Classification of Eating Disorders Obesity

Obesity can be classified as an eating disorder since, primarily or secondarily, obese patients eat

Figure 1 Classification of eating disorders based on the interaction between the preoccupation with food and body weight and the self-control of hunger. © 1999 Academic Press.

Preoccupation with food and weight

Figure 1 Classification of eating disorders based on the interaction between the preoccupation with food and body weight and the self-control of hunger. © 1999 Academic Press.

inappropriately for their increased weight and because obese individuals tend to suffer also from the other eating disorders.

Anorexia Nervosa

Anorexia nervosa is usually seen in younger women who restrict their food intake and increase exercise, causing a voluntary, stubborn malnutrition.

Bulimia

People who cannot control their hunger over a long period of time tend to have secret binging episodes. This is followed by an overwhelming feeling of guilt and depression, which frequently leads to self-induced vomiting. For this reason, the terms 'bulimia' (which means binge eating) and 'self-induced vomiting' are used interchangeably.

Anorexoid Syndromes

These abnormalities are seen in individuals who can no longer control their weight by dieting and exercising and have to resort to abnormal subterfuges, such as the following:

Self-induced vomiting Ipecac abuse Laxative abuse Diuretic abuse Anorexic agents abuse

Self-induced glycosuria in patients with insulin-dependent diabetes mellitus

Thyroid hormone abuse Excessive, compulsive exercising

Professional Hyperthinness

This is a borderline condition, not necessarily pathological, in which individuals, usually with narcissistic tendencies, overvalue personal appearance and thinness as a way of obtaining professional success. It is commonly seen among models, figure skaters, ballerinas, artists, gymnasts, etc. They do not use the 'subterfuges' of the anorexoid patients; they are not socially isolated; their weight loss is not extreme; they have normal psychosexual activity; and they do not see themselves as overweight, unlike people with anorexia nervosa. For them, thinness is a means of obtaining success, not the final goal as in anorexia nervosa.

Anorexia Nervosa

Anorexia nervosa is a serious disease.

Psychological Disturbances

Psychological disturbances are most likely to be the initial event; they result in a complex obsession characterized by the following features:

1. An intrusive body image delusion makes the patients see themselves as being overweight when they are actually severely undernourished. This leads to a pathological fear of fatness (dys-morphophobia), a chronic voluntary starvation, and resistance to any external pressures to gain weight. Anorexic patients hide and dispose of food in the most ingenious ways to avoid eating.

2. An overwhelming sense of personal ineffectiveness makes anorexic patients believe that they cannot control the world around them. They continuously fear that they are going to lose their inner control. They therefore tightly control their world inside and slowly separate themselves from their social surroundings, with growing feelings of alienation and loneliness. There is no psychosexual development or interest, and no dating, unlike patients with bulimia.

3. Depression occurs which may be primary or secondary, obvious or atypical, and may or may not be amenable to treatment with psychotherapy and/or antidepressant medications.

4. Increased physical activity coexists with an apparent lack of hunger and fatigue and is inappropriate for the degree of malnutrition and depression.

Diabetes 2

Diabetes 2

Diabetes is a disease that affects the way your body uses food. Normally, your body converts sugars, starches and other foods into a form of sugar called glucose. Your body uses glucose for fuel. The cells receive the glucose through the bloodstream. They then use insulin a hormone made by the pancreas to absorb the glucose, convert it into energy, and either use it or store it for later use. Learn more...

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