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Eating disorders and risk factors
Disorders in eating behavior (TCA) are a group of alterations involved with food intake and weight control. These are associated with a variety of adverse manifestations that will compromise the psychological, physical and social state of the people who suffer from it. These alterations are usually secondary to acute or chronic episodes of body dissatisfaction. The objective of the following review is to analyze the concepts of eating disorders and their associated factors, through database search. Eating disorders include the presentation of distorted pictures of multifactorial origin that, without a clear establishment of how risk factors interact, hinder the proper management of them, thus increasing the risk of greater complications.
As of May 2013, the American Psychiatric Association (APA) defines eating disorders, such as eating disorders and food intake thus adding four diagnoses that come together to those already associated with behavior disorders Food: Anorexia Nervosa (AN), Bulimia Nervosa (BN) and unpopulated eating behavior disorder (TCA-NE), which are: Binge Disorder (TA), and Avitation Disorder/Restriction of Food Ingestion.
These eating disorders are going to be characterized by being alterations in food intake, which can be observed in people who have changes in behavior at eating time causing the intake to be excessively or in its absence. to do it; This occurs in response to a psychic impulse and not by a metabolic or biological need. The TCA encompass a series of pathological entities that vary significantly in terms of their physical, psychological and behavioral expressions.
The precise origin of these alterations has not yet been elucidated. The two main types of eating disorders are: anorexia and bulimia nervous. Among these unspecified disorders, is binger disorder (TA), cataloged as a new category that must be subjected to reviews.
Obesity is the result of an imbalance between intake and its expense, resulting in fat accumulation and therefore a weight gain; It does not distinguish skin color, age, socioeconomic level, sex or geographical situation, which is why it constitutes the most frequent nutritional disease in developed countries. There is a high associated morbidity and mortality rate, since it has multiple consequences in our health.
Eating disorders are more frequent in women generally, they begin during adolescence or youth, although there are reports of cases where they appear in childhood or adult life.
These diseases, which are qualified by their chronicity, as well as the frequent appearance of relapses, cause alterations in the psychosocial functioning of individuals, since, in addition to having a devastating effect on patients and their families, they are associated at a high risk of suicidal behaviors.
In addition, they are frequently presented in association with other psychiatric disorders such as: depression, anxiety, obsessive-compulsive disorder and substance abuse, which determines a marked deterioration in social functioning.
The increase in the number of cases of alterations of eating behavior has made these conditions constitute one of the highest prevalence psychiatric problems in today’s world, with the consequent impact on public health, both for medical and psychological aspects, as for the high costs that their management requires.
Different studies show that the prevalence of CTA is greater in Western countries. However, although the incidence of these diseases has apparently increased in recent decades, it should be considered that it has not been possible to determine whether this constitutes a real phenomenon, or it is only that some sociocultural changes observed in the last years, facilitate the diagnosis of these diseases. Since the beginning of the seventies there was a dissemination process on eating disorders, through the different media. This motivated that at present a high percentage of adolescents and their relatives have knowledge about the existence of these alterations. In addition, it has been emphasized that the abnormal behaviors of these individuals constitute a disease, so it has been recommended to provide them with all kinds of support, as well as avoid attitudes of reprobation and intolerance to symptoms. All of the above, has favored the development of an environment that allows establishing the diagnosis more easily. It is likely that some of the cases diagnosed today, in the past they had elapsed inadvertently as they were not detected by relatives or colleagues. In addition, it is not possible to rule out that in previous generations eating disorders were ‘better hidden’ by patients, given the greatest shame caused by a less tolerant and permissive environment.
The favorable or unfavorable changes in the family member identified as ‘sick’ exert effects on the psychological and physical health of the complete family. The relationships that parents (specifically mothers) maintain with their daughters, during childhood and adolescence are crucial for the subsequent psychological and social development of these. It has long been shown that there is a causal correlation between the different parental attitudes, the various family functioning structures and the development of psychopathologies in adulthood such as depression, neurosis and eating disorders.
It has been shown that a certain type of family organization and functioning convey in particular to the appearance and maintenance of eating disorders. Members of this type of families are trapped in family interaction patterns.
It has been determined that the greatest influence on change in weight modification behaviors in adolescents, mainly comes from mothers and friends.
Eating in response to negative emotions is also more associated with mothers and daughters. Younger mothers share more attitudes towards the body with their daughters, on the contrary. The eating behavior of the children seems to be more independent and can be determined by factors other than those of the daughters. For this reason, emphasis has been given to the mother-daughter relationship. For example, it has been observed that girls of girls with purgative anorexia have a greater incidence of obesity than the mothers of girls with restrictive anorexia, so it is suggested that there is an association between the obesity and eating behavior of the mother and the daughter.
Girls’ mothers with a eating disorder have higher scales on scales that measure bulimic symptoms, more frequent binge No eating disorder.
- Genetic predisposition: The risk of suffering a TCA increases above the general population values if there is a relative of a relative with a TCA.
- Low self – esteem: that is, making a negative and unsatisfied self-assessment of oneself will increase the possibility of suffering from TCA.
- Body image: distortion of the real image of your body and that, in addition, the emotions and feelings they are negative have more vulnerability to suffering from a TCA.
- Adolescent Age: Adolescence is the crucial stage in which there is an increased risk of developing a TCA. It should be noted that TCA can be diagnosed in people of all ages, but that most cases the disease occurs during adolescence. This occurs because within this stage, the personality, self – esteem and social role of the person are in development and, therefore, are more vulnerable to a social environment in which the pressure by the image is quite high.
- Sex: Of every 100 cases of TCA, 99 are cases of women and 1 is male, so being a woman leads to having a greater risk of suffering from a TCA.
- Family scope: families in which there is no stable and safe nucleus has a greater possibility of developing a TCA in one of the members, such as teenage girls. On the other hand, those families in which communication and family dynamics are excessively rigid, controlling and demanding can influence the development of a TCA.
- Stressful vital experiences: traumatic changes in family structure such as the death of one of the members, suffering the breakdown of a love relationship can increase the probability of TCA.
- Others: there are social factors such as criticism and mockery related to people’s physique, especially children and adolescents, who have received criticism and teasing related to their physical appearance and that due to this they have felt insecure with their image may present A higher risk to develop a TCA.
- Crisis periods
- Adverse events
- Subsistence allowance
Lack of prevention
- Genetic factors
- Environmental factors
They are attitudes that are usually linked to the existence of an eating disorder (TCA).It is important to highlight that they are not diagnostic criteria, therefore, they are not confirming the disease.
In relation to food:
- Use of very restrictive diets
- State of constant restlessness for food
- Feeling of guilt after intake
- Strange attitude to intake (eating very fast, not digesting food, not feeling satiety etc.)
- Go to the bathroom just after each meal
- Increase the amount of time in the bathroom
- Do not go to eat with family
- Finish too fast.
- Have hidden food, in the room or a place of each person
In relation to weight:
- Lose weight quickly and without justification
- Feel fear of gaining weight
- Perform excessively exercise with the main objective of thinning
- Auto induced vomit
- Use laxatives and diuretics consecutively
In relation to body image:
- wrong feeling of having a body that is not the real
- pretend to hide the body with clothes much larger than the real
- Hormonal alterations
- Hair loss
- Fragile nails
- Dry and cracked skin
- Marked bone highlights
- Cold and cyanotic limbs
- Decrease in muscle mass
In relation to behavior:
- Decrease in academic or work performance
- Need to be away from the rest
- Increase in irritability and aggressiveness
- Elevation of depressive symptoms and/or anxiety
- Manipulative behavior and shadow of lying
It is characterized by high weight loss (more than 15%) due to the realization of highly restrictive diets and purgative behaviors (vomiting, laxatives, diuretics, excess physical exercise). These people have an alteration of their true body image by distorting the size of any part of their body.
Purgative anorexia: use of purgative methods such as vomiting, diuretics or laxatives after having ingested high food portions.
Psychological and social characteristics include fear of eating in the presence of others, low carbohydrates and fat diets, concern for food, laxative abuse and lies. The main victims of this are women, especially young women, who can sometimes be influenced by following stereotypes of famous people such as actresses and models.
Table other than anorexia, because, in this, patients perform excessive food consumption, which are subsequently eliminated by provocation of vomiting or the use of diuretics and laxatives. It is a picture of difficult detection, since, as there is no malnutrition, it cannot be observed ‘signs of nutritional gravity’; Its manifestations, being dispersed, can make us think of more than one possible diagnosis.
The person with Bulimia experiences constant appetite attacks that will be followed by fasting or vomiting to counteract exaggerated intake, use and abuse of laxatives to facilitate evacuation, excessive concern about body image and feelings of depression, anxiety and guilt for not having self-control.
Binge eating disorder
It is characterized by recurrent compulsive intake events. It has many similarities with bulimia nervosa. The main difference is that the person suffering from a binge disorder does not perform compensatory behaviors that is (induced auto vomiting, laxatives, diuretics, fasting, physical exercise in exaggerated, etc.)
One of the most common consequences of bearing disorder is overweight or obesity, with the risks that this entails for health: diabetes, hypertension, cholesterol, etc.
It is the opposite side of anorexia: really obese people who are thin and healthy in front of the mirror.
If people who suffer from anorexia look in the mirror and look obese, even if this is not reality and suffer a thin limit, the megaraxic happens otherwise, they are not able to perceive their excess weight, they find their pleasant physical appearance , and not only do not care about their body, but their diet is unhealthy food, high in fat and sweet carbohydrates. They are malnourished obese, which are increasingly and worse.
Megarxia is an eating disorder, less known than anorexia, but no less serious. In addition, taking into account that obesity is an increasing phenomenon, which already affects more than 500 million people worldwide, it is possible that many overweight individuals are megaréxic and not diagnosed, who will end up being obese if they do not take awareness and rectify their lifestyle in time.
CTs are important pictures due to the association of organic symptoms and signs, which could lead to a future death of patients. It is clear that it is much to advance to know all the pathophysiological mechanisms involved in the development of food behavior disorders, which allows us to establish the most appropriate strategies of prevention and intervention. However there are reasons for optimism. Advances in molecular genetics can allow the identification of genes that predispose an individual to develop anorexia or bulimia nervous. The greatest knowledge of the biological factors involved in weight control, such as leptin, can also shed light in this field. And the study of patients with complete or partial recovery will help differentiate biological alterations that are a consequence of the disease from those that predict symptoms or contribute to their maintenance. Clearness must then have the differences between somatic and behavioral alterations that can be associated with the presentation of the paintings to perform the appropriate addressing. It is important to recognize the factors associated with the presentation of each particular picture to define strategies that allow modifying the consequences; However, it is clear that prevention requires changes in social and cultural concepts; as well as the support of the family nucleus and that of the Transdisciplinary Health Team.
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