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Eating Disorders

Each year, millions of people in the United States are affected by serious and sometimes life-threatening eating disorders. The vast majority – more than 90% – are adolescent and young adult women.

Approximately 1% of adolescent girls develop anorexia nervosa, a dangerous condition in which they can literally starve themselves to death. Another 2-3% of young women develop bulimia nervosa, a destructive pattern of excessive or binge overeating followed by vomiting or other "purging" behaviors to control their weight. These eating disorders also occur in men and older women, but much less frequently.

Many young women learn how to be “eating-disordered” from their parents and the media. Prevention starts early with messages we give ourselves and young women on attitudes about body image, weight and food.

Here are some useful tips to help foster a more positive dialogue about body image.

  • Avoid referring to food as being good or bad, low-fat or fattening. 
  • Promote interests that do not have an emphasis on appearance, but will lead to personal fulfillment. 
  • Know the dangers of trying to alter body shape through dieting and over exercising. Discuss how genes play a role in body shapes and weight.
  • Lead the discussion on media’s presentation on the perfect “body.” Help them to understand that what they see in the media is really just a fantasy.
  • Challenge negative self talk on diet, weight, self-worth
  • Find ways to be positive about body image.
  • Develop healthy eating habits; avoid strict rules about food and eating, focus on nutrition rather than dieting.

We’ve briefly defined some of the most common eating disorders below. Speak with your health professional immediately if you, or someone you love, may be showing signs of an eating disorder.

Symptoms of Eating Disorders
  • Dramatic weight loss in a relatively short period of time.
  • Wearing big or baggy clothes, or dressing in layers to hide body shape and/or weight loss.
  • Obsession with weight and complaining of weight problems (even if of "average" weight or thin).
  • Obsession with calories and fat content of foods.
  • Obsession with continuous exercise.
  • Frequent trips to the bathroom immediately following meals (sometimes accompanied by water running in the bathroom for a long period of time to hide the sound of vomiting).
  • Visible food restriction and self-starvation.
  • Visible bingeing and/or purging.
  • Unusual food rituals such as shifting the food around on the plate to look eaten; cutting food into tiny pieces; making sure the fork avoids contact with the lips (using teeth to scrap food off the fork or spoon); chewing food and spitting it out rather than swallowing; dropping food into napkin on lap to throw away later.
  • Self-defeating statements after food consumption.
  • Hair loss; pale or "grey" appearance to the skin.
  • Loss of menstrual cycle.
  • Loss of sexual desire or promiscuous relations.
  • Mood swings; depression; fatigue.
  • What are the consequences of eating disorders?

    The consequences of eating disorders can be severe, leading to death from starvation, cardiac arrest, other medical complications, or suicide. Medical complications are frequently a result of eating disorders. Individuals with eating disorders who use drugs to stimulate vomiting, bowel movements, or urination may be in considerable danger, as this practice increases the risk of heart failure.

  • Binge Eating

    An illness that resembles bulimia nervosa is binge eating disorder. Like bulimia, the disorder is characterized by episodes of uncontrolled eating or bingeing. However binge eating disorders differs from bulimia because its sufferers do not purge their bodies of excess food.

    Individuals with binge eating disorders feel that they lose control of themselves when eating. They eat large quantities of food and do not stop until they are uncomfortably full. Usually, they have more difficulty losing weight and keeping it off than do people with other serious weight problems. Most people with the disorder are obese and have a history of weight fluctuations. Binge eating disorder is found in about 2 percent of the general population – more often in women than men. Recent research shows that binge-eating disorder occurs in about 30% of people participating in medically supervised weight control programs.

    Medical consequences of binge eating

    People with binge eating disorder usually are overweight so they are prone to the serious medical problems associated with obesity, such as high cholesterol, high blood pressure, and diabetes. Obese individuals also have a higher risk for gallbladder disease, heart disease, and some types of cancer. Individuals with binge eating disorder also have high rates of other psychiatric illnesses – especially depression.

  • Bulimia Nervosa

    People with bulimia nervosa consume large amounts of food and then rid their bodies of the excess calories. This may be done by vomiting, abusing laxatives or diuretics, taking enemas, or exercising obsessively. Some use a combination of all of these forms of purging. Because many individuals with bulimia "binge and purge" in secret and maintain normal or above normal body weight, they can often successfully hide the problem from others for years. When this occurs on average at least twice a week for three months and also is accompanied by excessive concern about body shape and weight, concern about bulimia nervosa is warranted. Dieting heavily between episodes of bingeing and purging is common; eventually half of those with anorexia will develop bulimia.

    As with anorexia, bulimia typically begins during adolescence. The condition occurs most often in women, but is also found in men. Many individuals with bulimia who are ashamed of their strange habits, do not seek help until they are between ages 30-40 years. By this time, their eating behavior is deeply ingrained and more difficult to change.

    Medical consequences of bulimia nervosa

    Bulimia nervosa patients – even those of normal weight – can severely damage their bodies by frequent binge eating and purging. In rare instances, binge eating causes the stomach to rupture. Purging may result in heart failure due to loss of vital minerals such as potassium. Vomiting causes other less deadly, but serious, problems – the acid in vomit wears down the outer layer of the teeth, and can cause scarring on the backs of hands when fingers are pushed down the throat to induce vomiting. Further, the esophagus becomes inflamed and glands near the cheeks become swollen. As in anorexia, bulimia may lead to irregular menstrual periods. Interest in sex may also diminish.

    Some individuals with bulimia struggle with addictions including abuse of drugs and alcohol, and compulsive stealing. Like individuals with anorexia, many people with bulimia suffer from clinical depression, anxiety, OCD, and other psychiatric illnesses. These problems combined with their impulsive tendencies, place them at increased risk for suicidal behavior.

  • Anorexia Nervosa

    People who intentionally starve themselves suffer from an eating disorder called anorexia nervosa. The disorder which usually begins in young people around the time of puberty, involves extreme weight loss – at least 15% below an individual’s normal body weight. Those experiencing anorexia nervosa also have an intense fear of becoming fat, even when underweight. Many people with the disorder look emaciated but are convinced that they are overweight.

    Sometimes hospitalization to prevent starvation is needed while the individual continues to deny the condition. The illness may stop the menstrual cycle, a condition called amenorrhea. Men with anorexia often become impotent.

    For reasons not fully understood, individuals suffering from anorexia nervosa become terrified of gaining any weight. Food and weight become obsessions. For some, compulsive behavior shows up in strange eating rituals or the refusal to eat in front of others. It is not uncommon for people with anorexia to collect recipes and prepare lavish gourmet feasts for family and friends, but not partake in the meals themselves. They may adhere to strict exercise routines to keep off weight.

    Medical consequences of anorexia nervosa

    In people with anorexia, starvation can damage vital organs such as the brain and heart. To protect itself, the body shifts into "slow gear": monthly menstrual periods stop; breathing, pulse and blood pressure rates drop; thyroid function slows; nails and hair become brittle, skin dries, yellows, and becomes covered with soft hair called lanugo. Excessive thirst and frequent urination may occur.

    Dehydration contributes to constipation, and reduced body fat leads to lowered body temperature and the inability to withstand cold. Mild anemia, swollen joints, reduced muscle mass, and light-headedness also commonly occur in anorexia. If the disorder becomes severe, loss of calcium from bones, making them brittle and prone to breakage can occur. Patients also may experience irregular heart rhythms and heart failure. In some patients, the brain shrinks, causing personality changes. Fortunately, this condition can be reversed when normal weight is reestablished.

    Scientists have found that many patients with anorexia also suffer from other psychiatric illnesses. While the majority suffers from clinical depression, others experience anxiety, personality or substance abuse disorders, and many are at risk for suicide. Obsessive-compulsive disorder (OCD), an illness characterized by repetitive thoughts and behaviors, can also accompany anorexia. Individuals with anorexia are typically compliant in personality, but may have sudden outbursts of hostility and anger or become socially withdrawn.

  • What causes eating disorders?

    In trying to understand the causes of eating disorders, scientists have studied the personalities, genetics, environments, and biochemistries of people with these illnesses.

    One reason that women in this age group are particularly vulnerable to eating disorders is their tendency to go on strict diets to achieve what they think is the "ideal" figure. Researchers have found that such dieting can play a key role in triggering eating disorders.

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