It is estimated that 3% of girls, adolescents and young people present some of the 2 main varieties of the eating disorder: Anorexia and Bulimia. Up to 6% may have some other clinical variant.
Varieties of eating disorder
It is the third most common disease after Asthma and Obesity during adolescence.
The frequency of anorexia ranges from 1 to 2%, while bulimia is 2 to 4%.
The anorexia nervosa or anorexia has been described since ancient times. There are reports that indicate that it exists from century II.
It is defined as a psychiatric illness of multifactorial origin that is characterized by voluntary weight loss that conditions a series of organic consequences. There are causal factors involved: genetic, biological, psychological and social.
It is based on an exacerbated and irrational fear of gaining weight and a distortion of their own perception or body image.
There are a whole series of abnormal eating habits that are acquired during the course of the disease, which can serve as a guide or orientation to detect the development of this disease early:
· Excessive handling or preparation of food (washing, removing fat, dividing, chopping).
· Selective rejection or rejection of some foods.
· The performance of rituals or unusual repeated behaviors, which can be classified as obsessive, in relation to the moment of eating or preparing food.
· Eat separately from the family group or in isolation.
· Do some different activity during the eating process. Patients who eat and walk in their office or home during meals. This effect serves as a distraction to avoid rejection of food.
· People who take too long to eat, without having an excuse or reason for it.
· Unusual and irrational changes in meal times.
· Excessive and almost exclusive interest in nutrition and food issues.
· Great interest is shown in the type and quantity of food of the family group.
· Desire for the family group to eat abundantly.
Main characteristics of anorexia
Severe weight loss leading to emaciation. They are people with normal or low weight, with excessive care in the amounts of food to eat and with great fear of gaining weight. They have a totally distorted body image. They are considered obese or overweight when they are actually underweight.
They obsessively handle the issue of diet and weight loss. They ration food very carefully, weigh food, and prepare extremely small portions.
They tend to weigh themselves several times a day.
They have episodes or crisis of heavy meals, which are commonly called binge eating. After that, they go through a period of severe diet, unusual increase in the level of physical exercise, provoked vomiting, abuse of medications such as diuretics, laxatives or enemas.
Amenorrhea or lack of menstruation in adolescents and young people
Signs and symptoms as a consequence of anorexic disorder:
· Osteopenia or osteoporosis.
· Alterations in skin and attachments, with brittle hair and nails, dry and cracked skin.
· Symptoms of anemia: drowsiness, pale skin and mucous membranes, tiredness, poor exercise tolerance, general weakness.
· Accentuated constipation
· Alteration in vital signs: with a tendency to low blood pressure, decreased heart and respiratory rates.
· Decreased attention and intellectual capacity or academic performance.
· Decrease in body temperature
· Peripheral neuropathy and muscle aches.
· Frequent headaches (headaches).
The Bulimia was described, and differs from anorexia because patients do binge or heavy frequent food intakes and then try to eject, through induced vomiting or through medications such as diuretics and laxatives, used arbitrarily.
These patients tend to be of normal or even heavy weight. Binge-eating episodes can occur a few times a week or be as frequent as several times a day, depending on how advanced the disorder is. The person completely loses control of their meals, servings and the need to vomit or forcibly evacuate food.
They usually incorporate periods of fasting to compensate for binges, as well as excessive exercise or physical activity.
As in anorexia nervosa, they have an excessive and irrational fear of gaining weight, and they have a distortion of their own body image, so much so that they can avoid performing a lot in public and have feelings of disgust or shame towards themselves.
Symptoms of Bulimia
Symptoms derived from malnutrition may occur, as well as the repetitive provocation of vomiting
· Pain and inflammation of the throat, it can present chronic changes in salivation, with inflammation of the salivary glands.
· Dental alterations, caused by the change of PH in the mouth, secondary to repeated vomiting and reflux of gastric contents. Multiple cavities, tooth enamel wear, and periodontal disease can be seen.
· Gastrointestinal symptoms such as colicky pain, heartburn, frequent changes in bowel habits, symptoms of gastroesophageal reflux, caused by vomiting and inappropriate use of laxatives.
· Symptoms secondary to excessive losses of fluids and electrolytes due to vomiting and diarrhea forced by laxatives. They can present dehydration and alterations in the levels of magnesium, potassium, calcium, phosphorus and sodium, with different consequences in many organs.
Treatment of eating disorders
Treatment in these cases is based on four basic principles
1. Personal psychotherapy and / or family therapy.
2. Medical care, to improve the organic consequences of the eating disorder. In severe cases, hospitalization is needed. Hormonal treatments if necessary to correct secondary alterations, particularly in fertility and menstrual disorders. Incorporate nutritional supplements.
3. Close nutritional advice, to correct bad habits. Discontinue laxatives and self-prescribed medications, as well as reduce the level of exercise in the recovery phase.
4. Pharmacological treatment, if necessary for the better management of more severe cases that warrant additional drug therapy.
In the case of Bulimia, the use of antidepressants works very well, which can also be useful in the management of depression and / or anxiety that underlies these patients.
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