Eating Disorders
Understanding
Eating Disorders
Eating
is something that most people look forward to. It can mean experiencing good
food, doing something healthy for your body, and spending time with family or
friends. Many social events such as parties and holidays also involve food.
But, for a person who has an eating disorder, eating brings about very
different feelings. Constant thoughts about eating and an intense fear of
gaining weight become an obsession for a person who has an eating disorder.
Living
with an eating disorder is very hard. The road to recovery is not easy but,
with treatment, a person can recover and go on to lead a healthy life. Without
help, a person with an eating disorder can have a number of medical problems,
become very sick, and even die.
The
two most common eating disorders are anorexia nervosa and bulimia
nervosa. Anorexia is self-starvation. Bulimia is a disorder in which a
person eats large amounts of food ("bingeing") and then rids the body
of that food before it can be absorbed ("purging"). A person who is
bulimic purges either by vomiting or using laxatives or diuretics (water
pills). Some people have symptoms of both anorexia and bulimia.
Anorexia
and bulimia starve the body of food. This causes many physical changes to occur
which can lead to kidney and liver damage, very low blood pressure, and heart
failure. Other physical changes that can happen include:
- The
constant feeling of being cold because the body has lost the fat and
muscle it needs to keep warm. This may make the anorexic exercise even
more in an attempt to get warm.
- Eyes
become vacant and hollow.
- Bones
stick out and the skin shrinks around the bones, often making the stomach
seem like it is sticking out (leading the anorexic to still think that she
is fat or overweight).
- Hair
on the head falls out, while fine hair appears on other parts of the body
for warmth.
- Hair
and fingernails become brittle and skin becomes dry and rough due to a
lack of protein and vitamins in the diet.
- Menstrual
periods stop (or do not start at all if a girl developed anorexia before
her first period). This puts the anorexic at higher risk of developing
osteoporosis, a disease that causes bones to become brittle and break more
easily.
- Pain
in the abdomen, constipation, and bloating.
- Stunted
growth, resulting in permanent short stature.
- Anemia.
Most anorexics and bulimics
are girls; however, boys can suffer from these disorders as well. Adolescents
experience many social pressures, especially from the media, to be thin. This pressure to be thin or to diet can be especially strong for
teens if their friends are dieting or trying to lose weight. It is easy
for teens to get over-the-counter diet pills to reduce their appetite so that
they do not eat as much ( a practice that can become
habit-forming. Diet pills can raise blood pressure, cause kidney damage, make a
person dizzy or hallucinate, or even lead to fatal stroke.
There
is no single cause of an eating disorder. Many factors may be involved and are
different for each person. Some factors include:
- Feeling
insecure
- An
excessive desire to be in control
- A
distorted body image (feeling fat) and striving for the perfect body
- A
family history of depression or an eating disorder
- Severe
family problems
- A
history of sexual abuse
- Extreme
social pressures
- Pressure
from activities such as running, gymnastics, wrestling, or ballet
It is important, however,
for both girls and boys to understand that not everyone has the type of body
that is superthin. In fact, only a small number do. If a person is not meant to
be naturally thin, that person needs to accept that fact and learn to like his
or her body the way it is. It is important to have a healthy attitude toward
weight and to feel good about oneself.
Understanding
anorexia
Anorexia is self-starvation. This disorder mainly affects females between 14
and 18 years of age. A person with anorexia has such an intense fear of
becoming fat that she hardly eats anything and becomes dangerously thin.
Anorexics often weigh as little as 80 to 100 pounds. Many anorexics also
over-exercise and may abuse diet pills to keep from gaining weight. If the
condition gets worse, anorexics can die from suicide, heart attack, or
starvation.
Some
people who struggle with eating disorders alternate between anorexic and
bulimic behaviors. About half of all people who have anorexia at one time or
another develop some symptoms of bulimia (mainly the
bingeing and purging).
When a person develops anorexia nervosa, her
behavior changes, especially in regard to eating. A person with anorexia
may:
- Eat
only "safe" foods, usually those low in calories and fat.
- Cut
up food into very small pieces.
- Spend
more time playing with food than eating it, such as rearranging it on the
plate throughout a meal.
- Buy,
prepare, and cook food only for others.
As the
anorexic becomes more obsessed with food, her personality changes as well. She may become more
self-centered, as all her energy and focus is on herself and staying thin. In
addition, a person with anorexia may:
- Exercise
compulsively.
- Wear
baggy clothing to hide extreme thinness, or complain that normal clothing
is too tight.
- Spend
less time with friends and family, becoming more isolated, withdrawn, and
secretive.
- Develop
rituals to keep her mind off her hunger, such as chewing each bite of food
30 times before swallowing.
- Get
angry if she is not able to exercise or if her daily routine is disturbed.
Teens who develop anorexia
are usually good students, even overachievers. They try to get along with
others, tend to be perfectionists, and do not like to admit they need help with
anything. To others they appear to be in control. However, they are actually
unsure of themselves, are self-critical, and have low self-esteem. They are
very concerned about whether other people like them and about pleasing others.
Some of these negative feelings may come from having a poor body image (the way
a person feels about how his or her body looks).
Many
young people think that losing weight will make them feel better about how they
look. This is why most people who develop anorexia start by dieting. The
message they get from our culture, including the media, is that a slim body is
attractive and desirable. They may also start dieting in response to some kind
of major life change, like puberty or going away to college. Because anorexics
have low self-esteem, they do not feel confident that they can handle these
changes. They do not feel like they have control. Dieting makes them feel
better about themselves and becomes something they are
able to do well on their own. Over time, the dieting is really no longer about
food, but becomes a way for the anorexic to feel like she has control over her
life.
Understanding
bulimia
Bulimia and anorexia share some of the same symptoms. As with anorexia, food
and staying thin become an obsession, but the bulimic does not starve herself. Instead, the bulimic gets an uncontrollable urge to
binge (eat a large amount of food in a short period of time) and then purge
this food from her body.
Bulimia
usually develops between the ages of 15 and 24 and affects mostly females. A
bulimic's weight is usually within the range of what is normal for her size and
height, but it tends to go up and down a lot because of all the bingeing and
purging.
A
bulimic no longer has full control over eating. She may be afraid to eat in
restaurants or with other people because she cannot control the urges to binge
or the urges to purge after eating normal amounts of food. This fear may cause
her to avoid social situations and isolate herself from other people. Bulimics
may also change in other ways by:
- Becoming
very secretive about food, spending a lot of time thinking about and
planning the next binge, and setting aside certain times to binge.
- Stealing
food or hoarding it in strange places, such as under the bed or in
closets.
- Bingeing
on foods with distinct colors in order to know when they are later thrown
up.
- Spending
a lot of time, energy, and money, because bulimia is a time-consuming and
expensive addiction.
People who develop bulimia
often have a hard time dealing with and controlling impulses, stress, and
anxieties. They are not happy with their body image and think they are
overweight or fat. This leads them to start dieting, but then, in response to
anxiety and other emotions, they give in to their impulses and cravings for
food by bingeing.
During
a binge, a person with bulimia may eat between 3,000 and 7,000 calories, often
in less than a few hours. Depression, boredom, or anger often trigger a binge. Eating during a binge is almost robot-like.
The bulimic chews and swallows without paying attention to what the food tastes
like or whether she is hungry or full. Binges usually end when there is no more
food to eat, when the stomach hurts so much from eating, or when something such
as a phone call breaks the bulimic's concentration on bingeing.
After
eating large amounts of food, the bulimic feels guilty and is afraid of gaining
weight. To ease her guilt and fear, she purges the food from her body by vomiting
or taking pills that cause diarrhea. After bingeing she may turn to extreme
exercise or strict dieting. This period of "control" lasts until the
next binge, and then the cycle starts all over again. Bulimia becomes an
attempt to control two very strong impulses ( the
desire to be thin and the desire to eat.
The
following changes may be signs that a person has bulimia:
- Teeth
start to decay from contact with stomach acids during vomiting.
- Weight
goes up and down.
- Menstrual
periods become irregular.
- The
face and throat look puffy and swollen.
- Periods
of dizziness and blackouts occur.
- Dehydration
due to loss of body fluids occurs. The bulimic may need to be hospitalized
if this happens.
- Constant
upset stomach, constipation, and sore throat may be present.
- Damage
to vital organs, such as the liver and kidneys, heart failure, and death
can occur.
Treating
Eating Disorders
Recognizing
the early signs of an eating disorder is important for successful treatment.
Otherwise, it may be too late. If someone answers "yes" to any of the
following statements, that person should get help right away.
- I
cannot stop dieting, even though my family and friends warn me that I have
lost too much weight.
- Even
though I have lost a lot of weight, when I look in the mirror I still
think that certain parts of my body are fat.
- I
cannot stop exercising.
- I
do not get my menstrual period monthly.
The chance of successfully
treating someone who has an eating disorder is much higher if the disorder is
detected early and the person begins to get help. Treatment depends on many
things, including the person's willingness to cooperate, family and support
structure, and the stage of the disorder.
Successful
treatment of eating disorders involves many health professionals who work
together by treating a certain aspect of the disorder. Treatment begins with a
visit to a pediatrician, who will examine the person's medical condition to see
how the eating disorder has affected the body. If the effects are severe, the
person may need to be hospitalized for treatment.
In
treating anorexia, increasing the person's weight is crucial. If the anorexic
needs to be hospitalized, her treatment will focus on getting her weight back up
to a normal level. If she refuses to eat, she may need a feeding tube to get
the proper nutrients into her body. Hospitalization often helps the anorexic
slowly change her behavior so that when she returns home, she can gain weight
slowly with outpatient pediatric and psychiatric treatment. A person with
bulimia may need hospitalization to control the cycles of bingeing and purging
and to replace needed nutrients in the body.
Counseling
is necessary to help a person with an eating disorder understand how she uses
food as a way of handling problems and feelings. It will help her improve her
self-image (including body image) and develop independence so that she can take
control of her life in positive ways. A mix of individual therapy and family
therapy is usually most effective in treating eating disorders. Since an eating
disorder usually affects a person's entire family, a therapist can try to help
family members understand the disorder. The therapist can also help families
create a supportive home environment for the person with an eating disorder.
Occasionally, people who have eating disorders also have problems with alcohol
abuse or other substance abuse, and may need to be treated for those as well.
Anorexia
and bulimia are both very serious eating disorders that do not go away by
themselves. However, eating disorders are treatable with help. A person with an
eating disorder needs professional help to recover and become healthy again.
For
other resources and help with eating disorders, contact the following
organizations:
National Association
of Anorexia Nervosa and Associated Disorders
708/ 831-3438
American
Anorexia/Bulimia Association
212/ 734-1114
Anorexia Nervosa and
Related Eating Disorders
503/ 344-1144
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