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Eating Disorders (Eating Disorders): definition and typologies

marzo 31, 2021
Eating disorders (ED), including anorexia and bulimia nervosa, are an emerging health problem that has a strong impact on our society. The problem of these disorders is so varied and multifactorial that it requires attention and action that includes clinical, family, but also cultural, social and especially educational aspects. As a consequence, these difficulties do not have to be dealt with exclusively from a health perspective. We are faced with a social and cultural problem in which we would have to try to deepen the different sectors and agents involved, to find the most appropriate tools to respond with the sensitivity required by the special situation of the people who suffer from it and of their families.

The term “Eating Disorders? it refers in general to psychological disorders that involve serious abnormalities in the behavior of eating, that is, the basis and foundation of these disorders is found in a psychological alteration. It is understood, then, that the external symptom could be an alteration in eating behavior (prolonged diets, weight loss …) but the origin of these disorders would have to be explained from a psychological alteration (high level of personal dissatisfaction , fear of maturing, high levels of self-demand, distorted ideas about weight or food, …).

The best known eating disorders that fall within this group are anorexia and bulimia nervosa and binge eating disorder:

The characteristics (diagnostic criteria) of people who suffer from one of the eating disorders just mentioned are detailed below:

Anorexia Nervosa (DSM-IV):

1. Refusal by the sick person to maintain a body weight equal to or above a normal minimum.
2. Weight loss equal to or greater than 15% of the theoretical weight.
3. Intense fear of gaining weight even while under a normal weight.
4. Alterations in the assessment of body weight and silhouette: Distortion of the Body Image.
5. In girls, loss of three consecutive menstrual cycles. A woman is considered to have amenorrhea if her periods only occur after the administration of hormones (ex. Estrogens).
Bulimic subtype: During the period of AN the person presents recurrent episodes of overeating.
Restrictive Subtype: During the AN period the person does NOT present recurrent episodes of overeating.

Bulimia Nervosa (DSM-IV):

1. Repetitive episodes of compulsive overeating (binge eating).
A binge is characterized by:
to. Eating for a period of time (for example, for two hours) an amount of food that is greater than what most people would eat during a similar period of time and under similar circumstances.
b. Feeling of lack of control over your intake during the binge episode (for example, feeling that you are not able to stop eating or control the amount you are eating).
2. Feelings of lack of control and guilt in relation to bingeing.
3. Inappropriate recurrent behaviors to compensate and prevent weight gain after binge eating episodes such as vomiting, use of laxatives, increased physical exercise or fasting.
4. An average of 2 episodes of voracious eating per week for a minimum of 3 months.
5. Self-esteem excessively influenced by weight and silhouette.
6. The disorder does not occur exclusively during episodes of AN.

Purgative type: The person usually self-induces vomiting or abuses laxatives and / or diuretics to prevent weight gain.
Non-purgative type: The person uses other compensatory, non-purgative behaviors such as fasting or excessive exercise but does not induce vomiting or abuse laxatives and / or diuretics.

Binge eating disorder (DSM-IV)

1. Repetitive episodes of compulsive overeating (binge eating).
A binge is characterized by:
to. Eating over a period of time (for example, two hours) an amount of food that is greater than what most people would eat during a similar period of time and under similar circumstances.
b. Feeling of lack of control over your intake during the binge episode (for example, feeling that you are not able to stop eating or control the amount you are eating).
2. Binge eating is associated with three (or more) of the following symptoms:
to. I eat much faster than normal.
b. Eating until you feel unpleasantly full.
c. Eating large amounts of food despite not being hungry.
d. Eating alone to hide their voracity.
and. Feeling uncomfortable with yourself, depression, or great guilt after the binge.
3. Deep discomfort when remembering binge eating.
4. An average of 2 episodes of voracious eating per week for a minimum of 6 months.
5. Binge eating is not associated with inappropriate compensatory behaviors (eg, purging, fasting, excessive physical exercise) and does not occur exclusively in the course of anorexia nervosa or bulimia nervosa.