How to treat an eating disorder. How to deal with an eating disorder

Eating disorders (also called eating disorders or eating disorders) are a group of complex psychogenic pathologies ( anorexia, bulimia, orthorexia, compulsive overeating, compulsion to exercise etc. ) , which manifests itself in a person with problems with nutrition, weight and appearance.

Weight, however, is not a significant clinical marker because even people with normal body weight can be affected by the disease.

Eating disorders, if not treated on time and with adequate methods, can become a permanent disease and seriously endanger the health of all organs and systems of the body (cardiovascular, gastrointestinal, endocrine, hematological, skeletal, central nervous system, dermatology, etc.). and, in severe cases, lead to death. Mortality among people with anorexia nervosa 5-10 times higher than healthy people of the same age and sex.

Currently, these disorders represent an important public health problem, as the age of onset has gradually decreased in recent decades. anorexia And bulimia, as a result of which diseases are increasingly diagnosed before the onset of menstruation, up to 8-9 years in girls.

The disease affects not only teenagers more, but also children before they reach puberty, which has much more serious consequences for their body and psyche. Early onset of the disease may lead to a higher risk of irreversible damage due to malnutrition, especially in tissues that have not yet reached full maturity, such as bones and the central nervous system.

Given the complexity of the problem, early intervention is of particular importance; it is essential that specialists from different specializations (psychiatrists, paediatricians, psychologists, nutritionists, internal medicine specialists) actively cooperate with each other for the purposes of early diagnosis and prompt action.

According to official estimates, 95,9% people with eating disorders are women. The incidence of anorexia nervosa is at least 8 new cases per 100,000 people per year among women, while in men it ranges from 0.02 to 1.4 new cases. Concerning bulimia, Every year per 100 thousand people account for 12 new cases among women and about 0.8 new cases among men.

Causes and risk factors

We are talking about risk factors, not causes.

In fact, these are disorders of complex etiology, in which genetic, biological and psychosocial factors interact with each other in pathogenesis.

In a consensus document on eating disorders, prepared by the Higher Sanitary Institute in collaboration with the USL Umbria 2 association, the following disorders were noted as predisposing factors:

genetic predisposition;
, drug addiction, alcoholism;
possible adverse/traumatic events, chronic childhood illnesses and early feeding difficulties;
increased socio-cultural pressure for thinness (models, gymnasts, dancers, etc.);
idealization of thinness;
dissatisfaction with appearance;
low self-esteem and perfectionism;
negative emotional states.

Signs and symptoms

Common signs of eating disorders are problems with eating, weight, and appearance. However, each option manifests itself in a certain way.

Anorexia nervosa

This is a psychiatric pathology with the highest mortality (the risk of death in these patients during the first 10 years from the onset of the disease is 10 times higher than in the general population of the same age).

People who suffer from anorexia nervosa fear gaining weight and engage in persistent behaviors that prevent them from gaining weight, through extreme dieting, vomiting, or very intense physical activity.

The onset is gradual and insidious, with a gradual reduction in food intake. Reducing calorie intake consists of reducing portions and/or eliminating certain foods.

In the first period, we observe a phase of subjective well-being associated with weight loss, image improvement, a sense of omnipotence, which gives the ability to control hunger; later, concerns about the lines and shapes of the body become obsessive.

Fear of losing weight does not decrease with weight loss, it usually increases in parallel with weight loss.

Usually resort to excessive physical activity (compulsive/obsessive), constant checking with a mirror, clothing size and scales, counting calories, eating for several hours and / or grinding food into small pieces.

Obsessive-compulsive symptoms are also exacerbated by reduced calorie intake and weight loss.

Affected people absolutely deny that they are in a dangerous condition for their health and life and are against any treatment.

The level of self-esteem is affected by physical fitness and weight, in which weight loss is a sign of self-discipline, an increase is perceived as a loss of control. Typically, they come to clinical examination under pressure from family members when they observe weight loss.

To lose weight, in addition to the fact that patients avoid eating, they can resort to the following methods:

compulsive physical training;
resort to taking laxatives, anorexigenic drugs, diuretics;
provoke vomiting.

People with anorexia nervosa have:

extreme thinness with the disappearance of body fat and muscle atrophy;
dry, wrinkled skin, the appearance of fluff on the face and limbs; reduction of sebaceous products and sweat; yellowish coloration of the skin;
bluish hands and feet due to exposure to cold ();
scars or calluses on the back of the fingers (Russell's sign), from continuously putting the fingers down the throat to induce vomiting;
dull and thinning hair;
teeth with opaque enamel, caries and erosions, inflammation of the gums, enlargement of the parotid glands (due to frequent self-induced vomiting and subsequent increase in acidity in the mouth);
(slow heart rate), arrhythmia, and hypotension;
stomach cramps, delayed gastric emptying;
constipation, hemorrhoids, rectal prolapse;
sleep changes;
(disappearance, at least 3 consecutive cycles) or violations;
loss of sexual interest;
and increased risk of fractures;
memory loss, difficulty concentrating;
depression (possible suicidal thoughts), self-harming behavior, anxiety, ;
possible rapid fluctuations in electrolyte levels, with important consequences for the heart (up to cardiac arrest).

bulimia

The main feature that distinguishes it from anorexia is the presence of repetitive overeating.

This causes episodes in which a large amount of food is consumed in a short period of time (bulimic crises alone, planned, characteristic speed of eating). It is preceded by dysphoric mood states, interpersonal stress states, feelings of dissatisfaction with weight and body shape, feelings of emptiness and loneliness. There may be a brief reduction in dysphoria after overeating, but they usually follow a depressive and self-critical mood.

People with bulimia use repetitive compensatory actions to prevent weight gain, such as spontaneous vomiting, abuse of laxatives, diuretics, or other drugs, and excessive exercise.

A bulimic crisis is accompanied by a feeling of loss of control; feelings of alienation, some report similar experiences of derealization and depersonalization.

Often the onset of the disease is associated with a history of dietary restrictions or after an emotional trauma in which the person cannot cope with feelings of loss or disappointment.

Binge eating and compensatory behaviors occur on average once a week for three months.

Spontaneous vomiting (80-90%) reduces the feeling of physical discomfort, in addition to the fear of gaining weight.

Uncontrolled ingestion of large amounts of food ( binge eating )

Binge eating disorder is characterized by recurring episodes of compulsive eating for a limited period of time and a lack of control over eating during meals (for example, feeling that you cannot stop eating or that you cannot control what or how much you eat).

Binge eating episodes are associated with at least three of the following:

Eat much faster than usual
Eat until you have a painful feeling of fullness;
Eat a lot without feeling hungry;
Eating alone out of embarrassment about the amount of food you have swallowed;
Feeling self-loathing, depression, or intense guilt after eating too much.

Binge eating compulsions cause distress, discomfort, and have occurred on average at least once a week for the past six months without compensating behaviors or disorders.

Restrictive eating behavior

Restrictive eating behavior is mostly a feature of adolescence, however, it can also occur in adults.

This is an eating disorder (eg, marked lack of interest in food; avoidance based on sensory characteristics of food; anxiety about unpleasant consequences of eating) that is manifested by a persistent inability to adequately assess the contribution of nutrition. As a result, this provokes:

Significant weight loss or, in children, failure to reach the expected weight or height;
Significant nutritional deficiencies;
Dependence on enteral nutrition or oral nutritional supplements;
Overt interference with psychosocial functioning.

This disorder includes many disorders referred to by other terms: for example, functional dysphagia, hysterical lump or choking phobia(inability to eat solid food for fear of suffocation); selective eating disorder(restricted eating of a few foods, always the same, usually carbohydrates, such as bread-pasta-pizza); nervous orthorexia(obsessive desire to eat right, eat only healthy food); food neophobia(phobic avoidance of any new food).

Rumination disorder

Mericism or rumination disorder is characterized by repeated food regurgitation over a period of at least 1 month. Regurgitation is the regurgitation of food from the esophagus or stomach.

Recurrent regurgitation is not associated with a gastrointestinal disorder or other disease (eg, hypertrophic pyloric stenosis); it does not occur exclusively during anorexia nervosa, bulimia nervosa, binge eating disorder, or restrictive eating behavior.

If symptoms occur in the course of mental retardation or pervasive developmental disorder, or intellectual disability and other neurological developmental disorders, they are in themselves severe enough to justify further clinical attention.

Pica

Cicero is an eating disorder characterized by the constant ingestion of inedible substances over a period of at least 1 month. Substances commonly taken vary by age and availability, and may include wood, paper (xylophagy), soap, earth (geophagy), ice (pagophagy).

The consumption of these substances does not correspond to the level of individual development.

This eating behavior is not part of a culturally or socially accepted normative practice. It may be associated with mental retardation or chronic psychotic disorders with prolonged institutionalization.

If eating behavior occurs in the context of another psychiatric disorder (intellectual disability, autism spectrum disorder, schizophrenia) or medical condition (including pregnancy), it is severe enough to warrant further clinical attention.

Complications

Eating disorders can have serious health consequences, most commonly in anorexia nervosa, due to the effects of malnutrition (affecting all organs and body systems) and elimination behaviors (gastrointestinal tract, electrolytes, kidney function).

Women with eating disorders have greater perinatal complications and have an increased risk of developing postpartum depression.

For these reasons, the evaluation of medical complications requires specialists in this field.

Anorexia, in the long run can cause:

endocrine disorders (reproductive system, thyroid gland, stress hormones and growth hormone);
specific nutritional deficiency: lack of vitamins, lack of amino acids or essential fatty acids;
metabolic changes (, hypercholesterolemia, hyperazotemia, ketosis, ketonuria, hyperuricemia, etc.);
fertility problems and decreased libido;
cardiovascular disorders (bradycardia and arrhythmias);
changes in the skin and appendages;
osteoarticular complications (osteopenia and subsequent bone fragility and increased risk of fractures);
hematological changes (microcytic and hypochromic due to iron deficiency, leukopenia with a decrease in neutrophils);
electrolyte imbalance (especially important reductions in potassium, with risk of cardiac arrest);
depression (possibly suicidal ideation).

bulimia may cause:

enamel erosion, gum problems;
water retention, swelling of the lower extremities, bloating;
acute, swallowing disorders due to damage to the esophagus;
decrease in potassium levels;
amenorrhea or irregular menstrual cycles.

Treatment of eating disorders

Nutritional rehabilitation for eating disorders at every level of care, whether for outpatient or intensive care with partial or total hospitalization, should be carried out as part of a comprehensive multidisciplinary approach that includes the integration of psychiatric/psychotherapeutic treatment with nutrition, in addition to nutritional complications, with the specific psychopathology of the disorder eating behavior and general psychopathology that may be present.

Interdisciplinary intervention is indicated, in particular, when the psychopathology of an eating disorder coexists with a state of malnutrition or overeating.

During treatment, it must be constantly taken into account that malnutrition and its complications, if any, contribute to the maintenance of the psychopathology of the eating disorder and interfere with psychiatric/psychotherapeutic treatment and vice versa, if weight restoration and the elimination of food restriction are not associated with an improvement in psychopathology, there is a high probability of relapse.

Depending on the intensity of treatment, the interdisciplinary group may include the following professionals: physicians (psychiatrists/child neuropsychiatrists, nutritionists, internists, pediatricians, endocrinologists), nutritionists, psychologists, nurses, professional educators, psychiatric rehabilitation specialists and physiotherapists.

Having clinicians of different specialties has the advantage of facilitating the management of complex patients with serious medical and psychiatric problems associated with an eating disorder. In addition, both the psychopathology of the eating disorder and the caloric and cognitive dietary restriction, as well as the somatic, psychiatric and nutritional complications that eventually occur, can be appropriately addressed with this approach.

In fact, people suffering from eating disorders should receive interventions that address both psychiatric and psychological aspects, as well as nutritional, physical and socio-environmental aspects. These interventions should also be rejected based on age, type of disorder, and on the basis of clinical judgment and the presence of other pathologies in the patient.

Interesting

Diets, detoxes, proper nutrition, and even Instagram intuitive eating - eating disorders are insidious and well disguised. How to recognize eating disorders, Irina Ushkova tells and names five main signs common to all disorders.

Today I want to talk about the main signs of eating disorders. Yes, my colleagues and I have talked many times about various diagnoses, about various manifestations of eating disorders. Today I want to talk about what is common, what is key. Why You Need It? In order to notice the peculiarities of eating behavior in yourself or your loved ones. This is especially true for relatives of people with eating disorders.

There are 5 main points on which eating disorders are built. These are dietary restrictions, bouts of overeating, various kinds of compensation, negative body image and weight fluctuations throughout life.

Dietary restrictions

With severe eating disorders, a person has many inflexible, strict food rules that he follows. It is clear that with anorexia a person can eat a meager set of food for a long time, but sometimes disturbed forms of eating behavior are disguised as other manifestations. Sometimes it's self-care, sometimes it's some supposedly somatic manifestations. And in general, people who have an eating disorder say: "Well, I'm not on a diet, I just follow certain food rules." In general, all restrictions that go beyond common sense are always a certain trigger, a danger for the development of an eating disorder. What else can food restrictions mimic in the framework of eating disorders?

Food allergies. It is a serious disease, often with serious health risks, but it affects a small percentage of the world's population. But at the same time, many people with an eating disorder eliminate entire food groups from their diet, these are dairy products, sugary foods, gluten-containing foods. All this is masked under the sauce "I have a food allergy." It makes sense to be wary if a person has been eating bread all his life, and then said that now he is gluten-free. There is reason to think about what this is connected with, and whether it is connected with some kind of intolerance.

Sugar addiction. The idea of food addiction is actively exploited by all sorts of diet gurus, they suggest replacing refined sugars with “healthy” ones that are not dangerous. But there is no evidence that any food component has addictogenic properties, that is, they cause addiction. Everything in the food is completely safe. We are all dependent on sleep, rest, oxygen, food! None of us can do without it, but at the same time, there is no special component in food that is addictive. I had an issue on this topic, if you are interested, you can listen to more about it.

Toxin cleansing. All kinds of detoxes are time-limited, but very pronounced and destructive food restrictions, when, for example, you have to eat only juices for a whole week. In fact, the human body is such a wisely organized system in which everything is taken into account, there are such fine adjustments. Our body has innate and complex self-cleaning systems. The most dangerous thing we can do is intervene if everything is working fine there. Of course, if there are any diseases, then you need to go to a specialist and take care of your health, but if you just decided to cleanse yourself of toxins in the spring, please put this idea out of your head. This is a painful practice.

Vegetarianism. Initially, vegetarianism is associated with the rejection of meat food for ethical and environmental reasons. There are quite convincing arguments "for", and "against" too. But there are a certain number of people for whom vegetarianism is a form of dietary restriction. You watch the Instagram of a beautiful yogini, where she preaches veganism and you think, that's what I want too. We need to stop at this point, check the facts and think about how useful it is for you, how safe it is. Because any dietary restrictions, including when you comply with restrictions for medical reasons, increase the risk of developing an eating disorder in a person. There is evidence that people who adhere to a vegetarian diet have had episodes of eating disorders in almost half of the cases. Dear vegetarians, this is not a hit on you, but simply a statement of the fact that for some people this takes sometimes painful forms. The same goes for religious posts. Literally in my environment there are people who fast, because it would be cool to lose weight by the summer.

And my favorite thing that eating disorder restrictions can masquerade as is Instagram Intuitive Eating. It's hard for me not to be sarcastic here, but I'll try. If people who sometimes, due to their own illness, begin to practice intuitive eating and interpret it completely wrong, as they can. It's not their fault, yj it's their fault that they are promoting this idea to the masses. If a marathon where you are offered to eat intuitively and lose weight, but you need to follow certain rules, for example, do not eat after 6, eat for 1000 kcal, only raw uncooked foods, do not eat fruit or meat, even if you really like it, if you offer to eat only round-shaped foods, only 30 minutes after a glass of cold water - just know: this is NOT intuitive nutrition, but a certain system of food rules, which is wrapped in a beautiful wrapper of intuitive nutrition. We talk a lot about intuitive eating, you may already know a lot about it. But I'll reiterate that intuitive eating is eating based on what you eat when you're hungry, eat what you want, what you like, and stop eating when you're full. There are no food restrictions, rules, you can mix any products, even if you have pasta with jam, start with dessert, etc.

Binge eating

The second symptom of all eating disorders is bouts of overeating.
Usually, people with eating disorders are proud of their willpower that they follow some kind of food rules, but at the same time they are ashamed of bouts of overeating, because for them this is an indicator that they have not coped with their super mission. Of course, this is not for this reason, there are psychological, biological reasons for this, we have talked about this many times. People with eating disorders try to hide bouts of overeating. It happens that for a very long time, up to the point that a husband for 20 years of marriage does not know what happens to his wife when he is not around. Sometimes these are objective bouts of overeating, when a person eats large amounts of food, someone measures it in calories and this is 4-5 thousand calories. Sometimes subjective overeating, when a person breaks their food rules. He cannot but break them, because they are very inflexible, incompatible with life. The person gets upset about this, this effect is called “fuck the diet”, he thinks that now he can eat everything, and this often leads to objective bouts of overeating. In any case, these are quite painful conditions. If you have them from time to time, it is worth considering why this is happening. People with normal eating behavior do not overeat, except in very rare cases, and these are still not so pronounced conditions. If you understand that you are overeating, you need to take control of this and, possibly, contact a specialist.

Compensation

The third point, which is also a certain marker that eating behavior does not correspond to normal indicators, is various kinds of compensation. There are quite a lot of them, but in general, these are any attempts that you make in order to compensate for what was eaten. This has great negative consequences because any compensation keeps the cycle of the eating disorder going. It usually starts with the thought that something is wrong with me, I should lose weight, the person resorts to some form of food restrictions, then he overeats, the person thinks how I can compensate for this, and the circle closes. This is very painful, and most people cannot break out of this circle without the help of a specialist. Forms of compensation include induction of vomiting, abuse of diuretics and laxatives, diet pills. This is something that usually immediately alerts the relatives of people with eating disorders, so it is carefully kept secret. And here everything is obvious that there is nothing healthy in these practices.

There is another form of compensatory behavior. This is a sport, and this area is actively supported by society, the environment. Everyone gives a standing ovation when a person with an eating disorder runs to the gym on January 2, because that's it, the end, on January 1, he ate so much. If you hear snippets of phrases “I ate today, and then I have to work it out in training,” this is also not a normal option.

Any food restriction or fasting as a punishment and form of compensation for what was eaten is the practice that we classify as compensatory forms of eating disorders. If a person eats a piece of cake today and spends the next day on juices or green tea, then this also does not correspond to healthy behavioral manifestations.

Negative body image

The fourth pillar of an eating disorder is negative body image. Most people are dissatisfied with their body from time to time, we have wrinkles, gray hair appears, generally hair appears somewhere. Here we are all under social pressure. For example, there is evidence that before television came to the island of Fiji, there were no disorders like bulimia nervosa. And literally within 10 years there was a dramatic increase in these diseases. Not all of us write off the influence of society, but we remain quite critical of the role it plays in the formation of eating disorders. It’s really difficult for us when the ideals of beauty are the same, standardized, if you are different, then you feel the pressure of what you don’t match. Have you noticed how big the eyes of anime characters are? This is about the fact that the single standard of beautiful eyes is big eyes on the floor of the face. We live in a world where supermodels don't look like supermodels thanks to advances in photo retouching. But for a person with eating disorders, this is especially pronounced, and the body image totally dominates all areas of his life. When you ask a person what areas of life are significant for you (significant is that if something works out there, then you feel good, great, if there are difficulties there, then you feel much worse), for most people with eating disorders is just a total dominance of the body, weight, numbers on the scales. They may be successful in other areas, but it all becomes irrelevant if you can't fit into jeans of a certain size.

Another way of expressing negative body image for a person with an eating disorder is a body check. In English, this is called body checking. This is when people unnecessarily often, sometimes several times a day, use forms of control, checking whether everything is in order with their body. Frequent weighing on the scales, several times a day. This is not exactly a signal, but behavior that does not correspond to normal, we are not required to know our weight every day. It could be measurements. If you've watched The Marvelous Mrs Maisel, there's this moment where she's measuring her calves, hips, waist. Frequent looking at oneself in the mirror, when a person literally checks in every reflective surface whether a second chin has appeared, whether a stomach has grown. The problem with these checks is that it increases body dissatisfaction. Whatever we examine, closely and attentively, we will find faults there. Plus, there are purely perceptual difficulties with perception, i.e. a person looks in the mirror and he sees only one part of the body, conditionally, his stomach. It does not focus on everything else, and is perceived as more than it really is. I like the comparison that when a person has a phobia, like a fear of spiders, they don't perceive the spider's size objectively, but larger because it's a threat. The same thing happens with people with eating disorders. Those areas that they consider as problematic, they perceive as large, because they measure them with the general background. People with eating disorders do not pay attention to their advantages, which in principle they like.

There is a downside to checks - the complete avoidance of the body. This is what we often see in weighing. The person was weighed every day for three years, then the phase changed, he gained weight and stopped weighing. This is a very traumatic event for him. But this is also a signal that there is a pronounced dissatisfaction with your body. Avoidance can be expressed in the fact that a person does not like being touched, he cannot touch himself, he cannot even wash himself without a washcloth, because he is disgusted. A person does not buy new clothes for himself, he walks in a hoodie, because it is hard for him to go to the fitting room, to collide with his body. It is hard for him to face the fact that clothes that have become small must be given away and live life in a new weight.

Frequent fluctuations in weight

The last sign, not absolute, is fairly frequent fluctuations in weight. Usually, people who do not have eating disorders have a stable weight throughout their lives, which gradually increases with age, which is natural. People with eating disorders quite often have situations when a person has lost 15 kilograms of weight, then gained it, and this can be three or four cycles in a life. And it can also be a signal. Although RPP does not discriminate against anyone, they can be at any weight, but this is also a signal.

Here are the main red flags to look out for in order to suspect an eating disorder. Of course, they are sometimes difficult to detect even for specialists, psychologists, psychiatrists who do not work with eating disorders, so for accurate diagnosis it is better to contact those who work with this problem. If you are interested, I can tell you on the next broadcast how to choose a psychologist if you have a negative attitude towards your own body and disturbed forms of eating behavior.

Question from our subscriber:
I recently switched to intuitive eating, but there were some problems. I eat very quickly and it worries me. It seems like I am trying to savor food, to feel its taste, but I almost always do not feel pleasure, although I eat different foods. I eat quickly, then I get upset because I wanted to eat more. I can't enjoy it. Is it worth waiting for a stronger hunger, or is it better to give the body a break from food for a day or two?

Thank you for describing the situation in such detail. I feel how important this is to you. There is some belief that intuitive eating will help to cope with some experience of relationship with food. Look, under no circumstances do we restrict food (except if you cannot eat because of the operation). I was a little lacking information about what was before you came to intuitive eating. I can throw ideas, and if you still have questions, you can write by mail, or in the comments, or contact us for diagnostics. It seems that you feel some kind of hunger, you begin to feel full very early. Quite often this happens in cases where a person has extensive experience with food restrictions. We call this the feeling of being overwhelmed; ate a normal portion, even a little less, and you feel heaviness. If it passes after 15 minutes, then you ate normally. If you want to eat soon enough after that, then the portion was small. If after three hours you want to eat, then OK. The second thing I hear is food perfectionism - food should always be a pleasure. But even on intuitive eating, this is not always the case, sometimes food is just food. Ate, went to work. The first is not to limit yourself, it is worth continuing to eat intuitively, it may be better to start with the structured eating phase, which we do with our clients who want to switch to intuitive eating after they have had a restrictive eating behavior. Stock up on patience, time, listen to yourself. I hope I was able to help with the answer. If not, write, it's important to me.

Release video:

What are eating disorders, how they manifest and what to do if you or your loved one is sick

Eating disorders: what they are, how to recognize and treat them

999

Eating disorders are common and dangerous diseases. However, changes in eating habits and attitudes towards the body are often not perceived by either the sick or their loved ones as a serious threat to health. Shame and guilt (for example, shame about the appearance of the body or guilt for overeating) - frequent companions of disorders - can prevent a person from seeking help from doctors or relatives and leave him alone with a difficult problem.

Eating disorders (EDD) are mental disorders that manifest themselves in violation of eating habits and distortion of the perception of one's own body. A person with eating disorders may overeat or not eat at all, eat inedible food, aggressively “cleanse” the body, exercise excessively in order to lose weight or, conversely, gain muscle mass (even if medically this is not necessary). Thoughts about food, the body, its shape and weight in a person with eating disorders can gradually crowd out all other thoughts.

The most famous and dangerous eating disorders are anorexia and bulimia, but the list of disorders is not limited to them. The latest edition of the International Classification of Diseases (ICD-11) includes psychogenic overeating, peeing, rumination, and restrictive eating behavior.

It is difficult to distinguish a sick person from a healthy one. Symptoms of the disease, as a rule, a person hides even from loved ones. Fear, shame, guilt, anxiety (eg, fear or anxiety due to changes in weight, shame for inducing vomiting, guilt for an overeating attack), painful control over oneself and one's diet, make patients remain silent and not seek help.

To diagnose RPP, it is necessary to exclude the possibility of diseases of a physiological nature - problems with the gastrointestinal tract, neurological and hormonal failures. For example, a person may vomit because they have a stomach ulcer and because they are ashamed of a bout of overeating (one of the symptoms of bulimia is a mental illness). At the same time, with the course of eating disorders, real physiological problems arise: metabolism is disturbed, the kidneys and heart fail, the digestive organs can seriously suffer. And most often, both the mental disorder and its physiological consequences need to be treated.

regular "cleansing" (inducing vomiting, taking diuretics or laxatives);

self-inflicted injury;

suicidal thoughts.

The duration of outpatient treatment depends on the patient's condition and usually takes from one month to six months.

Psychotherapy for RPP

How psychotherapy works when hospitalization is not needed, says Elizaveta Balabanova, a medical psychologist, a full member of the all-Russian professional psychotherapeutic league. Elizabeth works as a psychodynamic therapist (psychodynamic therapy is based on psychoanalysis and is aimed at making the patient aware of how his life experience and internal conflicts affect life in the present, reworking them and, with the help of a psychotherapist, finding new models of behavior and ways of reacting to the outside world) .

“The eating disorder itself is only a symptom. Almost always, it is observed as part of a serious neurosis - a depressive syndrome, an anxiety-phobic disorder, and so on.

Compulsive overeating overwhelmingly helps to numb anxiety, and therefore high levels of stress, depression, and anxiety contribute to eating disorders. Why? Because [according to the theory of psychoanalysis] when a person is born, the food that his mother gives him is the only source of rest for him. In a severe neurotic state, the psyche automatically seeks consolation in that early experience. If we talk about anorexia, then there is also the so-called perfection neurosis with the rejection of one's own body (and one's own psyche at the same time).

Any mental disorders of the bodily level are corrected slowly, so a person needs to tune in to regular long work. Eating disorders are not about food, so the task of the psychotherapist is to find out the cause of the distortions and to understand at what stage in the development of the psyche the failure occurred.

How to know if you have an eating disorder

You are ashamed of being hungry, of having eaten too much, of the way your body looks. You are afraid of gaining weight, bouts of overeating or not eating at a time of great tension. Your body and your diet may seem disgusting to you. (typical for all RPP)

After eating, you try to get rid of what you have eaten - induce vomiting, take a laxative or diuretic. It happens all the time (typical for bulimia, anorexia)

You try to eat alone because you are embarrassed and ashamed of your eating habits in the company. For example, you are afraid that you will be judged for eating too much. (typical for all RPP)

You do not feel hungry or full, or you constantly suppress them with an effort of will for a long time (typical for anorexia, bulimia, psychogenic overeating)

Meals are overgrown with rituals: you sort food on a plate, count the number of calories or nutrients in each serving, carefully chew each bite (typical for all disorders, more often - bulimia, anorexia, psychogenic overeating)

You train to the point of exhaustion without looking back at how your body feels - overcoming intense pain, ignoring fatigue and general malaise (typical for anorexia, bulimia)

You have been eating inedible food for a long time (a month or more) (typical for spades)

You think you have to tightly control your eating habits or completely lose control when eating. For example, eat on a strict schedule or break loose by eating everything you can find around you. (typical for all RPP)

You began to notice weakness, problems with the gastrointestinal tract (pain, constipation, diarrhea), for no apparent reason, the blood vessels of the eyes began to burst or convulsions appeared. Women may experience menstrual irregularities

Your weight fluctuates noticeably too often. Normal weight change with a change in diet is 0.5-1 kg per week or 5%-10% of the initial weight per month (typical for all disorders)

If you have found at least two signs from the list, do not be afraid to contact a psychotherapist or psychiatrist - it is important to stop the development of the disorder as soon as possible.

What should you do if you think someone close to you is sick?

Learn what eating disorders are, pay attention to what your loved one has been diagnosed/suspected.

Remain calm, do not expose yourself and your loved one to panic and annoying sudden guardianship - this can violate trust.

Talk softly with your loved one about how and what he eats and how it feels. Do not pressure and demand to tell more than you have already heard. The person may not be ready for this.

Discuss with your loved one the perception of the body: how you both imagine its normal state, what forms you consider healthy, how nutrition helps in this. This will help you better understand your loved one, and he will trust you. Do not claim that the person is unhealthy or point to what you think is healthy behavior.

Offer to contact you for help. Let your loved one know that no matter what help he needs, you are always there. No need to impose (for example, offer to keep a food diary, cook and monitor each meal). In no case do not force him to eat or refuse food.

Don't blame yourself. An eating disorder can have many causes. If you are a parent or partner and feel that you have made mistakes that could affect the condition of a loved one, ask for forgiveness and change your behavior.

7. Discuss the possibility of treatment with a psychotherapist. Therapy is necessary in order to cure eating disorders. In most cases, eating disorders are accompanied by other psychiatric disorders. Depression and anxiety disorder are the most common of these. Psychotherapy can help deal with the emotions that underlie these conditions.

8. Discuss the possibility of treatment in the hospital. In some cases this may be necessary. Eating disorders pose a threat to both emotional and physical condition. In the clinic, specialists will be able to take care of the nutrition of a loved one and the methods of psychotherapy that are suitable for him.

9. Help a loved one choose a clinic. On the websites of private and public hospitals, as a rule, there are treatment programs, and by phone, specialists can quickly tell you about the timing and methods of treating ED. Usually hospitalization in Russia is preceded by a consultation with a psychiatrist. Visit her together or find out about her results if your loved one does not mind.

10. Contact only qualified centers and doctors with medical education. Evidence-based medicine has managed to find effective methods for dealing with eating disorders. The help of uneducated doctors, spiritual centers and people practicing alternative medicine can cost your loved one their life.

Thank you for reading this text to the end!
It was written by Marina Bushueva, a freelance writer for the Roizman Foundation. She spoke to experts, collected material from many sources, and produced this text. We really hope that it will be useful for you, as eating disorders are a really dangerous disease.
We are glad that you are interested in what we do: it is important for us to write texts for you that slightly change your (and our!) picture of the world. And this is not easy to do without support. Please make a small donation to the Roizman Foundation so we can write more and tell better stories. Thank you for being with us.

Many believe that the fashion for excessive thinness, anorexia and bulimia has finally and irrevocably sunk into oblivion. However, despite the absence of high-profile scandals, deaths in the press or on television, there are still many people suffering from various eating disorders, the test for which must be taken at the slightest suspicion. Let's deal with the details, because minor symptoms today, tomorrow can become really threatening.

Just about the complex: what is an eating disorder

If you think that there is nothing wrong with such disorders, then you are deeply mistaken. Usually, starting with the most harmless things, like skipping breakfast or dinner, or maybe vice versa, systematic nightly "overeating", it can develop into something much more dangerous. Therefore, it does not hurt to find out what eating disorders are in adults and children in order to assess the scale of the “disaster” for yourself.

In medical terms, an eating disorder is a psychogenic behavioral syndrome. It is directly related to violations in meals, skipping them, additional plentiful snacks and other non-standard situations that become habitual. They can lead to very sad consequences, even death, therefore, at the slightest suspicion, measures must be taken immediately.

Types and forms of eating disorders: symptoms

Medicine distinguishes several types of eating disorders. At the same time, in most cases, a complex effect is observed, which significantly aggravates the situation. Our website contains separate materials on these issues.

In a nutshell, patients have a persistent reluctance to eat, even with a strong physiological need. A person can literally die of hunger, but stubbornly refuse the offered dishes. There are a number of symptoms by which you can "calculate" anorexia nervosa.

Self-restraint in food even with a relatively small weight.
Unfounded belief in the presence of excess weight.
Amenorrhea (cessation of menstruation in girls).

One or more signs may not appear, then the disease is called atypical. Most often, doctors manage to help patients with this disease on an outpatient basis, but in the most difficult cases, it is possible to be admitted to a hospital, sometimes even forcibly.

This disease is polar to anorexia. The disorder lies in the fact that the patient cannot control the amount of food absorbed at a time. Because of this, they systematically overeat. After eating, bulimics cause conscious bouts of vomiting to get rid of what they have eaten. Other types of compensatory behavior are also possible, for example, exhausting yourself with long intensive wear training. At the same time, there is a psychological fear of getting better, getting fat, complexes about the parameters of the body. The symptoms of the disease are simple.

Frequent consumption of large quantities of food.
Regular vomiting.
Chronic use of laxatives.
Excessive physical activity.

Typically, patients start out with binge eating attacks once or twice a week. If the picture does not normalize within three months, treatment is prescribed. In ninety percent of cases, women under 25 are affected.

An irresistible, obsessive desire to constantly eat something can be a symptom of a psychogenic illness. That is, a person does not feel hunger, but continues to eat. It is usually the body's response to stress. Troubles at home, at work, problems with parents or children, a busy work schedule - all this can provoke an attack. People who are prone to overweight are especially susceptible.

Large amounts of food eaten during the day.
Strong feeling of hunger.
Eating food at high speed.
Hunger even after eating.
Responsibility and guilt. Desire to punish yourself.
Stealth, eating in secret, alone.

Unlike bulimia, overeating does not precede a cleanse, so it is especially dangerous. Often people gain weight, suffer from obesity and its accompanying symptoms. Low self-esteem, guilt leads to depression, suicidal tendencies.

Psychogenic vomiting and other diseases

This eating disorder is put on a par with disorders. The cause may be mental and emotional symptoms. Most often, people with this disease suffer from exhaustion. May be due to hypochondriacal and dissociative disorders. But there are other types of diseases. They are less common, but by no means safer or less serious.

Loss of appetite of a psychogenic nature.
The need to eat something inedible that does not have a biological nature (plastic, metal, etc.).
Propensity to eat inedible biological origin.
Orthorexia is an obsession with proper nutrition.
Obsessive-compulsive overeating associated with constant thoughts about food, laid tables, various dishes.
Selective eating disorder - refusal of any food or food groups. This also includes the desire to eat only a strictly defined set of products, the unwillingness to try something new.
External type of eating behavior. That is, the desire to eat arises not because of physiological needs, but because of the type of food, the table set, appetizing dishes.

Psychiatrists believe that they should not be taken lightly, even to the most seemingly minor eating disorders, in any case. One disorder can easily transform into another, which is why often even experienced doctors cannot immediately determine the type, type, nature of the disease, as well as determine the path to recovery.

Among eating disorders, obsessive calorie counting is common, and somewhat less often - refusal to eat from other dishes, eating in a certain sequence, in a specific place. At the same time, such mental problems cannot be called purely psychological. They are complex, combining disorders with physiological factors (exhaustion, increased physical activity, various metabolic disorders in the body).

Reasons for developing an eating disorder

There are many reasons why people develop eating disorders.

genetic. Recent studies by scientists in this regard show that the risk of developing bulimia or anorexia, provided that parents or other family members had the same problems, is much higher. The probability reaches sixty percent, which is a lot.
Educational (family). Most often, children learn by looking at adults, because the example of their parents becomes, as it were, a kind of protective mechanism. However, sometimes excessive obsession with food can have the opposite effect on the child.
Social. Eating disorders appear more often in those who have experienced a negative emotional experience, ostracism of society, who could not adapt to the outside world, having got out of their father's house. Fairly low self-esteem is the main sign of such a development of events.
Traumatic incidents or events. It is believed that they can cause various psychogenic disorders, including nutritional disorders. People who have experienced physical or mental abuse often suffer.
Excessive perfectionism. Oddly enough, such patients often also suffer from eating disorders, unable to fit the world around them into an ideal order.

Anything can become an impetus, and often abrupt changes in life, traumatic events and incidents: the death of loved ones, moving far from their usual places, a change in occupation, the collapse of stereotypes or worldview. .

Dutch Eating Behavior Questionnaire (DEBQ)

Back in 1986, Dutch experts jointly developed a special questionnaire, The Dutch Eating Behavior Questionnaire. It is by far the best test for an eating disorder known to medicine. It allows just a few simple questions to determine not only the presence of the disease, but also the likely ways of its treatment. Moreover, there can be only three main reasons.

The habit of "jamming" unpleasant or pleasant emotions.
The impossibility of fighting temptations (the inability to resist "sweets").
The desire to severely and drastically limit oneself in food.

By completing this simple questionnaire, you can find out what is wrong with your relationship with food, how you can fix the problem.

Instructions on how to complete the questionnaire, results

In general, the test consists of thirty-three questions, which must be answered as honestly and openly as possible. In this case, you must immediately give answers, without hesitation for a long time. For each answer "Never" you get only 1 point, for "Very rarely" - 2, for "Sometimes" - 3, for "Often" - 4, and for "Very often" - 5.

*In question number 31, answers should be scored in reverse order.

Add up the scores for questions 1-10 and divide by 10.
Sum the scores for 11-23 questions, divide by 13.
Add up the scores for questions 24-33 and divide by 10.
Plus your points.

To pass, you will need a pen and a piece of paper where you will write down your answers.

Questions to be answered

Do you eat less if you notice that your body weight has started to increase?
Do you try to consume less than you would like, limit yourself in nutrition during any meal?
Do you often refuse to eat or drink due to concerns about being overweight?
Do you always control the amount of food you eat?
Are you choosing food for weight loss?
After overeating, do you eat smaller amounts of food the next day?
Do you seek to limit food so as not to gain weight?
Do you often have to try not to snack between meals as you struggle with your weight?
Do you try not to eat in the evening because you are watching your weight?
Before you eat something, do you think about body weight?
Do you feel like eating when you're irritable?
Do you want to eat in moments of idleness and laziness?
Do you feel like eating when depressed or discouraged?
Do you eat when you are alone?
Do you want to eat after the betrayal of loved ones, deceit?
Do you want to eat when plans are disrupted?
Do you eat in anticipation of trouble?
Concern, tension cause a desire to eat?
If “everything is wrong” and “falls out of hand” do you start to seize it?
Do you want to eat when you are scared?
Shattered hopes and disappointments cause bouts of hunger and desire to eat?
In frustrated feelings or with strong excitement, you immediately want to eat?
Anxiety and fatigue - the best reason to eat?
When food is delicious, do you eat large portions?
If the food smells good and looks appetizing, will you eat more of it?
Do you want to eat as soon as you see delicious, beautiful food with a pleasant aroma?
Do you eat all the goodies you have right away?
Do you want to buy delicious, passing by outlets?
Do you want to immediately refresh yourself if you pass by a cafe that smells good?
Does the sight of other people eating food whet your appetite?
Are you able to stop when you are eating something delicious?
When you eat in company, do you eat more than usual?
When you cook yourself, do you often taste dishes?

Interpretation of survey results

Restrictive behavior (1-10 questions)

The ideal average score is 2.4 points. This suggests that in the absence of other disturbing factors, you can not worry too much. If your result is much lower, then you almost do not know what, how, in what quantities, when you eat. You should pay more attention to your diet. If the answer is more, then most likely you tend to clearly limit yourself, which can border on frustration. These people often have anorexia and bulimia.

Emotional line of behavior (11-23 questions)

These questions indicate whether you generally have a tendency to "jam" all sorts of emotional (mental) problems, troubles and inconveniences. The lower the number of points scored, the better, and the average can be considered 1.8. Higher numbers indicate that you have a habit of pouncing on "sweets" as soon as your mood deteriorates, out of boredom, idleness.

External eating behavior (questions 24-33)

The last answers to the questions show how easily you can succumb to the temptation to eat something tasty. Here the average score will be 2.7, and it will be necessary to navigate by it. The more you count, the easier it is to give in to the desire to snack, even if you didn’t feel hunger at all before. If the results are much higher, then the problem definitely takes place, it needs to be solved as quickly as possible.

A simple algorithm: how to get rid of an eating disorder

As soon as you understand that the problem really exists, you need to immediately take action, without waiting for anorexia or obesity to bring many unpleasant surprises into your life.

Acceptance and understanding

There are three very basic steps that must be followed before choosing methods for managing the symptoms of an eating disorder.

The main condition for the treatment of any psychogenic factor is the recognition of the problem. Until a person sees a problem, it does not exist, and he simply will not go to the doctor. Realizing that the disease is real, you need to seek help from a specialist psychotherapist or psychiatrist.
After the doctor examines, interviews and conducts research, he will prescribe treatment. The entire course must be completed from start to finish. Treatment not brought to its logical conclusion may be ineffective, and the problem will eventually make itself felt.
Both before the appointment of a course of treatment, and during it, and at the same time after, it is necessary to carefully avoid traumatic situations.

Stress, troubles at work or at home, the inability to find a common language with colleagues, parents or children, teachers or superiors, all this can lead to breakdowns and a return to the initial stages of the disease.

Treatment Methods

Speaking about different ways of treating eating disorders, you need to understand that all patients react to them in different ways. Even with exactly the same symptoms, people's behavior can be very different, and what works for one will be completely ineffective for another. Below are the most popular treatments. Some of them have proven themselves very well, while others are more reminiscent of healer dances with a tambourine.

Psychotherapy

Such an approach primarily involves the doctor's work with thoughts, behavior, emotions, a person's attitude to food and interpersonal relationships in the family and close environment.

transactional analysis.
Dialectical behavioral psychotherapy.
Cognitive-behavioral, analytical therapy.

Most often, such methods are practiced by psychologists, less often by psychiatrists. However, the developed treatment models can also be used by psychotherapists, as well as various behavioral consultants. Subject to the selection of a competent, experienced specialist, the prognosis for such treatment is mostly only positive, and a cure is possible one hundred percent.

Family Approach

This type of therapy is often used to deal with eating disorders in children or adolescents. It implies active participation in the cure not only of the patient himself, but also of his family members, friends and loved ones. The essence of this technique is simple - you need to teach the correct principles of nutrition to all family members so that they can independently control the problem in the future, as well as stop crises if they arise. It is quite real and affordable.

Usually, in clinics where a family approach is developed, several specialists work with one unit of society at once. It can be a nutritionist, psychiatrist, psychologist, cosmetologist, behavioral disorder specialist. Command methods of this plan give excellent results.

Medical treatment

When eating disorders do not come alone, but bring “friends” with them (depression, psychosis, insomnia, excessive sleepiness, unreasonable anxiety), then doctors prescribe drug treatment. Moreover, all these variants of non-diseases are classified as concomitant diseases.

It is impossible to “prescribe” such medicines on your own, since they usually have strict prescriptions, as well as a large number of “side effects”. Only a specialist can prescribe or cancel certain medications. They help only in combination with other measures of influence. It must be understood, however, that medications alone will not cure behavioral disorders. There is no coveted magic pill, drinking which you will immediately recover.

diet therapy

Since such a disorder is primarily related to food, it will be quite difficult to cope with it without an experienced nutritionist. The correct diet, however, can be advised even by an ordinary therapist from the clinic. The rules here will be the same in all cases. It is important that the patient receives with food, with small amounts of it, all the substances necessary for life: minerals, vitamins, proteins, fats, amino acids, macro- and microelements.

With the right approach, patients can easily develop the right eating habits, which they can then use with benefit throughout their lives. For example, many recommend paying attention to, with virtually no restrictions. However, you need to understand that a nutritionist is far from being a specialist in disorders, therefore he is not able to cure them on his own.

Folk methods and self-medication

Many people do not attach much importance to the warning symptoms until the problem starts to snowball. Therefore, instead of turning to specialists, they begin to look for alternative methods of struggle, often quite absurd. For example, no sorcerer grandfather or healer grandmother will brew a potion that can correct eating habits.

Yes, and independent steps without the help of professionals can hardly help at the very initial stages, when there is no disorder as such yet. The Russian Association of Eating Disorders (RARPP) notes that any steps taken without a doctor result in failures and a return to previous behavioral patterns in more than 93% of cases. It makes you think.

Features of the formation of eating disorders in adolescents

Children are in the most dangerous risk group, because their eating habits are formed under the influence of their environment. With poor heredity, a tendency to emotional breakdowns, mental instability, the chances of getting eating disorders in adulthood increases significantly.

According to studies conducted for children and adolescents, only 23% of the total number do not have any disorders, while the other 77% are prone to various kinds of “malfunctions” or are prone to developing problems of this kind. This is due to the ever-growing “hamburger cult”, when children consider fast food, fast food an indicator of wealth and prestige. It is very important at the first stages to detect the problems of a teenager, to “switch” him, to captivate him with something, not allowing him to get hung up on food and eating habits.

Prevention

Preventive measures to stop the very possibility of eating disorders exist. Moreover, they can be used very effectively, paying more attention to children's educational institutions, schools, universities. But any adult can pay attention to ways to prevent a likely addiction to food in order to protect themselves and their loved ones.

Correct and objective perception of one's own body.
Respectful, competent and positive attitude towards the body.
Understanding that appearance does not in any way testify to the internal qualities of a person, about his character.
Stop worrying too much about being overweight or underweight.
Understanding, knowledge is half the solution to the problem. Acceptance of yourself and your weight leads to finding ways to recover.
Going in for sports and body culture, not because it is necessary, but to get satisfaction, positive emotions, maintain activity, and one's own shape. .

Socialization is a very important preventive factor. Man is a herd animal, he needs communication, the approval of others. Therefore, one must always pay attention to the situation in the team where he is. If an unhealthy atmosphere of ridicule, prodding, censure reigns there, then you should think about whether to change this place of work, school, club of interests to some other one. The negative must be left in the past, tuning in only to positive emotions, without this it will be difficult to cope with the disorder.

Popular books and movies about eating disorders

Books

«Sociological methods of research of addictive behavior. Preventive and Clinical Medicine” Sukhorukov D.V.

"Food addictions, addictions - anorexia nervosa, bulimia nervosa" Mendelevich V.D.

"Preserving the health of schoolchildren as a pedagogical problem" Pazyrkina M. V., Buinov L. G.

"Anorexia nervosa in children and adolescents" Balakireva E.E.

Movies

Girl, Interrupted (1999), directed by James Mangold.

Sharing a Secret (2000), directed by Katt Shea.

Hunger (2003), directed by Joan Micklin Silver.

"Anorexia" (2006), directed by Lauren Greenfield (documentary).

"Example for weight loss" (2014), directed by Tara Miel.

To the Bone (2017), directed by Marty Noxon.

Any eating disorder can lead to the development of serious health problems. As a rule, it is based on psychological factors. Therefore, it is necessary to get rid of them together with specialists.

Problem types

Experts know that an eating disorder can manifest itself in many different ways. The tactics of treatment in each case should be selected individually. It will depend on the established diagnosis and the condition of the patient.

The most popular types of disorders are:

It is not always possible to recognize people who suffer from any of these disorders. For example, with bulimia nervosa, weight may be within the normal range or slightly below the lower limit. At the same time, people themselves do not realize that they have an eating disorder. Treatment, in their opinion, they do not need. Dangerous is any condition in which a person tries to draw up nutritional rules for himself and strictly adheres to them. For example, a complete refusal to eat after 4 p.m., a strict restriction or a complete rejection of the use of fats, including vegetable origin, should alert.

What to look for: dangerous symptoms

It is not always possible to understand that a person has an eating disorder. The symptoms of this disease must be known. To identify if there are problems, a small test will help. You just need to answer the following questions:

Do you have a fear that you will gain weight?
Do you find yourself thinking about food too often?
Do you refuse food when you feel hungry?
Do you count calories?
Do you cut food into small pieces?
Do you periodically have bouts of uncontrolled eating?
Are you often told about your thinness?
Do you have an obsessive desire to lose weight?
Do you induce vomiting after eating?
You appear
Do you refuse to eat fast carbohydrates (baked goods, chocolate)?
Are there only dietary dishes on your menu?
Do people around you try to tell you that you could eat more?

If you answered “yes” more than 5 times to these questions, then it is advisable for you to consult with a specialist. He will be able to determine the type of disease and choose the most appropriate treatment tactics.

Characteristics of anorexia

Refusal to eat appears in people as a result of mental disorders. Any severe self-restraint, an unusual choice of products are characteristic of anorexia. At the same time, patients have a constant fear that they will recover. Patients with anorexia may be 15% less than the established lower limit of normal. They have a constant fear of obesity. They believe that the weight should be below normal.

In addition, people suffering from this disease are characterized by the following:

the appearance of amenorrhea in women (absence of menstruation);
violation of the functioning of the body;
loss of sexual desire.

This eating disorder is often accompanied by:

taking diuretics and laxatives;
exclusion from the diet of high-calorie foods;
provoking vomiting;
taking medications designed to reduce appetite;
long and exhausting workouts at home and in the gym in order to lose weight.

To establish the final diagnosis, the doctor must fully examine the patient. This allows you to exclude other problems that manifest themselves in almost the same way. Only then can treatment be prescribed.

Characteristic signs of bulimia

But it's not just anorexia that can develop in people with eating habits. Specialists can diagnose a neurogenic disease such as bulimia. In this condition, patients periodically cease to control how much they eat. They have bouts of gluttony. As soon as the overeating is over, patients experience severe discomfort. There is pain in the stomach, nausea, often episodes of overeating end in vomiting. Feelings of guilt for such behavior, self-dislike, and even depression cause this eating disorder. Treatment alone is unlikely to succeed.

Patients try to eliminate the consequences of such overeating by inducing vomiting, gastric lavage, or taking laxatives. You can suspect the development of this problem if a person is haunted by thoughts about food, he has frequent episodes of overeating, periodically he feels an irresistible craving for food. Often episodes of bulimia alternate with anorexia. If left untreated, this disease can lead to rapid weight loss, but the balance in the body is disturbed. As a result, severe complications occur, and in some cases, death is possible.

Binge Eating Symptoms

Understanding how to get rid of an eating disorder, many forget that such problems are not limited to bulimia and anorexia. Doctors also face such a disease as compulsive overeating. It is similar in its manifestations to bulimia. But the difference is that people suffering from it do not have regular discharges. Such patients do not take laxatives or diuretics, do not induce vomiting.

With this disease, bouts of gluttony and periods of self-restraint in food can alternate. Although in most cases between episodes of overeating, people constantly eat a little something. This is what causes significant weight gain. This may occur only intermittently for some and be short-lived. For example, this is how certain people react to stress, as if eating problems. With the help of food, people suffering from compulsive overeating look for an opportunity to get pleasure and give themselves new pleasant sensations.

Reasons for the development of deviations

In case of any malnutrition, the participation of specialists is indispensable. But help will only be effective if the causes of eating disorders can be identified and addressed.

Most often, the development of the disease is provoked by the following factors:

high standards for oneself and perfectionism;
the presence of traumatic experiences;
stress experienced due to ridicule in childhood and adolescence about;
mental trauma resulting from sexual abuse at an early age;
excessive concern for the figure and appearance in the family;
genetic predisposition to various eating disorders.

Each of these reasons can lead to the fact that self-perception will be violated. A person, regardless of his appearance, will be ashamed of himself. You can identify people with such problems by the fact that they are not satisfied with themselves, they cannot even talk about their bodies. They attribute all the failures in life to the fact that they have an unsatisfactory appearance.

Problems in teenagers

Eating disorders often begin during adolescence. Significant hormonal changes occur in the child's body, his appearance becomes different. At the same time, the psychological situation in the team also changes - at this time it is important for children to look the way they are accepted, not to go beyond the established standards.

Most teenagers are preoccupied with their appearance, and against this background, they may develop various psychological problems. If the family did not devote sufficient time to the development of an objective, adequate self-esteem in the child, did not instill a healthy attitude towards food, then there is a risk that he will develop an eating disorder. In children and adolescents, this disease often develops against a background of low self-esteem. At the same time, they manage to hide everything from their parents for quite a long time.

These problems develop, as a rule, at the age of 11-13 years - during puberty. Such teenagers concentrate all attention on their appearance. For them, this is the only means that allows them to gain self-confidence. Many parents play it safe, fearing that their child has developed an eating disorder. In adolescents, it can be difficult to determine the line between normal preoccupation with appearance and a pathological condition in which it is time to sound the alarm. Parents need to start worrying if they see that the child:

tries not to attend events where there will be feasts;
spends a lot of time on physical activity in order to burn calories;
too dissatisfied with his appearance;
uses laxatives and diuretics;
obsessed with weight control;
overly scrupulously monitors the calorie content of foods and portion sizes.

But many parents think that an eating disorder in children cannot be. At the same time, they continue to consider their teenagers at the age of 13-15 as babies, turning a blind eye to the disease that has arisen.

Possible Consequences of Eating Disorders

The problems that these symptoms can lead to should not be underestimated. After all, they not only adversely affect health, but can also cause death. Bulimia, like anorexia, causes kidney failure and heart disease. With frequent vomiting, which leads to a lack of nutrients, such problems can develop:

damage to the kidneys and stomach;
feeling of constant pain in the abdomen;
the development of caries (it begins due to the constant exposure to gastric juice);
lack of potassium (leads to heart problems and can cause death);
amenorrhea;
the appearance of the cheeks of the "hamster" (due to pathological enlargement of the salivary glands).

With anorexia, the body goes into a so-called starvation mode. This may be indicated by the following signs:

hair loss, breaking nails;
anemia;
amenorrhea in women;
decrease in heart rate, respiration, blood pressure;
constant dizziness;
the appearance of a hair gun all over the body;
the development of osteoporosis - a disease characterized by increased bone fragility;
an increase in the size of the joints.

The sooner the disease is diagnosed, the sooner it will be possible to get rid of it. In severe cases, even hospitalization is necessary.

Psychological help

Many people with overt eating disorders believe they don't have any problems. But without medical help, it is impossible to correct the situation. After all, it is impossible to independently figure out how to conduct psychotherapy for eating disorders. If the patient resists and refuses treatment, the help of a psychiatrist may be needed. With an integrated approach, a person can be helped to get rid of problems. After all, with severe violations, psychotherapy alone will not be enough. In this case, drug treatment is also prescribed.

Psychotherapy should be aimed at the work of a person on his own image. He must begin to adequately evaluate and accept his body. It is also necessary to correct the attitude towards food. But it is important to work out the reasons that led to such a violation. Specialists who work with people suffering from eating disorders say that their patients are overly sensitive and prone to frequent negative emotions such as anxiety, depression, anger, sadness.

For them, any restriction in food or overeating, excessive physical activity is a way to temporarily alleviate their condition. They need to learn to manage their emotions and feelings, without this they will not be able to overcome an eating disorder. How to treat this disease, you need to deal with a specialist. But the main task of therapy is the formation of a correct lifestyle for the patient.

Worse work to get rid of the problem is for those who have difficult relationships in the family or constant stress at the workplace. Therefore, psychotherapists must also work on relationships with others. The sooner a person realizes that he has a problem, the easier it will be to get rid of it.

Recovery period

The most difficult task for patients is the development of self-love. They need to learn to perceive themselves as a person. Only with adequate self-esteem can physical condition be restored. Therefore, nutritionists and psychologists (and in some cases psychiatrists) should work on such patients at the same time.

Professionals should help overcome an eating disorder. Treatment may include:

drawing up a nutrition plan;
inclusion in the life of adequate physical activity;
taking antidepressants (only necessary if there are certain indications);
work on self-perception and relationships with others;
treatment of mental disorders such as anxiety.

It is important that the patient has support during the treatment period. Indeed, often people break down, take breaks in treatment, promise to return to the planned action plan after a certain time. Some even consider themselves cured, although their eating behavior does not change much.