Symptoms of Eating Disorders

Symptoms

1. Anorexia nervosa

Anorexia nervosa is a disorder characterized by extreme weight loss to the point of being life-threatening.

It is also marked by an excessive fear of weight gain, an intense preoccupation with losing weight, and high sensitivity to even small changes in weight. Even the feeling that clothes that used to be slightly loose now fit snugly can make them feel that they have gained weight, and normal weight gain from growth or pregnancy can cause fear, leading to even stricter and more severe food restriction.

In general, they feel that they are overweight overall, while some worry that although they are thin, certain areas such as the abdomen, buttocks, or thighs are too fat.

They learn various techniques for measuring body size or weight. They weigh themselves excessively often, obsessively measure parts of their body, and constantly look in the mirror to observe their weight and body shape. Their self-esteem is greatly affected by the results.

For them, weight loss is a symbol of outstanding achievement and excellent self-control, while weight gain is regarded as an unacceptable failure of self-regulation. Even when they are extremely thin upon actual weighing, they are unwilling to acknowledge the serious internal medical problems that can result.

2. Bulimia nervosa

It is characterized by repeated binge eating and the accompanying compensatory behavior (vomiting) and fear of weight gain. In many cases, the patient’s binge eating involves consuming more food within a certain period of time than most people would eat. The patient loses a sense of control over eating and binges. Binge eating is often triggered by unpleasant feelings, increased interpersonal stress, or intense hunger following food restriction. In some cases, even after eating only a small amount of food, a person may feel that they have binged and engage in compensatory behavior. Because they are ashamed of these eating problems, difficulties may arise in interpersonal or social relationships as they try to hide the symptoms.

To prevent weight gain aside from binge eating, patients repeatedly engage in inappropriate compensatory behaviors, that is, purging behaviors. They use various maladaptive behaviors to eliminate the food they have eaten. They induce vomiting by putting their fingers in their mouths, use laxatives or diuretics, exercise excessively, or attempt strict dietary control.

Bulimia nervosa is commonly seen in people who have a history of obesity, and its onset often occurs after excessive dieting fails and binge eating begins. These individuals are characteristically within the normal weight range, and some may be slightly underweight or overweight.

3. Physical complications

Physical complications may accompany excessive weight loss. Without appropriate treatment to induce weight gain, it can become life-threatening. In the case of anorexia nervosa, a high mortality rate of 5–15% has been reported.

· Amenorrhea, constipation, abdominal pain, decreased tolerance to cold, lethargy, excessive activity

· Hypotension, hypothermia, dry skin

· Peripheral edema: often appears when weight increases and when the abuse of laxatives or diuretics is stopped.

· Parotid gland enlargement

· Erosion of tooth enamel due to vomiting

· Russell's sign: scars on the back of the hand caused by using the hand to induce vomiting

· Normochromic normocytic anemia, renal dysfunction associated with chronic dehydration and hypokalemia

· Medical disorders such as severe hypotension and cardiovascular problems such as arrhythmia, dental problems, decreased calcium intake and absorption, decreased estrogen secretion, and osteoporosis due to increased cortisol secretion also occur.

· In the long term, about 10% of hospitalized patients with anorexia nervosa die.

· In bulimia nervosa, laxative use can cause hypokalemia, hyponatremia, and hypochloremia, and vomiting can cause metabolic alkalosis, while frequent diarrhea can cause metabolic acidosis.

So far, I have explained the symptoms of eating disorders.

In the next installment, we will look at the diagnosis and treatment of eating disorders.

Source: Korea Disease Control and Prevention Agency, National Health Information Portal