Eating Disorders

Abstract

Anorexia nervosa (AN) is characterized by a restriction of energy intake leading to substantial weight loss. Bulimia nervosa (BN) is characterized by repeated binge eating, usually followed by recurrent inappropriate compensatory behavior, such as purging. The primary care physician’s role is to recognize the physical and psychological consequences of the eating disorder, to explain the consequences of the disease to the patient, to involve the family, and to cooperate with a psychotherapist. At the core of the disease, there often lies a desperate struggle for autonomy, control and self-esteem with hardly admitted dependency wishes. A third eating disorder, binge eating disorder (BED), is characterized by episodes of binge eating. Patients experience a loss of control over eating and eat without hunger, mostly alone and with subsequent feelings of shame and guilt. In contrast to BN, there is no compensatory behavior such as vomiting. Etiology is multifactorial. On a psychological level, difficulties with the affect regulation, low self-esteem, and interpersonal difficulties are at the core of the psychopathology.