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Bulimia nervosa is a serious life threatening disorder commonly
affecting young women. They go through binging (consumption of
large amounts of food very quickly) and purging (elimination of the
food by vomiting, laxatives, etc.) Bulimics fast, exercise vigorously,
vomit, and/or use laxatives. This disorder is partly caused by
extreme concern about weight and self image.
Anorexia Nervosa is an eating disorder commonly among young women.
This disorder is caused by excessive worry about the appearance of their
body which results in the fear of gaining weight, self-starvation, and a
distorted view of body image. There are two types of anorexia: on
characterized by strict diet and exercise, and the other involves binging
and purging.
Bulimia
Anorexia (vary widely
•Binging/purging
•Thin body
•Excessive concern with weight
•Dry yellowish skin
•Depression/mood swings
•Low blood pressure
•Irregular menstrual periods
•Amenorrhea
•Unusual dental problems
•Constipation
•Swollen cheeks/glands
•Lack of energy
•Heartburn/bloating
•Chills/damaged teeth
Bulimia:
•The word bulimia comes from the Greek words bous (ox) and limos
(hunger), meaning a state of excessive hunger.
•This disorder is characterized by frequent binging associated with
emotional misery and accompanied by excessive exercise, selfinduced vomiting, diuretic abuse, laxative abuse, use of appetite
suppressants, and/or medications used to speed up the metabolism.
• Eating disorders as a group are characterized by a fear of weight gain
and a distorted body image. Bulimia and anorexia nervosa are more
common in young females, while binge-eating disorder is the most
common eating disorder overall, and is more common in adults, with a
2:1 ratio of females to males .
Anorexia:
•Anorexia Nervosa was first described in England in the 17th
Century. It was known as an illness by modern medicine over one
hundred years ago by Professor Ernest Lasegue of the University of
Paris.
•Since more than 90 percent of people who are affected are
adolescents and young women, the disorder can be characterized as
a women's illness.
• Most activists of the biological cause believe that anorexia is
caused genealogically (passed down through their parents).
According to recent studies, mothers and sisters of people with
anorexia or bulimia are at higher risk of having one of these
disorders.
•Compared to the rest of the population, these mothers and sisters
have a risk for anorexia that is 11 times higher and a risk for bulimia
that is 4 times higher .
Bulimia:
•One hypothesis of a cause involves abnormalities of serotonergic
function. Serotonin is involved in the development of satiety. It is
believed to increase postprandial satiety rather than directly decreasing
appetite. Disturbances in serotonergic function or low levels of
serotonin may be responsible for stopping the sensation of satiety and
prolonging periods of food ingestion.
• Another possible pathophysiology involves the presence of increased
levels of peptides, specifically, pancreatic polypeptide, known to
increase appetite. Increased levels of the pancreatic polypeptide have
been found in some individuals with bulimia. Abnormalities of central
nervous system neurotransmitters may also be involved in bulimia
nervosa.
Anorexia:
•Evidence for the biological etiology of anorexia is found in the twin and
family background. Siblings of anorexics have are at a higher risk of
anorexia than the general population. This may be influenced by other
family factors. Identical twin studies have shown a higher concordance
rate in identical twins.
•Past research has made several connections with anorexia and
hormonal fluctuations, particularly in the hypothalamus and the anterior
pituitary gland. Anorexia is also shown to be associated with right
temporal disturbance. These are considered secondary factors in the
etiology of either anorexia or bulimia.
•Hormonal changes have been shown to occur as a result of starvation.
Cognitive Behavior TherapyThis most common type of therapy for this dysfunction focuses on
the thoughts that envelop food and eating and presents a
challenge to the dysfunctional beliefs on the part of the anorexic.
The disorder is treated as if it is nothing more than a fight for
freedom, intelligence, self-respect, and self-discipline. Another
goal of CBT is to correct the unhealthy cognitive processes that
are causing the distorted beliefs. One of the main goals of CBT is
for the affected person to have a more self-focused and selfobservant approach, so the person is asked to keep a diary of
food intake and a journal of thought processes during the
treatment period.
There are six cognitive approaches that are widely used in CBT:
1) education about the disorder
2) providing informational answers to questions in regard to
weight, calorie intake, and changing health status
3) showing the patient to recognize and focus upon negative
thoughts and other emotions linked to the distorted beliefs and
fixations associated with weight, body shape, nutrition, exercise,
and other aspects of the disorder.
4) teaching the patient to come up with and replace alternative,
more productive and positive thoughts for the negative ones
5) problem-solving discussions
6) teaching alternative coping strategies (Yager 160-161)
Family therapy is proved to be highly effective and
necessary in most cases, especially in cases where
the patient is still living at home. This is because
anorexia creates high emotional stress that echoes
among all family members. Families in which there
is a lot of ‘free expressed emotion' (families that
express large amounts of negative and critical
attitudes) affect the progress of an anorexic patient.
Families undergoing a large amount of stressors
may benefit from behavioral therapy techniques in
which the patient and the family together learn
communication and problem-solving skills
http://www.emedicine.com/med/topic255.htm
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eb2/arutigliano.html