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Geoffrey Schofield D.Hyp D.CBT

Eating Disorders in Derby

Eating Disorders in Derby

Eating Disorders

Popular opinion when thinking of an eating disorder is that the person “must” have a problem with food. Contrary to this opinion is that the eating disorder is actually an indication that the person has underlying (sub conscious) problems in his / her life. This page provides you with information pertaining to anorexia nervosa, bulimia nervosa, binge eating disorder and compulsive eating.

Anorexia

Anorexia nervosa is similar to Bulimia in some ways, but has different symptoms of the food and body controlling way of thinking. The diagnostic criteria for Anorexia Nervosa are:

  • Refusal to maintain body weight over a minimally normal weight for age and height. Weight loss leading to maintenance of less than 85% of expected weight.
  • Intense fear of gaining weight or becoming fat even though underweight.
  • Disturbance in the way that body weight, size or shape is experienced
  • Amenorrhoea in females with absence of at least 3 menstrual cycles

Easting Disorders Anorexia

Those with eating disorders tend to be perfectionists, they have unrealistic expectations of themselves and others, they feel worthless, inadequate and everything is good or bad, fat or thin. If they think of a thin person, which is good, thinner is better and thinnest is best. Many use it to take control of their lives and themselves. They usually win with any power struggle, but inside feel hopeless, powerless, defeated, resentful and often angry with themselves. Its this anger turned inwards, because they are so frightened of criticism, looking for approval, that they can only express their anger and control by starving themselves.

In Britain the incidence of Anorexia in young women has been estimated to range between 1% and 5% – the same as the USA. In the male population the numbers seem to be increasing. Twenty years ago it was thought that for every 15 women with Anorexia or Bulimia there was one man. Today researchers find that for every four females with Anorexia, there is one male.

Anorexia (including Bulimia & Binge Eating Disorder) can affect anyone regardless of social class, age, race or gender. 86% of people with Eating Disorders report onset by age 20 and 10% report onset at 10 years or younger. Nearly 50% or pre-pubescent girls admit to dieting or using other methods of weight control. Most sufferers come from respectable homes or affluent families, and many do not seek professional help with their problems until it becomes life threatening, mortality rates ranging from 5-15%, mainly from suicide. Many believe that Anorexia is of a very recent origin, however, patients with such a disorder have been described by doctors from the 17th century.

Those that develop Anorexia are usually attractive, sensitive, thoughtful and nice intelligent young females between the ages of 12 and 25 years old, although there are other considerable variations in age. Typically, they have been ‘good’ children; conscientious; wanting to please; seeking approval; avoiding conflict with a desire to take care of others; Dichotomist; striving for perfection; feeling inadequate; having a defect; attempting control by losing weight; feel stressed; anxious – especially with new situations; unrealistic standards for themselves; rigid ways of thinking; cannot maintain excellence; adopt rigid routines; do not risk anything; fear growing up; fear responsibility; cling to parents; prefer to live at home; dislike sexual activity; feel insecure; don’t ‘fit in’; dislike criticism and rejection; abundant frequent exercise. Of course these are main examples, some will have all of the above, others only 50% or more, others may have other states such as depression etc.

Overview of Symptoms

  • Brain chemistry alters to Euphoria – disorientation
  • Imbalance of Sodium, potassium, Calcium & Bicarbonates.
  • Intense fear of becoming fat
  • Hair loss or thinning
  • Lanugo – downy hair
  • Hands swell
  • Thyroid Function decreases
  • Incorrect body perception
  • Constipation – Slow gut motility
  • Low white blood cell count
  • Rigid dieting
  • Wears large or baggy clothes to hide thin body
  • Can feel cold – extremities
  • Compulsive exercising
  • Amenorrhoea (loss of menstrual cycle)
  • Arrhythmia’s (irregular heart beat) & heart failure
  • Bradycardia (slow heart rate)
  • Panic with smallest increase in weight
  • Inability to obtain pleasure – sex
  • Rough dry scaly skin
  • Rigid lifestyle
  • Muscle wasting
  • Perfectionist
  • Risk of osteoporosis
  • Organ deterioration

Bulimia Nervosa

This is a diet – binge – purge disorder and like Anorexia can kill. The sufferer puts on a courageous effort to be ‘normal’ but often experience depression, loneliness, inner anger, self doubt and feel ashamed / guilty when they are by themselves and are unable to talk about their feelings. They can be promiscuous, take illicit substances, binge drink and become reckless with shoplifting, often from food stores.

Their friends often say they are fun to be with, and would never assume there was anything wrong with them. They have distorted body image and obsessed with their body weight, frequently having a history of failed diets.

The difference between them is that while Anorexics feel better when they don’t eat, Bulimics are confronted every day with their explanation of their failure to control themselves and their food intake. As mentioned above, they gain a sense of control by using diuretics, enemas, suppositories, laxatives, forcibly vomiting with their fingers or taking emetic agent, so they feel more in control, as the excessive amount of food eaten can be got rid of. The other important factor is they do not show other people (especially parents), work colleagues, that they are losing weight or look anorexic in appearance.

Body weight may vary from normal to mild, moderate, or severe obesity. This of course keeps everyone happy, which is what the Bulimic is attempting to achieve. The only person that may be aware is the Dentist as their tooth enamel deteriorates, or a Doctor who finds a biochemical imbalance, for example low potassium, magnesium and sodium levels. There is a possibility of losing substantial weight, however, they regain this without any medical intervention.

Persons in the Bulimic category are more likely to accept elimination of Binge Eating as a primary goal. They can consume vast quantities of food, usually carbohydrates very rapidly, fast for days then have another binge.

Often when emotional problems are resolved and better coping skills and strategies are employed the outcome of therapy is generally good in most clients.

Simple Bulimia most commonly seems to occur when females are about 18 years of age. They have usually been slightly under confident and unassertive, although fairly popular. The illness is frequently started by a period of unhappiness or depression and this can be caused by a destructive relationship with a boyfriend. The feelings of self dislike focuses on appearance, so they begin to diet to improve self-esteem and confidence.

In comparison to an Anorexic, the diet is not very successful, with the rigid control needed in breaking down into spells of cheating. Vomiting is employed to achieve the weight loss and so the cycle of bingeing and vomiting begins. There is more loss of control as the body’s normal mechanisms of appetite control are over ridden and confused. The weight will remain near to normal but the eating regime becomes gradually poor.

This form of Bulimia is the least severe but does vary considerably in intensity. There are probably many females with reasonably mild symptoms who never seek help, but there is a significant risk that it will slowly get worse with time. A frequent time for those with mild Bulimia to seek help is when they are planning to start a family in their early twenties and are concerned about possible effects of conceiving or having children. Often when emotional problems are resolved and better coping skills are employed, the outcome of therapy is generally good.

Bulimia Overview

  • Possible recklessness
  • Possible shoplifting (food stores)
  • Guilt & low self esteem
  • Obsessed with weight
  • Many are normal within weight parameters
  • Large weight increase and / or loss
  • Depression / suicide
  • Tooth enamel deteriorates
  • Rupture of the Oesophagus
  • Inner anger
  • Eating huge amounts of food in a short time
  • Gastric rupture
  • Binge eating in secret
  • Ulcers & pancreatitis
  • Distorted body image
  • Constipation
  • Gastric ulcers
  • Perfectionist

The diagnostic criteria for Bulimia are as follows:

  • Recurrent episodes of Binge Eating (which is characterised by a sense of lack of control over eating large amounts of food in a discrete time period)
  • Recurrent, inappropriate compensatory behaviour in order to prevent weight gain, eg. Vomiting, abuse of laxatives, diuretics or other medications, fasting or excessive exercise.
  • A minimum average of two episodes pf binge eating and inappropriate compensatory behaviours per week for the past three months. Self evaluation unduly influenced by body shape and weight.

The disturbance does not occur exclusively during episodes of Anorexia Nervosa. Bulimia nervosa clients are further subdivided into purging type and non-purging type, based on the regular use of self induced vomiting, laxatives, diuretics or other medications, fasting or excessive exercise.

Binge Eating Disorder (B.E.D.) is an ailment with a distinct difference from Bulimia in that the sufferer does not purge their body of the food through vomiting, laxative abuse or over exercise. Therefore, they often eat abnormal amounts of food in a very short period of time, usually less than 2 hours. They eat so rapidly and swallow without chewing, and often for a long time, with a distinct lack of control over eating, usually secretly, tending to hide food as well. They eat for emotional reasons to avoid anxiety-provoking situations, reduce emotional pain and comfort themselves.

Eating at night or eating when they are not hungry frequently causes them to feel disgusted with themselves afterwards, as they attempt to cope with stress, anxiety, and unhappiness and then add to the disappointment with themselves about bingeing. Most are depressed and have anxiety states. They can eat such great quantities of food, manifesting in discomfort and pain. This in time causes obesity and a possibility of diabetes, hypertension, high cholesterol and many other complications.

Research suggests that around 60% of American adults are overweight, 34% are obese which means they are 20% or more above an average healthy weight. Many of these are binge eaters. Not included in this, is that 31% of American teenage girls and 28% of teenage boys are overweight, and 15% of girls are obese along with 14% of boys. (Stats 2004). Some of the possible causes are fast food, high sugar content snacks, use of automobiles; longer periods spent watching tv, video games and computers. A reported study shows 1% of females in the USA have a binge eating disorder and 30% of females seek treatment to lose weight.

Symptoms

  • Social isolation
  • Need to be in control
  • Eating huge amounts – usually alone
  • Eating large quantities when not hungry
  • Vascular disorders
  • Depression
  • Obstructive sleep apnoea
  • Hypertension
  • Gall bladder disease
  • Stroke
  • Diabetes
  • Heart disease
  • High cholesterol levels
  • Musculo-skeletal problems
  • Thrombosis

Compulsive Overeating

Attempting to cope with stress, anxiety, depression, low confidence or self-esteem, emotional conflicts, Compulsive Eating can become a detrimental problem to their health, becoming overweight. They often deny or recognise that there is a problem. Compulsive overeating can begin in early childhood when eating patterns are formed.

Most people who become Compulsive Eaters are those who never learned the proper way to deal with stressful situations and used food instead as a way of coping. Unlike Anorexia and Bulimia, there are a high proportion of excessive eaters. Over time, if this continues, can become morbid obesity where gastric banding or stapling would be necessary for survival. Obviously other factors need to be eradicated first, such as thyroid functioning.

They frequently withdraw from activities because of embarrassment about weight and many have tried so many different diets and feel tormented by these over eating habits where the main focus of life is on weight. They always think about food and often have secret hoards of food, becoming anxious when eating, and believing that hunger makes them feel uneasy or vulnerable. They then compulsively eat, which reduces their negative thought processes, then feel bad or guilty about over eating, and the whole process starts over again.

By significantly reducing their stressors, anxiety, depression or other underlying fears or concerns, enables them to cope easier with life.

Compulsive Eating Overview

  • Depression
  • Social isolation
  • Need to be in control
  • Eating huge amounts, usually alone
  • Eating large quantities when not hungry
  • Vascular disorders
  • Obstructive sleep apnoea
  • Hypertension
  • Gall bladder diseases
  • Stroke
  • Diabetes
  • Heart disease
  • High cholesterol levels
  • Musculo-skeletal problems
  • Thrombosis
Geoffrey Schofield D.CBT D.Hyp
1 Vernon Street
Derby, DE1 1FR.
Mobile : 07582 865 265
Telephone : 01332 559 126
Email : alexanderpracticederby@gmail.com