Healthy Eating

Related Terms

  • Anorexia, anorexia nervosa, bigorexia, binge eating, binging, bisacodyl, body dysmorphic disorder, bulimia, bulimia nervosa, carbonic anhydrase inhibitors, cascara sagrada, castor oil, Colyte Metamucil, diuretic abuse, dumping, EDNOS, Effersyllium, Epsom salts, Fibercon, GoLYTELY, gorging, ipecac syrup, laxative abuse, loop diuretics, milk of magnesia, orthorexia nervosa, osmotic diuretics, over exercise, potassium-sparing diuretics, psyllium, purging, senna, sleep-related eating disorder, thiazide diuretics.

Background

  • Eating disorders are illnesses that cause a person to adopt harmful eating habits. They are most common among teenage girls and women, and frequently occur along with other psychiatric disorders such as depression and anxiety disorders. The poor nutrition associated with eating disorders may harm organs in the body and, in severe cases, may lead to death.
  • An eating disorder is usually triggered by one or more events. Causes may range from a person's parents getting divorced, to emotional or sexual abuse, to a traumatic life-threatening event. After the person sufferers from a traumatic event similar to the above-mentioned examples, a trigger can initiate the disorder. A trigger can be a person commenting negatively on weight or appearance or exposure to the media or thin models and actresses. Once a trigger is introduced, the sufferer's energy is focused on food and weight and what starts out as a diet slowly escalates to a way of regaining control over situation.
  • Eating disorders commonly affect adolescent girls, but the number of males that suffer from these disorders is on the rise. These disorders can have their onset at any point in a person's life. It is important to understand that an eating disorder is not meant to be a weight loss tool, but often occurs as a way to cope with an underlying problem.

Types of Eating Disorders

  • Anorexia: Anorexia nervosa is a psychological condition that typically affects adolescent girls. The condition is characterized by a fear of becoming "fat" or gaining weight. People suffering from anorexia will go to extreme lengths to avoid consuming food. Many anorexics become quite good at lying about having already eaten or they will often make excuses so that they can eat less or even avoid meals altogether. There is no predetermined cause for anorexia and the disorder will have a varied onset from person to person. All people who suffer from anorexia have low self-esteem and a negative image of themselves. Anorexia and other eating disorders often start out as a diet but often change to an attempt to regain control of situations. People who suffer from anorexia may feel as though their life is out of control and that they can regain control by regulating what they put in their bodies as well as their weight.
  • Anorexia is characterized by an intense fear of gaining weight. This fear does not typically disappear when weight is lost. Anorexics normally have a dysmorphic (unrealistic) body image and claim to be fat when they are their skinniest. Once an anorexic begins to starve his or herself, a 15% weight loss is typical. These sufferers refuse to maintain a normal body weight and there is no underlying disease state or condition to blame for the drastic weight loss. In females suffering from anorexia, loss of a menstrual period for 3 consecutive months can also be a key to diagnosis.
  • Bigorexia: Bigorexia is the opposite of anorexia. These people believe that they are underweight when in fact they are overweight. This disorder tends to affect bodybuilders and may be damaging to their social lives. The disorder typically affects men more than women due to the constant pressure to be muscular and built.
  • Binge-eating disorder: Binge-eating disorder is a period of overeating characterized by a period of shame and guilt. Binges are usually not accompanied by purging, although purging may accompany the binge. People who suffer from this eating disorder are usually overweight. There is no identifiable cause for binge-eating disorder and the onset is usually of an unknown origin. Binge-eating disorder sufferers usually eat excessively to cope with their problems and generally feel out of control after they eat.
  • Sufferers of binge-eating disorder are aware that they have an abnormal eating pattern and are fearful that they will not be able to stop eating voluntarily. Binging typically occurs twice a week for at least three months and is accompanied by a depressed mood and self-deprecating thoughts that follow eating binges.
  • Body dysmorphic disorder (BDD): Body dysmorphic disorder is an obsession with a perceived defect with the sufferer's body. Typically, the face is the perceived flaw. Usually at fault is the size of the nose, eyes, ears and mouth. A person who sufferers from this disorder will typically check their appearance multiple times and agonize over wrinkles or blemishes on their skin.
  • Bulimia: Bulimia nervosa is a condition where the sufferer binges and purges. Binges are periods of excessive caloric intake and are not characteristic of all bulimic patients. After the patient consumes calories, they may purge or get rid of these calories by inducing vomiting or taking laxatives. There is no identifiable cause for bulimia and just like anorexia, the time of onset varies and the control factor remains present.
  • Bulimia is a disorder in which the sufferer is aware that his or her eating pattern is abnormal. This realization is often accompanied by repeated attempts to lose weight through severely restrictive diets, binge eating and purging occurring at least twice weekly for three months, a fear of not being able to stop eating voluntarily, a depressed mood, self-deprecating thoughts following eating binges and the over-evaluation of self body weight and shape.
  • Eating disorder not otherwise specified (EDNOS): An eating disorder not otherwise specified is a phrase used when a sufferer of an eating disorder clearly is afflicted with disordered eating habits but the habits do not fit a particular diagnostic criteria. This diagnosis may be made when a patient has a negative body image and is dieting regularly or fasting regularly but is still menstruating despite weight loss or, when a patient is purging after a large meal and believes they are fat but binging is not present and purging is not consistent.
  • Orthorexia nervosa: Orthorexia is an obsession with eating proper food. The definition of proper food may vary from person to person but is normally food that the sufferer considers to be healthy and nutritionally beneficial to them. Sufferers of orthorexia will spend more and more time planning what they are going to eat and imposing strict regimens on themselves that, if not followed, may result in punishment, guilt or negative thoughts.
  • Sleep-related eating disorder (NS-SED): Nocturnal sleep-related eating disorder is a disorder in which someone binges or overeats during their sleep. People who suffer from this disorder tend to notice a drastic weight gain and are unaware that they are eating during their sleep. Some sufferers will even wake up with candy wrappers surrounding them. The sufferer does not have a misperceived body image, and thus, it is not a true eating disorder.

Drug Abuse Related To Eating Disorders

  • Diuretic abuse: Diuretics are drugs that are used to lower the amount of salt and water present in the body by increasing the amount of urine that is eliminated. This process is called diuresis. When water is removed from the body, weight is lost, therefore, people who suffer from eating disorders commonly abuse diuretics. There are five main types of diuretics: thiazide diuretics, loop diuretics, potassium-sparing diuretics, carbonic anhydrase inhibitors and osmotic diuretics.
  • Ipecac abuse: Ipecac abuse is a method of purging the body of food because the drug is used to induce vomiting. Ipecac can be purchased over the counter and is often used as an aid for accidental poisoning.
  • Laxative abuse: Laxatives are normally used when a person has been unable to have a bowel movement for a long time. Laxative abuse occurs when a person attempts to get rid of unwanted calories, lose weight or feel "thin" or "empty" by repeatedly misusing laxatives. Laxatives are frequently misused following an eating binge, when an individual believes that the quick use of the laxative will push the food and calories through the stomach before they have the time to absorb.
  • There are a variety of laxatives, some more powerful than others. The types that are most dangerous for long-term use are called cathartic laxatives. These include cascara sagrada, bisacodyl, castor oil, senna and phenolphthalein. These last two are often found in over-the-counter chocolate or candy-like tablets. Cathartics work rapidly and can cause severe cramps and diarrhea.
  • Others work by drawing water into the colon. They are thought to be somewhat safer than cathartics, but can still lead to dehydration and electrolyte disturbance. They may include milk of magnesia and Epsom salts. Laxatives commonly thought of as the safest include bulk-forming agents that contain a crushed seed called psyllium. They are fairly easy to digest, but may cause gas in some people.

Safety

  • A qualified healthcare provider should be consulted before making decisions about therapies and/or health conditions.
  • Anorexia: As with other eating disorders, anorexia puts the sufferer at an increased risk of certain health conditions. Starvation of course is dangerous to all major body organs. The main response to starvation is for the body to hold on to its energy. However, the body will start to use its own energy, including muscles and organs. The liver and intestines lose the most during starvation followed by the heart and the kidneys. In addition to starvation, anorexics will usually suffer from dehydration and muscle and cartilage deterioration. Patients who continue to suffer from anorexia may develop slow or irregular heart rates and blood pressure as well as osteoporosis. Heart failure may result because of the nutritional deficiency that is common among anorexics.
  • Binge-eating disorder: Unlike bulimics and anorexics, binge-eating sufferers tend to suffer from problems associated with being overweight rather than malnourishment. Binge-eating sufferers are at an increased risk of obesity and type 2 diabetes. Additionally, high blood pressure and heart attacks are more common in overweight or obese individuals than people of normal weight. Osteoarthritis can accompany this disorder because of the extra strain being placed on the joints of overweight individuals.
  • Bulimia: Bulimics are at an increased risk of dehydration as well as the slow or irregular heart rate and low blood pressure that affects many anorexics. In addition, bulimics have an increased risk of tooth decay due to the constant flow of hydrochloric acid through the mouth. The stomach acid may cause the tooth enamel to erode. Another serious complication of bulimia is inflammation and rupture of the esophagus. Stomach acid continually irritates the esophagus, which can make swallowing painful. If aggravated enough by the consistent flow of acid and the stress induced by vomiting, an esophageal rupture can occur. In many cases, esophageal ruptures can be fatal. Likewise, stomach ulcers are more common among bulimics and the nutritional deficiency sufferers have can cause heart failure and death.
  • Diuretic abuse: Diuretics are commonly used to lower blood pressure and therefore, in a person with normal blood pressure who has an eating disorder can cause hypotension. Diuretics are not meant to be weight loss tools and can cause serious side effects including, but not limited to, increased uric acid levels and hypokalemia. Hypokalemia is perhaps the most serious side effect as it can cause headaches, dizziness, irregular heartbeats and muscle paralysis.
  • Ipecac abuse: Ipecac syrup is meant for use only in the case of an accidental ingestion of a poisonous non-corrosive substance. Ipecac causes severe vomiting and can cause a variety of short and long term side effects. These side effects include but are not limited to dizziness, nausea, stomach cramps, respiratory difficulties, fast, or irregular heartbeats, seizures and aspiration. If ipecac does not induce vomiting or an individual overdoses, it can cause heart problems and ultimately death.
  • Laxative abuse: Side effects of laxative use include severe abdominal pain, chronic diarrhea, bloating, dehydration, gas, nausea, vomiting, electrolyte disturbances and chronic constipation. Laxative abuse is very dangerous and can be life threatening. Laxative abuse upsets the balance of electrolytes and minerals in the body including sodium, potassium, magnesium, and phosphorus. Proper levels of these electrolytes and minerals are necessary for the appropriate functioning of the nerves and organs, including the colon and heart. Additionally, laxative abuse can cause severe dehydration. When the colon is full of indigestible food residue, the nerves are stimulated to cause the colon to contract and release its contents. Laxatives cause a false contraction. Since there is little food residue to take with it, the laxative takes a great deal of water with it when it evacuates the body. Severe dehydration can result and is characterized by tremors, weakness, blurry vision, fainting, kidney damage and, in extreme cases, death. After prolonged abuse of laxatives, the body becomes dependent on the laxatives and the colon stops reacting to usual doses of laxatives and larger and larger amounts of the laxative are necessary to produce a bowel movement. Finally, laxatives can sometimes cause "lazy colon", infections of the colon, irritable bowel syndrome, colon cancer and liver damage.
  • Orthorexia nervosa: Long-term consequences of orthorexia depend on the foods that the person typically consumes. Generally, the health risks of being orthorexic are not any more severe than the risks associated with being a vegetarian or vegan. Most of the problems encountered by these people tend to be social ones.

Author Information

  • This information has been edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

References

Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

  1. National Eating Disorders Association (NEDA). www.nationaleatingdisorders.org
  2. National Institutes of Health (NIH). www.nih.gov
  3. Natural Standard: The Authority on Integrative Medicine. www.naturalstandard.com