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  3. Eating Disorders: Facts About Eating Disorders and the Search for Solutions Eating is controlled by many factors, including

Eating Disorders: Facts About Eating Disorders and the Search for Solutions Eating is controlled by many factors, including

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问题         Eating Disorders: Facts About Eating Disorders and the Search for Solutions
    Eating is controlled by many factors, including appetite, food availability, family, peers, and cultural practices, and attempts at voluntary control. Dieting to a body weight leaner than needed for health is highly promoted by current fashion trends, sales campaigns for special foods, and in some activities and professions. Eating disorders involve serious disturbances in eating behaviour, such as extreme and unhealthy reduction of food intake or severe overeating, as well as feelings of distress or extreme concern about body shape or weight.
    Eating disorders are not due to a failure of will or behaviour; rather, they are real, treatable medical illnesses in which certain maladaptive (适应不良的) patterns of eating take on a life of their own. The main types of eating disorders are anorexia nervosa (厌食症) and bulimia nervosa (暴食症).  A third type, binge-eating (暴食行为) disorder, has been suggested but has not yet been approved as a formal psychiatric diagnosis. Eating disorders frequently develop during adolescence or early adulthood, but some reports indicate their onset can occur during childhood or later in adulthood.
    Eating disorders frequently co-occur with other psychiatric disorders such as depression, substance abuse, and anxiety disorders. In addition, people who suffer from eating disorders can experience a wide range of physical health complications, including serious heart conditions and kidney failure which may lead to death. Recognition of eating disorders as real and treatable diseases, therefore, is critically important.
    Females are much more likely than males to develop an eating disorder. Only an estimated 5 to 15 percent of people with anorexia or bulimia and an estimated 35 percent of those with binge-eating disorder are male.
Anorexia Nervosa
    An estimated 0.5 to 3.7 percent of females suffer from anorexia nervosa in their lifetime. Symptoms of anorexia nervosa include:
    resistance to maintaining body weight at or above a minimally normal weight tot age and height
    intense fear of gaining weight or becoming fat, even though underweight
    disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight
    infrequent or absent menstrual periods (in females who have reached puberty [青春期])
    People with this disorder see themselves as overweight even though they are dangerously thin. The process of eating becomes an obsession. Unusual eating habits develop, such as avoiding food and meals, picking out a few foods and eating these in small quantities, or carefully weighing and portioning food. People with anorexia may repeatedly check their body weight, and many engage in other techniques to control their weight, such as intense and compulsive exercise, or purging by means of vomiting and abuse of laxatives, enemas, and diuretics. Girls with anorexia often experience a delayed onset of their first menstrual period.
Bulimia Nervosa
    An estimated 1.1 percent to 4.2 percent of females have bulimia nervosa in their lifetime. Symptoms of bulimia nervosa include:
    recurrent episodes of binge eating, characterized by eating an excessive amount of food within a discrete period of time and by a sense of lack of control over eating during the episode
    recurrent inappropriate compensatory behaviour in order to prevent weight gain, such as self-induced  vomiting or misuse of laxatives, diuretics, enemas, or other medications (purging); fasting; or excessive exercise
    the binge eating and inappropriate compensatory behaviour both occur, on average, at least twice a week for 3 months
    self-evaluation unduly influenced by body shape and weight Because purging or other compensatory behaviour follows the binge-eating episodes, people with bulimia usually weigh within the normal range for their age and height. However, like individuals with anorexia, they may fear gaining weight, desire to lose weight, and feel intensely dissatisfied with their bodies. People with bulimia often perform the behaviours in secrecy, feeling disgusted and ashamed when they binge, yet relieved once they purge (催泻).
    Binge-Eating Disorder
    Community surveys have estimated that between 2 percent and 5 percent of Americans experience binge-eating disorder in a 6-month period. Symptoms of binge-eating disorder include:
    recurrent episodes of binge eating, characterized by eating an excessive amount of food within a discrete period of time and by a sense of lack of control over eating during the episode
    the binge-eating episodes are associated with at least 3 of the following: eating much more rapidly than normal; eating until feeling uncomfortably full; eating large amounts of food when not feeling physically hungry; eating alone because of being embarrassed by how much one is eating; feeling disgusted with oneself, depressed, or very guilty after overeating
    marked distress about the binge-eating behaviour
    the binge eating occurs, on average, at least 2 days a week for 6 months
    the binge eating is not associated with the regular use of inappropriate compensatory behaviour (e.g., purging, fasting, excessive exercise)
People with binge-eating disorder experience frequent episodes of out-of-control eating, with the same binge-eating symptoms as those with bulimia. The main difference is that individuals with binge-eating disorder do not purge their bodies of excess calories. Therefore, many with the disorder are overweight for their age and height. Feelings of self-disgust and shame associated with this illness can lead to bingeing again, creating a cycle of binge eating.
    Treatment Strategies
    Eating disorders can be treated and a healthy weight restored. The sooner these disorders are diagnosed and treated, the better file outcomes are likely to be. Because of their complexity, eating disorders require a comprehensive treatment plan involving medical care and monitoring, psychosocial interventions, nutritional counselling and, when appropriate, medication management. At the time of diagnosis, the clinician (临床医生) must determine whether the person is in immediate danger and requires hospitalization.
    Treatment of anorexia calls for a specific programme that involves three main phases: (1) restoring weight lost to severe dieting and purging; (2) treating psychological disturbances such as distortion of body image, low self-esteem, and interpersonal conflicts; and (3) achieving long-term remission and rehabilitation, or full recovery. Early diagnosis and treatment increases the treatment success rate. The acute management of severe weight loss is usually provided in an inpatient hospital setting, where feeding plans address the person’s medical and nutritional needs. In some cases, intravenous (静脉注射的)  feeding is recommended. Families are sometimes included in the therapeutic process.
    The primary goal of treatment for bulimia is to reduce or eliminate binge eating and purging behaviour. To this end, nutritional rehabilitation, psychosocial intervention, and medication management strategies are often employed. Establishment of a pattern of regular, non-binge meals, improvement of attitudes related to the eating disorder, encouragement of healthy but not excessive exercise, and resolution of co-occurring conditions such as mood or anxiety disorders are among the specific aims of these strategies. Individual psychotherapy (心理疗法), group psychotherapy, and family or marital therapy have been reported to be effective.
    People with eating disorders often do not recognize or admit that they are ill. As a result, they may strongly resist getting and staying in treatment. Family members or other trusted individuals can be helpful in ensuring that the person with all eating disorder receives needed care and rehabilitation. For some people, treatment may be long term.
The sooner eating disorders are treated, the better______.
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答案the outcomes are likely to be
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