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	Buckeye Sports Nutrition Eating Disorders The food choices we make each day will directly impact our overall health. Therefore, establishing healthy eating habits is crucial for optimizing one's performance, mood, behavior, and self-image. Eating behaviors involve a number of very complex individualized factors. Food choices are continuously influenced by a combination of biological, psychological, and cultural factors. Eating disorders can develop when one or more of these factors become distorted. Eating disorders involve more than obsession with food, but are syndromes often associated with underlying feelings of depression, fear, isolation, and possibly suicidal thoughts (1). Eating disorders affect the person's entire life, including; schoolwork, athletic performance, relationships, and self-esteem. Eating disorders are an increasingly common medical problem that affects five to ten million American girls and women, and five hundred thousand to one million American boys and men per year (1). Eating disorders have higher mortality rates than any other psychiatric disorder. Between five and twenty percent will die from medical complications associated with this syndrome. Therefore, it is crucial to identify an individual with an eating disorder and begin treatment immediately. The sooner an eating disorder is identified, the faster and more effective it can be treated. Individuals with eating disorders require qualified medical attention consisting of psychiatric, nutritional, and medical therapy. Identifying Eating Disorders The identification of an eating disorder can be a complicated process. There are currently three defined types of eating disorders; anorexia, bulimia, and binge eating disorder (BED). Although these are distinctly different disorders, they all share many similarities. Listed below are one or more characteristics shared by all eating disorders; Disordered eating habits Extreme low or high caloric intake Extreme physical exercise Depression Distorted body image Fear of gaining weight Denial and secrecy Anorexia Nervosa: "starvation sickness" in which the person denies their own hunger and refuses to consume sufficient caloric intake to meet their bodies needs. This individual becomes protein/calorie deprived, and their body slowly wastes away. A person with anorexia may: Refuse to maintain a body weight at or above an average weight for their age and height Have intense fear of gaining weight, even though they are underweight (always see themselves as being fat) Eat tiny portions, refuse to eat, and deny that they are hungry Show abnormal weight loss (common for an anorexic to lose 15% or more of body weight in a short period of time) In post-menarcheal females, amenorrhea (absence of at least three consecutive menstrual cycles) Act hyperactive, depressed, moody, and insecure Exercise excessively and compulsively Develop fine, downy hair on arms and face Complain of nausea or bloating after eating normal amounts of food Have episodes of binging and purging (usually by vomiting or diuretic use) (1,2,3) Bulimia Nervosa: identified mainly by frequent episodes of "binging and purging". A bulimic typically gorges on high caloric foods, and then later initiates self-induced vomiting or uses laxatives/diuretics with the intention of preventing weight gain. This individual is typically protein/calorie deprived, however can be overweight. A person with bulimia may: Have recurrent episodes of binge eating and purging. Become secret eaters. Show great fluctuations in weight. Eat enormous meals, but do not gain weight. Have binging and purging episodes, on average, at least twice per week for three months. Experience irregular menstrual cycles. Abuse alcohol or drugs. Feel ashamed and depressed after gorging. Have swollen parotid glands (one of the salivary glands which are located near our ears). Become dependent on diuretics, laxatives, diet pills to lose weight. Develop dental problems caused by acid from vomiting (1,2) Binge Eating Disorder (BED):BED was recently identified as a psychiatric disorder in 1993. The binge eater has recurrent episodes of binging on large quantities of food. This individual has an apparent lack of control over the types and volume of foods eaten. There are no purging episodes with BED. However, the BED person will most likely suffer from obesity and is at high risk for developing heart disease, diabetes, and vitamin/mineral deficiencies. A person with BED may: Have recurrent episodes of binge eating. Experience lack of control during eating. Eat until feeling uncomfortably full. Eat large amounts of food when not feeling physically hungry. Eat alone because of being embarrassed by the volume of food consumed. Have feelings of depression, low self esteem, guilt after overeating. Binge eat at least two days per week for six months. (1) Treatment of Eating Disorders Eating disorders involve obsessive-compulsive behavior. Therefore, individuals with an eating disorder need professional medical attention. Although family and friend support can be very beneficial, they are not professionals. Most disordered eating patterns have been well established, and concealed. Recovery may take from several months to several years. Symptoms and attitudes of eating disorders rarely disappear quickly (3). However, eating disorders CAN be treated and defeated! If you are concerned about a friend, family member, or yourself having an eating disorder, do not wait until a severe weight loss or medical problem arises. What to do: Speak to the person with the eating disorder about your concerns. Talk to medical professionals, team coaches, guidance counselors, and other family members who can all assist in the initiation and treatment process. Remember, the best treatment combines medical, psychological, and nutritional counseling, and possible psychoactive medications. Self-help groups and group counseling for family members can also help establish a strong support network. Successful treatment must include the resolution of any underlying psychological problem, not just reestablishing normal eating patterns. Be patient. Full recovery may take three to four years, or longer. (2,3) References Woolsey, M, MS, RD. Eating Disorders: A Clinical Guide to Counseling and Treatment. American Dietetic Association. 2002. Duyff, R, MS, RD, CFCS. The American Dietetic Association's Complete Food & Nutrition Guide. American Dietetic Association. 1996,1998. Herbert, V, MD, FACP and Subak-Sharpe, G, MS. Total Nutrition: The Only Guide You'll Ever Need. Mount Sinai School of Medicine. 1995. Helpful Links Academy for Eating Disorders (AED) www.acadeatdis.org American Anorexia/Bulimia Association (AABA) www.aabainc.org Anorexia Nervosa and Related Eating Disorders, Inc. www.anred.com Eating Disorders Awareness & Prevention www.members.aol.com/edapine/home.html Local (Columbus, OH) Eating Disorders Treatment http://www.centerforeatingdisorders.org/default1.asp Family Resources for Education on Eating Disorders www.cpcug.org/user/rpike/freed.html

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The food choices we make each day will directly impact our overall health. Therefore, establishing healthy eating habits is crucial for optimizing one's performance, mood, behavior, and self-image. Eating behaviors involve a number of very complex individualized factors. Food choices are continuously influenced by a combination of biological, psychological, and cultural factors. Eating disorders can develop when one or more of these factors become distorted. Eating disorders involve more than obsession with food, but are syndromes often associated with underlying feelings of depression, fear, isolation, and possibly suicidal thoughts (1). Eating disorders affect the person's entire life, including; schoolwork, athletic performance, relationships, and self-esteem.

Eating disorders are an increasingly common medical problem that affects five to ten million American girls and women, and five hundred thousand to one million American boys and men per year (1). Eating disorders have higher mortality rates than any other psychiatric disorder. Between five and twenty percent will die from medical complications associated with this syndrome. Therefore, it is crucial to identify an individual with an eating disorder and begin treatment immediately. The sooner an eating disorder is identified, the faster and more effective it can be treated. Individuals with eating disorders require qualified medical attention consisting of psychiatric, nutritional, and medical therapy.

Identifying Eating Disorders

The identification of an eating disorder can be a complicated process. There are currently three defined types of eating disorders; anorexia, bulimia, and binge eating disorder (BED). Although these are distinctly different disorders, they all share many similarities. Listed below are one or more characteristics shared by all eating disorders;

Disordered eating habits
Extreme low or high caloric intake
Extreme physical exercise
Depression
Distorted body image
Fear of gaining weight
Denial and secrecy

Anorexia Nervosa: "starvation sickness" in which the person denies their own hunger and refuses to consume sufficient caloric intake to meet their bodies needs. This individual becomes protein/calorie deprived, and their body slowly wastes away. A person with anorexia may:

Refuse to maintain a body weight at or above an average weight for their age and height
Have intense fear of gaining weight, even though they are underweight (always see themselves as being fat)
Eat tiny portions, refuse to eat, and deny that they are hungry
Show abnormal weight loss (common for an anorexic to lose 15% or more of body weight in a short period of time)
In post-menarcheal females, amenorrhea (absence of at least three consecutive menstrual cycles)
Act hyperactive, depressed, moody, and insecure
Exercise excessively and compulsively
Develop fine, downy hair on arms and face
Complain of nausea or bloating after eating normal amounts of food
Have episodes of binging and purging (usually by vomiting or diuretic use)

Bulimia Nervosa: identified mainly by frequent episodes of "binging and purging". A bulimic typically gorges on high caloric foods, and then later initiates self-induced vomiting or uses laxatives/diuretics with the intention of preventing weight gain. This individual is typically protein/calorie deprived, however can be overweight. A person with bulimia may:

Have recurrent episodes of binge eating and purging.
Become secret eaters.
Show great fluctuations in weight.
Eat enormous meals, but do not gain weight.
Have binging and purging episodes, on average, at least twice per week for three months.
Experience irregular menstrual cycles.
Abuse alcohol or drugs.
Feel ashamed and depressed after gorging.
Have swollen parotid glands (one of the salivary glands which are located near our ears).
Become dependent on diuretics, laxatives, diet pills to lose weight.
Develop dental problems caused by acid from vomiting

Binge Eating Disorder (BED):BED was recently identified as a psychiatric disorder in 1993. The binge eater has recurrent episodes of binging on large quantities of food. This individual has an apparent lack of control over the types and volume of foods eaten. There are no purging episodes with BED. However, the BED person will most likely suffer from obesity and is at high risk for developing heart disease, diabetes, and vitamin/mineral deficiencies. A person with BED may:

Treatment of Eating Disorders

Eating disorders involve obsessive-compulsive behavior. Therefore, individuals with an eating disorder need professional medical attention. Although family and friend support can be very beneficial, they are not professionals. Most disordered eating patterns have been well established, and concealed. Recovery may take from several months to several years. Symptoms and attitudes of eating disorders rarely disappear quickly (3). However, eating disorders CAN be treated and defeated!

If you are concerned about a friend, family member, or yourself having an eating disorder, do not wait until a severe weight loss or medical problem arises.

Speak to the person with the eating disorder about your concerns. Talk to medical professionals, team coaches, guidance counselors, and other family members who can all assist in the initiation and treatment process.
Remember, the best treatment combines medical, psychological, and nutritional counseling, and possible psychoactive medications.
Self-help groups and group counseling for family members can also help establish a strong support network.
Successful treatment must include the resolution of any underlying psychological problem, not just reestablishing normal eating patterns.
Be patient. Full recovery may take three to four years, or longer.

References

Woolsey, M, MS, RD. Eating Disorders: A Clinical Guide to Counseling and Treatment. American Dietetic Association. 2002.
Duyff, R, MS, RD, CFCS. The American Dietetic Association's Complete Food & Nutrition Guide. American Dietetic Association. 1996,1998.
Herbert, V, MD, FACP and Subak-Sharpe, G, MS. Total Nutrition: The Only Guide You'll Ever Need. Mount Sinai School of Medicine. 1995.

Identifying Eating Disorders

Treatment of Eating Disorders

References

Helpful Links