Other Eating Disorders
Compulsive (over)eating
People with this eating disorder eat according to emotional cues rather
than the physiological cues of hunger and satiation. While everyone might
'comfort eat' from time to time, compulsive over-eaters do this consistently,
as a way of filling a void they feel inside, 'stuffing' down emotional
problems, and coping with daily stresses. They tend to be (but are not
always) overweight, and feel terrible shame not only about their behaviour,
but also about the effect (real or imagined) that it has on their weight.
NB: The Eating Disorder does not provide treatment for compulsive
eating.
Compulsive exercising
This involves episodes of repeatedly exercising beyond the requirements
of what is considered safe, with the main goal being to burn calories
so as 'purge' after eating, or to give the individual permission to eat.
Those with compulsive exercise behaviours feel tremendously guilty when
they cannot exercise and almost never do it for fun.
As in other eating disorders, the exercise serves to give the individual
a feeling of power, control and/or self-respect. It is another way of
avoiding underlying issues and relieving guilt and stress.
Some groups of athletes tend to resort to disordered eating patterns
and behaviours (extreme compulsive exercise, and/or use of laxatives and
diuretics) explicitly for competition, while not displaying the psychological
symptoms of an eating disorder. Dancers, runners, gymnasts and wrestlers
seem to be at an elevated risk of serious injury or death because of their
desire to lose weight extremely rapidly prior to an event.
Compulsive exercising is associated with a number of physical risks,
including dehydration, stress fractures, osteoporosis, degenerative arthritis,
amenorrhea and reproductive problems, and heart problems.
Body Dysmorphic Disorder (BDD)
This is a preoccupation or obsession with a defect in visual appearance,
real or imagined. The object of preoccupation can be any part of the body,
but areas of the face and head, specifically the skin, hair and nose are
most common.
People with BDD often have a low self-esteem and unreasonable fears of
rejection from others due to their perceived ugliness. While some realise
that their perception of the 'defect' is distorted, they cannot control
the impulse to think about it. They often practice compulsive rituals
to look at, hide, cover and/or improve their defect(s). They may search
out doctors to treat them with medications and/or plastic surgery, some
even resorting to attempting their own surgery or suicide.
There are two types of BDD:
- Non-delusional
- Delusional
where the person has hallucinations of a completely imagined
defect, or an imagined gross exaggeration of a small defect.
The
delusional form is less common and more severe.
Diagnostic criteria
- Preoccupation with an imagined defect in appearance. If a slight
physical anomaly is present, the person's concern is markedly excessive.
- The preoccupation causes clinically significant distress or impairment
in social, occupational, or other important areas of functioning.
- The preoccupation is not better accounted for by another mental
disorder (e.g. dissatisfaction with body shape and size in Anorexia
Nervosa).
Pica
This is defined as a compulsive craving for eating, chewing or licking
non-food items or foods containing no nutrition. These can include
chalk, plaster, paint chips, baking soda, starch, glue, rust, ice, coffee
grounds and cigarette ashes. This widely understood phenomenon is sometimes
linked to certain mineral deficiencies (i.e. iron or zinc), and it is
possible that it is associated with certain psychological disturbances,
and social deprivation.
Pica is fairly common in pregnant women and symptoms usually disappear
following the birth. Pica has also been described in children with learning
difficulties. Complications of pica can include lead poisoning, malnutrition,
abdominal problems, intestinal obstruction, hypokalemia, hyperkalemia,
mercury poisoning, phosphorus intoxication and dental injury.
Prader-Willi Syndrome
This is a congenital condition believed to be caused by an abnormality
in the genes (although it does not seem to run in families). Children
born with Prader-Willi syndrome may have early feeding problems that
lead to tube feeding, and often have a degree of behavioural and/or mental
problems.
Prader-Willi syndrome is characterised by an insatiable appetite, caused
by a defect in the hypothalamus which results in the person never actually
feeling full. The individual is often overweight, and may resort to stealing,
eating pet foods and spoiled items. There may be sleep disorders and abnormalities,
bouts of rage, a higher threshold for pain, compulsive behaviours such
as picking the skin and psychoses.
Physical problems associated with the condition include delayed motor
development, abnormal growth, speech impairments, stunted sexual development,
poor muscle tone, dental problems, obesity and diabetes Type II.
Night Eating Syndrome
People with Night Eating Syndrome characteristically put off eating
until late in the day, binge on food in the evenings and experience problems
falling asleep and/or staying asleep. This condition can begin at an
early age, usually in children who are overweight, and it seems to be
associated with emotional disturbance.
Sleep Eating Disorder (SED-NOS)
Sleep Eating Disorder is a combined sleep-eating problem. People with
this condition tend to be overweight and have episodes of recurrent sleep
walking, during which they binge on unusually large quantities of food,
often high in sugar or fat. They typically do not remember these episodes,
which puts them at risk of unintentional self-injury.
Because of the compulsive nature of this illness, the physical health
risks are the same as those for compulsive overeaters with the added risks
of sleep walking. People with this disorder are often anxious, tired,
stressed and angry.
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