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Eating disorders are a range of psychological conditions characterized by abnormal eating habits that can have a negative impact on physical and emotional health. In Hong Kong, about 1 out of 200 schoolgirls suffer from anorexia nervosa, its occurrence is significantly higher, up to 6%, among ballet dancers or models. In contrast, bulimia nervosa is 5-10 times more prevalent than anorexia nervosa, affecting around 2-3% of young women. According to the report from Hong Kong Eating Disorders Association in 2022, which found among those cases, approximately 33% were diagnosed with anorexia, 24% were diagnosed with bulimia, while 6% were diagnosed with binge eating. In which, 96.6% are females and over 50% were between the ages of 16 and 25.

Here are the three most common types of eating disorders:

1) Anorexia nervosa: A condition in which a person fear of gaining weight, severely restricts one’s energy intake, and the use of purging behaviors such as self-induced vomiting or laxative abuse after meals. Patients with anorexia nervosa typically weigh 15% less than the normal weight range for their height, yet still perceive themselves as overweight. Prolonged starvation and malnutrition can cause brittle hair and nails, yellowing skin, anemia, osteoporosis, constipation, cold hands and feet, menstrual irregularities, and depression. Research indicates that individuals with anorexia nervosa frequently lacking essential nutrients such as calcium, vitamin D, and potassium.

2) Bulimia nervosa: Patients exhibit uncontrollable overeating behavior, often eating rapidly until they exceed their stomach’s capacity or feel sleepy. To avoid weight gain, patients frequently use laxatives, diuretics and induce vomiting after meals. Most patients with bulimia nervosa have normal body weight, while a minority are overweight. However, due to frequent vomiting, patients may experience chronic inflammation of the throat, erosion of teeth from stomach acid, frequent acid reflux, and loss of essential minerals such as potassium and chloride. Studies have shown that patients with bulimia nervosa are at a higher risk of magnesium, zinc, and vitamin B6 deficiencies.

3) Binge eating disorder: Patients with binge eating disorder experience uncontrollable episodes of consuming large amounts of food within a short period, typically within two hours. Unlike individuals with bulimia nervosa, those with binge eating disorder do not engage in compensatory behaviors such as purging to lose weight. Due to excessive calorie and nutrient intake, most patients with binge-eating disorder are overweight or even obese, which increases their risk for cardiovascular and other metabolic diseases such as insulin resistance and type 2 diabetes. Studies have shown that individuals with binge eating disorder tend to have a lower intake of fiber, vitamin A, vitamin C, vitamin E, magnesium, and potassium.

Proper nutrition is essential in the prevention, treatment, and recovery from eating disorders. Individuals with eating disorders often have inadequate nutrient intakes, which can contribute to a range of health problems. Studies have shown that a healthy diet, rich in fruits, vegetables, whole grains, and lean protein, can support mental health and help to reduce symptoms of depression and anxiety. Furthermore, research has shown that certain nutrients, such as omega-3 fatty acids and vitamin D, may have a protective effect against the development of depression and other mental health conditions.

A study published in the Journal of the Academy of Nutrition and Dietetics found that nutrition counseling was effective in improving the dietary intake and nutritional status of individuals with eating disorders. Nutrition therapy aims to provide individuals with the knowledge and skills to make healthy food choices and develop a healthy relationship with food. As well establish healthy eating habits, recover from malnutrition, and improve their physical and mental health.

References:

1. National Institute of Mental Health. (2018). Eating disorders. Retrieved from [https://www.nimh.nih.gov/health/topics/eating-disorders/index.shtml]
2. National Eating Disorders Association. (n.d.). What are eating disorders? Retrieved from [https://www.nationaleatingdisorders.org/warning-signs-and-symptoms]
3. Hong Kong Eating Disorders Association. (2022). Annual report 2021-22. Retrieved from [https://www.heda-hk.org/index.php?option=com_content&view=article&id=436&p=112]
4. Robinson, L., Holt, C., & Weatherall, R. (2016). Nutritional deficiencies in anorexia nervosa: A review. Australian Family Physician, 45(7), 492-496.
5. Galmiche, M., Déchelotte, P., & Lambert, G. (2019). Tackling malnutrition in anorexia nervosa: Challenges and solutions. Journal of Multidisciplinary Healthcare, 12, 209-221.
6. Telch, C. F., Agras, W. S., & Rossiter, E. M. (1987). Binge eating: Characteristics and response to behavioral treatment. Journal of Consulting and Clinical Psychology, 55(5), 645-651.
7. Penckofer, S., Kouba, J., Byrn, M., Estwing Ferrans, C., & Lustman, P. (2010). Vitamin D and depression: Where is all the sunshine? Issues in Mental Health Nursing, 31(6), 385-393.
8. Grosso, G., Galvano, F., Marventano, S., Malaguarnera, M., Bucolo, C., Drago, F., & Caraci, F. (2014). Omega-3 fatty acids and depression: Scientific evidence and biological mechanisms. Oxidative Medicine and Cellular Longevity, 2014, 313570.
9. Matheson, B. E., Bohon, C., Lock, J., & La Via, M. (2019). Nutrition education and counseling as an effective adjunct to family-based therapy for adolescents with anorexia nervosa: A pilot study. Journal of the Academy of Nutrition and Dietetics, 119(11), 1869-1877.