A Nursing perspective – part 1
How skinny is too skinny ? Is your health at risk?
With so many having health anxiety and the societal vision of being either thin or buff, this week I want to educate my readers on eating disorders. I will first talk about anorexia nervosa then bulimia then binge-eating. These are pathways of behavior that need to be interrupted quickly for the best recovery.
Eating disorders are not just a lifestyle choice. They fall under mental health, and most with eating disorders suffer from some sort of anxiety.
This is not just a problem with females. Many males also suffer. ( see statistics below) Most often eating disorders start during adolescence but can appear after any stressful life event. In fact, in the last 25 years male’s dissatisfaction with body image has grown from 15% to 40%. Women most often think that if they lost weight all be well in the world while men feel the same way about increasing muscle mass. ( referred to as body dysmorphic disorder BDD). Men often slim down to appear to bulk up using steroids and dangerous drugs and untested protein powders that may contain dangerous ingredients and put the user at risk.
However, there is a common starting place for all three, that affect male and female. The common starting point is dissatisfaction with body image. It is said that 80% of women and 55% of men are dissatisfied with their appearance. The statistics – about 0.6% have anorexia nervosa, 1% bulimia and 2.8% binge eating? Friends and family need to be aware of what to look for and not just push aside these disorders because as with anything repetitive as behaviors and thoughts become ingrained, they become more difficult to get rid of. Given that 55% of the adult population in the US are dieting at any given time the percentage of these disorders may seem low. But those who diet are at risk especially if they suffer from anxiety disorder or experience a life changing situation of progressing to pathological eating.
All of those with eating disorders also can share genetic, biological, and psychological factors This includes behavioral and social issues. The issues affecting this audience would include loneliness, stress anxiety, depression, anger, and low self-esteem.
FYI only 1 in 10 people with an eating disorder receives treatment. Mostly because on lookers do not want to interfere. In fact, people in general often just want to shove it under the carpet as if their friend or family member has enough other stuff they are dealing with. You must be aware that the the most success in overcoming an eating disorder is when treatment starts within 6 months of the first signs of the eating disorder
Of course, it is imperative to have a complete physical whenever there is an eating problem to check for medical reasons. You must choose a Dr carefully who will not just dismiss the weight loss as a lifestyle choice.
This in only a guide to general information that may help you or a loved one.
Many are surprised by these – MALE Statistics
*18% are concerned about body image *29% think about their appearance five or more times per day * 50% care only for gaining muscle mass *30% desire both thinness and muscle mass I have read that 38% of males state they would give up an entire year of their life for their perceived perfect body!
TRIGGER WARNING If you are prone to health-related anxiety it may be best to have a friend read this information. Of course, a complete physical is important to rule out other anomalies. IMPORTANT TO NOTE: Families are NOT often good judges of if you are at a good body weight! Too often their opinions are their genetics have influenced you in the first place. Even friends may be complimentary by saying you look normal, and not be able to see past “you” to the abnormal body weight.
Often a nutritionist is a good place to start.
ANOREXIA NERVOSA “self-imposed starvation”
We will start with anoxia nervosa because it can be extremely dangerous and has the highest mortality rate! The key to overcoming any of the eating disorders are awareness and quick intervention. The most success is had is when a person starts treatment within 6 months.
A distorted body image is often at the root of the problem. They cannot see themselves as others do! Here is the trailer for the documentary EMBRACE.
There was a TV show years ago called, HOW TO LOOK GOOD NAKED. The host Carson Kressley would line up women of different sizes and shapes wearing only black bra and panties and women who considered them selves too large would have to compare themselves with those standing in line. Time and time again the women would place themselves next to the woman obviously several inches or more bigger than them. And these were reg women with out eating disorders. They truly see themselves as much bigger than they are! Those with an eating disorderd can only see them selves much larger than is truthful no matter what photos or video of them may prove to anyone else. It is all about Body perception.
Here is a video clip from that old TV show. How to Look Good Naked. A distorted body Image
I have seen many women place them selves at the complete opposite end of the line! Here is a clip about : Is there such a thing as being too skinny?
Anorexia Nervosa is a distorted body image of being overweight and unattractive, no matter what evidence to the contrary is presented. This starvation causes major nutrition problems and speed at diagnosis is key to helping someone correct their mindset about being overweight. To be able to get the individual on the right path to health, physically and mentally. Most of the physical effects with nutritional rehab are reversible. (However, they say bone loss is not.)
Major life stressors are often associated with the onset, such as moving away from home , heading for college, death of a loved one… anything that causes great stress and anxiety. This along with genetics, biological, and psychological factors. (First rule out any physical problem.)
Extreme dieting can change your metabolism. Studies have also shown that people with this eating disorder may also have lower levels of serotonin and nor-epinephrine, At the same time they may have higher cortisol levels. This goes hand in hand with those with anxiety and or depression.
SYMPTOMS of STAVATION / POOR NUTRITION
The list of general signs and symptoms is long and can mimic signs of panic and anxiety attacks here are a few:
- some of those are muscle weakness,
- constipation ( bloating and pain )
- brittle nails and hair,
- sleep disturbances,
- memory problems,
- muscle aches,
- chest pain /angina
- cold intolerance,
- numbness of hands and feet – nerve damage
- skin disturbances such as swelling, bluish hands and feet, dry cracked skin…
- memory loss and impaired cognition difficulty concentrating
In the heart alone starvation can be responsible for Low BP, slow heart-rate, and irregular heart-rates.
Everybody system is affected when proper nutrition is not observed.
Re-feeding and weight gain with proper nutrition is critical
There is no medication that is known to be effective, but some antidepressants or antianxiety meds may be beneficial. Psychotherapy and Cognitive Behavior Therapy is recommended.
Anorexia Nervosa is a serious illness and in today’s world, TV, magazines, and other social media continue to promote the ultra-thin physique.