 |  Perspectives in Nutrition, 5/e Gordon M. Wardlaw,
Ohio State University
Margaret W. Kessel,
Ohio State University
Eating Disorders: Anorexia Nervosa, Bulimia Nervosa, and other Conditions
Chapter 15 Summary- Anorexia nervosa is most common among high-achieving perfectionist
girls from families marked by conflict, high expectations, rigidity, and denial.
The disorder usually starts with dieting in early puberty and proceeds to the
near-total refusal to eat. Early warning signs include intense concern about
weight gain and dieting, as well as abnormal food habits, such as cooking food
that they won't allow themselves to eat and classifying foods as safe and unsafe.
- Anorexic persons become irritable, hostile, overly critical, and
joyless; they tend to withdraw from family and friends. Eventually, anorexia
nervosa can lead to numerous physical effects, including a profound decrease
in body weight and body fat, a fall in body temperature and heart rate, iron
deficiency anemia, a low white blood cell count, hair loss, constipation, low
blood potassium, and the cessation of menstrual periods. Those with anorexia
nervosa are physically very ill.
- Treatment of anorexia nervosa includes increasing food intake to
support slow weight gain. Psychological counseling attempts to help patients
establish regular food habits and to find means of coping with the life stresses
that led to the disorder. Hospitalization may be necessary, as well as use of
certain medications.
- Bulimia nervosa is characterized by bingeing on large amounts of
food at one sitting and then purging by vomiting or misuse of laxatives, diuretics,
or enemas. Alternately fasting and excessive exercise may be used. Both men
and women are at risk. Vomiting as a means of purging is especially destructive
to the body; it can cause severe tooth decay, stomach ulcers, irritation of
the esophagus, low blood potassium, and other problems. Bulimia nervosa poses
a serious health problem and is associated with significant risk of suicide.
- Treatment of bulimia nervosa includes psychological as well as nutritional
counseling. During treatment, bulimic persons learn to accept themselves and
to cope with problems in ways that do not involve food. Regular eating patterns
are developed as these patients begin to plan meals in an informed, healthful
manner. Certain medications can be a helpful addition to the regimen.
- The female athlete triad consists of disordered eating, amenorrhea,
and osteoporosis and is particularly common in appearance-related and endurance
sports. If not corrected, this disorder eventually leads to decreased athletic
performance and general health problems.
- Binge-eating disorder, which is more widespread than either anorexia
nervosa or bulimia nervosa, is most common among people with a history of frequent,
unsuccessful dieting. Binge eaters typically either practice grazing (i.e.,
eating continually over extended periods) or bingeing without purging. Emotional
disturbances are often at the root of this disordered form of eating. Treatment
addresses deeper emotional issues, discourages food deprivation and restrictive
diets, and helps restore normal eating behaviors. Certain medications may be
a useful addition to this therapy.
- Baryophobia is a condition in which children are underfed by caregivers
in an attempt to limit the risk of future disease, such as obesity or cardiovascular
disease. Growth failure--in weight and height gains--can result if nutrient intake
is not increased to appropriate amounts.
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2002 McGraw-Hill Higher Education