The Role of Healthcare in Education, Treatment, and Prevention of Eating Disorders
Approximately 30 million nationwide suffer from some kind of eating disorder and the problem is not likely to disappear. Eating disorders affect every section of society. However, with advances in treatment, increased support and greater access to education, it is possible to spread awareness of eating disorders as well as prevent them.
Many mistakenly believe that eating disorders are a lifestyle choice. In truth, this view downplays the seriousness of eating disorders. The National Institute of Mental Health defines eating disorders as “obsessions with food, body weight and shape.” The most commonplace are “anorexia nervosa, bulimia nervosa and binge eating disorder”.
Spreading Awareness of the Most Common Eating Disorders
In order to spread eating disorder awareness, it is important to understand the three most common eating disorders. There are essential differences between these three main illnesses under the eating disorder umbrella. Anorexia is when the person sees themselves as overweight. Bulimia Nervosa is when a person eats an abnormal amount of food without being able to control this behavior. They then attempt to compensate by fasting, doing excessive exercise or excessively using laxatives or diuretics. Binge eating is when a person lacks the control over their overeating. Unlike Bulimia Nervosa, there are no compensating behaviors like purging or extensive exercise.
Eating disorders can also be defined as psycho-social diseases. Like any behavioral health illness, early diagnosis is essential. In common with other mental illnesses, people who suffer from eating disorders are likely to experience “extreme emotions, attitudes and behavior surrounding weight and food issues”
The Challenges of Diagnosis
One of the difficulties with diagnosis is that the patient tries to conceal their symptoms for fear of the stigma and embarrassment. An important point to consider for physicians is that many behavioral health symptoms are also common to eating disorders. A study was conducted by the National Institute of Mental Health on 10,000 teenagers between the ages of 13 to 18 years. Researchers “found that as many as 88 percent reported suffering from anxiety, depression or a behavioral disorder…” The study also showed that it is less likely that a doctor will identify an eating disorder than pick up on other mental health illnesses.
Heather Monroe, contributor to the US News and World Report, argues that “isn’t discussed in a typical doctor’s visit, given both the time constraints and the discomfort associated with the topic” Another factor, is that both doctors and parents may quickly rule out the likelihood of an eating disorder if the symptoms are not apparent.
Eating Disorder Prevention Through Mental Health Promotion
Health promotion largely focuses on prevention of diseases before they start. They often include community-wide programs such as banning smoking in public areas to introducing vaccine clinics at local schools. These types of Disease Prevention initiatives are very common. However, in terms of health promotion, an emphasis is placed on physical rather than mental health illness. Research by Jung-Ah Min et al. shows that the same interventions for health promotion such as stress management can be used for both.
For many people with eating disorders the physician is the first point of call. Most physicians can easily pick on physical symptoms of illness, yet some may find it more challenging to identify symptoms of mental illnesses. At the same time, it is very common that a physician will make referrals to professionals that are professionally trained as therapists or psychologists.
How to Diagnose Eating Disorders
One solution to the difficulty of diagnosing eating disorders is screening. Screening can be used for patients with symptoms of persistent heartburn, bloating or abdominal pain. These symptoms are also the side -effects of purging. Sometimes patients show some indications of “eating order pathology without meeting the full criteria”. These patients should also be screened.
If the screening results show that a patient is of higher risk of having an eating disorder, a follow up appointment should be made. This will allow the physician to discuss the results in greater detail with the patient.
Once an ED diagnosis is suspected, one recommendation is to use a selection of tests to determine any triggers that could contribute to an eating disorder. At this stage, a physician may refer the patient to an eating disorder therapy program or prescribe anti-depressant medication. An alternative approach is for a physician to establish a patients’ daily eating habits. At the same time the physician will evaluate the patients’ motivations to change their diet.
Do Eating Disorders Have Neurological Roots?
A question that scientists have looked into in recent years is whether there is a neurological basis why patients with either “…anorexia or bulimia have the ability to override the desire for food.” As Christina Wierenga, PhD, a clinical neuropsychologist and associate professor of psychiatry at University of California, San Diego says, “Eating disorders seem very behavioral. Sometimes it even seems oppositional when a child refuses to eat”. Wierenga adds “Showing there are brain circuits that are not functioning effectively gives parents some pause, and helps them understand their child’s illness”. According to a report published by the American Psychological Association, isolated studies show the key role that parts of the brain and neural circuits play in mental health illnesses. This research adds a new dimension to understanding eating disorders. Rather than being shaped by environment or culture, the roots of eating disorders may be neurological.
How can we prevent eating disorders?
Dealing with eating disorders is a problem that is not going to disappear despite progress in research and technology. In terms of health promotion, the emphasis is mostly on harmful habits like smoking, rather than mental illness promotion. As research highlights, there are common symptoms shared between mental health illness and eating disorders. Among the many challenges for physicians is picking up on symptoms of eating disorders. However, there are measures that can be taken to help prevent eating disorders and to treat them. For example, screening for eating disorders may be an effective approach that will hopefully get the help that their patients’ need. In the field of science, there is research that has discovered a possible neurological root of eating disorders. This has the potential to add a new depth to understanding and maybe even treating patients with eating disorders.
By: Jonathan Gordon
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