Page 81 Complete Your CE Test Online - Click Here Incidence and prevalence of eating disorders Eating disorders can affect anyone of any age, gender, or socioeconomic status. In the United States alone, a clinically significant eating disorder affects an estimated 20 million females and 10 million males at some time in their lives[5] . Historically, more women than men suffered from eating disorders. However, the rate of occurrence among men is increasing. Research shows that the number of teen-age males dissatisfied with their bodies has tripled over the last 25 years. Both males and females with eating disorders have distorted senses of body image and exhibit many of the same signs and symptoms. However, males are less likely to be accurately diagnosed because many people, including some healthcare professionals, view eating disorders as female diseases[5,6] . There are often different types of body image concerns in males compared to females. While females with eating disorders are generally obsessed with losing weight, some males may have a disorder characterized by an obsession with becoming more muscular. This disorder is referred to as body dysmorphic disorder (BDD) (sometimes called muscle dysmorphia). To increase their muscle mass, males with this disorder are often likely to use steroids or other types of dangerous drugs to increase muscle mass and “bulk up”[6] . EBP alert! Research shows that 50% of males with muscle dysmorphia abuse steroids in attempts to add muscle mass to their bodies. In addition to using injectable steroids, some males use what are advertised as “natural” protein powders and supplements as well. These powders and supplements are not regulated by the food and Drug Administration (FDA), may contain unhealthy and even dangerous ingredients, and may also cause adverse side effects[6] . Nurses and other healthcare professionals must be alert to steroid use and ask about such use when evaluating nutritional status. Nursing consideration: Some members of not only the general public but also of the healthcare provider community may not recognize how the problem of eating disorders among males has increased. Nurses have a serious obligation to educate clients, families, and professional colleagues about the existence of these types of disorders in both males and females. Statistics pertaining to eating disorders show the incidence, prevalence, and some of the dangers of these diseases[5,6,7] : ● ● 95% of all eating disorders begin at adolescence. ● ● The rate of new cases of eating disorders has been increasing since 1950. ● ● It is common for eating disorders to occur in conjunction with other mental health disorders: ○ ○ Alcohol and other substance abuse disorders are four time more common in persons with eating disorders than in the general population. ○ ○ Depression and other mood disorders are often found to co- exist in persons with eating disorders. ○ ○ There is a significant increase in risk for persons with eating disorders to develop obsessive-compulsive disorder. ● ● The incidence of anorexia in young women ages 15-19 has increased in each decade since 1930. ● ● By the age of six, girls in particular express worries about their own weight or body shape, and 40 to 60% of elementary school girls are worried about their weight or about becoming too fat. ● ● One in 200 American women suffers from anorexia nervosa. ● ● Two to three in 100 American women suffer from bulimia nervosa. ● ● 35% of “normal dieters” progress to pathological dieting, with 20- 25% of these people progressing to partial or full-syndrome eating disorders. ● ● One in four eating disorders now occurs in males. ● ● 38% of teen males report that they would sacrifice at least a year of their life for a perfect body. ● ● 31% of male teens report binge eating, purging or overeating. Adolescents are particularly vulnerable to the development of eating disorders. Physical appearances, as well as being popular and attractive are especially important to this age group. Eating disorders may start with the belief that dieting and losing weight will make them popular, attractive, and happy. As weight loss occurs and they receive compliments about their slimmer appearance, susceptible adolescents may be tempted to carry weight loss to extremes. Still other adolescents may turn to food as a means of compensation for feelings of inadequacy, resulting in weight gain and even obesity[2,3,4] . The statistics pertaining to treatment and mortality are very disturbing. Anorexia has the highest mortality rate of any mental illness. Research shows that 5-10% of people with anorexia nervosa die within 10 years of developing the disease, and 18 to 20% will be dead within 20 years of developing the disease[5] . Statistics regarding recovery from eating disorders indicate that only 30 to 40% of persons with anorexia nervosa ever fully recover from the disease. Additionally[5] : ● ● Only one in 10 people with an eating disorder receive treatment for the disorder. ● ● The mortality rate among people with anorexia nervosa has been estimated at 0.56% annually, or about 5.6% per decade. ● ● The death rate for anorexia nervosa is approximately 12 times higher than the annual death rate due to all causes of death among females ages 15-24 in the general population. ● ● Without treatment, as many as 20% of people with serious eating disorders will die. With treatment the mortality rate decreases to 2 to 3%. What causes eating disorders? There is no simple answer to this question. Researchers believe that eating disorders are the result of a complex combination of factors including genetic, biological, behavioral, psychological, and social issues[3] . Researchers are investigating the following factors that may contribute to the development of eating disorders[8] : ● ● Biological factors: Specific chemicals in the brain control hunger, appetite, and digestion. In persons with eating disorders these chemicals may be imbalanced. ● ● Genetics: Eating disorders are often found to run in families. Evidence indicates that there are major genetic contributions to eating disorders. ● ● Psychological factors: Stress, loneliness, depression, anxiety, anger, low self-esteem, and/or feelings of lack of control or inadequacy contribute to eating disorders. ● ● Social factors: Society glorifies thinness in women and muscularity in men. The media helps to perpetuate this glorification to the point that even young children are consumed with worry about their weights. Eating disorders have some commonalties. But it is important to study each disorder for those issues that are specific to development, recognition, and treatment.