We eat to live and eating is an important focus for our family and social lives. In a country like the United States, food is readily available. But large amounts of food put us at risk for the three major eating disorders: obesity, bulimia, and anorexia nervosa. This fact sheet will discuss the role of behavior therapy in the treatment of these disorders.
A recent report from the National Institutes of Health suggests that people who are more than 20% over their ideal weight should seek treatment. Over one quarter of all women, and nearly as many men, in the United States fall into this category. Obesity is related to health risks, including high blood pressure, diabetes, and gall bladder disease. At very high levels of obesity, life expectancy is shortened. People should lose weight for health reasons and not for beauty reasons.
We do not understand all the causes of obesity. Recent research suggests that both family genetics and the environment are involved. Environmental factors include easy access to large amounts of food, eating high-caloric and high-fat foods, and having lower activity levels, including little or no excercise.
Social standards for body shape change over time. This is especially true for women. In the United States, a thin body is expected for women. Most women diet from time to time. However, a few restrict their diet in a major way. These women tend lose control of their eating and begin to binge-eat. Binge eating leads to the possibility of weight gain. As a result, individuals begin to purge. Some ways people purge include vomiting or using laxatives or diuretics. Less often, people purge by not eating for several days.
Over time, an extreme concern about body shape develops. This fosters more severe dieting and increases the frequency of purging when diet rules are broken. These behaviors are known as bulimia. Bulimia carries health risks, including increased dental problems and a loss of potassium, which may lead to problems such as abnormal heart rhythms. Psychological problems, including irritability and depression, can also occur. The vast majority of bulimics are women, although a few men do develop this problem.
Anorexia is the rarest of the three eating disorders. Anorexia is characterized by a large loss of body weight. People often fall 20% to 30% below their ideal weight. Anorexia nervosa may become a chronic illness. It usually begins in early adolescence. It can require frequent hospitalization for the medical problems of starvation. About 5% of anorexic patients die because of the disorder. About half of those die from the complications of the disorder and about half from suicide. Most patients with this disorder need to be hospitalized, preferably in a unit designed for the treatment of eating disorders. Early cases, in which weight loss has not fallen to low levels, can be treated on an outpatient basis.
A publication from the Association for Behavioral and Cognitive TherapiesDownload