Eating Disorders

Eating disorders affect millions of women and men.  One out of every 100 college students has anorexia nervosa, and four out of every 100 college students suffer from bulimia nervosa.  Eating disorders are not about food.  They are psychological illnesses that can impact many facets of a person's life.  The earlier someone with an eating disorder is identified and treated, the more likely they are to recover with no long-term mental or physical effects.  They are serious illnesses that require prompt intervention by a specialized treatment team.

There are three main types of eating disorders

Anorexia Nervosa:

People with Anorexia Nervosa have a distorted body image. They believe that they are overweight and see themselves as "fat" even thought they might be seriously underweight. These individuals restrict their food intake, often limiting themselves to little or no food. Many times, excessive exercise habits are formed, contributing to the loss in body mass. There are many unhealthy habits that are associated with this disorder, and they include: obsessive thoughts about food, weight and exercise, hiding from others when eating and lack of intimacy.  Left untreated, up to 25% of persons with anorexia will die.

Physical, behavioral and emotional signs and symptoms of Anorexia Nervosa:

Loss of 15% or more of body weight
Amenorrhea (loss of the menstrual period in females)
Disturbed body image; denial of thinness even as weight loss progresses
Hyperactivity - excessive exercise
Growth of body hair
Loss of hair on scalp
Nervousness around mealtime
Cutting food into small pieces or playing with food
Increased interest in collecting recipes and cooking/baking for others
Weighing frequently
Increased isolation from family and friends
Tendency to be highly self-critical
Episodes of binge-eating and purging may alternate with self-starvation
Feelings of depression

Bulimia Nervosa:

Sometimes referred to as bingeing and purging, these individuals eat large quantities of food and then vomit or use other means to rid their bodies of the food they just ate. Bulimics use laxatives, diuretics, exercise, and/or vomiting to eliminate calories and food from their bodies. They usually feel great shame and embarrassment because of these habits, but these feelings are over-ridden by the sense of relief they feel when they rid their bodies of calories through these methods. It provides a way for them to release the negative emotions they are feeling.

Physical, behavioral and emotional signs and symptoms of Bulimia Nervosa are:

Eating high calorie food, often secretly, during a binge
Purging by means of self-induced vomiting, use of laxatives or diuretics.
Excessive exercise
Excessive fasting
Preoccupation with food, weight and bodily concerns
Frequent weight fluctuations due to alternating binges and fasts
Feeling unable to control eating behavior
Feelings of depression and self-criticism

Binge Eating Disorder:

This disorder is characterized by excessive food intake, often in a specific time period where the individual feels out-of-control to stop. The difference between binge eating disorders and bulimia eating disorder is that binge eaters do not purge after eating these excessive amounts of food and calories. Binge eaters use food as a comfort to ease empty and negative emotions. The food is used as a way to "fill" them emotionally.

Behavioral, emotional and physical signs and symptoms of binge eating disorder are:

Episodes of binge-eating
Eating when not physically hungry
Frequent dieting, going from one rigid diet to the next
Restricted activities due to embarrassment about weight
Preoccupation with weight, eating and dieting
Self-worth based on weight and control of eating
Awareness that eating patterns are abnormal
Feeling unable to stop eating voluntarily
Depressed mood
Social and professional successes and failures attributed to weight
Weight fluctuations
Mobility problems
Diabetes
Heart ailments

WHAT CAN FAMILY AND FRIENDS DO?

There are certain things you can do as a friend or relative of someone you suspect might have an eating disorder:

Tell the person you are concerned, that you care and would like to help. You can suggest that they talk to a mental health professional or their physician.

Do not discuss weight, calorie intake, how much or little they eat or exercise, or particular eating habits. But do try and talk about things other than food, like feelings or emotions they may be experiencing.

Avoid making comments about their appearance. These comments about excessive weight loss can be interpreted as a compliment, and those comments about weight gain can be taken as criticism. And either can actually exacerbate the problem.

Do not get into a power struggle with this individual -- it is not worth it -- and you won't win. You cannot force a person to eat or stop eating.

You can offer your support. Ultimately, it is up to the individual to decide whether they want to change or get help.

HOW DO YOU TREAT AN EATING DISORDER?

Because eating disorders are physical, psychological, social, cultural and familial in nature, most require a specialized treatment team approach in order to be managed properly. 

The team should consist of:

Medical Doctor -  To monitor the heart and other organs affected by restriction of food.

Therapist (who specializes in eating disorders) - to discuss the psychological predisposing, precipitating and perpetuating factors of the disorder.

Nutritionist (who specializes in eating disorders) - to learn healthy ways of eating in a safe and supportive environment

Family therapist - to identify and explore familial patterns of interaction and effect change where needed.

Psychiatrist - when necessary, to address underlying illnesses like depression and anxiety that so often accompany eating disorders.
Others may need to be involved in the team as well to help monitor and support the individuals progress.

These persons may include:
Coaches
School nurses
Significant others
Resident Advisors or Hall Directors
If you are concerned about a friend or yourself, contact the Counseling Center for support -- call (203) 837-8690

WHAT IS NORMAL EATING?

Normal eating is going to the table hungry and eating until you are satisfied. It is being able to choose food you like and eat it and truly get enough of it -- not just stop eating because you think you should. Normal eating is being able to give some thought to your food selection so you get nutritious food, but not being so wary and restrictive that you miss out on enjoyable food. Normal eating is giving yourself permission to eat sometimes because you are happy, sad, or bored, or just because it feels good. Normal eating is three meals a day, or four or five, or it can be choosing to munch along the way. It is leaving some cookies on the plate because you know you can have some again tomorrow, or it is eating more now because they taste so wonderful. Normal eating is overeating at times; feeling stuffed and uncomfortable. And it can be under-eating at times and wishing you had more. Normal eating is trusting your body to make up for your mistakes in eating. Normal eating takes up some of your time and attention, but keeps its place as only one important area of your life.

In short, normal eating is flexible. It varies in response to your hunger, your schedule, your proximity to food, and your feelings.
(c) Copyright 1999 Ellyn Satter from Secrets of Feeding a Healthy Family, Kelcy Press, Madison, WI, 1999, page 5. For purchase information, call (877) 844-0857.

Recommended Reading:

  1. Your Dieting Daughter, Is She Dying For Attention? By Carolyn Costin, M.A., M.Ed., M.F.C.C. (c) 1997
  2. Father Hunger: Fathers, Daughters and Hunger. Margo Maine, Ph.D. (c) 1991
  3. Bulimia: A Guide for Friends and Family. Roberta Trattner Sherman, Ph.D. and Ron A. Thompson, Ph.D. (c) 1990
  4. Body Betrayed. A Deeper Understanding of Women, Eating Disorders and Treatment. Kathryn J. Zerbe, M.D. (c) 1993
  5. Making Peace with Food. Freeing Yourself from the Diet-Weight Obsession. Susan Kano. (c) 1989
  6. Hunger Pain. The Modern Woman's Tragic Quest for Thinness. Mary Pipher, Ph.D. (c) 1995

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