Eating disorders: anorexia and bulimia

Lack of appetite, excessive desire to eat and then vomit, excessive concern for the body, unbearable abdominal pain, anxiety , hormonal lack of control, fatigue, dizziness and recurrent headaches … these are some of the symptoms that may indicate that you are facing a disorder nutritional.

What are eating disorders?

Eating disorders are psychopathologies that affect the individual both in their mental and physical health. These usually manifest themselves through excessive preoccupation with body image and excessive or insufficient desire to eat. They can affect people of all ages, sex, race, ethnicity, and social status.

While eating disorders are complex, most begin with significant weight gain or loss, which occurs accidentally or deliberately, which can lead to unhealthy steps to sustain the loss or to be unconcerned about that gain that will later be part of a serious health problem.

Causes of eating disorders

An exact cause of eating disorders is not yet known. These disorders are believed to be the result of one or more biological, behavioral and social factors, including: genetics, unpleasant traumatic experiences , school pressure, discrimination, being part of a family with eating disorders, among others.

Although eating disorders are often the result of a number of personal, environmental, psychological, biological, and social factors, it appears that adolescents are the group of people most at risk for developing an eating disorder.

School bullying has been shown to be one of the most frequent causes of eating disorders. Adolescents who have suffered discrimination since childhood tend to suffer the most from eating disorders such as anorexia or bulimia nervosa. These disorders can also occur in adolescents who have grown up in perfectionist families, where if something falls outside the “normal parameters” it will be frowned upon. For example: a family where everyone is skinny and one of the members is not, he or she will feel not only social pressure, but also pressure from his environment, to which he must adapt following the parameters that he imposes.

It is also estimated that those who have been victims of abuse or have suffered traumatic experiences are more likely to present mental disorders such as eating disorders -especially anorexia or bulimia-. Some of these people choose to self-mutilate as punishment when eating food, where in reality, unconsciously , this punishment is being done to themselves, because of the guilt and helplessness they feel about that disturbing situation of which they were part.

Eating disorders in adolescence

The adolescent period is a period of intense change that can bring a great deal of stress , confusion, and anxiety for many adolescents. The physical transformation that takes place during this time is enormous and is often intertwined with feelings of self-awareness, low self-esteem, and comparison with other peers. In this period hormonal and brain changes are taking place that affect a person physically, mentally, emotionally and psychologically.

Adolescence is a particularly challenging time for those with eating disorders. This is due to emotional, physical, and hormonal changes, as well as academic pressures, family pressures, and peer pressures. At this stage, concerns about body image intensify. If we add to these concerns the peer pressure, discrimination and poor judgment that some people may have, these can be potential risk factors in the development of an eating disorder.

Bulimia and anorexia

Bulimia and anorexia are serious, life-threatening and neurotic eating disorders if not treated early. Within the disease , the first signs that something is not working well appear in adolescents between 15 and 17 years of age . It is common for a case that began as anorexia at that age, ends in a picture of bulimia at 18 or 20 years when the person becomes aware of the disease .

The difference between a person who takes care of his body and eats healthily, and a person who is sick from food, lies in the time he spends per day on the subject. Young people with bulimia and anorexia are both “obsessed” with their weight . Their whole life revolves around what they ate, the exercises they did, the weight they got up with and the weight they went to sleep with, what clothes they have and what they no longer have, etc. . This occurs to such an extent that they develop a hidden language that only they can decipher.

Some of the young women come to think that they are lesbians because they spent all day looking at other women’s bodies. When they go down the street they look at all the bodies that surround them and calculate the weight of each one of them.

The life of a subject with this pathology revolves around it (anorexia and bulimia). It revolves around managing to develop a language that allows you to feel better, that allows you not to think about your weight or your appearance; but on the contrary, with all these techniques the only thing they achieve is to feed this obsession.

General symptoms

• They stop going to places where they know there will be food
• They do several hours of physical exercise a day
• They stop eating in public (in the case of the bulimicas, it can happen that late at night they destroy everything they have in their refrigerator)
• They take diuretics and laxatives to expel everything they ate.
• They can look at each mirror or glass on the street without being able to see themselves as they are
• They look for different ways of sitting to hide the “fat” of their legs
• They develop mechanisms to facilitate vomiting
• They have a real distortion of their body scheme
• They are people with very low self-esteem
• They live a  constant inner struggle, as they are terrified of getting fat and becoming obese.
• They self-mutilate when feeling distressed or in any stressful situation
• They generally present depressive symptoms
• They present physical and emotional fatigue
• They are  unsure of themselves
• They have little self-confidence
• They are obsessive people
• They are perfectionists and frequently pessimistic
• They have compulsive feelings: anger, anxiety, boredom, irritability
• They frequently have mood swings and suffer from panic attacks

Paraphrasing Ana María Foseh, we would say that the absence of appetite has nothing to do with food, but with life, the desire for life . Said appetite can lead in some cases to death.

Anorexic and bulimic people lead a life of lies. They live inventing excuses not to sit at the table and avoid eating in front of people.

Anorexia nervosa

Etymologically anorexia means “lack of appetite . ” However, the scientific explanation of this disease indicates that people who suffer from it do not lose the desire to eat but, on the contrary, they achieve “strict control” over all the foods they eat.

The personality of an anorexic has very marked traits that are repeated in each case. Anorexic people have exemplary discipline. They are demanding and strict people in everything they do . In order to reach the weight they want, they carry out “restrictive” behaviors . They stop eating for a long time, engage in physical activities, and have purgative behaviors through vomiting from food, laxatives, or diuretics.

In most cases, anorexia does not create a feeling of guilt . Anorexics are not aware of the harm they are causing themselves. A clear symptom in women, in addition to weight loss, is the absence of menstruation .

Having anorexia does not mean that you are not hungry. Only they do not eat, but they are hungry, they also have a significant low weight, a mass index much lower than normal. Many times a different skin appears, their hair falls out and their nails break.

It has been proven that every three people with bulimia there is one with anorexia .

Bulimia nervosa

The life of the bulimic is quite different from that of the anorexic. He lives with permanent guilt for what he eats and what he does to drive it out. You can go several hours without eating, and then eat whatever food you can find when no one sees you. In most cases they are aware that they have a disease. Their weight is generally normal but with ups and downs . They have stages in which they gain weight and others in which they lose weight.

These subjects, when they look in the mirror, look fat even though they are not;  They cannot see their body as it is, to the point that if they have to pass between two objects, it is most likely that the objects separate them too much to be able to pass, since they really believe that this is the space their body needs. They are capable of doing anything so that the food they ate does not affect their weight.

70% of the registered cases of bulimia are associated with severe depression. In addition, they generally have very marked mood swings. Guilt leads them not to want to be among other people. They don’t want to go out because they look fat and are fickle in everything they do.

In most cases, bulimic people have inflamed parotid glands, some have injured knuckles from putting their hands in their mouths to generate vomiting, they have many cavities (they even lose teeth), their hair loses strength and they take a lot of Water.

It should be noted that unlike anorexic people, bulimics do not lose weight by not eating. They eat, get fat, vomit and live hell because they hide food, because they secretly buy sweets and because they cheat on the diet they are doing. Many times they started a diet and could not comply with it so they starved all day, night came, he got stuck, ate the whole refrigerator, vomited, felt bad, and started the diet again; they really live in a constant internal struggle.

Bulimia is much more communicative than anorexia; The anorexic can do a lot of physical exercise, she is very isolated, she looks very perfect, very distant; instead you enter a room of a bulimic and it is that messy girl; this is his life and this is his head.

How to treat anorexia and bulimia?

Treatment for eating disorders generally – especially in adolescents – involves a multidisciplinary approach. This should include a doctor; psychologist; individual, group and family therapy ; together with the nutritional rehabilitation that is destined to restore the health and the corporal weight and, to modify the behaviors related to the feeding and the exercise. Treatment for these types of eating disorders should always be based on a comprehensive assessment of the individual and the family.

The individual therapy used for these disorders is cognitive behavioral therapy. This type of psychotherapy helps people with eating disorders find a place where they can open up and be honest about their problems, interact with others and receive the support and tools necessary to cope with their condition in the best way.

Note: If we are in front of someone who suffers from some type of eating disorder, it is necessary to help them become aware of what is happening. In the event that the person refuses to speak or denies their condition, we must contact a professional who will help them understand what is happening to them and the serious consequences it could have on their health, both physical and mental.