ARE WE REALLY IN CONTROL?

[WendyT]

Ok this has crossed my mind as well as my stomach and it is not all to common.

Have any of your pt's you have had to deal with on a call that was a Binge eater?

You get a call for a moderate to a very large frame sized person, they are claming they arent feeling very well and so you do your whole 9 yards of assessment and you ask them questions, sometimes they will tell you and some dont.

The case is probably clear about other things, but really and truly like anorexia, binge eating is a hidden cause factor, where anorexia is easy to establish just by looking at these really very thin people and maybe not all the time.

We all have a hidden secret, mine is binge eating, when to recognize when a family member is eating more than they should and for those who dont have any family, anybody die from this that you know of?

I'm curious . . .

[Bethadone]

Terri Schiavo's death (the original cardiac arrest that led to the brain damage and subsequent coma) was due to a potassium imbalance from bulimia. There have been other cases, but it is fairly rare

Excessive vomiting in any patient (whether bulimic or from other causes) will cause electrolyte imbalances, deydration and vitamin and mineral deficiencies. Electrolyte imblances especially can put the patient at a high risk of arrythmias, plus bulimia is often accompanied by laxative, emetic and diuertic abuse which puts the patient at further risk of cardiac complications.

I personally haven't had a patient suffering from complications of bulimia but I suppose it is something EMS providers should be aware of as a young female isn't a 'typical' cardiac patient but could be suffering cardiac complications.

In terms of binge eating disorder, I've heard of people eating to the point that the stomach actually ruptures. Hellooooo sepsis.

A good tip off that your patient may be bulimic would be the rotting teeth and vomit breath.

[VentMedic]

We all have a hidden secret, mine is binge eating, when to recognize when a family member is eating more than they should and for those who dont have any family, anybody die from this that you know of?

I know a couple of regular patients, young women in their 20s, that now have multiple problems including cardiac arrhymias and esophogeal errosion. Unless they can get their psychological problems of image under control soon, their physical problems probably won't let them live past 28. We also see cardiac problems from patients taking many diet aides along with their binging.

The Karen Carpenter Story is an excellent movie and true story. I am in that generation that watched her weight yo-yo over the years and literally die slowly in plain public view for all to see. Yet, in the 1970s and beginning of 1980s, bulimia and anorexia were not talked about.

[WendyT]

I wonder how many people that are in EMS that have something like this and not so much bullimia or anorexia. But something along the line of binge eating or starvation.

[bleep]

WendyT said: "I wonder how many people that are in EMS that have something like this and not so much bullimia or anorexia. But something along the line of binge eating or starvation."

uhhh binge eating... starvation.... = anorexia.

[Eydawn]

I think we've got some terminology confusion here.

Bulemia is defined as periods of binge eating followed by subsequent purging, via vomiting, laxatives, and/or heavy exercise (or any combination of the three). It can exist on its own, without intermittent periods of decreased food intake.

Anorexia is defined as purposeful abstinence from food to achieve an ideal body appearance or weight. It may include strict calorie counting, abstinence from certain food types or groups altogether, eating only lettuce, and various other manifestations. It can also include cessation of food intake- period. Anorexia may also exist on its own, without intermittent binging periods.

Often, anorexia and bulemia will manifest together; a person will cycle from one of these behaviors to another.

Binge eating is a behavior in which people will spontaneously overeat a certain food item or a large number of items. It is not followed by purging. If it is, it is bulemia. Many people will go on diets and not eat dessert, and then relapse and binge on nothing but desserts. Binge eating periods vary from a few hours to weeks, and are often accompanied by significant weight gain.

These behaviors often have psychological causes. If you are experiencing some of these behaviors, seeing a qualified professional would be beneficial to you. It's not about the weight, or the body image... it's usually about control. Hence why you get girls literally dying of starvation with lanugo (fine downy yellowish hairs) all over their bodies... that isn't the image they're going for, it's about controlling something...

Until you get help for the underlying psychological issue, you will probably not get the behavior under control. Support groups can also be useful. Google is your friend... there are many forums and groups on these issues.

WARNING- there are forums out there in cyberland that are pro-anorexia groups and promote the anorexic lifestyle. Please, don't stay there too long... it won't help you.

Knew that my psych class would come in handy at some point...

Wendy

CO EMT-B