Anorexia and eating disorders

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Anorexia or anorexia nervosa is a mental disorder involving distorted thoughts around food, eating or body weight combined with reducing food intake and/or other behaviors that lead to sufferer being significantly underweight.[1][2] Other eating disorders include bulimia or bulimia nervosa,[3][4] which involves intentional vomiting or purging food to avoid weight gain; binge eating disorder,[5][6] and orthorexia[7][8][9] (eating an extremely restricted diet based on fear of eating "unhealthy" foods) and other specified feeding or eating disorder (OSFED).[10]

Anorexia and ME/CFS[edit | edit source]

Anorexia or abnormal appetite is listed as a possibleneuroendocrine system symptom in the Canadian Consensus Criteria for ME/CFS.

Digestive problems are very common symptoms in ME/CFS, and may some cause changes in eating behaviors or weight.

Severe myalgic encephalomyelitis/chronic fatigue syndrome can also cause

  • dysphagia (swallowing difficulties or an inability to swallow)[11]
a symptom also found in some people after a stroke, and in multiple sclerosis and Parkinson's diseases[12]
this may cause a reluctance to eat/swallow in severe cases[13]

These swallowing and eating symptoms can lead to the sufferer becoming severely underweight; this can cause a misdiagnosis of anorexia[14] or another eating disorder, which may lead to inappropriate treatment.

Some people severely affected by ME/CFS need feeding tubes or artificial nutritional, and may become severely underweight purely as a result of their ME/CFS symptoms, and may starve to death.[15] This is also the case for some people with anorexia or eating disorders.

Children and "refusal" to eat[edit | edit source]

Some parents have reported that their child’s swallowing difficulties or vomiting have resulted in medical professionals interpreting these ME/CFS as an indicator of a mental disorder, for example some children originally diagnosed with chronic fatigue syndrome have had their diagnosis changed to Pervasive Refusal Syndrome because they were wrongly judged as "refusing" to eat, wash, or increase their activity levels.[16][14]

Our son’s main symptom was dizziness / orthostatic intolerance and abnormal gait which he adopted because of his dizziness. We were told that as neurological examination was normal there must be a psychological element to his problems (this was from a very eminent Consultant Paediatric Neurologist).

When we finally had to give in and admit him to hospital he was too weak to swallow his own saliva and had lost 20% of his body weight. Within 24 hours of admission he developed myoclonic jerks. We were asked whether he had a negative body image (ie was he anorexic) and whether we thought he was ‘putting on’ the muscle jerks. HELP! Please educate the Doctors and Nurses.

— From a family outside Essex, UK, Our needs, our lives (2003)[17]

Prevalence[edit | edit source]


Symptom recognition[edit | edit source]

Whitney Dafoe is an American photographer who has very severe ME, which causes him to remain severely underweight. Whitney can no longer speak, eat, or have contact with anyone but his parents due to visual dysfunction. Whitney is fed via a TPN and needs full time care.
Merryn Crofts was bedbound and unable to eat. Merryn weighed six stone (84 lbs) at her death; her autopsy revealed ganglia inflammation. It is suspected that in the later years of her illness Merryn also suffered from EDS and MCAD. Her death certificate is the 2nd in the UK to attribute a death to ME

Anorexia is recognized as a possible symptom in the Canadian Consensus Criteria for ME, but is not regarded as a diagnostic symptom.[13] A number of patient groups have raised concerns that anorexia may be a misdiagnosis in some patients with ME, particularly children or young people, and the severely ill.[14]

Digestive symptoms problems are well recognized, particularly irritable bowel syndrome, and food intolerances, and are optional diagnostic criteria. Common ME/CFS symptoms which may cause changes in eating or weight include:

Notable studies[edit | edit source]

There do not appear to be any significant studies assessing swallowing or eating issues in patients with ME/CFS, or investigating the presence of comorbid eating disorders, or the potential misdiagnosing of eating disorders, although there are many different accounts from patients or their carers/parents.

Byron and Hyde have started that enteroviruses may disrupt swallowing reflexes.[12]

Possible causes[edit | edit source]

See also[edit | edit source]

Learn more[edit | edit source]

References[edit | edit source]

  1. "Anorexia Nervosa". National Eating Disorders Association. Feb 25, 2017. Retrieved Feb 25, 2019. 
  2. "Anorexia nervosa - Symptoms and causes". Mayo Clinic. Retrieved Feb 25, 2019. 
  3. "Bulimia Nervosa". National Eating Disorders Association. Feb 26, 2017. Retrieved Feb 25, 2019. 
  4. "Bulimia nervosa - Symptoms and causes". Mayo Clinic. Retrieved Feb 25, 2019. 
  5. "Binge Eating Disorder". National Eating Disorders Association. Feb 26, 2017. Retrieved Feb 25, 2019. 
  6. "Mental Health and Binge Eating Disorder". WebMD. Retrieved Feb 25, 2019. 
  7. "orthorexia at DuckDuckGo". Retrieved Feb 25, 2019. 
  8. Hill, Amelia (Aug 15, 2009). "Pure food obsession is latest eating disorder". The Observer. ISSN 0029-7712. Retrieved Feb 25, 2019. 
  9. Bratman, Steven (Jan 23, 2014). "What is Orthorexia? | Orthorexia". Retrieved Feb 25, 2019. 
  10. "Other Specified Feeding or Eating Disorder". National Eating Disorders Association. Mar 21, 2017. Retrieved Feb 25, 2019. 
  11. The Grace Charity for M.E.; The 25% ME Group (Jan 2019). "KNOWLEDGE IN THE HOPE OF PROTECTING M.E. SUFFERERS FROM UNNECESSARY SECTIONING". ... the terrible act of sectioning sound minded M.E. patients who are neither a threat to themselves nor to others ... 
  12. 12.012.1 The 25% ME Group (Summer 2018), "Drs. Byron Hyde and John Chia - Questions and Answers", The Quarterly Newsletter, 25 Percent ME Group, p. 10, Some M.E. specialist researchers believe that the gastric mucosa which is infected with enteroviruses may reach the brain by travelling up the vagus nerve, which controls the swallowing reflex. 
  13. Carruthers, Bruce M.; Jain, Anil Kumar; De Meirleir, Kenny L.; Peterson, Daniel L.; Klimas, Nancy G.; Lerner, A. Martin; Bested, Alison C.; Flor-Henry, Pierre; Joshi, Pradip; Powles, A C Peter; Sherkey, Jeffrey A.; van de Sande, Marjorie I. (2003). Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols (PDF). Journal of Chronic Fatigue Syndrome. 11. p. 7-115. doi:10.1300/J092v11n01_02. 
  14. Colby, Jane. "ME - The Illness and Common Misconceptions: Abuse, Neglect, Mental Incapacity. A summary originally produced for the legal profession" (PDF). Tymes Trust. Retrieved Feb 25, 2019. 
  15. ME sufferer who was dismissed as hysterical vindicated in death’ The Times 29 May 2018 by Lucy Bannerman; also The Quarterly published by the 25% ME Group Summer 2018 pages 22-23
  17. Tymes Trust (2003). "Our Needs Our Lives" (PDF). 

The information provided at this site is not intended to diagnose or treat any illness.
From MEpedia, a crowd-sourced encyclopedia of ME and CFS science and history.