Anorexia and Bilumia

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Introduction Anorexia nervosa and bulimia nervosa are the two main eating disorders. Anorexia nervosa and bulimia nervosa are similar in that there is an inaccurate perception of body weight, size or shape and/or marked over-concern about body weight, size or shape. However, there are differences. Anorexia nervosa is characterized by voluntary maintenance of unhealthy low weight (less than 85% of expected), cessation of menstrual periods for at least three cycles (amenorrhea), and an intense fear of weight gain or becoming fat. On the other hand, bulimia nervosa is characterized by inappropriate weight reducing behavior (vomiting, laxative or diuretic abuse, excessive exercise, fasting) at least twice a week and large uncontrolled binge eating at least twice a week. In spite of this extreme weight loss, people with these eating disorders usually believe they are fat and are terrified of becoming what is in fact a normal weight or shape. Anorexia nervosa most commonly starts in the mid-teens. About one in a hundred 16 to 18 year olds has the illness. It is much more common in girls. Bulimia nervosa usually starts when people are a little older, but is again more common in girls. Bulimia is more common than anorexia, although people with anorexia in particular do not always ask for treatment. The average prevalence of bulimia nervosa and anorexia nervosa in young females in developed countries is 1% and 0.3% respectively. Countries where eating disorders are common include Japan, South Korea, Thailand, China, Taiwan, Hong Kong, Singapore, India, Pakistan, Egypt and Israel. It is also difficult to identify a person with eating disorders, especially Asians, because the females tend to be thinner and have a smaller frame. Although there is no local data, it is believed the prevalence in Malaysia is not very far off these rates. Occasionally men develop eating

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