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Psychology; Eating disorders

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Psychology; Eating disorders Anorexia Nervosa Onset of an eating disorder typically follows a period of restrictive dieting; however, only a minority of people who diet develop eating disorders. Those who do are emotionally and psychologically vulnerable when they develop the self-destructive behaviors characteristic of an eating disorder (eg, practicing unsafe dieting techniques, taking unproven diet products, and maintaining arbitrary standards of weight). As purveyors of food, nutrition, and health information, registered dietitians should identify and inform health professionals and the lay public of the dangers of fad diets and diet products and should educate the public regarding healthful weight ranges and weight stabilization methods. Dietitians should also discuss risk factors for developing an eating disorder. Such interventions may play an important part in the treatment and prevention of eating disorders. Anorexia nervosa is a disorder characterized by deliberate weight loss, induced and/or sustained by the patient. The disorder occurs most commonly in adolescent girls and young women from middle class backgrounds, but adolescent boys and young men may be affected more rarely, as may children approaching puberty and older women up to the menopause. Anorexia nervosa constitutes an independent syndrome in the following sense: A, the clinical features of the syndrome are easily recognized, so that diagnosis is reliable with a high level of agreement between clinicians; B, follow-up studies have shown that, among patients who do not recover, a considerable number continue to show the same main features of anorexia nervosa, in a chronic form.


What is the difference between anorexia and bulimia? People with anorexia starve themselves, avoid high-calorie foods and exercise constantly. People with bulimia eat huge amounts of food, but they throw up soon after eating, or take laxatives or diuretics (water pills) to keep from gaining weight. People with bulimia don't usually lose as much weight as people with anorexia. Bulimia Nervosa Bulimia Nervosa is an illness that is most commonly found in girls of later adolescence and early adulthood the age and sex distribution is similar to that of anorexia nervosa, but the age of presentation tends to be slightly later. It is very rarely found in men. It is characterised by episodes of binge eating; eating large quantities of food in a short time. This behaviour may be very severe with enormous quantities of food, most typically carbohydrates being consumed. To prevent the otherwise inevitable consequence of weight gain there are periods of food restriction and often vomiting, laxative abuse or excessive exercising. When vomiting is used then the binges may become multiple with repeating cycles over several hours in which the sufferer eats until full, then vomits and eats again. With increasing severity the girls' lives become more chaotic with the focus increasingly on the bulimic behaviour.Bulimia nervosa is a syndrome characterized by repeated bouts of overeating and an excessive preoccupation with the control of body weight, leading the patient to adopt extreme measures so as to mitigate the 'fattening" effects of ingested food.


Treatment Options Most sufferers will first go to their general practitioner. He may well have a good knowledge of the local possibilities for appropriate treatment. If specialist help is needed he should be consulted as to choice of person and place. Another source of unbiased advice is the Eating Disorders Association. The N.H.S. has a number of eating disorder units often based on teaching hospitals. Many of these are excellent but the quality is very patchy. They often have long waiting lists and it may take several months to wait for an assessment and longer to start an agreed course of treatment. Your general practitioner should be able to find out what the situation is locally quite easily. The private sector also runs eating disorder units and many of these are also of good quality. However inpatient stays frequently run to several months so cost may be high. For most people medical insurance is necessary. The area where you live may not have an eating disorder unit run by the N.H.S. If this is so the N.H.S. may buy treatment from the private sector under the Extra Contractual Referral scheme. Assistance will be needed from your general practitioner and from the admitting hospital but in practice this means that the area health authority may pay for private care on a private unit of your and the GP's choice. ?? ?? ?? ?? Rachel 16/05/07 Rebecca Jones 1

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