Anorexia Nervosa and Bulimia Nervosa

Eating disorders are a range of mental health problems that involve preoccupations with food, weight and appearance to the degree that a person’s health, relationships and daily activities are adversely affected. Anorexia Nervosa (anorexia) and Bulimia Nervosa (bulimia) are two of the most recognised and most serious eating disorders.

Anorexia Nervosa is characterised by a preoccupation with thinness, even though the person is underweight. Bulimia Nervosa is characterised by cycles of binge eating followed by behaviour to prevent weight gain. Individuals may have a mixture of symptoms and some people develop bulimia nervosa after anorexia nervosa. Both illnesses can be overcome, and the sooner the person seeks advice about the condition the better.

Eating disorders are widespread and can affect people of all ages and both sexes, but they are more common in adolescent girls and young women. Statistics vary, but anorexia is thought to affect less than one per cent of teenage girls and young women. Estimates suggest that about two per cent of adolescent girls and young women have bulimia. Approximately five per cent of people with anorexia are male. It is thought that the number of males with bulimia may be somewhat higher.

Some people develop eating disorders after a distressing event, but this is not the case for everyone. There is no scientifically established cause for eating disorders.
What are the signs or symptoms?

Anorexia Nervosa
The usual symptoms of anorexia are:

* being underweight for their age and height (less than 85 per cent of expected weight for height is the generally accepted benchmark)
* a distorted perception of body weight or shape (the person thinks they are fat even when they are very thin)
* a drive for thinness and an accompanying fear of weight gain
* excessive behaviours to control weight, such as restricting food, over-exercising, vomiting, misuse of laxatives, diuretics (“fluid tablets”) or diet pills
* a loss of monthly periods in women or delay in starting them in girls.

The usual symptoms of bulimia are:

* feeling out of control when bingeing and feeling guilty afterwards
* using methods to prevent weight gain, such as self-induced vomiting, fasting, excessive exercise, misuse of laxatives, diuretics (“fluid tablets”) and diet pills
* frequent changes in weight, but their weight is typically in the normal range or a little above normal.

What problems can anorexia and bulimia cause?
Psychological, social and emotional effects may include depression, mood swings, social isolation, family conflict, guilt, and secretive or deceptive behaviours. There is an increased risk of suicide in people with eating disorders.

Physical effects of these disorders can be very severe, and in extreme cases may be fatal. Physical problems may include constipation, difficulty in thinking clearly, cold sensitivity, growth of fine downy hair over the face and body, fertility problems, erosion of tooth enamel with tooth decay, swollen salivary glands, osteoporosis (weakened bones), anaemia, impaired kidney function, dehydration, abnormal heart rhythm, ruptured stomach, and seizures.

How can anorexia and bulimia be treated?
Recognising these disorders in their early stages and getting effective help early may prevent long-term problems. Treatment may include counselling or other therapy, dietary education for healthy eating, medication to assist severe depression, or nutritional supplements if required. Medication may also be helpful for some people with bulimia.

Dealing with a family member with an eating disorder can be very difficult for families. Family therapy may assist families to help their affected family member.

Most people with eating disorders are effectively treated in the community. People with complex and severe disorders sometimes require hospitalisation. Those with severe weight loss or children and adolescents who are behind in growth may need a specific refeeding program to reach a healthy weight range.

The information on this page is very brief and general. If you have any concerns that you or your family may suffer from an eating disorder or another mental disorder, it is important that you discuss these with your GP or a mental health professional. For most mental health problems, early detection and treatment gives the best results.


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