The idealization of an extremely skinny body in the fashion world, television, press, and social media resulted in the rise in the number of individuals with eating disorders (EDs). ED is a group of syndromes associated with psychological illnesses and abnormal eating behavior resulting in unhealthy weight changes (Qian et al., 2021). It includes such diseases as anorexia nervosa (AN), bulimia nervosa (BN), and eating disorders not otherwise specified (EDNOS) (Qian et al., 2021). According to Streatfeild et al. (2021), the prevalence of these psychiatric conditions in the United States is 4.6%, in Asian countries, 3.5%, and in Europe, about 2.2% (p. 852). Moreover, the worldwide statistical data showed that the lifetime frequency of EDs among females was almost 3.5 times higher than in males (Qian et al., 2021). This paper aims to compare the statistics of EDs in the U.S. and Puerto Rico and discuss ways health professionals can contribute to improving the nutritional health of these patients. ED is a serious problem that affects people’s mental and physical well-being; hence, measures should be taken to help individuals with this condition to shift to healthier nutritional patterns.
The prevalence of EDs in the United States is relatively high. Specifically, the number of patients with these disorders in the U.S. in 2019 was 5.5 million, 80% of which were females, and 20% were males (Streatfeild et al., 2021, p. 858). Most of them belonged to the age group of 20-29 years old (Streatfeild et al., 2021). Furthermore, it was estimated that more than 10,000 deaths were associated with EDs during that calendar year, and the mortality increased with patients’ age (Streatfeild et al., 2021). The two most prevalent diseases were AN and BN among all ages, which are described as restrictive eating and overeating and purging, respectively (Streatfeild et al., 2021). The economic costs of EDs are significant and include both medical bills and efficiency losses. For instance, the annual cost of EDs in the United States was estimated to be almost $65 billion (Streatfeild et al., 2021, p. 858). It appears that Americans struggle with this psychiatric disorder at approximately the same level as with the obesity epidemic.
Although Puerto Ricans are less affected by this problem than people in the U.S., the number of ED patients was noticeably high. Specifically, the statistical data from 2019 showed that the prevalence of these disorders in Puerto Rico was about 0.3%, which was equal to about 10,000 individuals with EDs (Our World in Data, 2019b). This number includes AN, BN, and EDNOS among all ages and genders. The mortality rate associated with EDs was below 0.01 in 2019, lower than in the United States (Our World in Data, 2019a). Puerto Rico is less affected by the EDs than the U.S. Still, individuals with this psychiatric issue should receive appropriate assistance to overcome this disease.
The goal of any health practitioner is to recognize and address the eating behavior abnormalities that their patients may have. ED should be managed because the complications that these patients develop due to their dysfunctional nutrition may be fatal. For example, the medical problems associated with AN include anemia, neutropenia, osteoporosis, hypokalemia, hypophosphatemia, hypoglycemia, cardiac dysfunction, infectious diseases, immune dysfunction, and hormonal abnormalities (Guinhut et al., 2021). Therefore, the treatment should be aimed not only to stabilize these individuals when they are hospitalized but also to provide them assistance in normalizing their nutrition. It is essential to understand that these patients have a psychological barrier that prevents them from eating an adequate amount of food without counting calories or thinking about purging or using laxatives in case of BN. Thus, the initial recommended amount should be as low as 10 kcal per kilogram of weight, which should gradually increase to 30 kcal (Guinhut et al., 2021). Once the complications are managed and nutritional balance is attained, clinicians should help these individuals to be accustomed to eating balanced meals daily.
As a health professional, I can also contribute to resolving this problem by helping ED patients to improve their nutrition. The first thing that I would do after these individuals are stabilized and not in acute distress is to schedule them for individual therapy so that they can discuss their concerns with a professional. Furthermore, I would try to help them by consulting with a nutritionist and preparing a weekly menu of balanced meals that will allow them to attain a healthy weight. Another thing that I can recommend for these individuals is engaging in physical training to rebuild their muscle mass. Lastly, starting a new hobby or community work may be useful for them to change their mindsets and recover from this mental illness.
In summary, eating disorders are severe and complex psychiatric conditions that may harm people’s emotional and physical health. Notably, despite the common misconception, it is not only the disease of the developed world because the prevalence is relatively high worldwide. Although fewer people are affected by EDs in Puerto Rico than in the United States, these patients still require professional help to overcome this problem and return to a healthy weight and eating habits. Overall, after the acute complications associated with EDs are managed, it is essential to create refeeding and exercise programs for these individuals to assist them in resolving this issue.
References
Guinhut, M., Melchior, J. C., Godart, N., & Hanachi, M. (2021). Extremely severe anorexia nervosa: Hospital course of 354 adult patients in a clinical nutrition-eating disorders unit. Clinical Nutrition, 40(4), 1954-1965. Web.
Our World in Data. (2019a). Death rates from eating disorders, 1990 to 2019. Web.
Our World in Data. (2019b). Number of people with an eating disorder, 1990 to 2019. Web.
Qian, J., Wu, Y., Liu, F., Zhu, Y., Jin, H., Zhang, H., Wan, Y., Li, C., & Yu, D. (2021). An update on the prevalence of eating disorders in the general population: A systematic review and meta-analysis.Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 27, 415-428.Web.
Streatfeild, J., Hickson, J., Austin, S. B., Hutcheson, R., Kandel, J. S., Lampert, J. G., Myers, E. M., Richmond, T. K., Samnaliev, M., Velasquez, K., Weissman, R. S., & Pezzullo, L. (2021). Social and economic cost of eating disorders in the United States: Evidence to inform policy action.International Journal of Eating Disorders, 54(5), 851-868.Web.