Anorexia and Bulimia Nervosa
“When she was fourteen, a modeling agency said that her face was too fat.
It was a death sentence.” (Toronto Sun, 1994)
Sheena Carpenter died in November 1993. She was found on the kitchen
floor of her apartment by her mother. She was twenty-two years old. . . and
weighed only fifty pounds. Sheena was just one of the alarming numbers of young
women who become obsessed with the shape and size of their bodies, and suffer
harmful, or in this case, fatal effects from eating disorders. At any given time,
almost one out of every two women is on some sort of a diet, and this statistic
is apparently reflected the revenues of the diet industry, currently a $33
billion a year industry. It should be noted that this estimate does not include
profits generated by exercise or workout programs, gyms, health clubs, or
cosmetic surgery.
A recent national survey in the US reveled that the majority of women,
when asked what would make them happiest, choose thinness over all other choices,
even such thing as job promotion, romance, prestige and power. In fact, more
women feared becoming fat, then feared dying. These statistics revel an alarming
social problem that is reaching epic proportions.
Although the topic of eating disorders has gained a larger audience
within the last decade, the number of cases of eating disorders continues to
rise at a resounding rate. Today many scientists are looking into possible
causes for the onset of an eating disorder. The most prevalent and influencing
factor is the media and society’s view. They act as a controlling presence for
susceptible individuals. ? The socioculture pressure on today’s adolescent and
young women to be thin and attractive also play an important role in the
development of eating disorders. Thinness in today’s society is associated with
self-control, attractiveness, intelligence, happiness , wealth and success. The
media, fashion, and the diet industry exploit this myth by bombarding us with
products and services designed to push us towards losing weight. As a result, it
is not surprising to find that adolescents who are undergoing uncontrollable
body changes and the onset of new emotional and sexual drives seek dieting in
order to enhance their sense of self-control and acceptance by others.?
Recently it has been discovered that a possible cause for eating
disorders is due to an defective hormone. That hormone serotonin, said to
activate in response to food, is still a mystery and even though it has some
value as a blood clotting factor, but its functions have yet to be totally
understood. At the current speed of progress however, it has been said that we
should expect definite information as to the cause of an eating disorder in
about a decade. Following soon after will be a better form of treatment to help
all who have become effected by this dreadful disorder.
Both Anorexia and Bulimia have effects and differences on the
body that causes the body to take drastic measures to sustain the life of the
individual. (for the sake of brevity and to avoid redundancy the abbreviation ED
will be used in pace of eating disorder)
The lack of any digested food to become a useful ingredient to the body
has detrimental effects to the body as a whole. With each disorder, Anorexia and
Bulimia Nervosa, you will see how each contributes to this problem.
A variety of changes in thought and perception accompany Anorexia
Nervosa. Notable behavioral changes, however, center around food. The
individual with anorexia often divides her foods into ?good? and ?bad?
categories. Good foods are hypocaloric which includes fruits and vegetables,
while bad foods are hypercaloric, such as carbohydrates and sweets. The
hypocaloric foods are eaten while hypercaloric foods are avoided. Mealtimes are
usually skipped or small amounts of foods may be eaten, leading to low daily
calorie intake levels. To an anorexic, every act of eating may be governed by
rules such as cutting the food into small pieces, taking hours to eat, or
hoarding food. This person also becomes obsessed with exercise in yet another
attempt to lose weight. Physically, the disorder causes the body to slowly
deteriorate. Obvious signs to look for are excessive weight loss in a short
period of time and continuing dieting of a bone thin person. The body, in its
amazing capabilities, begins to protect itself by shutting down non-life
sustaining processes. The heart rate and blood pressure slow, very fine hairs
called lanugo grow on the body to prevent loss of body heat, and the skin
becomes dry and yellow. The master gland, the thyroid, slows, which in turn
slows development. Amenorrhea begins, stopping the menstrual cycle in women. Due
to nutrient restriction and electrolyte imbalance, the heart and kidneys become
severely damaged and the brain may even shrink causing drastic personality
changes.
Bulimia Nervosa is characterized by frequent binge eating, which is
followed by some form of compensative behavior, whether it be self-induced
vomiting, laxatives, or compulsive exercise. Unlike anorexics who are usually in
a state of self denial, bulimics are fully aware of their illness and
consciously try to hide it from others. This deception allows the bulimic to
carry on for many years without anyone ever knowing. However, the hunger
sensation is overwhelmingly strong and the individual gives in, devouring large
amounts of food each time. Then guilt and compensatory behaviors follow, such
as vomiting or laxative use. Because bulimics only lose the food they’ve just
eaten, they do not drastically lose weight, but fluctuate instead. The body
still tries to preserve life and discontinues non-life sustaining processes as
well. Many experience signs common to an anorexic such as obsessive exercise,
which could led to heavy involvement in sports. Loss of menstrual periods, and
feeling fat are also common signs of bulimia. Bulimics still eat but purging
starves their bodies of much needed nutrients. This action can lead to heart and
kidney damage due to lack of potassium. Purging can also cause the stomach wall
and esophagus to rupture, as well as tooth decay due to the acidity of the
stomach.
ED’s have their similarities and differences as can be shown, but inside
the body the both cause virtually the same chemical responses.
Anorexia and Bulimia Nervosa are two disorders unlike any other disorder,
sickness, or disease. The eating disorders such as these two strike in a
vulnerable division in the body. The body is sustained by the food we eat and
the liquids we drink, take those away or out of their homeostatic state and the
body suffers greatly. Although the body is amazing in its capabilities to deal
with life functions and changes within, without the proper nutrients, the body
is unable to do its job. This is why the disorder is so terrible. The body is
unable and incapable without this food to repair itself, provide the means for
organs to work, or to sustain life processes. With the limitation of food intake,
mineral levels fall towards dangerous levels. As a result vitamins don not work
and then food can’t be digested and a whole cascade of dangerous effects follow.
Minerals are used in the body not a source of food but rather as a aid
to other body nutrients. They increase the ability of a nutrient to function and
strengthen its effectiveness.
With the decrease in food and energy from food, a fluid electrolyte
disorder called hyponatremia develops where there is not enough sodium in the
body. Made worse by laxatives (diuretics) and excessive sweating through the
compulsive exercise, low sodium levels trigger the adrenal cortex to release
aldosterone, targeting the kidney tubules. When stimulated, the kidneys raise
the absorption rate of Na+ in the proximal convoluted tubules and the loops of
Henle. It is important to understand that while the sodium content of the body
may change, its concentration in the extracellular fluid remains stabile because
of adjustments in water volume. Hyponatremia, when not corrected, causes a
neurologic dysfunction due to brain swelling, systemic edemia, decreased water
loss which leads to decreased blood pressure and volume, as well as cardiac
arrhythmia and circulatory shock. Physical signs of this electrolyte disorder
are headaches, muscle cramps, thirst, lethargy, and weakness. Relating very
closely to sodium’s role in the body is that of potassium.
“Potassium, the chief intracellular cation, is required for normal
neuromuscular functioning, as well as for several essential metabolic activities,
including protein synthesis.” Although potassium can be toxic at high levels,
eating disorders cause the level of potassium to fall dramatically lower than
normal causing the same drastic effects. A deficit of potassium can cause
hyperpolarization and nonresponsiveness of the neurons controlling our body, a
condition called hypokalemia. The heart, being the most sensitive to K+, may
develop cardiac arrhythmia and possible arrest also. Muscular weaknesses,
alkalosis of the blood, and hypovenilation may accompany low levels of potassium.
The effects of hyponatremia and hypokalemia may not be prevalent at the
onset of an eating disorder and may not even show up for quite some time due to
the low levels of other chemicals that hinder, compensate, or account for the
difference. For example, not enough magnesium (hypomagnesemia) can cause tremors
and increase neuromuscular excitability. A lack of phosphorus causes a condition
known as rickets, when the epiphyseal plates in young growing children continue
to widen and become enlarged. Even a lack in trace minerals like Iron and Iodine
can cause an inability to maintain body temperature and hypothyroidism,
respectively.
Vitamins are essential for the life-sustaining process in the body to be
carried out. Vitamins in the body act as a coenzyme. They act in junction with
other specific enzymes allowing them to function. Without the assistance of
vitamins, all of the carbohydrates, fats, and proteins would not be able to be
broken down and digested and used for energy.
Most vitamins are not made in the body and therefore most come from our
diet, and since no one food contains all of the essential vitamins need for the
body, a balanced diet is necessary. The deficiency of vitamins in the body is
primarily what causes the effects that are visible in an ED patient. Vitamin A
deficiencies cause night blindness (controls pigmentation of rods and cones) and
the drying of the epidermis of the skin. Shown in the dry eyes and chapped lips,
coarse hair, and the drying eye conjunctiva and yellowing skin. Lack of vitamin
D causes problems in the skeleton leading to brittleness and easy breakage of
bones. Vitamin K that adds to blood coagulation will cause an increase of
clotting time and bruising. Those are to name the effects of low fat-soluble
vitamin. The water-soluble vitamins effect the body in yet another way. Vitamin
C, labels by many as the ?health vitamin?, is an antioxidant, meaning that it is
used to repair the body of damage from free oxygen radicals. Low levels
therefore, let damaged tissue to go unrepaired. Other common problems are an
inability to form the intercellular ?cement?, joint pains, bone growth problems,
increased susceptibility to infection, and further weight loss.
As the vitamin level dwindles, the body becomes less able to properly
digest food into energy. Carbohydrate, lipids, and proteins that due come into
the body, can’t be broken down properly. The body continually needs energy for
basel and regular metabolic rates. When the food intake no longer provides that
necessity, the body begins to break down its own resources of stored energy.
First to be broken down, is carbohydrates. Carbohydrates consist of
sugars and is the easiest obtainable and best used energy source. The complex
and simple sugars are broken down directly into glucose. Carbohydrates are
burned at a fast rate and since the body doesn’t store a lot of it the body next
turns upon the lipid or fat reserves.
A large portion of energy is storied in fat however it takes more energy
to turn it to a useful substance. As the body breaks down itself, the loss of
insulating fat causes loss of body heat and an increased metabolic rate. As
stored fats become depleted and the body has to due work to keep itself together,
next the proteins become targeted.
Most proteins are located and stored in muscle. The break down of
proteins is really the break down of muscle. Protein digestion is the worst form
of energy since it takes a lot of energy to get small amounts of energy.
As shown, one thing that may seam minor and minuet can turn into a
dangerous situation. Experimentation has proven that the best form of treatment
includes the use of anti-depressant drugs. In situation where the patient has
become critical the individual is often hospitalized and monitored around the
clock with close observation on slow recovery of body chemical. The damages to
the body can usually be restored in a relatively short time as compared to the
emotional damage that goes on for years. Thankfully most of the physical
problems with an eating disorder are caused by malnutrition and go back to
normal when normal body weight is restored.
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