Eastern Carolina Parent - March 2009 - (Page 20)

Feature Eating: A Source of Nutrition or a Means of Control? ance rather than inner strengths, having narrow definitions of beauty, subscribing to media messages that encourage dieting or pressure to lose weight quickly for certain activities (sports, modeling, weddings, etc.) • Interpersonal factors – Difficulty identifying and expressing feelings and emotions, dysfunctional interpersonal relationships, history of ridiculed weight, history of emotional, verbal, physical and/or sexual abuse, parental preoccupation with eating and weight, unrealistic expectations for achievement, and/or dysfunctional or chaotic home life. • Biological factors – Imbalances related to chemicals that control hunger, appetite, and digestion, lower levels of serotonin and nor epinephrine or higher levels of cortisol and vasopressin. Eating disorders appear to run in families and female relatives are 10 times more likely to develop an eating disorder. A history of obesity in the family might also be a predisposing factor. Many individuals who develop eating disorders tend to become withdrawn. Additionally, they become obsessed about their weight (weighing themselves several times a day) and their food consumption to the degree that it is difficult for them to concentrate on anything else. The following describes different eating disorders, including signs, symptoms, causes, and treatment: • Anorexia Nervosa: There are two subtypes of this disorder – restricting and binge eating/ purging: Restricting consists of the refusal to maintain a minimal, normal body weight by restricting food intake and possibly engaging in excessive exercise. Binge eating/purging is characterized by a restricted food intake; but also, it regularly consists of engaging in binge eating and/or purging behaviors such as self-induced vomiting, and/or misuse of laxatives, diuretics or enemas. With both types, individuals tend to take in less than 1,000 calories per day. They avoid fattening, high calorie foods and often eliminate meat. They tend to consume low calorie foods and drinks such as lettuce, carrots, popcorn, and diet sodas. Individuals in this category have an overall preoccupation with food. They often think that that they are fat despite being bone thin. Their nails and hair become brittle, their skin becomes dry and might develop a yellow tint. These individuals often report feeling cold due to decreased body temperature, and they could even develop lanugo (fine hair) on the body. When young girls become too thin, they may experience the absence of menstrual cycles. Medical complications resulting from anorexia include: heart, kidney, and brain damage in which pulse rate and blood pressure drops, irregular heart rhythms, potential heart failure, electrolyte abnormalities, calcium loss, decreased brain volume, and possible death (anorexia has the highest mortality rate of any psychiatric illness). • Bulimia Nervosa: This disorder has two types – purging and non-purging: Purging involves self-induced vomiting or misuse of laxatives, diuretics and/or enemas. Non-purging uses fasting or excessive exercising to control weight. Both types demonstrate patterns of binge eating and recurrent inappropriate behaviors to compensate the binge eating in order to control possible weight gain. The binge eating tends to make one feel out of control while the compensatory behaviors, such as vomiting or exercising, often results in a rush or “high.” Individuals are constantly concerned about food and weight. The self-induced vomiting leads to erosion of dental enamel, scarring on the backs of hands, and swelling of cheeks (irritated saliva glands). Individuals tend to have irregular menstrual periods, mood fluctuations, sore throats, and abdominal brain. Some medical complications include electrolyte imbalance, dehydration, www.easterncarolinaparent.com “If I lose just ten more pounds, then I will be happy.” Many have made this statement at least once before. Though this comment may appear innocent, thoughts such as this could contribute to serious negative behaviors such as eating disorders. Approximately 42% of 1st-3rd grade girls would like to be thinner, and 81% of 10year-old girls are afraid of being fat. Eating disorders typically begin between the ages of 11 and 13 and seem to be most prevalent between the ages of 12 and 25. Ninety percent of individuals with eating disorders are female; however, many males are also affected by eating disorders. Common underlying factors of an eating disorder include: • Psychological factors – Low self-esteem, perfectionism, rigid standards, depression (looks like irritability in adolescents), anxiety, obsessivecompulsive traits, anger, sense of emptiness, loneliness, feelings of lack of control or inadequacy, and/or difficulty coping with life stressors and/or life transitions. • Socio-cultural factors – Placing too much value or worth on being thin and obtaining the perfect body, placing value on physical appear- GREENVILLE PEDIATRICS We care for children from Birth to College Michael L. Bramley, MD • Steven H. Prevatte, MD • Brian C. Tyler, MD • Rebecca S. Coker, MD Ernest O. Sutton, MD • John M. Ogle, Jr, MD • Thomas E. Thielen, MD · Weekend Hours for Urgent Care · After Hours Clinic · Weight Management/Obesity · Comprehensive Child Care · Immunizations · Minor Injuries · ADD/ADHD Accepting New Patients! Farmville Pediatrics 3444 S. 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Eastern Carolina Parent - March 2009

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