Eating disorders.

Abstract

The main forms of eating disorders are anorexia and bulimia nervosa and obesity. The clinical features, aetiology, treatment and prognosis of anorexia and bulimia nervosa are described to highlight the similarities and differences between these two conditions. Both conditions affect predominantly the young female population with body image disturbance as one of the core symptoms. Whilst the body weight of anorexics are by definition low, most bulimics have normal or near normal body weight. Sufferers of anorexia nervosa tend to deny their illness while those with bulimia are often miserable and acutely aware of their eating difficulties. The aetiological factors in both conditions overlap to a large extent. The outcome of treatment for bulimia is reportedly better than that of anorexia nervosa. Obese people often become depressed and anxious as a result of low self-esteem causing them to seek psychiatric treatment. The severely obese who are placed on very low calorie diets may develop adverse emotional disturbances whilst weight gain may follow a major depressive illness or develop as a side effect of psychotropic medications. A subgroup of the obese population engage in frequent binge eating and preliminary criteria are being developed for this condition called "binge eating disorder". Behaviour therapy is the treatment of choice for obesity. Other forms of treatment include individual and group psychotherapy, use of appetite suppressants and in the severely obese, surgical methods.