The purpose of National Eating Disorders Awareness Week Feb. 23 to March 1 is to raise awareness about different types of eating disorders and provide resources with knowledge that can lead to healing and healthy lifestyles.
“Eating disorders” is a broad term describing a series of addiction-like disorders involving eating. They may well represent the largest grouping of addictive disorders in our society today.
Obesity affects more than one third of America’s population and is defined as a Body Mass Index greater than 30. The primary cause of obesity is overeating combined with too little physical activity. Though some would say this is an oversimplification, in some cases of morbid obesity (BMI greater than 40), it appears an accurate description of America’s most common eating disorder.
The next three eating disorders are anorexia, bulimia and binge eating.
Anorexia is characterized by severe food restrictions, body image distortion and a BMI less than 17. While anorexia can occur at any age, it is seen more frequently in adolescence, in girls more than boys. It can frequently result in severe malnutrition, metabolic dysfunction, and death can occur. Anorexia is frequently diagnosed during pediatric or medical examination because it is usually hidden from parents or friends.
Bulimia is characterized by eating that is followed shortly by vomiting. It is also a hidden disorder, sometimes diagnosed during dental examination by the erosion of tooth enamel from the hydrochloric acid in the vomitus. It can also lead to chronic malnutrition, electrolyte imbalance and often continues into full adulthood. While death is less frequent, it can occur due to metabolic toxicity if vomiting agents such as epicac are used to induce vomiting.
Binge eating disorder is characterized by periodic binge eating, sometimes, but not always, followed by vomiting.
These disorders are almost always difficult to treat, often require specialized (and sometimes life saving) residential treatment. Outpatient treatment is often available and may be adjunctive to residential treatment, but it can also be the primary treatment modality in nonlife threatening situations.
Further information is available online, a very useful resource: www.nationaleatingdisorders.org and in Hawaii, through the Kapiolani Medical Center for Women and Children in Honolulu.
• Dr. Gerald J. McKenna is medical director of McKenna Recovery Center. He is board certified in psychiatry and addiction medicine, and has been serving to improve the behavioral health of our island community’s kupuna, adults and youth. He lives, works and plays in Kauai with his family.
