Causes and Treatment of Eating Disorders and Obesity
What is an eating disorder?
It exists when a person's attitudes toward food and weight are such that feelings about work, school, relationships, daily activities and emotions are determined by what has or has not been eaten or by a number in the scale. People suffering from a diet disorder are characterized by:
* Terms food consumption, as evidenced by severe weight loss, rapid weight gain, or major fluctuations in weight.
* Those unhappy with their body image, often accompanied by a distorted perception of body signals (hunger, anger, fatigue, etc.)..
* Unhealthy Practices to maintain weight, such as: fasting, starvation, compulsive eating, indiscriminate use of laxatives, weight loss drugs, diuretics and excessive exercise.
* An irrational fear of gaining weight and an obsessive desire to lose weight.
* The most common eating disorders are Anorexia Nervosa and Bulimia Nervosa.
There are others such as compulsive overeating or Compulsive Exercising. Some people may have symptoms of more than one of these disorders.
What causes an eating disorder?
There are many theories. For a particular person, all or only a few factors conspire to produce eventually the problem.
Biological Factors:
Possible abnormalities in noradrenergic transmission system (low levels of norepinephrine in the cerebrospinal fluid of patients with AN). Recent studies have shown the likely reduction of a protein called leptin, which comes from adipocytes (fat cells). Currently there are some theories that associate research its origin to an infectious problem. Temperament, which is partly determined by genetic factors, makes certain people more vulnerable than others to develop eating disorders. Furthermore, once a person has begun with periods of starvation, bingeing or purging, these behaviors may alter brain chemistry and prolong the problem.
Psychological Factors:
People with eating disorders tend to be perfectionist. They usually have a legitimate "courage", but as always seek approval and fear of criticism, do not know how to express anger in a healthy way. The turn toward themselves provoking starvation or bingeing.
Family Factors:
Within your family, tend to feel unappreciated, neglected, and alone. These are families that tend to be overprotective, rigid and ineffective to resolve conflicts. Usually require higher ranks of perfection and success.
Social Factors:
Never before in history, women have been urged to be so thin. The TV, movies, magazines are clear examples of all messages received by women of the "advantages" of staying thin.
Triggers:
If a person is vulnerable to having a eating disorder for having one or more of the above factors, sometimes all it takes to put into action the "avalanche" is an event that can not or do not know how to handle. A trigger can be something as simple as harassment for being fat to something so desvastante as incest or rape.
Warning signs
Because now it seems that everyone cares about weight, and since most people have ever been on a diet, how can one say that behavior toward food and weight is "normal" or must be considered a problem that endangers the life and happiness? Probably many people express any of the following characteristics, but most people with eating disorders, meet with several of them:
* Significant weight loss or extreme, in a short time, without underlying disease.
* Decrease in food intake.
* Development of certain rituals to the food: cut food into very small pieces, "play" with the food on the plate, chewing each bite a thousand times, skipping meals, eating in front of others, always have an excuse for not be hungry, and so on.
* Denial of being hungry.
* Become more tolerant of criticism and little else.
* Fluctuations in character (almost always in a bad mood or angry).
* Excessive exercise.
* When you eat, basically just choose foods low in fat or calories.
* Says he / she is too fat (a), even though it is obviously not.
* Intense fear of gaining weight and obesity.
* Hates specific parts of your body, especially breasts, abdomen, thighs, hips and buttocks.
* Insists that does not feel good about yourself (a) unless it is thin (a), but never is thin enough (a) to be comfortable.
* Has difficulty of exposing her feelings.
* Avoid socializing as possible.
* Answer the confrontations about their mood, tears, tantrums or ignoring them.
* When you eat too much, always looking for ways to get rid of the calories consumed (vomiting, exercise, medication).
Treatment of eating disorders
The eating disorders are treatable, and people can rehabilitate them. The recovery, however, goes beyond leave to remain in starvation, to leave or stop bingeing purges (vomiting, laxatives, exercise, diuretics). To assume recovery, it should include establishing healthy eating patterns and weight, and the resolution of medical, psychological, social and family who helped to develop the disorder. Successful treatment should be multidisciplinary, and is highly individualized. Treatment should begin with a medical evaluation and continue the development of a plan that will include: individual psychotherapy, family therapy, couples therapy, group therapy, medication to improve depression, anxiety and other similar disorders, hospitalization, and advice nutrition. The above information in any way substitute for medical care and advice. There are many variations in diagnosis and treatment which should be assessed and managed individually.
What is anorexia?
The anorexics are usually very nice people, conscious, hardworking and good students. They tend to try to please everyone, seeking approval and avoiding conflicts. They worry about caring for others and lie in perfection, but beneath this attitude, they feel insecure and inadequate. Want to be special to stand out from the masses. They try to achieve this goal by losing weight and keeping slim. Anorexia, like bulimia can kill.
The diagnostic criteria for anorexia nervosa are:
* They refuse to maintain body weight above the minimum for their age and height, eg., Weight loss leading to body weight 15% below expected weight or failure to achieve expected weight gain during the growth, leading to body weight 15% lower than expected.
* Intense fear of gaining weight or becoming fat despite being alarmingly thin.
* Distortion of body image. It refers herself as fat when it is obvious that it is not.
* In women, absence of at least three consecutive menstrual periods for no apparent reason or inability to initiate in prepubertal girls (it is considered that a woman has no menstrual periods occur only themselves their after administration of hormonal drugs).
* Exercise compulsive.
What is Bulimia?
People with bulimia often have problems with anxiety, depression and impulsivity. They are usually very dependent on their families but otherwise desecrated. Many have trouble trusting others and have few satisfactory emotional relationships. Bulimia, like anorexia can kill. Eating disorder caused by anxiety and an excessive preoccupation with body weight and physical appearance. It is characterized by repeated episodes of overeating followed by induced vomiting, laxative use, diet exaggerated and / or abuse of exercise to control weight. Sometimes the behavior seen in bulimic patients with anorexia nervosa or people who perform excessive diets, but the bulimia itself does not produce significant weight loss. What I do sometimes occur because of induced vomiting, are gastrointestinal problems, and hypokalemia (low potassium levels in the blood), serious as damage to teeth due to the acidity of the vomiting. Bulimia occurs predominantly in adolescents, especially in women, due to different psychological mechanisms, the most obvious is the response to social pressure that values thinness as physical attractiveness, but also by the difficulties in taking a sexed body. To treat the disease using various group therapy and conditioning therapy. Antidepressants may also be effective, because many bulimics also suffer from depression.
The diagnostic criteria for bulimia nervosa are:
* Recurrent episodes of binge eating (rapid consumption of a large amount of food in a normal time for anyone).
* Feeling unable to control their eating patterns during binges.
* The person usually practice some way to get rid of what you ate: self-induced vomiting, use of laxatives or diuretics, strict dieting or fasting, vigorous exercise.
* Concern about weight and shape.
* Like the anorexic believes his value as a person depends on stay thin.
* Your weight may be normal or slightly below or above normal.
What is compulsive overeating?
The compulsive eater, also eating disorder called binge, binge eating syndrome is a persistent and frequently are not accompanied by compensatory purging behaviors that are required for the diagnosis of Bulimia Nervosa. The diagnosis of BED (Binge Eating Disorder) or compulsive eater, has been included in the Diagnostic and Statistical Manual of Mental Disorders as an example of an eating disorder unspecified, and a appendix in which he proposed in a diagnostic category that deserves further study.
The compulsive binge eating in the dining room are defined exactly as in bulimia nervosa, ie, ingestion of large quantities of food in specific circumstances, and loss of control over what you eat, how much you eat and when eat.
Classical features of compulsive overeating:
1. Frequently eat large amounts of food, much more than what most people would eat in a similar period.
2. Come quickly
3. Come to the point where it is satisfied uncontrollably
4. Usually eats alone
5. Irritable and angry with himself after binge
6. It uses methods for purging (vomiting, laxatives, fasting, etc.).
7. You can eat continuously throughout the day.
8. During the binge, you feel unable to control or stop.
9. Usually has a history of having tried every other diet
10. Eating helps decrease their anxiety and stress.
11. She feels ashamed of his figure.
12. Start a new diet every morning
13. Visit all "diet doctors" without success or with temporary success
14. Hiding food
15. She feels very guilty about their behavior toward food.
16. Usually a person is obese and depressed.
17. When does reduce weight, it usually recovers quickly.
18. In contrast to bulimic patients, who often use exercise as a compensatory behavior and consistently exceed the same, binge eaters tend to be inactive.
19. Constantly suffer from feelings of guilt, shame, anger.
People who are compulsive eaters, generally do not purge like bulimics. There is a small group of persons serving on an occasional basis, but not as regularly as they do those with bulimia. May be genetically predisposed to have more weight which is considered the cultural ideal, so why is subjected to different diets, it is "starving" and then have a binge in response to that hunger. Or they may eat for emotional reasons: to feel better about themselves, to console, to escape situations that bothered to conceal emotional pain. Regardless of the reason that the feast takes place, diet programs are not the answer. In fact, diets often worsen the problem.
Most binge eaters are obese and may have medical complications such as increased blood pressure, increased cholesterol levels, diabetes and heart disease.
Like other eating disorders, compulsive overeating treatment must include medical management, to achieve standardization in the way of eating through proper nutrition therapy, exercise routine, individual counseling, family and couples, group therapy , drugs for improving depression and anxiety, and in some cases, hospitalization.
Obesity, body condition characterized by excessive storage of fat in adipose tissue under the skin and internal organs such as muscle. All mammals store fat, under normal conditions it constitutes 25% of body weight in women, and 15% in men. The deposition of fat, as energy capacity is twice that of protein or carbohydrates, is a form of energy storage for future needs. However, when these are excessive fat reserves represent a health problem. Data from insurance companies shows that people whose weight exceeds 30% the ideal weight are at increased risk of disease, and especially diabetes, gallbladder disease, cardiovascular disease, hypertension, some cancers and arthritis ; also surgical procedures pose a greater risk in this patient group.
Body mass index
Body mass index (BMI) is often used to determine whether or not the person has excess weight. This index is the ratio of the weight in kilograms to the square of height in meters person. Given this relationship, a figure is considered overweight BMI above 25 kg/m2 and talk about obesity when BMI was above 30 kg/m2. BMI, ie the relationship between weight and height, is a good reference but does not determine with accuracy the ideal weight of a person because, as many experts acknowledge, we must also take into account a number of other factors. For example, an athlete may have a high BMI because it has a large muscle mass, which in turn translates into a weight higher, but that means you are obese.
Causes of Obesity
Obesity is only due to endocrine disorders rarely. In most cases, obesity is the result of an energy intake through food consumption exceeds energy through the activity, the excess calories are stored in the body as fat. However, basal metabolism, the minimum amount of energy needed to maintain bodily activity, varies from one person to another, so that there are people who use, naturally, the more calories to maintain normal body activity. Obesity may also be due to lack of activity, as in the sedentary or bedridden.
In the development of obesity influence various factors, besides those already mentioned, such as genetic, or environmental and psychological factors. It was noted that adopted children with biological parents obese tend to be overweight if their adoptive parents are not obese. However, it remains unclear how genes influence obesity. Studies in mice showed that when certain genes are missing or mutated facilitate the development of obesity. However, these investigations have not had the same result in humans. On the other hand, dietary habits, social and family are also important and often resorted to excessive intake of food in times of stress and anxiety.
Treatment of Obesity
Have tried different weight loss methods to combat obesity, with little effect in general. Diet pills whose composition is based on the stimulant drug dextroamphetamine or its derivatives were widely used in the 1950s but were ineffective and it was found that could lead to addiction, so it fell into disuse. Have been promoted many slimming diets, but there is no scientific evidence to be effective in severe cases of obesity. A diet called liquid protein diet, which derived from the type of power supply in hospitalized patients, was sold until the year 1979, which showed that some patients had died from using this diet as sole source of nutrition. Its composition alter the body's balance of sodium and potassium ions, which resulted in cardiac disorders.
In recent years it has appeared a new drug, whose active ingredient is orlisat for the treatment of obese or overweight patients. This drug works by inhibiting gastrointestinal lipases which modifies the absorption of fat by the body. This treatment is associated with a reduced calorie diet.
There are surgical techniques that complement the treatment of obesity. One of them, intestinal bypass, involves resection of a segment of intestine to reduce absorption of nutrients. This technique produces numerous side effects such as diarrhea or chronic liver damage and even death, so every time it is used less frequently. Another technique is the gastric bypass, which involves reducing the stomach capacity by using staples or other procedures. Is thus a small gastric pouch that keeps the patient can ingest large amounts of food.
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