What you need to know about Anorexia Nervosa and Bulimia
Anorexia Nervosa
The name literally means “nervous loss of appetite” but is a misnomer. People with Anorexia are, in fact, suppressing a constant strong desire to eat, for fear of becoming fat.
Sufferers fear that their appetites, if given into, will become out of control, that they will not feel satisfied by a normal meal, and will be unable to stop eating.
Although typically sufferers are 15% or more below normal body weight, they do not recognise that they have a serious problem, often feel physically quite well, and are convinced that they are in fact overweight.
Despite their avoidance of eating at all costs, they are often obsessed with food and its calorie content, and this dominates their lives.
General feelings of insecurity, dissatisfaction with themselves, and obsession with thinness, will reduce them from previously happy, healthy people, to irritable, obstinate and depressed near skeletons.
Many persons suffering Anorexia may develop Bulimia.
Bulimia Nervosa
A variation of Anorexia, Bulimia ranges from excessive food intake, to an out of control compulsive cycle of binge eating where extraordinary amounts of any available food, usually of high carbohydrate content, may be consumed.
Once having gorged, the victims are overcome with the urge to rid themselves of what they have eaten, by purging themselves, usually by vomiting, and sometimes by massive doses of laxatives. Between these obsessive bouts, most are able to accept some nutrition.
Whereas the anorexic sufferer fears fatness from anticipated loss of eating control, the bulimic sufferer fears fatness from actual loss of eating control, and unlike the anorexic sufferer the typical bulimic individual is not emaciated, but usually maintains a normal body weight and appears to be fit and healthy.
However, the obsessive binge purge cycle causes them deep distress, shame, guilt, self loathing, and social isolation, and many will go to any lengths to hide their “shameful” secret from family and friends.
How New is it?
The condition, as far as we know, was first described in England in the 17th Century, and there is no reason to believe that it did not exist in earlier times. It was identified as an illness by modem medicine just over one hundred years ago by Professor Ernest Lasegue of the University of Paris.
In recent years the condition has been the subject of considerable study overseas. There are clinics dedicated solely to eating disorders in Britain and the United States.
In Australia, ABNA leads the way in having been established in South Australia in 1983 by Mrs Joyce Williams. There are now support groups and clinics in most other States of Australia.
Typical Sufferers
The anorexic or bulimic sufferer may be either sex, but the smaller percentage are male. However, the male percentage is on the increase. Most sufferers come from middle and upper income families, and are usually highly intelligent.
Anorexic and bulimic people are often perfectionists, with unrealistically high expectations. They frequently lack self esteem, with feelings of ineffectiveness and a strong need for other peoples’ approval.
Causes
There is at present no generally accepted view of the causes of Anorexia and Bulimia. Most authorities believe the problem to be psychologically based, possibly stemming from family and social pressures, or other forms of stress in our modern environment. Where a high value is placed on slimness, women are more likely to be judged on their appearance, against a heavy background of high carbohydrate ‘junk’ food promotion. Often, the illness is triggered by a major change in the person’s life. Usually eating disorders develop from a combination of contributing factors.
Age and Extent
Anorexia tends to start in the early teens, whereas Bulimia usually occurs in the late teens and older age groups. Sometimes Bulimia develops out of Anorexia, but can occur without a previous history of Anorexia. It often persists over many years.
It is known that girls as young as 8 have displayed an unhealthy pre-occupation with dieting.
The full extent of the problem is not known, but estimates vary from one in every hundred school girls with Anorexia, to six percent of Australian women with Bulimia. Since Bulimia is not a physically obvious condition, the numbers could be far higher
Social Isolation
People who have Anorexia or Bulimia have probably been feeling isolated and friendless for a long time. This may have been one of the factors contributing to their belief that they are essentially unacceptable people. However, the condition itself increases social isolation. Sufferers dare not let people get too close to them in case their real self, which they dislike, is discovered. They cannot tolerate any disruption of their rigid daily routine, which often includes long periods of physical exercise designed to keep weight down, fixed eating times, and carefully hidden arrangements for bingeing and purging.
Shared meals and social occasions are shunned, for fear of exposing the problem. For the same reason, sufferers will often reject offers of help. All this leads to increased social isolation.
Money Problems
The self-starvation/bingeing pattern of eating can be parallelled by attitudes to money and things that money can buy. Some sufferers become extremely thrifty, only buying what can be justified as an absolute necessity. Some, just as with overeating, may overspend, and get into debt. Some will, after long periods of self-denial, possibly start pilfering from family or friends, or perhaps become involved with shop-lifting.
Psychological Effects
In addition to social isolation, the victims suffer from self disgust, guilt and shame, fear of change, and feelings of inadequacy and rejection. They are lonely, desperate and depressed, and may consider suicide as the only way to end the nightmare.
Physical Effects
Anorexia and Bulimia are serious disorders, which in extreme cases can result in death. Among known adverse physical effects are:-
Loss of menstruation
Constipation
Low blood sugar
Dizziness
Lack of protein leading to oedema, loss of hair and teeth, & growth of
downy hair on face & elsewhere
Ruptured stomach and oesophagus
Severe dehydration
Gastritis
Ulcers
Vagal nerve block
Rupturing of internal membranes
Bowel tumours
Megacolon
Breathing Discomfort
Loss of sex-drive
Receding gums and rotting teeth
Intestinal infection
Ruptured facial blood vessels
Hypoglycaemia
Chronic sinusitis
Kidney damage
Bleeding and infection of the throat
Abnormal metabolism
Severe electrolyte imbalances which can lead to neuromuscular problems, including muscle spasms and cardiac arrest
Treatment
Contact casualty at major Public Hospitals in emergencies. Sufferers of both Anorexia and Bulimia need to realise that they have a serious problem, and require encouragement to take personal responsibility in seeking help. They must learn to accept their strengths, weaknesses, successes, and failures, as part of a balance leading to a normal happy existence.
By clinging to their self destructive behaviour, sufferers are rejecting normal participation in life, but can be helped to realise the rewards that a fuller commitment can bring.
If the person with Anorexia has reached a dangerously low body weight, this physical problem must also be overcome, to help achieve normal body function and logical thought. In extreme cases of Anorexia this may require hospitalisation, to enable nutrition to be monitored.
Various forms of treatment are available such as psychotherapy (individual, group or family), counselling, self help groups, medical and non medical practices.
Treatment often needs to be prolonged and although occasional regressions may occur, the patient needs to accept these positively as part of the process of change for the better, rather than to see them as reasons for continued self hatred and punishment.
The effort to recover is rewarded by the relief that the recovery brings, both to the sufferers and their families and friends.
Support Services
Referral to professional treatment agencies. Telephone help and support lines.
Provision of educational speakers at Health Seminars, Schools and Groups etc.
Workshops providing training and information. Provision of Information Kits for sufferers, carers and students (small charge applies).
Meetings
Meetings are informal gatherings for sufferers, families and friends, in a safe place for people to be heard and feel understood. A place where they can be offered practical help and encouragement as they move along the road to recovery.
Participants have the right and freedom to join in only as much as they wish, and to move along at a pace with which they feel comfortable.
Meetings are regular, but time frames change from time to time. For the latest information please contact ABNA’s Community Services Officer at the phone number shown in the information segment below.
Information
Loan library books and audio tapes for members.
Video tapes for “in house” use only - Not for loan.
Regular Newsletter to members.
Telephone help line aiding sufferers and families. Correspondence with persons living in country areas or interstate.
For further information please contact or phone ABNA during business
* Source : Anorexia Bulimia Nervosa Association Inc.
