Range of treatments: Eating disorders
Do your thoughts revolve around the subject of food more than an average amount? Do you check your weight several times a day? Do you decide in advance what you can and cannot eat during the day? Do you sometimes eat in secret and immediately feel bad after consuming more calories? If any of these apply to you, you may have an eating disorder.
What are eating disorders?
Eating disorders are very serious psychosomatic illnesses. They usually develop insidiously and manifest themselves in the form of severe disturbances in eating behaviour and a disturbed perception of one’s own body image. Those affected are almost exclusively fixated on the issues of food, calories and figure. The tendency towards eating disorders often develops in childhood. Most cases occur in teenage years and early adolescence. Girls and young women are around 10 times more likely to suffer from this disease than boys and young men. If left untreated, there can be serious health consequences with organ damage, with around ten percent of those affected even dying from it.
Eating disorders: When the soul is hungry …
The causes of eating disorders are very complex and usually consist of many different factors, which are often weighted very differently and can mutually influence each other. Usually several factors have to come together for an eating disorder to develop. The most important factors include:
- Biological causes
Hereditary influences as well as changes in the hormonal balance and certain messenger substances can promote the development of eating disorders. The respective normal weight also differs from person to person. Due to genetics, some people can utilise food particularly well and thus gain weight more easily, while others can eat significantly more, more or less “with impunity”.
- Personal causes
Certain personality traits, such as low self-esteem paired with extremely high standards as well as pronounced perfectionism and a high desire for control, are observed particularly frequently in people with eating disorders. The ability to resolve conflicts, on the other hand, is often below average. In addition, there are often problems coping with stress. Traumatic experiences such as violence, parental separation or the loss of a loved one are also considered risk factors. Often there have already been problems with eating and nutrition or being overweight in childhood.
- Family causes
Family structures with bad role models in terms of nutrition as well as parental neglect, but also excessive control and relief problems during puberty can play a role in the development of eating disorders. Depressive and addictive behaviour by a parent are also considered risk factors. In addition, certain values such as success, performance and self-control often play an above-average role in families of people with eating disorders. By contrast, understanding discussions, conflict resolution and a positive culture of debate are often neglected.
- Socio-cultural causes
In addition, prevailing western ideals of beauty with extremely slim role models, such as models, influencers, artists, etc. also promote dissatisfaction with one’s own body. Comparisons with peers often lead to conflict situations with high social pressure due to negative comments and bullying by the peer group.
What type of eating disorders are there?
Eating disorders come in different forms and can become visible to the outside world through being very underweight or very overweight. But they can also remain largely hidden from those around the individual, because even people with a normal weight can suffer from an eating disorder.
Eating disorders are broadly classified into three forms, which cannot always be clearly separated from one another. Sometimes one eating disorder merges into or develops from the other. Different eating disorders can also occur in phases or alternately in the same person.
Eating disorders: Important indications
– Anorexia nervosa
– Bulimia nervosa
– Binge eating
Anorexia nervosa – What is anorexia?
People who suffer from anorexia nervosa try to lose weight or prevent weight gain in an abnormal manner. Behind this is a distorted perception of one’s own body image, where they often reject and perceive their body as too fat, even if it appears normal or is already underweight. The everyday life of those suffering from anorexia is mainly characterised by strong control and renunciation. In order to continue to lose weight, those affected ignore physical signals and also accept the health consequences.
What are the symptoms of anorexia?
- Significant weight loss or extremely low body weight.
- Refusal to take part in meals together.
- Small portion sizes and pecking around the plate without eating.
- Demonisation and complete renunciation of high-calorie meals.
- Strict fasting.
- Constant fear of gaining weight.
- Criticism and derogatory remarks about one’s own body.
- High preoccupation with calories and food ingredients.
- Excessive exercise to lose weight.
- Abuse of laxatives or diuretics in order to lose weight.
- Frequent freezing.
- Absence of menstruation in girls.
- Potency problems in boys.
Bulimia nervosa – What is bulimia?
Bulimia nervosa is an eating disorder which involves recurring cravings with uncontrolled binge eating, usually in secret. Those affected consume incredibly large amounts of high-calorie foods within a short period of time – which are otherwise strictly forbidden. They then feel very ashamed and try to counteract weight gain using all means necessary. Usually, vomiting is induced by the ingested food itself. In addition, appetite suppressants, laxatives, thyroid medication or excessive exercise can be used to maintain or reduce weight. It is not uncommon for bulimia nervosa to be preceded by anorexia. Bulimics also have phases in which they fast strictly or eat normally again.
What are the symptoms of bulimia?
- Weight fluctuations
- Self-esteem is mainly defined by body weight and figure
- Repetitive binge eating
- Repetitive vomiting
- Low self-esteem
- Hunger for approval
- Shame, disgust, feelings of guilt
- Withdrawal and isolation to carry out binge eating with vomiting
- Feeling of inner emptiness
- Disorders of hunger and satiety
- Tooth damage with enamel defects from stomach acid
- Skin injuries on the knuckles (Russell’s Sign) caused by frequently “sticking fingers into the throat”
- Disruptions to menstrual cycle
Binge eating: What is it?
Binge eating disorder also involves repeated binge eating in which large amounts of food are consumed in an uncontrolled manner. The feeling of physical satiety is usually no longer perceived and the individual only stops eating when they start to feel unpleasantly full. The binge eating often takes place independently of feelings of hunger. Rather, it is more about reducing frustration and strong emotional tensions. In contrast to bulimia nervosa, the food eaten is not vomited again afterwards. Therefore, people with binge eating disorder usually put on weight a lot. They are usually overweight or even obese. The proportion of male patients is around a third in binge eating patients, significantly higher than in anorexia or bulimia.
What are the symptoms of binge eating disorder?
- Recurring uncontrolled binge eating
- Disrupted feelings of hunger and satiety
- Eating particularly quickly
- No stopping until an uncomfortable feeling of fullness sets in
- Self-disgust, shame and feelings of guilt after binge eating
- Low self-esteem
- Hiding binge eating from other people
- Hoarding and hiding food
- People often eat alone out of shame
Eating disorders: Health consequences
All eating disorders have serious health effects because – even with eating disorders with normal or overweight – the body is permanently undernourished. If essential vitamins and minerals are missing, important biological processes are disrupted, and the body breaks down more muscle mass. The longer the diseases are left untreated, the more severe the health effects. The main health consequences of eating disorders include:
For anorexia nervosa (anorexia)
- Hair loss
- Dry skin and brittle nails
- Loss of muscle mass
- Changes in blood count
- Circulatory disorders with constant freezing
- Kidney damage
- Cardiovascular disorders
- Disorders of the bone metabolism with an increased risk of breakage
- Hormonal imbalances with no menstruation
- Liver disease
For bulimia nervosa (bulimia)
- Tooth damage with pain from stomach acid
- Burns and tears in the oesophagus from stomach acid
- Disturbances in the water and electrolyte content
- Circulatory disorders
- Cardiac arrhythmias
- Difficulty concentrating
- Menstrual disorders
- Kidney problems
For binge eating disorder (eating addiction)
- Severe weight gain
- Shortness of breath
- Sleep apnoea
- High blood pressure
- Insulin resistance
- Lipid metabolism disorders
- Cardiovascular disease
- Joint problems
- Risk of suicide
Common comorbidities of eating disorders
Eating disorders often appear along with other mental illnesses, some of which are the cause of the eating disorder. However, they can also develop as a result of the eating disorder. It is not uncommon for the symptoms to fuel each other, meaning that the situation of those affected continues to worsen. The most common comorbidities associated with eating disorders include:
Feelings of extreme depression, loneliness, shame, and self-disgust are often associated with eating disorders and can themselves be triggers for the eating disorders. Since strong social withdrawal and self-debasing feelings often occur in connection with eating disorders, the depressive tendencies often intensify even further, and even up to the risk of suicide.
It is not uncommon for patients with eating disorders to also suffer from anxiety disorders. In particular, social phobias, i.e. the fear of being perceived by others as “disturbed” or “not right” and being assessed negatively, are often pronounced in people with eating disorders.
Obsessive-compulsive disorder, in which certain actions have to be carried out over and over again or obsessive-compulsive thoughts have to be constantly thought and simply cannot be shaken off, are also common in patients with eating disorders. In particular, people with anorexia are often also affected by obsessive-compulsive disorder.
In many cases, patients with eating disorders are also dependent on addictive substances. Certain substances such as nicotine, appetite suppressants and cocaine are primarily consumed because they reduce the feeling of hunger. Alcohol and nicotine also affect the mood. Alcohol addiction is often also especially found in bulimia.
Which therapies exist for eating disorders?
Unfortunately, eating disorders do not go away on their own, but get worse over time if left untreated. In the worst case, this can lead to death. Around one in ten people affected die from these diseases. In order to help people with eating disorders, comprehensive and intensive treatment is required that takes into account the many different causes, recognises all comorbidities and also compensates for individual physical deficits and deficiency symptoms in a targeted manner. Current therapies primarily prescribe the use of psychotherapy and psychiatric drugs.
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If you are suffering from an eating disorder, we recommend that you participate in the CALDA Full Program.