Eating disorders are so common in America that 1 or 2 out of
every 100 students will struggle with one.
Eating disorders are more than just going on a diet to lose
weight or trying to make sure you exercise every day. They're
extremes in eating behavior - the diet that never ends and
gradually gets more restrictive, for example. Or the person who
can't go out with friends because he or she thinks it's
more important to go running to work off a piece of candy.
The most common types of eating disorder are
anorexia nervosa
and
bulimia nervosa
(usually called simply "anorexia" and
"bulimia"). But other food-related disorders, like binge
eating disorders, body image disorders, and food phobias, are
showing up more frequently than they used to.
Anorexia
People with anorexia have an extreme fear of weight gain and a
distorted view of their body size and shape. As a result, they
can't maintain a normal body weight. Some people with anorexia
restrict their food intake by dieting, fasting, or excessive
exercise. They hardly eat at all - and the small amount of food
they do eat becomes an obsession.
Other people with anorexia do something called binge eating and
purging, where they eat a lot of food and then try to get rid of
the calories by forcing themselves to vomit, using laxatives, or
exercising excessively.
Bulimia
Bulimia is similar to anorexia. With bulimia, a person binge
eats (eats a lot of food) and then tries to compensate in extreme
ways, such as forced vomiting or excessive exercise, to prevent
weight gain. Over time, these steps can be dangerous.
To be diagnosed with bulimia, a person must be binging and
purging regularly, at least twice a week for a couple of months.
Binge eating is different from going to a party and "pigging
out" on pizza, then deciding to go to the gym the next day and
eat more healthfully. People with bulimia eat a large amount of
food (often junk food) at once, usually in secret. The person
typically feels powerless to stop the eating and can only stop once
he or she is too full to eat any more. Most people with bulimia
then purge by vomiting, but may also use laxatives or excessive
exercise.
Although anorexia and bulimia are very similar, people with
anorexia are usually very thin and underweight but those with
bulimia may be a normal weight or even overweight.
Binge Eating Disorder
This
eating disorder
is similar to anorexia and bulimia because a person binges
regularly on food (more than three times a week). But, unlike the
other eating disorders, a person with binge eating disorder does
not try to "compensate" by purging the food.
Anorexia, bulimia, and binge eating disorder all involve
unhealthy eating patterns that begin gradually and build to the
point where a person feels unable to control them.
Anorexia and Bulimia: What to Look For
Sometimes a person with anorexia or bulimia starts out just
trying to lose some weight or hoping to get in shape. But the urge
to eat less or to purge spirals out of control.
People with anorexia or bulimia frequently have an intense fear
of being fat or think that they are fat when they are not. A person
with anorexia may weigh food before eating it or compulsively count
the calories of everything. When it seems "normal" or
"cool" to do things like restrict food intake to an
unhealthy level, it's a sign that a person has a problem.
So how do you know if a person is struggling with anorexia or
bulimia? You can't tell just by looking at someone. A person
who loses a lot of weight may have another health condition or may
be losing weight through healthy eating and exercise.
Here are some signs that a person may have anorexia or
bulimia:
Anorexia
- becomes very thin, frail, or emaciated
- obsessed with eating, food, and weight control
- weighs herself or himself repeatedly
- counts or portions food carefully
- only eats certain foods, avoiding foods like dairy,
meat, wheat, etc. (of course, lots of people who are
allergic to a particular food or are vegetarians avoid
certain foods)
- exercises excessively
- feels fat
- withdraws from social activities, especially meals and
celebrations involving food
- may be depressed, lethargic (lacking in energy), and feel
cold a lot
Bulimia
- fears weight gain
- intensely unhappy with body size, shape, and weight
- makes excuses to go to the bathroom immediately after
meals
- may only eat diet or low-fat foods (except during
binges)
- regularly buys laxatives, diuretics, or enemas
- spends most of his or her time working out or trying to work
off calories
- withdraws from social activities, especially meals and
celebrations involving food
What Causes Eating Disorders?
No one is really sure what causes eating disorders, although
there are many theories about why people develop them. Many people
who develop an eating disorder are between 13 and 17 years old.
This is a time of emotional and physical changes, academic
pressures, and a greater degree of peer pressure. Although there is
a sense of greater independence during the teen years, teens might
feel that they are not in control of their personal freedom and,
sometimes, of their bodies. This can be especially true during
puberty.
For girls, even though it's completely normal (and
necessary) to gain some additional body fat during puberty, some
respond to this change by becoming very fearful of their new
weight. They might mistakenly feel compelled to get rid of it any
way they can.
When you combine the pressure to be like celeb role models with
the fact that during puberty our bodies change, it's not hard
to see why some teens develop a negative view of themselves.
Many people with eating disorders also can be depressed or
anxious, or have other mental health problems such as
obsessive-compulsive disorder (OCD). There is also evidence that
eating disorders may run in families. Although part of this may be
our in genes, it's also because we learn our values and
behaviors from our families.
Sports and Eating Disorders
Athletes and dancers are particularly vulnerable to developing
eating disorders around the time of puberty, as they may want to
stop or suppress growth (both height and weight).
Coaches, family members, and others may encourage teens in
certain sports - such as gymnastics, ice-skating, and ballet - to
be as thin as possible. Some athletes and runners are also
encouraged to weigh less or shed body fat at a time when they are
biologically destined to gain it.
Effects of Eating Disorders
Eating disorders are serious medical illnesses. They often go
along with other problems such as stress, anxiety, depression, and
substance use. People with eating disorders also can have serious
physical health problems, such as heart conditions or kidney
failure. People who weigh at least 15% less than the normal weight
for their height may not have enough body fat to keep their organs
and other body parts healthy. In severe cases, eating disorders can
lead to severe malnutrition and even death.
With anorexia, the body goes into starvation mode, and the lack
of nutrition can affect the body in many ways:
- a drop in blood pressure, pulse, and breathing rate
- hair loss and fingernail breakage
- loss of periods
- lanugo hair - a soft hair that can grow all over the
skin
- lightheadedness and inability to concentrate
- anemia
- swollen joints
- brittle bones
With bulimia, constant vomiting and lack of nutrients can cause
these problems:
- constant stomach pain
- damage to a person's stomach and kidneys
- tooth decay (from exposure to stomach acids)
- "chipmunk cheeks," when the salivary glands
permanently expand from throwing up so often
- loss of periods
- loss of the mineral potassium (this can contribute to heart
problems and even death)
A person with binge eating disorder who gains a lot of weight is
at risk of developing diabetes, heart disease, and some of the
other diseases associated with being
overweight
.
The emotional pain of an eating disorder can take its toll, too.
When a person becomes obsessed with weight, it's hard to
concentrate on much else. Many people with eating disorders become
withdrawn and less social. People with eating disorders might not
join in on snacks and meals with their friends or families, and
they often don't want to break from their intense exercise
routine to have fun.
People with eating disorders often spend a lot of mental
energy on planning what they eat, how to avoid food, or their
next binge, spend a lot of their money on food, hide in the
bathroom for a long time after meals, or make excuses for going on
long walks (alone) after a meal.
Treatment for Eating Disorders
Fortunately, people with eating disorders can get well and
gradually learn to eat normally again. Eating disorders involve
both the mind and body. So medical doctors, mental health
professionals, and dietitians will often be involved in a
person's treatment and recovery.
Therapy or counseling is a critical part of treating eating
disorders - in many cases, family therapy is one of the keys to
eating healthily again. Parents and other family members are
important in helping a person see that his or her normal body shape
is perfectly fine and that being excessively thin can be
dangerous.
If you want to talk to someone about eating disorders and you
don't feel as though you can approach a parent, try talking to
a teacher, a neighbor, your doctor, or another trusted adult.
Remember that eating disorders are very common among teens.
Treatment options depend on each person and their families, but
many options are available to help you overcome an eating disorder.
Therapy can help you feel in charge again and learn to like your
body, just as it is.
Reviewed by:
Michelle New, PhD
Date reviewed: November 2007
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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