Question

Anna, age 19 years, fainted at the gym, where she worked out for a minimum of 2 hours every day. When paramedics arrived, they found her dehydrated, but conscious. Further physical examination revealed erosion of some of her tooth enamel, open lesions in her oral mucosa, and a slightly irregular heartbeat, and she reported abdominal cramping. When questioned about medications, she told them she had taken some laxatives that day but otherwise she had been feeling fine.

Relate the signs and symptoms and behaviors to eating disorders. Discuss what other signs and symptoms or behaviors might also indicate this condition, and what factors might predispose toward this disorder.

Answer 1

Eating disorders are serious conditions related to persistent eating behaviors that negatively impact health, emotions and theathe to function in important areas of life.

Eating disorders usually include anorexia nervosa and bulimia nervosa. In anorexia nervosa, the client obsess about weight gain and develop a image of being overweight where as in bulimia nervosa client indulge in binge eating and develop guilt about their eating followed by vomiting or use of laxatives to lose weight.

Symptoms vary, depending on the type of eating disorder.

Anorexia nervosa is a potentially life-threatening eating disorder characterized by an abnormally low body weight, intense fear of gaining weight, and a distorted perception of weight or shape. People with anorexia use extreme efforts to control their weight and shape, which often significantly interferes with their health and life activities.

Symptoms are excessively limiting calories or use other methods to lose weight, such as excessive exercise, using laxatives or diet aids, or vomiting after eating. Efforts to reduce your weight, even when underweight, can cause severe health problems, sometimes to the point of deadly self-starvation.

Bulimia nervosa is a serious, potentially life-threatening eating disorder. It involves episodes of bingeing and purging that involve feeling a lack of control over your eating. Many people with bulimia also restrict their eating during the day, which often leads to more binge eating and purging.

During these episodes, you typically eat a large amount of food in a short time, and then try to rid yourself of the extra calories in an unhealthy way. Because of guilt, shame and an intense fear of weight gain from overeating, you may force vomiting or you may exercise too much or use other methods, such as laxatives, to get rid of the calories.

Red flags that may indicate an eating disorder include:

• Skipping meals or making excuses for not eating
• Adopting an overly restrictive diet
• Excessive focus on healthy eating
• Making own meals rather than eating what the family eats
• Withdrawing from normal social activities
• Persistent worry or complaining about being fat and talk of losing weight
• Frequent checking in the mirror for perceived flaws
• Repeatedly eating large amounts of sweets or high-fat foods
• Use of dietary supplements, laxatives or herbal products for weight loss
• Excessive exercise
• Calluses on the knuckles from inducing vomiting
• Problems with loss of tooth enamel that may be a sign of repeated vomiting
• Leaving during meals to use the toilet for vomiting
• Eating much more food in a meal or snack than is considered normal
• Expressing depression, disgust, shame or guilt about eating habits
• Eating in secret

In this case, Anna has a habit of doing exercise for 2 hours, tooth erosion due to continuous vomiting and ulcer can be a sign of induced vomiting. She also looks dehydrated and has a history of laxative use which might be for weight loss. Also she doesn't care about seeking medical help which are all signs of an eating disorder.

The predisposing factors include

• Biological factors, such as changes in brain chemicals, may play a role in eating disorders.
• Psychological and emotional problems like low self-esteem, perfectionism, impulsive behavior and troubled relationships.

Risk factors

Teenage girls and young women are more likely to develop in the teens and early 20s.

Certain factors may increase the risk of developing an eating disorder, including:

• Family history
• Other mental health disorders like history of an anxiety disorder, depression or obsessive-compulsive disorder.
• Dieting and starvation
• Stress