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Eating Disorders

Introduction

Eating disorders, from anorexia to bulimia to binge eating disorder, involve changes in appetite and disordered eating; providing a surplus or deficiency in essential body dietary nutrients, which can cause short and long term effects. Each disorder is patient specific, and they affect people of all ages, genders, and ethnicities. There are many causes, including genetics, and treatments for eating disorders, which each require multi-disciplinary interventions. On average, according to Beat UK, (Beat, 2022) eating disorders take six to seven years to recover from, with most in lifetime remission (always sensitive to relapse) from the disorder. Currently less than 50% of sufferers fully recover.  

Early diagnosis with access to comprehensive treatment, has been shown to reduce recovery time, and can be the crisis prevention that can save lives. It is predicted, according to Beat, that currently over 1.25 million people (Gov UK, 2018), both male and female, have an eating disorder in the UK and 30 million in the USA, with numbers continuing to grow, especially in Japan, China, and Europe. Over the pandemic, NHS eating disorder clinic services (NHS, 2022) saw an almost doubling of cases (Solmi et al, 2021).  

Why do we Eat? 

We eat to satisfy our appetite. Whether this be because of an energy deficit (every cell in our bodies requires energy from respiration and metabolism which requires glucose), vitamin, and mineral deficit. To motivate us to do this, our brains (which are the same caveman brains as our biological ancestors) produce chemicals called neurotransmitters which control our behaviour. These include Serotonin, which calms us down and which is broken down into Melatonin, which helps us sleep. It also includes Dopamine (pleasure and reward), Adrenaline (for activity), Acetylcholine (for mental alertness) and GABA (which calms and relaxes us) and many more.  

Eating disorders are a biological phenomenon where the usual brain and body pathways that dictate appetite, food behaviour and mood come out of homeostatic balance, and this alters the persons behaviour in response to food. Our biology can be self-adapted and regulated with treatment to restore this balance and return to a healthy dietary medium, free from dietary restriction or binge eating, where you eat freely and intuitively in response to the body’s energy and nutritional demands.  

Recovery  

Recovery from an eating disorder is incredibly hard, with on an average six to ten years until full recovery according to UK charity Beat (Beat, 2022) and more than half of sufferers never fully recovering. Recovery is defined as eating at regular intervals, guided by physical rather than emotional hunger. It is a life free from dietary restriction, bingeing or purging and weight maintained at a healthy level. It is the ability to eat spontaneously, especially out in public, a balanced diet with every food group and the ability to tolerate natural shifts in weight due to illness, times of the year or bloating. It is possible for every eating disorder sufferer, with the right support and treatment. 

Resources for sufferers 

  • Beat 
  • Eating Disorder Institute 
  • Mind 
  • National Osteoporosis Society 
  • National Eating Disorders (NEDA) 
  • NHS website 
  • ANRED 

Three different eating disorders are explored in depth in this section: anorexia nervosa, bulimia nervosa and binge eating disorder. Click on the links below to read further regarding each eating disorder.

Researched by: Laurentia (Laura) Campbell. Neuroscience and Nutrition scientist (with focus on the gut microbiota and omega 3) and writer. Former anorexic and binge eater turned gourmet food connoisseur, researcher, writer, marketer, and evidence-based nutritionist. See https://www.linkedin.com/in/lauracampbell007/ and https://medium.com/@laurentiacampbell.  

References for Anorexia, Bulimia and Binge Eating Disorder pages:  

  1. UK, N.G.A., 2017. Eating disorders: recognition and treatment. 
  2. Beat. 2022. Anorexia Nervosa – Beat. [online] Available at: <https://www.beateatingdisorders.org.uk/get-information-and-support/about-eating-disorders/types/anorexia/> [Accessed 14 March 2022]. 
  3. Glossary.feast-ed.org. 2022. Anorexia Nervosa – Eating Disorders Glossary. [online] Available at: <http://glossary.feast-ed.org/types-of-eating-disorders-and-disordered-eating/anorexia-nervosa-1> [Accessed 14 March 2022]. 
  4. GOV.UK. 2022. Statistics on Obesity, Physical Activity and Diet, England 2018. [online] Available at: <https://www.gov.uk/government/statistics/statistics-on-obesity-physical-activity-and-diet-england-2018> [Accessed 14 March 2022]. 
  5. Solmi, F., Downs, J.L. and Nicholls, D.E., 2021. COVID-19 and eating disorders in young people. The Lancet Child & Adolescent Health5(5), pp.316-318. 
  6. Bulik, C.M., Blake, L. and Austin, J., 2019. Genetics of eating disorders: What the clinician needs to know. Psychiatric Clinics42(1), pp.59-73. 
  7. Hinney, A. and Volckmar, A.L., 2013. Genetics of eating disorders. Current Psychiatry Reports15(12), pp.1-9. 
  8. Silber, B.Y. and Schmitt, J.A.J., 2010. Effects of tryptophan loading on human cognition, mood, and sleep. Neuroscience & biobehavioural reviews34(3), pp.387-407. 
  9. Young, S.N. and Leyton, M., 2002. The role of serotonin in human mood and social interaction: insight from altered tryptophan levels. Pharmacology Biochemistry and Behaviour71(4), pp.857-865. 
  10. Kikuchi, A.M., Tanabe, A. and Iwahori, Y., 2021. A systematic review of the effect of L-tryptophan supplementation on mood and emotional functioning. Journal of dietary supplements18(3), pp.316-333. 
  11. Dommisse, J., 1991. Subtle vitamin-B12 deficiency and psychiatry: a largely unnoticed but devastating relationship?. Medical hypotheses34(2), pp.131-140. 
  12. Phelan, D., Molero, P., Martínez-González, M.A. and Molendijk, M., 2018. Magnesium and mood disorders: systematic review and meta-analysis. BJPsych open4(4), pp.167-179. 
  13. Serefko, A., Szopa, A., Wlaź, P., Nowak, G., Radziwoń-Zaleska, M., Skalski, M. and Poleszak, E., 2013. Magnesium in depression. Pharmacological Reports65(3), pp.547-554. 
  14. Chollet, D., Franken, P., Raffin, Y., Henrotte, J.G., Widmer, J., Malafosse, A. and Tafti, M., 2001. Magnesium involvement in sleep: genetic and nutritional models. Behaviour genetics31(5), pp.413-425. 
  15. Serefko, A., Szopa, A., Wlaź, P., Nowak, G., Radziwoń-Zaleska, M., Skalski, M. and Poleszak, E., 2013. Magnesium in depression. Pharmacological Reports65(3), pp.547-554. 
  16. Wienecke, E. and Nolden, C., 2016. Long-term HRV analysis shows stress reduction by magnesium intake. MMW Fortschritte der Medizin158(Suppl 6), pp.12-16. 
  17. Rondanelli, M., Miccono, A., Lamburghini, S., Avanzato, I., Riva, A., Allegrini, P., Faliva, M.A., Peroni, G., Nichetti, M. and Perna, S., 2018. Self-care for common colds: the pivotal role of vitamin D, vitamin C, zinc, and echinacea in three main immune interactive clusters (physical barriers, innate and adaptive immunity) involved during an episode of common colds—practical advice on dosages and on the time to take these nutrients/botanicals in order to prevent or treat common colds. Evidence-Based Complementary and Alternative Medicine2018
  18. Aslam, F., Muhammad, S.M., Aslam, S. and Irfan, J.A., 2017. Vitamins: key role players in boosting up immune response-a mini review. Vitamins & Minerals6(01). 
  19. Zhao, M., Tuo, H., Wang, S. and Zhao, L., 2020. The effects of dietary nutrition on sleep and sleep disorders. Mediators of inflammation2020
  20. Bardone-Cone, A.M., Harney, M.B., Maldonado, C.R., Lawson, M.A., Robinson, D.P., Smith, R. and Tosh, A., 2010. Defining recovery from an eating disorder: Conceptualization, validation, and examination of psychosocial functioning and psychiatric comorbidity. Behaviour research and therapy48(3), pp.194-202.