Friday, February 3, 2012

Eating disorder - a serious mental illness

Eating Disorders (EDs) are serious mental illnesses, and include anorexia, bulimia and binge eating, to name a few, and compulsive eating disorders not otherwise specified. All EDs result in serious emotional suffering and maladaptive coping mechanisms, and can lead to medical complications and even death. You cannot tell whether someone has an ED or is at risk of death based on their size.

The mortality rate for eating disorders is the highest of any mental illness, at 10 to 20 per cent. About half of the mortalities result from medical causes, the other half from suicide. Eating disorder behaviours are maladaptive coping mechanisms to respond to fear and ambivalence. Weight restoration/stabilization or symptom interruption ramp up the distress and fear. As a result, we may engage in dangerous compensatory behaviours, including compulsive over-exercise, laxatives, diuretics, "diet pills" and deliberate self-harm. These behaviours can lead to electrolyte imbalance, sudden heart failure, osteopenia and osteoporosis, loss of bowel function and kidney failure.

We all believe we are "different." An ED won't happen to us because "we're not really that skinny," "we don't need as much food as others" or "we aren't really that sick and other people are more sick and 'deserving.'"

Weight stabilization is not a cure for EDs. Eating disorders are a mental illness, not a physical disease. EDs are often accompanied by ambivalence about recovery. We would really like to recover without having to stabilize our weight or stop compensatory behaviours. We are often afraid of recovery; that if our weight stabilizes, people will think we are cured and no one will help us any more.

Signs that someone you know may be developing or suffering an ED include strange or rigid eating habits, restrictive eating, large quantities of food disappearing, lots of empty wrappers in the garbage, dramatically increased exercise, disappearing after every meal, dramatic weight change accompanied by denial of a problem, isolation from friends, family and social events, and difficulties at school or work as a result of reduced cognition, concentration and short-term memory. Whatever your relationship to a child or adult with an ED, express your love, support and concern, and open the door for us to talk about it.

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