Classification of Eating Disorders

Classification of Eating Disorders

Eating disorders refer to a group of conditions defined by abnormal eating habits that may involve either insufficient or excessive food intake to the detriment of an individual’s physical and mental health. Bulimia nervosa, anorexia nervosa, and binge eating disorder are the most common specific forms in the United Kingdom.Though primarily thought of as affecting females eating disorders affect males as well. An estimated 10 – 15% of people with eating disorders are males. Although eating disorders are increasing all over the world among both men and women, there is evidence to suggest that it is women in the Western world who are at the highest risk of developing them and the degree of westernization increases the risk. Nearly half of all Americans personally know someone with an eating disorder. The skill to comprehend the central processes of appetite has increased tremendously since leptin was discovered, and the skill to observe the functions of the brain as well.

The precise cause of eating disorders is not entirely understood, but there is evidence that it may be linked to other medical conditions and situations. Cultural idealization of thinness and youthfulness have contributed to eating disorders affecting diverse populations. One study showed that girls with ADHD have a greater chance of getting an eating disorder than those not affected by ADHD.Another study suggested that women with PTSD, especially due to sexually related trauma, are more likely to develop anorexia nervosa.One study showed that foster girls are more likely to develop bulimia nervosa. Some think that peer pressure and idealized body-types seen in the media are also a significant factor. Some research show that for certain people there are genetic reasons why they may be prone to developing an eating disorder.

While proper treatment can be highly effective for many suffering from specific types of eating disorders, the consequences of eating disorders can be severe, including death(whether from direct medical effects of disturbed eating habits or from comorbid conditions such as suicidal thinking

The specific cause/ causes of eating disorders are unknown. However, it is believed to be due to a combination of biological, psychological and/or environmental abnormalities. A common belief is that “Genetics loads the gun, environment pulls the trigger. This would mean that some people are born with a predisposition to it, which can be brought to the surface pending on environment and reactions to it. Many people with eating disorders suffer also from body dysmorphic disorder, altering the way a person sees themselves.There are also many other possibilities such as environmental, social and interpersonal issues that could promote and sustain this illness.Also, the media are oftentimes blamed for the rise in the incidence of eating disorders due to the fact that media images of idealized slim physical shape of people such as models and celebrities motivate or even force people to attempt to achieve slimness themselves. The media are accused of distorting reality, in the sense that people portrayed in the media are either naturally thin and thus unrepresentative of normality or unnaturally thin by forcing their bodies to look like the ideal image by putting excessive pressure on themselves to look a certain way.

Classification of Eating Disorders

  • Anorexia nervosa (AN), characterized by refusal to maintain a healthy body weight, an obsessive fear of gaining weight, and an unrealistic perception of current body weight. However, some patients can suffer from Anorexia nervosa unconsciously. These patients are classified under “atypical eating disorders”. Anorexia can cause menstruation to stop, and often leads to bone loss, loss of skin integrity, etc. It greatly stresses the heart, increasing the risk of heart attacks and related heart problems. The risk of death is greatly increased in individuals with this disease.
  • Bulimia nervosa (BN), characterized by recurrent binge eating followed by compensatory behaviors such as purging (self-induced vomiting, excessive use of laxatives/diuretics, or excessive exercise). Fasting and over exercise may also used as a method of purging following a binge.
  • Binge eating disorder (BED) or ‘compulsive overeating’, characterized by binge eating, without compensatory behavior. This type of eating disorder is even more common than Bulimia or anorexia. This disorder does not have a category of people in which it can develop. In fact, this disorder can develop in a range of ages and is unbiased to classes.
  • Compulsive overeating, (COE) characteristic of binge eating disorder, in which people tend to eat more than necessary resulting in more stress. This is mainly caused by ‘binge eating disorder’.
  • Purging disorder, characterized by recurrent purging to control weight or shape in the absence of binge eating episodes.
  • Rumination, characterized by involving the repeated painless regurgitation of food following a meal which is then either re-chewed and re-swallowed, or discarded.
  • Diabulimia, characterized by the deliberate manipulation of insulin levels by diabetics in an effort to control their weight.
  • Food maintenance, characterized by a set of aberrant eating behaviors of children in foster care.[19]
  • Eating disorders not otherwise specified (EDNOS) can refer to a number of disorders. It can refer to a female individual who suffers from anorexia but still has her period, someone who may be at a “healthy weight”, but who has anorexic thought patterns and behaviors, it can mean the sufferer equally participates in some anorexic as well as bulimic behaviors (sometimes referred to as purge-type anorexia), or to any combination of eating disorder behaviors which do not directly put them in a separate category.
  • Pica, characterized by a compulsive craving for eating, chewing or licking non-food items or foods containing no nutrition. These can include such things as chalk, paper, plaster, paint chips, baking soda, starch, glue, rust, ice, coffee grounds, and cigarette ashes. These individuals cannot distinguish a difference between food and non food items.
  • Night eating syndrome, characterized by morning anorexia, evening polyphagia (abnormally increased appetite for consumption of food (frequently associated with insomnia, and injury to the hypothalamus).
  • Orthorexia nervosa, a term used by Steven Bratman to characterize an obsession with a “pure” diet, in which people develop an obsession with avoiding unhealthy foods to the point where it interferes with a person’s life.

Several of the above mentioned disorders, such as diabulimia, food maintenance syndrome and orthorexia nervosa, are not currently recognized as mental disorders in any of the medical manuals, such as the ICD-10 or the DSM-IV

References:

  • Patrick, L (2002). “Eating disorders: a review of the literature with emphasis on medical complications and clinical nutrition”. Alternative medicine review : a journal of clinical therapeutic 7 (3): 184–202.
  • Frieling, H; Römer, KD; Scholz, S; Mittelbach, F; Wilhelm, J; De Zwaan, M; Jacoby, GE; Kornhuber, J et al. (2010). “Epigenetic dysregulation of dopaminergic genes in eating disorders”. The International Journal of Eating Disorders 43 (7): 577–83. .
  • Frieling, H; Bleich, S; Otten, J; Römer, KD; Kornhuber, J; De Zwaan, M; Jacoby, GE; Wilhelm, J et al. (2008). “Epigenetic downregulation of atrial natriuretic peptide but not vasopressin mRNA expression in females with eating disorders is related to impulsivity”. Neuropsychopharmacology 33 (11): 2605–9.
  • Gross, MJ; Kahn, JP; Laxenaire, M; Nicolas, JP; Burlet, C (1994). “Corticotropin-releasing factor and anorexia nervosa: reactions of the hypothalamus-pituitary-adrenal axis to neurotropic stress”. Annales d’endocrinologie 55 (6): 221–8.
  • Licinio, J; Wong, ML; Gold, PW (1996). “The hypothalamic-pituitary-adrenal axis in anorexia nervosa”. Psychiatry Research 62 (1): 75–83.
  • Chaudhri, O; Small, C; Bloom, S (2006). “Gastrointestinal hormones regulating appetite”. Philosophical transactions of the Royal Society of London. Series B, Biological sciences 361 (1471): 1187–209.
  • ^ Gendall, KA; Kaye, WH; Altemus, M; McConaha, CW; La Via, MC (1999). “Leptin, neuropeptide Y, and peptide YY in long-term recovered eating disorder patients”. Biological Psychiatry 46 (2): 292–9.
  • Wilhelm, J; Müller, E; De Zwaan, M; Fischer, J; Hillemacher, T; Kornhuber, J; Bleich, S; Frieling, H (2010). “Elevation of homocysteine levels is only partially reversed after therapy in females with eating disorders”. Journal of neural transmission (Vienna, Austria : 1996) 117 (4): 521–7.
  • Jimerson, DC; Lesem, MD; Kaye, WH; Hegg, AP; Brewerton, TD (1990). “Eating disorders and depression: is there a serotonin connection?”. Biological Psychiatry 28 (5): 443–54.

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