Unit II Children & Women in Sports

Common Postural Deformities - Knock Knee; Bow Legs; Flat Foot; Round Shoulders; Lordosis,
Kyphosis, and Scoliosis and their corrective measures
Special consideration (Menarche & Menstrual Dysfunction)
Female Athletes Triad (Osteoporosis, Amenorrhea, Eating Disorders)

CONCEPT AND ADVANTAGES OF CORRECT POSTURES

Correct posture means the balancing of body in accurate and proper manner while sitting,
standing, reading, writing etc.
According to Avery, “Good posture is one in which the body is so balanced as to produce least
fatigue”.
Correct Standing Postures: Some General Rules For Standing
1. Stand tall, maintain a straight back rather than bending to the side.
2. In standing position keep the feet about 8-10 inches apart.
3. The whole body should be erect, avoid bending forward or sideways.
4. Keep the chin up with the head centered over the shoulders, chest forward, and belly
backward and pressed inside.
5. Equal body weight on the both feet.
6. From the side, line of gravity must pass through ear, shoulder, hip, knee and ankle. In this
position muscles and ligaments remain stress free.
7. Wear comfortable shoes and leave the heels at home
Correct Sitting Postures: Some General Rules For Sitting
1.Sit tall and distribute your body weight evenly on both hips.
2. When we sit on a chair, our hips should be as a far back in the chair as possible and
shoulders rolled back.
3. Head, spinal-column, shoulder and hips should be in straight line and erect.
4. Feet should touch the ground and not in hanging position. Use a foot stool if feet are in
hanging position.
5. Thighs should be in horizontal position.
6. While we read, the book should be on table with approximate distance of 50cm between
book and eyes.
7. For writing, table should have slight inclination.
Correct posture of walking:
Some general rules of walking are:
1. Walk with erect neck and chest out.
2. Bending forward or sideways should be avoided.
3. Arms and Legs should make a proper alternate movement.
4. While walking one should lift foot properly.
5. While walking the lines of feet should be parallel to the line of direction.
6. Walking should be efficient and graceful, smoothness is essential in walking.
Correct posture of lying: Some general rules of lying are:
1. Normal size of pillow should be used by individual.
2. Hard bed is beneficial for those who have spinal problems.
3. We should sleep in such a state that there is not any difficulty in breathing.
4. We should not sleep on stomach because it has adverse effects on internal organs and
weakens the back muscles.
 Advantages of Correct Posture
Good posture is the sign of individual’s health. It helps to improve the personality of the person.
Following are the advantages of correct posture :
1.Physical fitness : Physical fitness can be attained easily by a person who is having a good
posture.
2. Physical appearance : Physical appearance depends upon the posture of the individual. A
person with good posture looks smart and attractive.
3.Grace and efficiency of movements : Physical posture plays a vital role in the field of sports
and games. It gives grace as well as efficiency of movements and helps in performance.
4.Economic value (efficient use of energy) : A person with good posture makes less expenditure
of energy while performing any type of activity in comparison to the person having bad posture.
5. Prevents disorders and diseases : Correct posture prevents low back pain , neck strain,
disturbance in blood circulation etc. Good posture reduces strain on spine.
6.Social value : The people who have good posture are usually admired in every society. They
can stand smart among the group. They do not hesitate in public dealing. People with bad
posture have a feeling of inferiority.
7.Change in mental attitude : Correct posture boosts up self confidence and self esteem while
as bad posture results in anxiety, unhappiness etc.
Some causes of bad postures are:
1) Accident-Because of the injury to bone, ligament and muscles faulty posture may remain
continue for a long time during healing process which might result in a deformity.
2) Habit-Wrong postural habits while sitting, standing, walking, studying, lying, etc may cause
poor posture
3) Disease- Chronic disease can causes loss of function in certain muscle groups which may
become a reason for developing deformed posture.
4) Age-Bad posture may arise during old age because of reduction in muscular strength like
kyphosis.
5) Diet-Improper diet may result in postural deformities.
6) Lifting heavy load: Lifting heavy load continuously on shoulder especially during growing
years may result in postural deformities.
7.) Lack of exercise- Exercises tone up the all muscle groups and help to maintain good
posture while as lack of exercise leads to postural deformities.
8) Obesity- Over weight of the body put extra stress on the body muscle which may result in
posture deformities.
5.6 COMMON POSTURAL DEFORMITIES – KNOCK KNEE ; FLAT FOOT ; ROUND SHOULDERS ;
LORDOSIS, KYPHOSIS, BOW LEGS AND SCOLIOSIS
Deformity is the malformation of any component or body part or joint of the body. Followings
are the common postural deformities:

1. Spinal Curvature
 This type of deformity is related to spine. This deformity is caused by carrying excessive weight
beyond capacity. There are three types of spinal deformities: (a) Kyphosis (b) Lordosis
(c) Scoliosis
(a) Kyphosis :
Kyphosis is a forward rounding of upper back. Some rounding is normal but the term
“Kyphosis” usually refers to and exaggerated rounding, more than 50 degrees. This deformity
is also called round back or hunch back.

Causes: Following are the causes of Kyphosis.

(i) Malnutrition.
(ii) Carrying heavy loads and Insufficient exercise.
(iii) Improper furniture.
(iv) Weak muscles.
(v)Bending while walking.
(vi)Wearing shapeless and tight cloths.
(vi)Non performance of exercise.

Precautions:- Following precautions can be taken to prevent Kyphosis

1.Proper diet should be taken.
2. Carrying heavy loads should be avoided and perform exercise.
3.Use suitable furniture.
4. Avoid Bending while walking.
5. Wear loose clothes.
6.Perform Exercise regularly.
Remedies: To correct this deformity the following points should take into consideration.
(i) Always keeps a pillow under your back while sleeping.
(ii)Bend your head backward in standing position.
(iii)Perform swimming.
(iv) Perform Dhanur asana, Chakra asana regularly.
(v). Sit in a normal position with a stick held in horizontal position over head, lower
the stick and then raise it behind head and shoulders. Repeat this 10 to 12 times.
(b) Lordosis :
Lordosis is an abnormal curvature of spine at front. It is a postural deformity in which the
lumbar region of spine bends in front beyond the normal level. Thus, abdomen is ahead of
body and shoulders come outward and sideward.
Causes of Lordosis : Following are the causes of lordosis.

(i) Imbalanced diet. (ii) Non-performance of exercise. (iii) Taking more food than required.
(iv) Overweight or obesity. (v) Diseases of spinal muscles.
Precautions-: Following precautions can be taken to prevent lordosis.
1. Balanced diet should be taken.
2. Perform Exercise regularly.
3. Excessive intake of food should be avoided.
4.Maintain your weight.
Remedies: To correct this deformity the following points should be taken into consideration.
 1. From standing position, bend forward from hip level. Repeat this exercise for 10 times.
3. Perform sit ups regularly .
4. Perform Halasana , Pashimaton asana and vipritkarni asana regularly.
5. Sit on a chair with feet wide apart. Bend and positing shoulders between knees then reach to the floor
under back of chair. Hold this position for some duration.
6. Sit in long sitting position bend forward and try to touch toes by fingers.
(c) Scoliosis :
Scoliosis is a sideways curvature of the spine that occurs most often during the growth spurt just before
puberty. It means bending, twisting or rotating of spine. Scoliosis causes one shoulder down and other
is raised up. Body weight is shifted to sideward and it causes lot of pressure on one side of the foot.

Causes: Following are the causes of scoliosis.

1. Lifting weight towards one side in routine. 2. Difference in the lengths of the legs.
3. Rickets 4 Unsuitable furniture 5. Partial deafness .6. Infantile paralysis
Precautions:- Following precautions can be taken to prevent
1. Avoid walking for long time while carrying weight in one hand.
2. Use suitable shoe sole to overcome the problem.
3.Balanced diet should be taken.
4..Use suitable furniture. 5. Use hearing aid.
Remedies: (i) Bending exercise should be performed in opposite direction of 'c' shaped
curve.
(ii) Ardh Chakra Asana : In this body is bent sideward while standing with feet apart. One hand
should be close to head.
(iii) Trikon Asana : In this, body is bent to sideward with feet apart while opposite hand try to
touch the feet and other hand is raised up.
(iv)Tad Asana : In this, body is raised up over the toes whereas hands are raised up while
looking up.
(v) By hanging on a horizontal bar.
(vi) Holding horizontal bar and swing body towards left and right.
(vii) Swimming by using breast stroke.

2. Knock Knees
Genu valgum, commonly called "knock-knee is a postural deformity in which the legs are bent
inward and knees touch each other while walking or running. In knock knees, the knees join
together while there is wide gap between the ankles varying directly with the degree of
deformity.
Causes :Following are the causes of knock knee:
1. Lack of balanced diet specially vitamin D, calcium and phosphorus.
2. Due to rickets and lack of exercise
3.Obesity during childhood.
4. Forcing babies to walk at very early stage.
5.Fractures and injuries involving the knee joint.
6.Flat foot.
Precautions: Following precautions can be taken to prevent knock knee.

1. Balanced diet should be taken.

2.Perform proper exercises.
 3.Maintain your weight.
4.Babies should not be forced to walk at very early age.

Remedies: To correct this deformity the following points should be taken into consideration.
I. Exercises related to Knock Knee
(i) Horse riding
(ii) Vriksh Asana : It is balancing on one foot while other leg is flexed resting on other leg
Hands are kept in front.
(iii) Akarn Dhanur Asana : In this asana the person stretches one leg near the ear whereas
other hand holds the opposite leg straight.
(iv) Padma Asana : It is sitting with crossed legs in such a way that feet should touch the opposite
hip while hands are on the knees and back is straight.
(v) Pillow Walking : In this pillow is kept between legs and person presses the legs.
(vi) Outward Walking : In this person tries to walk over the outer edges of foot while the inner
part of sole is raised up.
3. Flat Foot
It is a deformity in which the natural arch in the feet is missing .Flat foot is a postural
deformity in which the inner curve of foot has bulge more than normal. In this default the feet
of a person gives complete print of his foot sole over the plane surface.
Causes: Following are the causes of flat foot:
: (i) Weak muscles and lack of exercise.
(ii)Increase in body weight.
(iii)Using improper and high heeled shoes.
(iv) Carrying heavy weight for a longer period.
(v)Forcing babies to walk at very early stage.
(vi). Walking barefooted for long time
Precautions: - Following precautions can be taken to prevent flat foot.

1. Perform proper exercises.

2. Obesity should be avoided.

3. Use proper shoes and avoid high heeled shoes.

4. Carrying heavy weight in early childhood should be avoided
5.. Don’t force babies to walk at very early stage.
6 Don’t walk bare foot for long time.
Remedies: - To correct this deformity the following points should be taken into consideration.
1. Walking on heels.
2. Walking on inner side of feet.
3. Walking on toes.
4. Jumping on toes for some time.
5. Perform vajra & Tad asana
6.Picking up marbles with toes.
7.Writing with foot.
4. Round Shoulders
 Round Shoulders is a postural deformity in which the shoulders become round and sometimes
they seem to be bent forward.
Causes: Following are the causes of Round shoulders:
(i) Due to heredity and improper diet .
(ii)By wearing very tight clothes.
(iii)By sitting on improper furniture.
(iv) By walking, sitting and standing in bent position.
(v)Lack of proper exercise.
Precautions: Following precautions can be taken to prevent round shoulders.

1. Take balanced diet

2) Avoid tight fitting clothes.
3) Always use proper furniture to sit.
4) Don’t sit, stand and walk in bent position.

5.Perform regular exercise.

Remedies: To correct this deformity the following points should be taken into consideration.
. Exercises related to Round Shoulders
(i) Sit on a chair. Rest the back against it. Pull the shoulders backward and see upwards.
(ii) Keep your tips of fingers on your shoulders and rotate the elbows in clockwise and direction
for equal number of times.
(iii) Hold the horizontal bar for some time.
(iv) Keep your chin upward, head straight and chest forward while standing, walking and sitting.
(v) Chakra Asana : In this body is lifted up while hands and feet are on the surface.
(vi) Dhanur Asana : From lying position the upper and lower body is raised up with support
of hands. Body balances on the abdomen.
(vii) Bhujang Asana : From prolying position the upper part of body is raised up while looking up.
(viii) Ushtt Asana : From the position of Vajra asana body is bent backward while chest raised
up. Hands hold the ankle while looking back.

5. Bow Legs
It is a postural deformity. It is opposite to knock-knees. In this deformity knees are widely apart.
There remains a wide gap between knees when a bow legged person keeps his feet together.
It occurs during childhood.

Causes : (i) Rickets.

(ii)Deficiency of vitamin D and calcium.
(iii)Improper way of walking.
(iv)Obesity.
(v)Using defaulted footwear.
(vi)Forcing babies to walk at early stage.
Precautions : (i) Don’t carry heavy weight in childhood.
(ii)Babies should not be forced to walk at very early age.
(iii)Balanced diet should be taken.
 (iv)Always walk properly.
(v)Use good quality shoes.
Remedies : (i) Try to walk on the inner edge of the feet for some distance regularly.
(ii) Massage the legs.
iii) Walking Inward : Try to walk by bending the toes inward.
(iv) Ardh Chakra Asana : In this person starts bending sideward. One hand close to head while
other pushes the leg.
v) Garud Asana : In this body balances over one leg while other leg is rolled over the other leg.
Hands are also rolled in front of face.
(vi) Ardh Matasyendra Asana : In the crossed leg sitting position one leg is placed over the
other so that the foot touches the opposite hip whereas one hand supports the leg and other
rolls over the spine.
6.2 Special consideration (menarche, menstrual dysfunction)
Greater emphases on the benefits of exercise have led to a greater participation of women
in sport at all levels. While moderate exercise does provide valuable benefits, intensive
exercise associated with elite female athlete’s poses serious health risks to the female
body. The female reproductive system is very intricate and highly sensitive to physiological
stress. This increased stress level is often associated with several reproductive
abnormalities such as delayed menarche, menstrual dysfunction,
1. Menarche: It is the first menstruation, first menstrual cycle typically occurs by age 12-13
initially may involve anovulatory (An anovulatory cycle is a menstrual cycle during which
the ovaries do not release an oocyte). or irregular cycles. It signifies uterine maturity, not
reproductive maturity.
The increased diet intake is associated with accelerated menarche, while increased
intensive sports activity is associated with a delay in menarche. Female athletes who
participate in Gymnastics, swimming, and running experience delayed menarche than non-
athletes.
Delayed menarche in female athletes has many negative consequences. Low LH
(Luteinizing hormone), FSH (Follicle-stimulating hormone) and the larch levels (Breast
development).
2. Menstrual Dysfunction: Menstrual dysfunction or menstrual disorder is a physical or
emotional problem that interferes with the normal menstrual cycle, causing pain,
unusually heavy or light bleeding, delayed menarche, or missed periods. Female athletes
can experience disruptions to their normal menstrual cycle. Collectively these disruptions
are termed ‘menstrual dysfunction’
The terms used for dysfunction are:
1. Oligomenorrhea : Abnormally infrequent or little menstruation, or bleeding occurring at
intervals longer than 35 days.
2. Amenorrhea : Absence of menstruation and includes primary amenorrhea (absence of
menarche in girls aged 16 yrs and over) and secondary amenorrhea – absence of
menstruation for 3 or more consecutive cycles.
Exercise-induced or athletic menstrual dysfunction (amenorrhea, oligomenorrhoea, ,) is
more common in active women and can significantly affect health and
sports performance. Although athletic amenorrhea represents the most extreme form of
menstrual dysfunction, other forms can also result in suppressed estrogen levels and affect
bone health and fertility.
A number of factors, such as energy balance, exercise intensity and training practices,
bodyweight and composition, disordered eating behaviors, and physical and emotional
stress levels, may contribute to the development of athletic menstrual dysfunction.
Menstrual Cycle and Sports Participation: During the menstrual cycle women can
experience physical symptoms such as joint and muscle pain, headaches, low energy levels
and emotional symptoms such as insomnia, poor concentration, and irritability can also
appear disturbing to physical activity, especially at top levels of competition when even the
smallest margins can prove decisive.

6.3 Female Athletes Triad (Osteoporosis, Amenorrhea, Eating Disorders

According to American College of Sports Medicine (2007) “It is described as a medical
condition identified by the complex interaction between energy availability (with or
without eating disorders), menstrual function and bone

health.”
The female athlete triad: The “female athlete triad” is recognized as a syndrome that has
the potential to affect female athletes and consists of three inter-related disorders:
i) Osteoporosis ii) Amenorrhea (The Absence of Periods for more than 3 months)
iii) Disordered eating
Signs and Symptoms of Female Athlete Triad
1. General weakness and fatigue disordered eating.
2. Cold intolerance, dry skin, dehydration.
3 .Noticeable weight loss, cessation of menstrual cycle,
4 .Stress fractures and extended healing time from injuries.
5. Low self-esteem, Depression.

Who Is At Risk?
Possibly all physically active girls and women are at risk of developing one or more
components of the Triad. Biological changes, peer pressure, society’s drive for thinness and
body-image preoccupation that occur during puberty make adolescence the most
vulnerable time.
Participation in sports that emphasis on low body weight: Such sports include:
1 Sports in which performance is subjectively scored (e.g.Ballet dance, Figure Skating and,
Gymnastics etc)
2. Endurance sports emphasizing a low body weight (e.g. Distance running, Cycling)
3. Sports requiring shape revealing clothing for competition (e.g. Volleyball, Swimming and
Diving etc.)
4 Sports using weight categories for participants (e.g Lightweight Rowing, Judo, Taekwondo
etc.)
5.Peer pressure and society’s drive for thinness
Prevention of Female Athlete Triad: The best way to prevent the Female Athlete Triad from
happening is by educating athletes, coaches, and parents on the subject. This will allow
them to recognize it and take steps to prevent it.
As a coach:
1. Remind athletes that eating is an important part of successful training and performance
2. Focus on a healthy body image, and NOT on weight.
3. Support athletes through training and everyday life.
4. Have available resources such as nutritionists, trainers, or counselors.
As an athlete:
1. Monitor menstrual cycle by using a calendar.
2. Consult a physician if you have an irregular menstrual cycle and recurrent injuries like
stress fractures.
3. Talk to a counselor if you are overly concerned about your body image.
4. See a sport nutritionist to help you design a healthy diet that is specific to your sport.
5. Seek emotional support from coaches, guardians, or teammates.

1. Osteoporosis: Osteoporosis is weakening of the bones due to loss of bone mineral

density (BMD) and improper bone formation. It can ruin a female player’s career and may
lead to an increased risk of fractures. Low estrogen levels and poor calcium intake can lead
to Osteoporosis.
Causes of Osteoporosis:
1. Age: As people grow older the body starts losing bone faster than it is able to replace it.
2. Menopause: Menopause can cause a women’s body to lose BMD more quickly.
3. Genetics: Risk is higher if there is Osteoporosis in the family.
4. Low calcium intake: Low intake of calcium can be a cause of Osteoporosis.
Treatment of Osteoporosis:
1. By taking sufficient calcium in the diet to prevent Osteoporosis:
2. Ensuring adequate vitamin D to prevent Osteoporosis.
3.Use drug treatments to protect against bone loss.
4.Perform weight bearing exercises such as (i) standing and rising on toes(ii) Exercise with
elastic bands and pilates etc.
2.Amenorrhea: It is the absence of menstrual cycles in a women of reproductive age which
means either they never begin periods or there is absence of menstruation cycle for more
than three months.
Primary amenorrhea: Refers to a delay in the age of menarche (first menstrual cycle)
Secondary amenorrhea:It is the absence of menstrual cycles lasting longer than three
months.
Causes of Amenorrhea:
1. Natural causes include Pregnancy, Breast feeding and Menopause.
2.Severe dietary restriction can disrupt reproductive function.
3.The physical ‘stress’ of exercise as well as mental stress can cause of the disruption to
menstrual function.
4.Low body weight can effect menstrual function.
Treatment of Amenorrhea:
1.An increase in dietary intake to meet the energy demands helps to restore menstrual
function.
2.By maintaining the level of exercise intensity helps to restore menstrual function.
3. By maintaining the body weight as per BMI helps to restore menstrual function.
Disordered eating: Some female athletes do have a classic eating disorder, potentially
driven by a need to maintain a low body mass for performance. The term “anorexia
athletica” has been used for eating disorders associated with training and sports
performance. The criteria for this include perfectionism, compulsiveness, competitiveness,
high self-motivation, menstrual disturbances, and at least one unhealthy method of weight
control (fasting, vomiting, and use of diet pills, laxatives, or diuretics).
Eating disorder :Eating disorders are conditions defined by abnormal eating habits that may
involve either insufficient or excessive food intake which can harm or damage an
individual's physical and mental health. The most common specific forms of eating disorders
are:
Anorexia nervosa (AN), Bulimia nervosa(BN) include binge eating disorder(BED) , eating
disorder not otherwise specified(EDNOS) .
Anorexia nervosa : Anorexia nervosa is an eating disorder that causes people to obsess
with their weight and the food they eat. The eating disorder is characterized by self-
starvation and excessive weight loss. To prevent weight gain or to continue losing weight,
people with anorexia nervosa may starve themselves or exercise excessively. It's much

more common in females than males.

Causes of Anorexia Nervosa :These may include:

1. Biological : Abnormalities in brain chemistry. Serotonin, a brain chemical that is involved

in depression, may play a role.
2. Psychological : Severe trauma or emotional stress (such as the death of a loved one or
sexual abuse) during puberty or pre-puberty. Experiencing a big life change, such as
moving or going to a new school.
3. Cultural pressure : There is a cultural emphasis on thinness which is especially prevalent
in western society.The cultural pressure on men and women to be "perfect" is an
important factor for the development of eating disorders.
4. Peer pressure: Dieting is reported to being influenced by peer behavior. The number of
friends dieting and the number of friends who pressured them to diet also played a
significant role in their own choices.
5. Parental influence: Parental influence has been shown to be an internal component in
the development of eating behaviors of children.
6.Family history : About one fifth of people with anorexia have a relative with an eating
disorder.
Signs and Symptoms
1. Excessive weight loss, thin appearance, abnormal blood counts.
2. Fatigue, insomnia, dizziness or fainting.
3. Distorted self- perception ,Refusal to eat, denial of hunger, afraid of gaining weight.
4. Absence of menstruation, Irregular heart rhythms, Low blood pressure.
5. Reduced interest in sex, Excessive exercise.
Treatment: The most successful treatment is a combination of psychotherapy, family
therapy, and medication. A combination of treatments can give the person the medical,
psychological, and practical support they need. Anorexia, treatment can include following
things:

1. Lifestyle change : Treating anorexia nervosa involves major lifestyle changes which
includes establishing regular eating habits and Sticking with your treatment and meal
plans. Manage stress and emotional issues and Ignoring the urge to weigh yourself.
2.Medical care: In severe cases, people with anorexia may initially require medical care for
monitoring of vital signs, hydration level and electrolytes and require feeding through a
tube.
3.Medications : There are no medications specifically approved to treat anorexia.
However, antidepressants are often prescribed to treat depression that may accompany
anorexia.
4.Nutrition and Dietary Supplements : Getting enough vitamins and minerals in your diet
or through supplements can correct the problems.
5.. Restoring a healthy weight: The first goal of treatment is getting back to a healthy
weight. You can't recover from an eating disorder without restoring an appropriate weight
and learning proper nutrition.
6.Individual therapy. This type of therapy can help you deal with the behavior and
thoughts that contribute to anorexia. You can gain a healthier self-esteem and learn
positive ways to cope with distress and other strong feelings.
7.Family-based therapy. . An important part of family-based therapy is that the family is
involved in making sure that healthy-eating patterns are followed. Family-based therapy
can be especially important for children with anorexia who still live at home.

Bulimia nervosa: Bulimia is an eating disorder in which a person binges and purges. The
person may eat a lot of food at once and then try to get rid of it by vomiting, using
laxatives, or sometimes over-exercising. It affects women and men of all ages. The binge

and purge cycle

Causes of Bulimia No one knows exactly what causes bulimia medical experts agree that
several factors work together in a complex way to lead to the eating disorder. These may
include:
1.Poor body image :This eating disorder may begin with a dissatisfaction of the person's
body and extreme concern with body size and shape because of media images of an
unrealistic physical ideal.
2.Low self-esteem : Usually individuals who think of themselves as useless, worthless, and
unattractive are at risk for bulimia.
3.History of trauma or abuse : Women with bulimia appear to have a higher incidence of
sexual abuse For example, one may develop the condition after dealing with a traumatic
experience, such as a death or divorce, or during the course of important life-changing
events, such as getting married or leaving home.
4.Appearance-oriented professions or activities : People who face tremendous image
pressure are vulnerable to developing bulimia. Those at risk include ballet dancers, models,
gymnasts, wrestlers, runners and actors.
Signs and Symptoms:
Binge eating signs and symptoms
1. Lack of control over eating – Inability to stop eating. Eating until the point of physical
discomfort and pain.
2. Secrecy surrounding eating – Going to the kitchen after everyone else has gone to bed.
Going out alone on unexpected food runs. Wanting to eat in privacy.
3. Eating unusually large amounts of food with no obvious change in weight.
4. Disappearance of food, numerous empty wrappers or food containers in the garbage, or
hidden stashes of junk food.
5. Alternating between overeating and fasting – Rarely eats normal meals. It's all-or-
nothing when it comes to food.
Purging signs and symptoms
1. Going to the bathroom after meals – Frequently disappears after meals or takes a trip
to the bathroom to throw up. May run the water to disguise sounds of vomiting.
2. Using laxatives, diuretics, or enemas after eating. May also take diet pills to curb
appetite or use the sauna to “sweat out” water weight.
3. Smell of vomit – The bathroom or the person may smell like vomit. They may try to cover
up the smell with mouthwash, perfume, air freshener, gum or mints.
4. Excessive exercising – Works out strenuously, especially after eating. Typical activities
include high-intensity calorie burners such as running or aerobics.
Physical signs and symptoms of Bulimia
1. Calluses or scars on the knuckles or hands from sticking fingers down the throat to
induce vomiting.
2. Puffy “chipmunk” cheeks caused by repeated vomiting.
3. Discolored teeth from exposure to stomach acid when throwing up. May look yellow,
ragged or clear.
4. Frequent fluctuations in weight – Weight may fluctuate by 10 pounds or more due to
alternating episodes of bingeing and purging.
5. Irregular periods– your menstrual cycle can become unpredictable, or even stop
altogether.
6. Poor skin and hair – a lack of nutrients through persistent vomiting or laxative use can
make your skin and hair unhealthy. Your skin and hair can become dry.
7. Bowel problems – excessive use of laxatives can damage your bowel muscles, resulting in
permanent constipation.
Treatment: The most successful treatment is a combination of psychotherapy, family
therapy, and medication. A combination of treatments can give the person the medical,
psychological, and practical support they need. Anorexia, treatment can include following
things:
1. Lifestyle change : Treating Bulimia involves major lifestyle changes which includes
establishing regular eating habits and Sticking with your treatment and meal plans.
Manage stress and emotional issues and Ignoring the urge to weigh yourself.
2.Medical care: In severe cases, people with Bulimia may initially require medical care for
monitoring of vital signs, hydration level and electrolytes and require feeding through a
tube.
3. Medications : There are no medications specifically approved to treat Bulimia .
However, antidepressants are often prescribed to treat depression that may accompany
anorexia.
4.Nutrition and Dietary Supplements : Getting enough vitamins and minerals in your diet
or through supplements can correct the problems.
5.. Restoring a healthy weight: The first goal of treatment is getting back to a healthy
weight by learning proper nutrition.
6.Individual therapy. This type of therapy can help you deal with the behavior and
thoughts that contribute to Bulimia.You can gain a healthier self-esteem and learn positive
ways to cope with distress and other strong feelings.
7.Family-based therapy. . An important part of family-based therapy is that the family is
involved in making sure that healthy-eating patterns are followed. Family-based therapy
can be especially important for children with Bulimia who still live at home.