bulimia – Hello Doctor

Binge eating: indulgence or addiction

November 30th, 2018 by The Hello Doctor Team

For most of us, food plays a central role in our lives. It’s not just to satisfy hunger, but also to celebrate a new birth, mourn death, commemorate marriage and bring people together. Yet, for an increasing number of South Africans, it’s an “addiction”, causing several eating disorders and resulting in more harm than good.

One of these disorders is called binge eating disorder (BED), and can lead to being overweight, and a whole host of illnesses.

What is Binge Eating Disorder?

Pigging out on pizza on movie night, stuffing ourselves at Christmas, or comforting ourselves with ice cream after a break-up isn’t unusual.

Bingeing every now and then is far from healthy but is not classified as a disorder. To be diagnosed with binge eating disorder, you must regularly overeat, over a short time, without purging (i.e. vomitting or exercising away the calories afterwards). With temptation never far away, combined with the increasing rates of obesity, it’s easy to see how this disorder can easily be overlooked or believed to be simply overeating.

It’s so easy to misunderstand or hide this disorder, that it is often overlooked, which is why BED is the most common eating disorder. In South Africa, research by Dr Zandile Mchiza, obesity and nutrition research specialist at the University of the Western Cape’s School of Public Health, shows that the disease is on the rise and in some part, driven by Western ideals of beauty.

What does BED look like?

Besides regularly overeating, those suffering from BED must display at least three of the following to be diagnosed with the disorder:

Two or more binge episodes per week over a period of six months.
Eating faster than normal.
Preferring to eat alone or lying about eating.
Hiding evidence of a binge.
Eating to the point of discomfort.
Feeling guilty, depressed or disgusted after eating.

For binge eaters, overeating, like any other drug and for those without the disorder, makes the sufferer feel good, but only for a short time. They need to do it again and again. Food acts like a “drug” to release feel-good chemicals in the brain. Eating releases dopamine, the body’s pleasure hormone, but eating also releases opioids, like those found in heroin and cocaine. Becoming addicted is deceptively easy; how long can most of us go without salty fried food or biscuits and cakes?

But for those with BED, binge eating goes much further. It helps to ease intense emotional suffering, offering a quick relief from anxiety and depression. The disgust and guilt felt after bingeing perpetuates the intense need to keep eating to feel better.

Objective and subjective binge eating

The main difference between the two types of binge eating is based on the quantities of food, and how the person feels after eating.

In objective binge eating, the person eats over the recommended daily calorie allowance (anywhere from 5 000 to 15 000 calories in a single binge.)

In subjective binge eating, the person may not have large amounts of food, but can still have intense feelings of guilt or disgust and loss of control over their eating habits. The amount of food eaten is less important than how the sufferer feels after eating.

Getting back to healthy

Those suffering from BED are susceptible to obesity, which itself is a risk factor for diabetes and heart disease. The risk of mood disorders, such as anxiety and depression is also increased. Treatment for the disorder involves the sufferer and their family working with psychiatrists, psychologists and nutrition counsellors. Families and friends can help by educating themselves about the disorder and understanding and acknowledging the underlying causes. Families should also encourage treatment and instead of talking about food, focus on other activities or conversations. Most of all: be supportive!

References:

What is Bulimia?

October 27th, 2017 by The Hello Doctor Team

Bulimia (bulimia nervosa) is a serious, potentially life-threatening eating disorder. People with this condition binge-eat a lot of food in a short amount of time, and then purge soon after to get rid of the food and calories.

Purging can involve self-induced vomiting, taking diuretics or laxatives, obsessive exercising or fasting.

Who’s at Risk?

Although bulimia is relatively uncommon in men, it’s very common in teenage and young adult women, and around 50% of bulimics have or had anorexia.

A lot of bulimics suffer from severe depression, and drug and alcohol abuse. And unlike people with anorexia, a bulimic’s weight is usually average or slightly above average, and often fluctuates.

What are the Signs of Bulimia?

Uncomfortable eating around other people, or eats large amounts of food on the spur of the moment and feels out of control and unable to stop eating
A tendency to buy binge foods and gorge in secret, or can’t explain the disappearance of food at home
Disappears to the bathroom after meals, and runs water to cover the sound of vomiting
Teeth are discoloured from vomiting, and they might use a lot of mouthwash and breath mints
Experiences mood swings, depression, loneliness, shame, and feelings of emptiness, and withdraws from friends.
Doesn’t seem to gain an excessive amount of weight given the amount of food they eat
Often exercises excessively

People battling with bulimia can often eat enormous amounts of food in one sitting – like a whole chicken, or several tubs of ice-cream, but they don’t like to keep food down. The two most common ways that bulimics purge is by vomiting up food, or taking a laxative.

How Does Bulimia Affect the Body?

Frequent binging stretches the stomach, which can cause it to rupture, and constant vomiting can irritate or even tear the lining of the throat. And using a lot of medication to prompt vomiting or empty the stomach can lead to a life-threatening loss of potassium that triggers irregular heartbeat or heart failure.

What to do if your friend has an eating disorder

February 23rd, 2017 by The Hello Doctor Team

Your friend is almost always on a diet. She’s preoccupied with how much she eats each day, obsessively counts calories, and usually has excuses not to eat in front of you. Other days she eats more than her body can handle and is wracked with guilt afterwards.

Your friend may be struggling with an eating disorder.

Eating disorders are complicated illnesses that usually start in the mind (contrary to popular belief that it’s simply a “body” issue). These issues are characterised by abnormal eating habits and severe distress over body weight or shape.

An eating disorder can make people starve themselves, overeat or take on other unhealthy behaviour around food and body weight. Naturally, this can be damaging to your physical and mental health and wellbeing.

Eating disorders do not discriminate. These serious and often fatal illnesses can affect anyone.

What to know

There are four major eating disorders.

1. Anorexia nervosa: defined by an extremely low body weight, extreme and unnecessary weight loss, intense fear of weight gain, and distorted perception of self-image and body. The person has an unnatural fixation with a thin figure, and abnormal eating patterns (think starving themselves or lack of appetite).

Know the signs:

Extreme weight loss.
Chronic dieting.
Harmful obsession with calories and fat.
Distortion of body image.
Abnormal drive to lose weight.
Excessive exercising.
Sleeplessness or lethargy.
Cessation of menstruation.
Low body temperature.
Fine downy hair growing on the face and body. This is apparently the body’s way of conserving some warmth.

2. Bulimia nervosa: characterised by eating large amounts of food in a short period, followed by purging. This includes self-induced vomitting, laxatives or diuretics, and excessive exercising.

Know the signs:

Constant weight fluctuations.
Lack of control when eating.
Eating in secret.
Gastric reflux after eating or peptic ulcers.
Disappearing to the bathroom after meals.
Smelling of vomit.
Chronic dehydration.
Broken blood vessels in the eyes.
Enlarged glands in the neck and under the jaw line.
Cuts in the lining of the mouth or throat.

3. Binge-eating disorder: known by compulsive overeating or eating an unusually large quantity of food in a short period, while feeling unable to stop or control how much you’re eating. It often leads to unwanted weight gain and a negative self-image, which can reinforce further compulsive eating.

Know the signs:

Eating a lot of food, despite not being hungry.
Inability to stop or lack of sensation while eating.
Eating until uncomfortably full.
Never feeling satisfied, no matter how much you eat.
Eating without actually tasting food.
Stockpiling food.
Gorging alone and then feeling guilty or disgusted after.
Using food to cope with stress, anxiety or depression.

4. Avoidant/restrictive food intake disorder: a persistent pattern of disordered eating characterised by selective eating, a disinterest in certain foods, and poor appetite. It may look like picky eating, but it’s often a mental or developmental disorder.

Know the signs:

Lack of appetite or interest in food.
Avoiding specific foods based on taste, smell, texture or colour.
Eating only a few types of food.
Picky eating that worsens over time.
Nutritional deficiency.
Significant weight loss or failure to gain weight.
Fear of negative consequences of eating, e.g. choking, vomitting, or allergic reaction.
Dependence on nutritional supplements or tube feeding.

Help at hand

If you’re worried that your friend (or even you) may have an eating disorder, speak out. But before you do, it’s important to educate yourself about the disorder first.

Choose the right time. Speak to your friend in private without any distractions. Have the conversation in an environment where she feels comfortable and safe. It’s also important to have the conversation at a time of emotional calm. Don’t talk if you’re around food.
Use your words wisely. Don’t use language that implies blame or that she’s doing something wrong. Avoid manipulative and threatening statements. This may worsen the eating disorder and make it more difficult for her to admit to the problem.
Focus on feelings. Mention her eating habits, but don’t centre on it. Place the emphasis on her emotional state. Remember, she may be going through a lot of anxiety, stress and guilt, so be patient and prepared to deal with anger or denial.
Listen without judgment. Truly listen and create a space for her to open up to you. Let her know that you won’t judge or criticise her. Avoid giving her advice. Simply, hear her out and make her feel heard, even if you don’t understand what she is going through.
Encourage help. Other than offering your unconditional care and support, encourage her to seek treatment and help. Reassure her that you will be there each step of the way. Never force her to do anything she doesn’t want to.

References:
https://www.eatingdisorderhope.com/treatment-for-eating-disorders/international/south-africa
https://www.eatingdisorderhope.com/information/anorexia
https://www.eatingdisorderhope.com/information/bulimia
https://www.eatingdisorderhope.com/information/binge-eating-disorder
https://www.eatingdisorderhope.com/blog/avoidantrestrictive-food-intake-disorder-signs-and-symptoms
http://www.nedc.com.au/what-to-say-and-do
https://www.helpguide.org/articles/eating-disorders/helping-someone-with-an-eating-disorder.htm
http://counseling.caltech.edu/general/InfoandResources/Eating_Disorder

How bulimia and anorexia harm your teeth

January 4th, 2017 by The Hello Doctor Team

By Dr. Corne Smith

Thanks to those Photoshopped magazine covers, adverts and social media, body disorders and eating disorders are more common than we realise. Young women, trying to look and feel more attractive, go to extreme measures to fit into impossible dress-sizes. Apart from the health risk, eating disorders, such as bulimia or anorexia, can also cause serious harm to your teeth.

Bulimia disorder is characterized by recurrent self-induced vomiting after eating high volumes of food. This continuous vomiting causes gastric acids and other substances to travel to the mouth resulting in:

Tooth enamel erosion
Cavities
Teeth discoloration
Tooth loss
Tooth decay

What other consequences can eating disorders have in my oral health?
Anorexia or semi-starvation deprives the body of the many nutrients it needs. It could end up causing bone diseases like osteoporosis which in turn, weakens the jaw bones that support your teeth, leading to tooth loss. Additionally, malnutrition affects the entire immune system, which makes a person more vulnerable to develop other dental disorders such as, tooth decay and gum disease.
If this is your case, Corne Smith Dentistry can help you, here’s how:

Start with a total hygiene care
Attend regular professional dental cleanings with your dentist
Fluoride treatments are recommended to prevent further erosion, decrease dentin sensitivity, neutralize acids and protect and mineralise the tooth surfaces
Frequent dental visits to monitor the condition of the mouth
And lastly – but most importantly – you will need to commit yourself to a professional treatment plan for your eating disorder.

We realise that eating disorder is a complex, difficult problem, but there is help – and hope – available! For more information, contact the Imani treatment clinic in Cape Town.

Continue reading “How bulimia and anorexia harm your teeth”

Bulimia: The food monster

April 4th, 2015 by The Hello Doctor Team

It seems like such an easy answer to weight-control: whatever you put in, you just throw out. But it isn’t how your body works – at all. We’re not sure where our connection between food and health broke down, but conditions like bulimia show how broken it can get. Continue reading “Bulimia: The food monster”