26. - NUTRITION AND
METABOLISM
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 divers 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 shows that for some people there is a genetic reason why they may be prone to developing an eating disorder.
While
proper treatment can be highly effective for many of the specific types of
eating disorder, 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).
ANOREXIA NERVOSA
Anorexia nervosa is an eating disorder characterized by excessive food restriction and irrational fear of
gaining weight, and a distorted body self-perception. It typically
involves
excessive weight loss. Anorexia nervosa usually develops during adolescence and
early adulthood. Due to the fear of gaining weight, people with this disorder
restrict the amount of food they consume. This restriction of food intake
causes metabolic and hormonal disorders. Outside of medical literature, the
terms anorexia nervosa and anorexia are often used interchangeably; however, anorexia is
simply a medical term for lack of appetite. However, people with anorexia
nervosa do not lose their appetites. People suffering from anorexia have extremely high levels of ghrelin, the hunger hormone that tells the brain when it is time to eat, in their blood. The high levels of ghrelin suggests that their bodies are trying desperately to switch hunger on but that hunger’s call is being suppressed, ignored, or overridden. Nevertheless, one small single-blind study found that intravenous administration of ghrelin to anorexia nervosa patients increased food intake by 12-36% over the trial period.
Anorexia nervosa has many complicated implications and may be thought of as a lifelong illness that may never be truly cured, but only managed over time. Anorexia nervosa is characterized by low body weight, inappropriate eating habits and obsession with having a thin figure. Individuals suffering from it may also practice repeated weighing, measuring, and mirror gazing, alongside other obsessive actions, to make sure they are still thin, a common practice known as "body checking".
Anorexia
nervosa is often coupled with a distorted self
image which may be maintained by
various cognitive biases that alter how the affected individual evaluates and thinks about her
or his body, food and eating. Anorexia nervosa is characterized by the fear of
gaining weight. Those suffering from this disorder often view themselves as
"too fat" even if they are already underweight. Persons with anorexia
nervosa continue to feel hunger, but deny themselves all but very small
quantities of food. The average caloric intake of a person with anorexia
nervosa is 600–800 calories per day, but extreme cases of complete
self-starvation are known. It is a serious mental illness with a high incidence
of comorbidity and similarly high mortality rates to serious psychiatric disorders. Anorexia nervosa most often has its onset in adolescence and is more prevalent among adolescent girls than adolescent males. However, more recent studies show the onset age has decreased from an average of 13 to 17 years of age to 9 to 12. While it can affect men and women of any age, race, and socioeconomic and cultural background, anorexia nervosa occurs in 10 times more females than males.
The term anorexia nervosa was established in 1873 by Sir William Gull, one of Queen Victoria's personal physicians. The term is of Greek origin: an- (ἀν-, prefix denoting negation) and orexis (ὄρεξις, "appetite"), thus meaning a lack of desire to eat. However, while the term "anorexia nervosa" literally means "neurotic loss of appetite", the literal meaning of the term is somewhat misleading. Many anorexics do enjoy eating and have certainly not lost their appetites as the term "loss of appetite" is normally understood; it is better to regard anorexia nervosa as a self-punitive addiction to fasting, rather than a literal loss of appetite.
Schneer suggested anorexia nervosa patients who have "difficulties in identifying, containing and articulating emotions resort to food as a symbolic expression of the inability to establish subjective limits in their relationships with others".
BULIMIA NERVOSA
Bulimia nervosa is an eating disorder characterized by binge
eating and purging, or consuming
a large amount of food in a short amount of time, followed by an attempt to rid
oneself of the food consumed (purging), typically by vomiting, taking a laxative or diuretic and/or excessive exercise, and commonly accompanied with fasting over
an extended period of time. Bulimia nervosa is considered to be less life
threatening than anorexia;
however, the occurrence of bulimia nervosa is higher. Bulimia nervosa is nine
times more likely to occur in women than men (Barker 2003). The vast majority
of those with bulimia nervosa are at normal weight. Antidepressants, especially
SSRIs, are widely used in the treatment of bulimia nervosa (Newell and
Gournay 2000). Patients who have bulimia nervosa are often linked with having
impulsive behaviors involving overspending and sexual behaviors as well as
having family histories of alcohol and substance abuse, and mood and eating disorders.
The term bulimia
comes from Greek βουλιμία (boulīmia; ravenous hunger), a compound of βους (bous), ox + λιμός (līmos),
hunger. Bulimia nervosa was named and first described by the British
psychiatrist Gerald Russell in 1979. Bulimia is strongly familial. Twin studies estimate the
heritability of syndromic bulimia to be 54-83%
These
cycles often involve rapid and out-of-control eating, which may stop when the
bulimic is interrupted by another person or the stomach hurts from
over-extension, followed by self-induced vomiting or other forms of purging.
This cycle may be repeated several times a week or, in more serious cases,
several times a day, and may directly cause:
- Chronic gastric reflux after eating
- Dehydration and hypokalemia caused by frequent vomiting
- Electrolyte imbalance, which can lead to cardiac arrhythmia, cardiac arrest, and even death
- Esophagitis, or inflammation of the esophagus
- Boerhaave syndrome, a rupture in the esophageal wall due to vomiting
- Oral trauma, in which repetitive insertion of fingers or other objects causes lacerations to the lining of the mouth or throat
- Gastroparesis or delayed emptying
- Constipation
- Infertility
- Enlarged glands in the neck, under the jaw line
- Peptic ulcers
- Calluses or scars on back of hands due to repeated trauma from incisors
- Constant weight fluctuations are common
The erosion on the lower teeth was caused by Bulimia. For comparison,
the upper teeth were restored with porcelain veneers.
The
frequent contact between teeth and gastric
acid, in particular, may cause:
- Severe dental erosion
- Perimolysis, or the erosion of tooth enamel
- Swollen salivary glands
- Constant vomiting can lead to gastroesophageal reflux
As with many psychiatric
illnesses, delusions can occur with other signs and symptoms leaving the person
with a false belief that is not ordinarily accepted by others.
The person may also suffer physical complications such as tetany, epileptic seizures, cardiac arrhythmias and muscle weakness.(ICD-10).
People with bulimia nervosa may also exercise to a point that excludes other activities
DIET
The person may also suffer physical complications such as tetany, epileptic seizures, cardiac arrhythmias and muscle weakness.(ICD-10).
People with bulimia nervosa may also exercise to a point that excludes other activities
DIET
A
diet is the set of nutrients taken during the habitual consumption of food.
Popularly, and in the case of the human diet is erroneously associated with the
practice of restricting the intake of food for only the nutrients and energy needed,
and thus achieve or maintain a certain body weight.
The human diet is considered balanced if it provides
nutrients and energy in such quantities that allow maintaining the functions of
the organism in a context of physical and mental health. This balanced diet is
particular to every individual and adapts to their sex, age, weight and health
situation. However, there are various factors (social, geographical,
economic, pathological, etc.) that influence the balance of the diet
Etymologically
the word 'diet' comes from the Greek dayta, which means 'regime of life'. It is
accepted as a synonym for diet,
which alludes to the 'set and amounts of food or mixtures of foods commonly
consumed'. You can also refer to the regime which, under certain circumstances, made people healthy,
sick or convalescing in eating, drinking and sleeping