Eating Disorders - New York State Office of Mental Health (PDF)

Eating Disorders   New York State Office of Mental Health Table of Contents Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Signs and Symptoms. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Anorexia Nervosa . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Symptoms of Anorexia Nervosa. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Long-term Symptoms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Bulimia Nervosa . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2 Symptoms of Bulimia Nervosa . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2 Binge-Eating Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3 Symptoms of Binge-Eating Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3 Risk Factors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3 Treatments and Therapies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4 Treatment Plans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4 Psychotherapies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4 Medication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4 Eating Disorders i  New York State Office of Mental Health Finding Help . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5 New York State Mental Health Program Directory . . . . . . . . . . . . . . . . . . . . . . . . . .5 Mental Health Treatment Program Locator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5 For Immediate Help . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6 Eating Disorders ii  New York State Office of Mental Health Eating Disorders Overview There is a commonly held view that eating disorders are a lifestyle choice. Eating disorders are actually serious and often fatal illnesses that cause severe disturbances to a person’s eating behaviors. Obsessions with food, body weight, and shape may also signal an eating disorder. Common eating disorders include anorexia nervosa, bulimia nervosa, and binge-eating disorder. Signs and Symptoms Anorexia Nervosa People with anorexia nervosa may see themselves as overweight, even when they are dangerously underweight. People with anorexia nervosa typically weigh themselves repeatedly, severely restrict the amount of food they eat, and eat very small quantities of only certain foods. Anorexia nervosa has the highest mortality rate of any mental disorder. While many young women and men with this disorder die from complications associated with starvation, others die of suicide. In women, suicide is much more common in those with anorexia than with most other mental disorders. Symptoms include: • Extremely restricted eating • Extreme thinness (emaciation) • A relentless pursuit of thinness and unwillingness to maintain a normal or healthy weight • Intense fear of gaining weight • Distorted body image, a self-esteem that is heavily influenced by perceptions of body weight and shape, or a denial of the seriousness of low body weight Other symptoms may develop over time, including: • Thinning of the bones (osteopenia or osteoporosis) • Mild anemia and muscle wasting and weakness Eating Disorders 1  New York State Office of Mental Health • Brittle hair and nails • Dry and yellowish skin • Growth of fine hair all over the body (lanugo) • Severe constipation • Low blood pressure, slowed breathing and pulse • Damage to the structure and function of the heart • Brain damage • Multi-organ failure • Drop in internal body temperature, causing a person to feel cold all the time • Lethargy, sluggishness, or feeling tired all the time • Infertility Bulimia Nervosa People with bulimia nervosa have recurrent and frequent episodes of eating unusually large amounts of food and feeling a lack of control over these episodes. This binge-eating is followed by behavior that compensates for the overeating such as forced vomiting, excessive use of laxatives or diuretics, fasting, excessive exercise, or a combination of these behaviors. Unlike anorexia nervosa, people with bulimia nervosa usually maintain what is considered a healthy or relatively normal weight. Symptoms include: • Chronically inflamed and sore throat • Swollen salivary glands in the neck and jaw area • Worn tooth enamel and increasingly sensitive and decaying teeth as a result of exposure to stomach acid • Acid reflux disorder and other gastrointestinal problems • Intestinal distress and irritation from laxative abuse • Severe dehydration from purging of fluids • Electrolyte imbalance (too low or too high levels of sodium, calcium, potassium and other minerals) which can lead to stroke or heart attack Eating Disorders 2  New York State Office of Mental Health Binge-Eating Disorder People with binge-eating disorder lose control over his or her eating. Unlike bulimia nervosa, periods of binge-eating are not followed by purging, excessive exercise, or fasting. As a result, people with binge-eating disorder often are overweight or obese. Binge-eating disorder is the most common eating disorder in the U.S. Symptoms include: • Eating unusually large amounts of food in a specific amount of time • Eating even when you’re full or not hungry • Eating fast during binge episodes • Eating until you’re uncomfortably full • Eating alone or in secret to avoid embarrassment • Feeling distressed, ashamed, or guilty about your eating • Frequently dieting, possibly without weight loss Risk Factors Eating disorders frequently appear during the teen years or young adulthood but may also develop during childhood or later in life. These disorders affect both genders, although rates among women are higher than among men. Like women who have eating disorders, men also have a distorted sense of body image. For example, men may have muscle dysmorphia, a type of disorder marked by an extreme concern with becoming more muscular. Researchers are finding that eating disorders are caused by a complex interaction of genetic, biological, behavioral, psychological, and social factors. Researchers are using the latest technology and science to better understand eating disorders. One approach involves the study of human genes. Eating disorders run in families. Researchers are working to identify DNA variations that are linked to the increased risk of developing eating disorders. Brain imaging studies are also providing a better understanding of eating disorders. For example, researchers have found differences in patterns of brain activity in women with eating disorders in comparison with healthy women. This kind of research can help guide the development of new means of diagnosis and treatment of eating disorders. Eating Disorders 3  New York State Office of Mental Health Treatments and Therapies Adequate nutrition, reducing excessive exercise, and stopping purging behaviors are the foundations of treatment. Treatment plans are tailored to individual needs and may include one or more of the following: • Individual, group, and/or family psychotherapy • Medical care and monitoring • Nutritional counseling • Medications Psychotherapies Psychotherapies such as a family-based therapy called the Maudsley approach, where parents of adolescents with anorexia nervosa assume responsibility for feeding their child, appear to be very effective in helping people gain weight and improve eating habits and moods. To reduce or eliminate binge-eating and purging behaviors, people may undergo cognitive behavioral therapy (CBT), which is another type of psychotherapy that helps a person learn how to identify distorted or unhelpful thinking patterns and recognize and change inaccurate beliefs. Medications Evidence also suggests that medications such as antidepressants, antipsychotics, or mood stabilizers approved by the U.S. Food and Drug Administration (FDA) may also be helpful for treating eating disorders and other co-occurring illnesses such as anxiety or depression. Check the FDA’s website: (http://www.fda.gov/), for the latest information on warnings, patient medication guides, or newly approved medications. Eating Disorders 4  New York State Office of Mental Health Finding Help New York State Mental Health Program Directory The Mental Health Program Directory provides information on all programs in New York State that are operated, licensed or funded by the State Office of Mental Health (OMH). This site includes three search options: Basic Search, Advanced Search, and Full Directory. Definitions for all programs are available under the Support tab, along with directory help and information on program data collection. Find services close to you at: Find a Program App at omh.ny.gov Mental Health Treatment Program Locator The Substance Abuse and Mental Health Services Administration (SAMHSA) provides this online resource for locating mental health treatment facilities and programs. The Mental Health Treatment Locator section of the Behavioral Health Treatment Services Locator lists facilities providing mental health services to persons with mental illness. Find a facility in your state at: https://findtreatment. samhsa.gov/ Eating Disorders 5  New York State Office of Mental Health For Immediate Help • If You Are in Crisis: Call the toll-free National Suicide Prevention Lifeline at 1-800-273-TALK (8255), available 24 hours a day, 7 days a week. The service is available to anyone. All calls are confidential. The TTY number is 1-800-799-4TTY (4889). If you are thinking about harming yourself or thinking about suicide: • Tell someone who can help right away • Call your licensed mental health professional if you are already working with one • Call your doctor • Go to the nearest hospital emergency department If a loved one is considering suicide: • Do not leave him or her alone • Try to get your loved one to seek immediate help from a doctor or the nearest hospital emergency room, or call 911 • Remove access to firearms or other potential tools for suicide, including medications Eating Disorders 6  The New York State Office of Mental Health thanks the National Institute of Mental Health for providing the information contained in this booklet. July 2018  For questions or complaints regarding mental health services anywhere in New York State please contact: New York State Office of Mental Health Customer Relations 44 Holland Avenue Albany, NY 12229 (800) 597-8481 (toll-free) For information about mental health services in your community, contact the New York State Office of Mental Health regional office nearest you: Western New York Field Office 737 Delaware Avenue, Suite 200 Buffalo, NY 14209 (716) 885-4219 Central New York Field Office 545 Cedar Street, 2nd Floor Syracuse, NY 13210-2319 (315) 426-3930 Hudson River Field Office 10 Ross Circle, Suite 5N Poughkeepsie, NY 12601 (845) 454-8229 Long Island Field Office 998 Crooked Hill Road Building #45-3 West Brentwood, NY 11717-1087 (631) 761-2886 New York City Field Office 330 Fifth Avenue, 9th Floor New York, NY 10001-3101 (212) 330-1650 In Crisis? We’ve got time to listen. Text Got5 to 741741 National Suicide Prevention Lifeline 1-800-273-TALK (8255) Available 24 hours a day, 7 days a week (toll-free). The service is available to anyone. All calls are confidential. The TTY number is: 1-800-799-4TTY (4889) Connect with OMH www.facebook.com/nysomh www.twitter.com/nysomh @nysomh www.youtube.com/user/nysomh For additional information regarding this publication please contact: NYS OMH Community Outreach and Public Education Office 44 Holland Avenue Albany, NY 12229 (800) 597-8481 (toll free) www.omh.ny.gov