (Zn), may trigger the unusual cravings. Pica may also occur in adults who crave a certain
texture in their mouth.

SYMPTOMS

Children and adults with pica may eat:

 Animal feces
 Clay
 Dirt
 Hairballs
 Ice
 Flaking paints
 Sand(tierra)

This pattern of eating must last for at least 1 month to fit the diagnosis of pica.

Depending on what is being eating and how much, symptoms of other problems may be present,
such as:

 Belly pain, nausea and bloating caused by blockage in the stomach or intestine.
 Fatigue, behavior problems and other findings of lead (Pb) poisoning or poor nutrition.

Possible Complications.

Bezoar (a mass of indigestible material trapped inside the body, most often in the stomach) and
infection.

1. One of the symptoms of bulimia is electrolyte imbalance. hyponatremia

Electrolytes play a vital role in maintaining homeostasis in the body. They help regulate
heart and neurological function, fluid balance, oxygen delivery, acid-base balance, and
much more.
Common symptoms of an electrolyte imbalance include:
 Irregular heartbeat(arritmia)
 Fast heart rate = tachycardia
 fatigue
 lethargy
 convulsions or seizures
 nausea
 vomiting
 diarrhea or constipation
What are the three main electrolytes?
Na, K, Cl- ions
K is one of the most important minerals in the body.
Why? It helps regulate fluid balance, muscle contractions, and nerve signals,
what’s more, a high K diet may help reduce blood pressure and water retention,
protect against stroke (CVA) and prevent osteoporosis and kidney stones(calculos
renales).
Low K level in the blood may cause dangerous heart rhythms.
Gorge (Verb) eat a lot of something, until you’re too full to eat any more.
Gorging atracón.
A person with binge-eating disorder keeps eating when full (gorging) or until
uncomfortably full. Stuff yourself(atragantarse a usted mismo).

One of the symptoms of anorexia is infertility. Why? Amenorrhea = absence of

periods, menstrual periods, menses, menstruation. Normal during pregnancy,
menopause.

Cutting
Pregorexia
Vigorexia
Diabulimia

What is the most common eating disorder in the United States?

Binge-eating disorders
What are the possible complications of binge-eating disorders?
With binge-eating, a person often eats unhealthy foods that are high in sugar and
fat, and low in nutrients and protein. This can lead to health problems such as high
cholesterol, diabetes type 2, gallbladder disease, and obesity.

Heart disease
High blood pressure
Joint pain
Menstrual problems. What are the menstrual problems due to a binge-eating
disorder?

Amenorrhea/ oligomenorrhea

Menorrhagia very heavy bleeding during menstruation

Polymenorrhea.
AMENORREO

Prolactin is a hormone produced by the pituitary gland.

High levels of prolactin > irregular or no periods.

>infertility
>breast milk discharge when you’re not pregnant or
nursing.
Tenderness in your breasts.
Menopausal symptoms: hot flushes, vaginal dryness