Category: Children

Do you feel out of control around food?

Do you tend to go out of bed to binge during the night?

Do you feel uncomfortable in your body size and lack of self confidence?

This month we’ll continue to have a look at Eating disorders. The first blog was on anorexia nervosa and today we shall focus on bulimia nervosa. Eating disorders are affecting a lot of people worldwide. In fact, it’s are on the rise as we are living in an era where everyone became conscience about food and what they are eating. There are three main eating disorders which are anorexia nervosa, bulimia nervosa and binge eating disorders. Bulimia nervosa is especially common among adolescents and women. Boys and men tend to suffer less but unfortunately it is also on the increase.

What is the bulimia nervosa?

Bulimia nervosa is a type of eating disorder, potentially life-threatening if not taken care of. A person suffering from bulimia nervosa has binge eating episodes. A binge is when a person over-eats massive amount of food in a short period of time, usually 1 or 2 hours. Then, fear and anxiety drive the person to restrict his diet in order to prevent weight gain. In addition, a person with bulimia nervosa may resort to self-induced vomiting after eating, perform excessive exercise and use diuretics or laxatives in order to sooth his anxiety.

There are some official diagnostic criteria for bulimia nervosa, in Diagnostic and Statistical Manual of Mental Disorders V (DSM-5). These are as following:

• Consuming an amount of food that is definitely larger than most people would eat within an 1 hour and usually in hiding
• A sense of losing control over eating during the binge episode
• Remittent unbecoming compensatory behaviour in order to prevent weight gain, such as vomiting, laxatives or diuretics, restricting food or excessive exercise
• Bingeing and purging both occur, averagely, at least once a week in three months’ time period
• Self-esteem is overly affected by physique

Unfortunately, the cause of eating disorders is still unknown but there is strong evidence that it may be caused by various factors such as family history, personality traits and environmental factors. In fact, it is well known that a person may be more prone to develop bulimia when:

• Family members are obese or have an eating disorder.
• Have a perfectionistic personality trait.
• You have a job or do a sport that emphasizes body size, such as bodybuilding, modelling, ballet, swimming or gymnastics.
• Continuously dieting or exercising in order to lose weight or change your physique.
• Have a distorted body image or think that your body should be looking like someone else’s body.

Signs and Symptoms

Someone who suffer from bulimia nervosa may have appropriate weight for his height and age. Unfortunately, the person may still perceive himself as being too heavy and therefore wants to lose weight. Patients suffering from bulimia often display the following symptoms:

• Being obsessed with body shape and weight
• Bingeing and feeling a lack of control or inability to stop eating
• Compulsively and excessive exercising
• Using laxatives or diuretics
• Self induced vomit after eating
• Restricting calories, fasting or avoiding certain foods for periods of time

Treatment should be comprehensive and include several types of therapy. The most effective way to treat bulimia is to get a team approach which includes a doctor specialized in mental health, registered dietitian and even your relatives. There are several treatment options which are recommended which are psychotherapy, medications such as fluoxetine and nutritional management.

Nutrition management

Individuals suffering from bulimia nervosa have the tendency to be rigid, controlling, obsessive-compulsive, impulsive and extreme perfectionist. By extension they should be discouraged from sticking to rigid meal plans and rigorous exercise routines. It should be emphasized to make the meals regular and maintain satiety throughout the day to stop binging. This can be accomplished through composing a healthy, well-balanced and flexible eating plan.

Many patients may request weight-reduction meal plan, which is not recommended as further restrictions may be triggering the disease. It can contribute to the onset of binge-purge cycle. Diet should consist of breakfast, 2 main courses and 2 – 3 snacks throughout the day. The meal plan should have clear and planned structure. Patients should be thought to eat their meals regardless of feeling hunger and not to skip the meals.

Eating disorders such as bulimia nervosa are serious conditions which should be dealt holistically in a professional way from specialised healthcare professionals in this topic. If you think you might have this condition seek professional help immediately. If, you are concerned about your child or a friend that might be suffering from bulimia nervosa encourage them to seek help.

Are you or your child experiencing intense fear near food?

Has eating become stressful?

Is diet hindering you from going out to meals with your friends or loved ones?

If, you answered one of these questions, yes, I encourage you to read this blog. This blog is dedicated to all those women and adolescents who are suffering in silence due to an eating disorder. This subject has become very special for me after 3 years working with clients suffering from this illness.

What are eating disorders?

Eating disorders are serious mental health illness associated with a person’s eating behaviors. This involves obsessive thinking about weight and food. This obsessive thinking may lead to the most common types of eating disorders which are anorexia nervosa, bulimia nervosa and binge eating disorders.

These conditions can have consequences such as medical issues, anxiety, depression, suicidal thoughts, growth and development problems in children. It is known that every 62 minutes a person dies from an eating disorder.

What is anorexia nervosa?

Anorexia nervosa is a type of eating disorder. It’s characterized by an intense fear of gaining weight and distorted perception of body image. People suffering from anorexia nervosa try to maintain their weight at the lowest possible point, by reducing food intake and/or exercising a lot. These actions contribute to a starvation mode in the body which can lead to serious medical conditions, as mentioned above.

According to the diagnostic criteria from Diagnostic and Statistical Manual of Mental Disorders (DSM-V) are as follows:

1. Restriction of energy intake relative to requirement, leading to a significantly low body weight
2. Fear of gaining weight, becoming fat or persistent behaviour that interferes with weight gain, despite significant low weight.
3. Disturbance in a way in which a person perceive his body weight and shape or persistent lack of recognition of the current low body weight.

What is the cause of anorexia nervosa?

The exact cause of anorexia is not known. People diagnosed with anorexia may have a bad body image and have the drive to be focused on being, ‘perfect’. They may also have the tendency to look for ways to control their lives. Unfortunately, the onset of anorexia is a combination of biology, psychology and environment aspects.

Even though it’s not yet clear which genes are responsible, there may be genetic sequences in the DNA that make some people more prone to develop anorexia nervosa. Many individuals may have a genetic tendency toward perfectionism, sensitivity and perseverance which are all features associated with this illness. On the other hand, some patients diagnosed with anorexia may have obsessive-compulsive personality features which helps to stick with such strict and restrictive diets and deny eating despite the feeling of hunger. Unfortunately, the environment also plays a role. Nowadays there is the trend to emphasize and promote thinness. Triumph and self-esteem are often equated with being thin. False body images from media like television or print media can significantly influence young people, especially teenage girls and promote the desire for thinness.

Symptoms and signs

The primary sign is apparent weight loss or very low body weight. It should be emphasized that not everyone will demonstrate the same symptoms. Appropriate early diagnosis and immediate treatment increase the chance of a positive outcome as severe malnutrition may lead to numerous physical signs and symptoms such as the following:

• Extreme weight loss
• Noticeable thinness
• Cold intolerance
• Low body temperature with cold limbs
• Irregular heart rhythm
• Fragile hair and nails
• Amenorrhea
• Abdominal pain and constipation
• Dizziness or fatigue
• Facial hair

Tips for anorexia nervosa

As a registered dietitian working with clients suffering from anorexia nervosa and specializing in mental health, I have a few tips that you or your child can try. Here we go:

• Set a structured meal plan throughout the day
• Plan your meals ahead
• Think quality instead of quantity
•  No food discrimination
• Keep a food diary

If you are a parent or know someone with anorexia nervosa you can still help him out. Let’s see the do’s and don’ts.

DOs

• Do speak and ask the person how they are feeling
• Do encourage them to seek help from a doctor
• Do be available for them

DON’Ts

• Don’t discuss the subject  of food and eating around that person
• Don’t mention anything about the way they look – not positive neither negative
• Don’t try to insult and shame the person for his/her new eating habits

Anorexia nervosa is quite a challenging illness and requires professional help. If you think that you might be suffering from this illness seek help immediately. On the other hand, if you notice that your own child or friend is suffering from this disorder speak to them immediately and offer help. The early, the better. If you have any queries please contact us.