EATING
DISORDERS
Not all women are aware that their oral health can be affected
by general health problems such as eating disorders.
Eating
Disorders Update
Researchers determine the
influence of bone density results in adolescents with anorexia
Physicians have long recognized that early
and severe osteoporosis is a serious consequence of anorexia
nervosa. Researchers at Children's Hospital Boston developed a
study to determine if having a bone measurement to screen for low
bone density changes the attitude and behavior of young women with
anorexia nervosa.
While examining normal and low bone density
results, researchers found the results to be interpreted both
positively and negatively by participants depending on what stage
of illness, from diagnosis to recovery, they were in. Those closer
to recovery reported bone density results further motivated their
recovery.
Nine out of 12 anorexia patients had abnormal
results. Ten of the participants stated that having a bone
measurement did not enhance their recovery process at the time
performed, but three of these 10 noted it motivated recovery later
in their course.***
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Eating Disorder Awareness
Week
A woman may know her body, but she may not know the impact it
has on her oral health.
A dentist can observe damaging effects on the inside surface
of the upper front teeth of patients with eating disorders, especially bulimia,
a disease which is prevalent among many older adolescents or young adult women.
The prolonged enamel erosion from the acidity caused by repeated regurgitation
is a tell-tale sign that the patient may be suffering from bulimia.
Toothbrushing
is not recommended immediately after regurgitation as it may accelerate tooth
enamel erosion.
It is a sensitive topic, but one that needs to be addressed by
a compassionate dentist in a non-threatening way. The dentist may recommend
counseling and prescribe topical fluoride to reduce further tooth erosion.
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Q. What are eating
disorders?
A. Each year, millions
of people in the United States are affected by serious and sometimes
life-threatening eating disorders. The vast majority -- more than 90 percent --
of those afflicted with eating disorders are adolescent and young adult women.
One reason that women in this
age group are particularly vulnerable to eating disorders is their tendency to
go on strict diets to achieve an "ideal" figure. Researchers have
found that such stringent dieting can play a key role in triggering eating
disorders.
Approximately 1 percent of adolescent
girls develop anorexia nervosa,
a dangerous condition in which they can literally starve themselves to
death.
Another 2-3 percent of young women
develop bulimia nervosa,
a destructive pattern of excessive overeating followed by vomiting or other
"purging" behaviors to control their weight.
The
present of eating disorders in athletes is higher than in the
general public. The incidence of eating disorders in the
normal population is 5 to 10 % but female athletes exhibit a
16-72% incidence.
These eating disorders also occur in
men and older women, but much less frequently.
The consequences of eating disorders
can be severe. For example, one in ten cases of anorexia nervosa leads to death
from starvation, cardiac arrest, other medical complications, or suicide.
Fortunately, increasing awareness of the dangers of eating disorders -- sparked
by medical studies and extensive media coverage of the illness -- has led many
people to seek help.
Nevertheless, some people with eating
disorders refuse to admit that they have a problem and do not get treatment.
Family members and friends can help recognize the problem and encourage the
person to seek treatment.
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Q. What are the medical complications of eating
disorders?
A. Medical
complications can frequently be a result of eating disorders. Individuals with
eating disorders who use drugs to stimulate vomiting, bowel movements, or
urination may be in considerable danger, because this practice increases the
risk of heart failure.
In patients with anorexia,
starvation can damage vital organs such as the brain and heart. To protect
itself, the body shifts into "slow gear": monthly menstrual periods
stop, breathing pulse and blood pressure rates drop, and thyroid function slows.
Nails and hair become brittle; the skin dries, yellows, and becomes covered with
soft hair called lanugo.
Excessive thirst and frequent
urination may occur. Dehydration contributes to constipation, and reduced body
fat leads to lowered body temperature and the inability to withstand cold.
Mild anemia, swollen joints, reduced
muscle mass, and light-headedness also commonly occur in anorexia. If the
disorder becomes severe, patients may lose calcium from their bones, making them
brittle and prone to breakage.
They may also experience irregular
heart rhythms and heart failure. In some patients, the brain shrinks, causing
personality changes. Fortunately, this condition can be reversed when normal
weight is reestablished.
Scientists have found that many
patients with anorexia also suffer from other psychiatric illnesses. While the
majority have co-occurring clinical depression, others suffer from anxiety,
personality or substance abuse disorders, and many are at risk for
suicide.
Obsessive-compulsive disorder (OCD), an
illness characterized by repetitive thoughts and behaviors, can also accompany
anorexia. Individuals with anorexia are typically compliant in personality but
may have sudden outbursts of hostility and anger or become socially withdrawn.
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Bulimia nervosa
patients --
even those of normal weight -- can severely damage their bodies by frequent
binge eating and purging. In rare instances, binge eating causes the stomach to
rupture; purging may result in heart failure due to loss of vital minerals such
as potassium.
Vomiting causes other less deadly,
but serious, problems -- the acid in vomit wears down the outer layer of the
teeth and can cause scarring on the backs of hands when fingers are pushed down
the throat to induce vomiting. Further, the esophagus becomes inflamed and
glands near the cheeks become swollen. As in anorexia, bulimia may lead to
irregular menstrual periods. Interest in sex may also diminish.
Some individuals with bulimia
struggle with addictions including abuse of drugs and alcohol, and compulsive
stealing. Like individuals with anorexia, many people with bulimia suffer from
clinical depression, anxiety, OCD, and other psychiatric illnesses. These
problems, combined with their impulsive tendencies, place them at higher risk
for suicidal behavior.
People with binge eating
disorder are usually overweight so they are prone to the serious medical
problems associated with obesity, such as high cholesterol, high blood pressure,
and diabetes. Obese individuals also have a higher risk for gallbladder disease,
heart disease, and some types of cancer. Individuals with binge eating disorder
also have high rates of co-occurring psychiatric illnesses -- especially
depression.
What
are The Dental Complications?
These
disorders have a high relapse rate which can affect the patient's
dental health. Often the first manifestations of an
eating disorder appears in the mouth. Often the first health
care professional to detect an eating disorder is a dental
professional. Oral complications are:
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Q. What causes eating
disorders?
A. In trying to
understand the causes of eating disorders, scientists have studied the
personalities, genetics, environments, and biochemistry of people with these
illnesses. As is often the case, the more that is learned, the more complex the
roots of eating disorders appear.
Dental Treatment
For more information on dental
treatment for the eating disordered person visit here:
Dental Treatment for Eating
Disordered Persons
Resources:
Source: "Eating
Disorders", National Institute of Mental Health. Source:
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You can find out more about eating disorders and other mental
disorders by contacting the following organizations:
Food and Nutrition
Information Center
Academy for Eating
Disorders
Phone: (703) 556-9222
Internet Address: www.aedweb.org
National Institute of
Mental Health
American Anorexia/Bulimia Association,
Inc.
Phone: (212) 575-6200
Internet Address: http://www.aabainc.org/home.html
Anorexia Nervosa and Related Eating
Disorders, Inc.
Phone: (541) 344-1144
Internet Address: http://www.anred.com/
Eating Disorders Awareness and
Prevention, Inc.
Phone: (800) 931-2237
Internet Address: http://www.edap.org/index.html
National Eating
Disorders Association
Phone: (206) 382-3587
Internet Address: www.NationalEatingDisorders.org
National
Institute of Mental Health
Phone: (301) 443-4513
Internet Address: www.nimh.nih.gov
National
Association of Anorexia Nervosa and Associated Disorders
Phone: (847) 831-3438
Internet Address: www.anad.org
American Academy of Family Physicians and
the National Institute of Mental Health (Facts about Anorexia Nervosa).
Eating
Disorders: a Food and Nutrition Resource List for Consumers
