Eating habits can become, at times, very difficult to guide and lead to the development of complex illnesses identified by the generic name of eating disorders.
The people affected by these disorders are obsessed by food, and the weight and image of their bodies. Eating disorders can lead to serious health problems
and grave consequences, even death.
In recent years, eating disorders have become much more common and now represent an alarming social phenomenon in western countries. They mostly affect the female population. For every 100 adolescent girls, 10 suffer some form of eating disorder although the disturbances now also appear precociously (in preadolescent and younger girls) and belatedly (at 30-40 years of age), creating very difficult social and health conditions.
Eating disorders are classified as psychiatric disorders and are, unfortunately, increasingly more widely diffused and represented mainly by anorexia nervosa and bulimia nervosa. Those affected use their bodies and their relation to food to express a psychological disturbance.
Anorexia nervosa is considered an ailment of the industrialised world, even if the first cases that were recognised and defined refer to earlier epochs. During the nineteenth century, the ailment was rigorously described in France and England. Already at that time, young women were most frequently afflicted. The ailment is characterised by rigidly controlled and obsessive eating habits that lead to an exaggerated loss of bodily weight, as far as 85% less than the standard for age and height. This situation is accompanied by:
• an exaggerated fear of becoming overweight, even while underweight;
• an alteration in the anorexic patient’s perception of her own body, which leads to seeing it as fat, even when extremely skinny;
• an absolute refusal to admit the existence of the state of the illness;
• amenorrhoea, that is the absence of at least three consecutive menstrual cycles.
The reduction of bodily weight is obtained by a restrictive diet to the point of fasting, reducing or eliminating all foods considered fattening and by reducing the quantity of the portions consumed. In general, an anorexic patient exercises an obsessive control of everything she eats, has perfect acquaintance with the caloric values of foods and, to control her weight, may adopt eliminatory procedures (such as self-induced vomiting or use of laxatives or diuretics) or exaggerated practice of physical activity.
Bulimia is characterised by an irregular control of eating. This results in disorderly, chaotic and obsessive eating behaviour. Its main characteristic is the alternation of short fasts with the ingestion of exaggerated quantities of food. The patient does not eat for the simple pleasure of doing so, but for solace in moments of depression. In general, bulimic patients are not underweight but are often subject to extreme oscillations of their weight from normal to overweight. Bulimia is more frequent in large urban areas and it develops to a peak at the age of 18-19 years, when patients are making their first steps toward autonomy and independence. The personality traits of a patient affected by bulimia are very like those of an anorexic. The beginning is quite similar but the course of the ailment is different:
• repeated binges accompanied by the sensation that the impulse to eat is irresistible, also in determining what and how much to eat;
• use of inappropriate means of compensation to prevent weight gain such as vomiting, laxatives, diuretics, enemas, fasting and excessive physical exercise;
• excessive concern about bodily weight and image.
The binge is a sort of programmed ritual in the case of bulimia, while it is instead something occasional and improvised in the case of anorexia.
BED (binge eating disorder)
BED, the binge eating disorder, is an illness characterised by the fast and voracious consumption of great quantities of food. It is associated with forms of overweight and the early onset of obesity. These two pathologies are strictly related because this disorder affects approximately 30% of obese patients with a history of dietary failure. While it presents many analogies with the bulimic syndrome, this disorder does not include the compensatory actions and the concern about overweight and physical form is less impelling.
OSFED (Other specified feeding or eating disorder)
OSFED (Other specified feeding or eating disorder) is the category for feeding disorders and eating disorders of clinical severity that are difficult to diagnose. Identifying an OSFED, but above all, not mistaking it for another eating disorder, is fundamentally important to undertake an appropriate therapy. There are numerous OSFED and not all of them have been adequately defined. These include orthorexia, the term for a condition of a manic obsession in pursuit of a healthy diet, with excessive attention to dietary rules. Patients affected by this disorder choose to eat only the foods they consider healthy and with specific nutritional characteristics. This behaviour can derive from the fear, which can be maniacal, to gain weight or not be perfectly healthy. Persons affected by this disorder tend to adopt rigid diets that go so far as to eliminate many primary foods with the consequent risk of nutritional deficiencies.
To sum up
This presentation makes it clear how important it is to recognise and promptly cure eating disorders, a diffuse social problem today, by assuming balanced attitudes toward food and adopting conduct that favours our well-being.
Primary foods: in the nutritional classification, these foods are essential for survival and are therefore obligatory in the diet of a healthy person (meats, fish, eggs, milk and dairy products, dried legumes, cereals, fruits and vegetables).
How Much Do You Know…?
Anorexia nervosa is characterised by an exaggerated loss of bodily weight below normal, to less than:
A binge is an exaggerated meal, an episode of eating great quantities of food in a short time or of losing control of the act itself of eating.