Tuesday, June 12, 2012
Eating disorders can have fatal results
"Tragically, there is a 15-21 percent mortality rate among anorexics. It's very common for someone to die of starvation or a complication from it."
Those words illustrate the seriousness of anorexia nervosa. They were spoken by Batesville psychiatrist William H. Goodin Jr., who classified the conditions of anorexia nervosa and bulimia as psychiatric disorders with physical manifestations.
A parent, friend or spouse who suspects a loved one might be suffering from one of the disorders should, Goodin said, "confront them. . .honestly and directly. . .and not accuse them or label them."
complete physical is a must, he said. "It's important not only for the individual to talk to the physician, but for the parent to as well."
He said the person to treat anorexia nervosa should be a medical doctor specializing in psychiatry who has the expertise for treating anorexia nervosa. Goodin said results of treatment generally are much quicker in someone suffering from bulimia. "Treatment for someone with anorexia nervosa is often long-term and requires frequent hospitalization."
Studies indicate that the incidence of bulimia is highest among college-age students, all though in the general population, it is very common from early adolescence through age 30, Goodin said.
Engaging in bulimic behavior may begin as a fad for college-aged girls, but those with some predisposed fears about getting overweight and who are overly concerned with their physical apearance do get into a pattern of bulimia. The pattern may shift from periodically inducing vomiting to recurrent episodes of eating until stuffed. "At that point," Goodin said, "it becomes an emotional
problem. And soon, it becomes a physical problem." Not only does the bulimic begin to consume large amounts of food, but she (or he) consumes it privately, often very rapidly and compulsively. The pattern includes stuffing within a two-hour period. After binging, the person may become very sleepy and withdrawn, and many immediately make themselves vomit.
Goodin said two giveways of bulimia a physician may discover during a physical exam are an abrasion on the hand from inducing vomiting and erosion of tooth enamel froni stomach acid.
Bulimia is more common in families that tend to be overweight. "The young woman (or man) is generally making strong attempts to lose weight," Goodin said. "She generally is not overweight but becomes obsessed with fear of being overweight.''
Her regimen may include highly restrictive diets, self-induced vomiting, use of diurectics (fluid pills) and laxatives. Her weight can fluctuate as much as 10 pounds from day to day.
"The bulimic is generally very aware that her eating pattern is abnormal, and she is not denying it to herself, as is the anorexic," he continued. "She has a fear that once she starts eating normally, she might not be able to stop.''
Depression is common to bulimics, especially after gorging. Related physical problems include fatigue, chemical imbalance, including dangerously lowering the body's potassium level, and arrhythmia of the heart.
Dr. Arnold E. Andersen, assistant professor of psychiatry and behaviorial sciences at the Johns Hopkins University and author of "Practical Comprehensive Treatment of Anorexia Nervosa and Bulimia," described anorexia nervosa as: " ... a serious, life-threatening disorder which occurs primarily in females who are typically 12-25 years of age at the onset of the condition.''
He said the syndrome is more common among patients from middle and upper-middle-class backgrounds, and the pre-illness personality is characterized by perfectionism, perseverance, model behavior as children and limited emotional insight.
With the progressive loss of weight, Andersen said, "the patient ironically perceives herself as still being overweight, even when severely emaciated. Food becomes a major obsession. Physical activity usually increases as a means of further weight loss.''
As weight is lost, mere is an increased interest in food preparation, and the anorexic becomes an expert in the caloric and fat contents of foods. "A person with anorexia nervosa has an intense fear of being fat," Goodin said. "That fear does not dissipate with weight loss. The person still feels fat. There is no way to talk her out of it." Although Goodin might suspect a patient of being anorexic, he said he assumes a physical problem might exist "until I've found otherwise."
The National Association of Anorexia Nervosa and Associated Disorders (ANAD) says families, not just the victim, needs therapy. "The real solution lies in getting the patient to talk out her feelings and begin to accept herself," ANAD says in its literature. "Once a patient becomes aware of why she has an eating disorder, she has a chance of beginning the slow, painful journey back toward self-control and self-confidence. The best help the victim's family can offer is not shaking a scolding finger or trying to force the loved one to eat, out a listening ear and an understanding heart."