Why anorexia and bulimia should be considered chronic diseases
Both anorexia and bulimia are eating disorders that are more prevalent in female adolescents, even though they have been documented in children as young as five years of age.
Anorexia and bulimia have the highest mortality rate, even more than suicide; it is estimated that one out of every five people who die from these eating disorders (ED) committed suicide, while the other four died from multiple organ failure, according to Karla Edith González Alcántara, a specialist at the UNAM's Faculty of Psychology (FP).
The researcher from the University's Health and Nutrition Laboratory explained that it usually takes years for a person with ADD to die from this condition. For this reason, they should be considered chronic diseases since the symptoms do not disappear completely and patients suffer a high percentage of relapses—48 percent of patients, on average.
"We are talking about a disorder that generates diverse consequences and, in addition, it would seem that it is a health problem that is growing. "This is something that specialists should consider because it could be thought that the treatments we work with and attend to these patients are not working," she said.
Anorexia and bulimia, besides being considered behaviors that individuals start at an early age (adolescents and young people), are based, above all, on the desire to modify their body image, especially to be thinner.
A person has anorexia when he/she refuses or restricts food consumption or intake, or performs compensatory behaviors such as laxative use or self-induced vomiting. This is manifested in a body weight below normal or expected for their age and presents an altered perception of their weight or body shape. While those with bulimia, the diagnostic criteria consider that they have a higher quantity of food intake than any other individual in short periods, or what is called "binge eating".
This behavior generates a feeling of loss of control over what they eat. In addition, "binge eating" is associated with sensations such as feeling unpleasantly full to the point of wanting to vomit. "Suddenly it gives them feelings of shame or guilt, because of these attitudes of overeating, even though they do not feel a real need to eat and they still do it."
Repercussions shared by anorexia and bulimia
There are several consequences associated with both anorexia and bulimia, particularly if they are present for a prolonged period. For example, anemia, tiredness, exhaustion, and muscle weakness could be triggered, even osteoporosis, brittle hair and nails, dry and yellowish skin, and a decrease in body temperature due to the low amount of calories, which could be related to hair growth in the body to keep warm.
In addition, low blood pressure, slow breathing, and pulse, and more in the long term, infertility, heart and brain damage, and, finally, organ failure, that is, "the time comes when, due to lack of nutrients or severe dehydration, multi-organ failure occurs."
It is difficult to determine the origin of the TCAs, although progress has been made in their knowledge, there are aspects to be known, such as the factors that precipitate and maintain them. For now, we can say that they are alterations of multifactorial origin: biological, such as genetic issues that have been considered to be related but also due to overweight or obesity; and psychological, that is, personality issues such as low self-esteem, depression, body dissatisfaction, and anxiety, among others."
In addition to those social factors related to criticism of appearance, including having been bullied for it, and the pressure of society to achieve the ideal of thinness.
What is known about the epidemiology of eating disorders is that they tend to be a more common problem or have a higher incidence in adolescent females, although this does not mean that males do not present an ED. Currently, these problems are observed in children as young as five years of age. "That means that if we think about the physical consequences described, we have an even greater focus of alarm than we had some time
She noted that the disorders appear to have a low prevalence; however, the Diagnostic and Statistical Manual (DSM) states that 0.4 percent of adolescent women worldwide will have anorexia and 1.5 percent will have bulimia. However, it is difficult to know how many people have been diagnosed and, even worse, to determine the number of those who engage in these behaviors.
In Mexico, in 2017, it was reported that approximately 20 thousand cases of eating disorders are observed each year, a significant figure. Meanwhile, in a study conducted in more than 200 countries in 2019, there were 13.6 million human beings who presented with an ED. "Although the prevalence may seem lower, we are talking about a significant number of people affected by these problems."
The diagnosed cases in the country are just the tip of the iceberg of mental disorders, as few people reach specialized care while there are a significant number of individuals who remain undiagnosed and, therefore, untreated. This means that prevalence data on EDs could be nine times higher than those recorded.
Given this, she highlighted the need for specialists to work on people with a diagnosis of disorders and try to identify those who engage in these behaviors to prevent the number of these health problems from rising and from becoming an eating disorder, which has also been associated with depression, suicidal ideation, and the consumption of toxic substances.
It is necessary to identify alterations or factors associated with this phenomenon. It is also necessary to be clear that this is a mental condition from which they cannot get out by themselves and, therefore, require help.