Eating Disorders
(Including Anorexia and Bulimia) information:
An Introduction to Eating Disorders
Eating disorders are one of the unspoken secrets that permeate many families. Millions of Americans are afflicted with this disorder every year, and most of them -- up to 90 percent -- are adolescent and young women. Rarely talked about, an eating disorder can affect up to 5 percent of the population of teenage girls.
Why are adolescent and young women so susceptible to getting an eating disorder? According to the National Institute of Mental Health, it is because during this period of time, women are more likely to diet to try and keep a slim figure and/or try stringent dieting. Certain sports (such as gymnastics) and careers (such as modeling) are especially prone to reinforcing the need to keep a fit figure, even if it means purging food or not eating at all.
There are three main types of eating disorders:
- Anorexia
- Bulimia
- Binge Eating
Anorexia (also known as anorexia nervosa) is the name for simply starving yourself because you are convinced you are overweight. If you are at least 15 percent under your normal body weight and you are losing weight through not eating, you may be suffering from this disorder.
Bulimia (also known as bulimia nervosa) is characterized by excessive eating, and then ridding yourself of the food by vomiting, abusing laxatives or diuretics, taking enemas, or exercising obsessively. This behavior of ridding yourself of the calories from consumed food is often called "purging."
A person who suffers from this disorder can have it go undetected for years, because the person's body weight will often remain normal. "Binging" and "purging" behavior is often done in secret and with a great deal of shame attached to the behavior. It is also the more common eating disorder.
Eating disorders are serious problems and need to be diagnosed and treated like any medical disease. If they continue to go untreated, these behaviors can result in future severe medical complications that can be life-threatening.
Treatment of eating disorders nearly always includes cognitive-behavioral or group psychotherapy. Medications may also be appropriate and have been found effective in the treatment of these disorders, when combined with psychotherapy.
If you believe you may be suffering from an eating disorder or know someone who is, please get help. Once properly diagnosed by a mental health professional, such disorders are readily treatable and often cured within a few months' time.
A person with an eating disorder should not be blamed for having it! The disorders are caused by a complex interaction of social, biological and psychological factors which bring about the harmful behaviors. The important thing is to stop as soon as you recognize these behaviors in yourself, or to get help to begin the road to recovery.
Symptoms of Anorexia Nervosa
Right now, 1 percent of all American women -- our sisters, mothers and daughters -- are starving themselves; some literally starving and exercising themselves to death. Eating disorders are becoming an epidemic, especially among our most promising young women. These women and girls, whom we admire and adore, feel a deep sense of inadequacy and ineffectiveness. Anorexia nervosa is a confusing, complex disease that many people know too little about.
There is no blame in anorexia nervosa. Anorexia is not an indication that parents have gone wrong in raising their children. Cultural, genetic and personality factors interact with life events to initiate and maintain eating disorders.
Anorexia is not fun. Many people who strive to lose weight state, "I wish I were anorexic." They fail to recognize the wretchedness of the disease. Anorexia is not about feeling thin, proud and beautiful; if you take the time to listen to an anorexic you will hear that they feel fat, unattractive and inadequate. They are scared and trapped.
Anorexia is not something sufferers can just "snap out of." Anorexics' minds are not their own; they are possessed by thoughts of weight, body image, food and calories. Many sufferers are not even free of the disease in their sleep, troubled by dreams of food, eating and exercise. Anorexia is an awful, lonely experience that often takes years to conquer.
Anorexia is hard on everyone involved. Living with someone with anorexia nervosa can be exasperating and confusing. To those who do not understand the complexity of the disorder, the sufferer's behavior seems selfish and manipulative. It is often hard to remember that eating disorders are a manifestation of profound unhappiness and distress.
Anorexia can be deadly. It has one of the highest fatality rates of any mental illness. If you or someone you know shows the signs or symptoms of an eating disorder, take action, get educated and seek help.
Specific Symptoms of Anorexia Nervosa:
A person who suffers from this disorder is typically characterized by their refusal to maintain a body weight which is consistent with their build, age and height. Specifically, a person's body weight needs to be 85% or less than that which is considered typical for someone of similar build, age and height.
The individual usually experiences an intense and overwhelming fear of gaining weight or becoming fat. This fear is regardless of the person's actual weight, and will often continue even when the person is near death from starvation. It is related to a person's poor self-image, which is also a symptom of this disorder. The individual suffering from this disorder believes that their body weight, shape and size is directly related to how good they feel about themselves and their worth as a human being. Persons with this disorder often deny the seriousness of their condition and can not objectively evaluate their own weight.
At least three consecutive menstrual cycles must be missed, if the woman was menstruating previously before the onset of the disorder. Specifically, a woman is considered to have amenorrhea if her periods occur only following hormone, e.g., estrogen, administration.
There are two types of anorexia nervosa:
- Restricting type -- The person restricts their food intake on their own and does not engage in binge-eating or purging behavior.
- Binge eating/purging type -- The person self-induces vomiting or misuses laxatives, diuretics, or enemas.
People with bulimia nervosa do two things. First, they eat. Second, they work very hard to get rid of what they have eaten. People with bulimia binge eat. That is, in a small amount of time they eat copious amounts of food, much more than an average person would eat in an equivalent amount of time. They often lose control over their eating, and are unable to stop until the food is gone. When the food is gone, guilt over the consumption appears and they have to get rid of the evidence. So they will vomit, or use laxatives, diuretics, enemas or other medications. Sometimes they choose to fast for days in response to a particularly bad binge. Others will exercise excessively. But the goal is to not absorb or to burn off any of the calories that were consumed in the binge.
Unlike people with anorexia nervosa, you cannot readily identify people with bulimia based on their weight and public eating behavior. Often body weights hover around the average range, although one might see remarkable weight fluctuations in a person.
People with bulimia are often ashamed of their eating problems and attempt to conceal their symptoms. Binge/purge behavior is often quite secretive, and one's obvious, or public, eating patterns vary from being relatively "normal" to being highly restrictive.
Typically people with bulimia are very body and weight conscious and are frequently dieting. They place excessive emphasis on body weight and shape in their self-evaluation. Often these factors are the most important ones for them in determining self-esteem.
Specific Symptoms of Bulimia Nervosa:
This disorder is characterized by recurrent episodes of binge eating, occurring at least twice a month for a minimum of three months, which consists of:
- Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances
- A sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating)
Individuals who suffer from this disorder often engage in behavior in order to try and prevent themselves from gaining any weight. This behavior may include such things as self-induced vomiting; overusing laxatives, diuretics, enemas, or other medications; refusing to eat (fasting); or excessive exercise.
Recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, enemas, or other medications; fasting; or excessive exercise. A person's self-image is usually directly correlated with their weight, with a great deal of attention focused on how their body looks.
This disorder can only be diagnosed if it is not better accounted for by anorexia nervosa.
There are two types of bulimia nervosa:
- Purging Type: -- The person regularly engages in self-induced vomiting or the misuse of laxatives, diuretics, or enemas
- Non-purging Type: -- The person has used other inappropriate compensatory behaviors, such as fasting or excessive exercise, but has not regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas
Symptoms of Binge Eating
"Bet you can't eat just one."
Many will recall this popular television commercial, where the announcer tempts an unsuspecting muncher with a single potato chip. He grabs the bag, examines a single chip and confidently eats it. Within moments his eyes are fixed on the bag of chips that seem to be calling his name. He looks away but the urge is too strong. Overwhelmed by his craving, he lunges for the bag, and devours the entire contents. The announcer smugly retorts. "Told you. You can't eat just one."
For the millions of Americans with binge eating disorder this scenario is all too real. Binge eating disorder is perhaps the most common, yet least studied, of the eating disorders.
There are striking similarities to substance abuse. Both include obsessive thoughts, preoccupation and strong compulsion to consume, followed by feelings of guilt and emotional angst.
There is hope, however. New and exciting research is providing a clearer picture of the causes of binge eating disorder and obesity. Neuroscientists have recently identified a number of brain messengers that are involved in the feelings of hunger, feeding and satiation. These are the targets for the development of new and better treatments for binge eating and other eating disorders.
Specific Symptoms of Binge Eating Disorder:
Most people overeat from time to time, and many people feel they frequently eat more than they should. Eating large amounts of food, however, does not mean that a person has binge eating disorder. Doctors are still debating the best ways to determine if someone has binge eating disorder. But most people with serious binge eating problems have:
- Frequent episodes of eating what others would consider an abnormally large amount of food.
- Frequent feelings of being unable to control what or how much is being eaten.
- Several of these behaviors or feelings:
- Eating much more rapidly than usual.
- Eating until uncomfortably full.
- Eating large amounts of food, even when not physically hungry.
- Eating alone out of embarrassment at the quantity of food being eaten.
- Feelings of disgust, depression, or guilt after overeating.
Episodes of binge eating also occur in the eating disorder bulimia nervosa. Persons with bulimia, however, regularly purge, fast, or engage in strenuous exercise after an episode of binge eating. Purging means vomiting or using diuretics (water pills) or laxatives in greater-than-recommended doses to avoid gaining weight. Fasting is not eating for at least 24 hours. Strenuous exercise, in this case, is defined as exercising for more than an hour solely to avoid gaining weight after binge eating. Purging, fasting, and strenuous exercise are dangerous ways to attempt weight control.
Treatment of Eating Disorders
The treatment of eating disorders can be challenging for both the person with the issue, and the professionals who try and help them. Eating disorders are characterized by often a life-long pattern of eating and associating food with emotional fulfillment. Many people who do this don't even realize the association they've made, and therefore one component of many people's successful treatment will be to help the person gain that insight.
Coping with Denial in Eating Disorders
What if the person you care about refuses to admit there is a problem? This is often the case with teenagers in general, and with anorexia nervosa at any age. Whether you merely suspect there is a problem, or you know that the problem exists and is serious, when your loved one or friend says nothing is wrong, you have a difficult situation.
The assessment of an eating disorder can be complex even for a professional. Knowing whether a disturbed eating pattern is part of a temporary phase, versus the beginning of a full-blown eating disorder, can be tricky. The best first step is to seek a professional consultation, with or without your loved one. You may start by going to a therapist without your child, loved one or friend. Do not second-guess yourself or put it off, the earlier an eating disorder has intervention, the better chance for recovery.
The worst case scenario, if you follow your instincts, is that the professional will say that they think the situation may best be handled by backing off. However, the professional will also be able to give you tools and information so that you will know what to do if things get worse.
Do not expect that your loved one will be open, cooperative or grateful to your intervention. It may feel like the hardest thing that you have ever had to do. You may worry that it will jeopardize the relationship you have with your loved one. When your loved one is in denial they are very ill. Their mind has been more or less possessed by the eating disorder and they are driven only by the fear of getting fat.
Do not personalize their irrationality or be controlled by the strong emotional displays, which are inevitable when they are taken over by the eating disorder “demon.” With recovery, gratitude often comes. |
