It must be a confusing state of affairs for young people. They pick up a magazine and they come across an article about the dangers of dieting, anorexia and bulimia. However, that same article is likely to be wedged between pages strewn with images of stick-thin models, slimming products and features on how to lose weight fast. No prizes for guessing which is most likely to have the biggest effect.
Eating disturbances are commonly associated with depression but depression can also result from self-imposed dietary controls. Eating disturbances such as anorexia and bulimia are most common in girls, but as eating controls become more severe the risk of health problems, including suicide, increases. In fact the risk of suicide is 20 times higher amongst girls with anorexia than with young people in general.
Young people are especially vulnerable to concerns over weight and appearance. During puberty and up to the age of 20 or even beyond, hormonal development often results in a natural chubbiness or ‘puppy fat’. This developmental stage should really be supported and nurtured through well-balanced diets and exercise, for both the body and the brain. Unfortunately these needs come at a time when many young people lack self-confidence. They may wrongly associate idealized body shapes with popularity and happiness and so exercise begins to turn into hard physical training and diet turns to dieting.
The path to anorexia usually starts with controls being exercised over food content. Sweets and sugary products are pushed to one side then foods judged to be fatty or full of carbohydrates. Eating behaviors change and the person becomes ever more picky. As they lose weight the process of food denial cascades to a point where controls once exercised are lost. Perceptions of body shape are distorted but so the likelihood of depression increases. In the treatment of anorexia it is quite common to find a corresponding treatment for depression.
There are some similarities between anorexia and bulimia. The fixation on weight, on appearance and the inability to interpret body signals are three of them. There is also a compulsion towards food denial although what characterizes bulimia is the consumption of sugary, fatty foods only to be followed by purging (vomiting); a pattern of behavior that can be repeated several times a week.
As in anorexia, depression is common. The treatment for bulimia tends to reflect that of anorexia, which is a combination of medication and cognitive behavior therapy. Currently, there is no evidence to suggest that antidepressants are helpful in the treatment of anorexia or bulimia. In fact medication for depression appears more effective once weight is restored to within normal limits. The unfortunate side effect of some antidepressants is weight gain so this is something to be considered when treating eating disturbances and depression together.
Published On: September 25, 2013