Eating
disorders are real illnesses that can affect how we eat and how we feel about
food. They can be treated to help people who have them have healthy and full
lives. From time to time, we all change our eating habits. Sometimes we reduce
the amount of food we eat or go on a diet to shed some pounds, or we eat more to
gain weight. These can be healthy ways to control or reach our ideal body
weight. But, people who have eating disorders have unhealthy ways, or patterns,
of eating. They may eat too much and become overweight, or way too little and
become very thin. Sometimes a person can eat so little, or nothing at all, they
actually begin to starve (called anorexia nervosa). A person can also
eat an extreme amount of food all at once and then do things like vomit to rid
the body of food (called bulimia nervosa). And, a person may not be
able to control the need to overeat, often keeping it a secret (called binge
eating disorder). People can also have wrong ideas, or misperceptions, of
their body weight. People with eating disorders can feel certain they weigh too
much, even though they may be well under the ideal body weight for a person
their size.
Who is at risk for eating disorders?
What
are the most common types of eating disorders? What effects do they have on a
person's health
How can you tell
if someone has an eating disorder?
What are the
treatments for eating disorders?
What
should you do if you or someone you know has an eating disorder?
In
the United States and other Western countries, women are more at risk for eating
disorders than are men. These disorders affect 8 to 10 times more women than
men. In the U.S., it was thought that eating disorders affected mostly white
women. But, recent research has shown that black women are affected as well. One
study found that black women were more likely than white women to have repeated
episodes of binge eating disorder. This may put black women more at risk for obesity
(being overweight).
No
one knows for sure what causes eating disorders. It is known, though, that these
disorders can't be willed or wished away - treatment is needed. If you or
someone you know has an eating disorder, don't wait to get help. Talk with a
health care provider, the sooner the better.
Much
research has been focused on how personality and environment can put a person at
risk for an eating disorder. People with eating disorders are thought to share
certain traits, such as low self-esteem (how you feel about who you
are), feelings of helplessness, and a fear of becoming overweight. Eating
disorders seem to develop as a way of dealing with stress. These disorders
appear to run in families, affecting women more than men. Research has shown
that a woman's social environment, including her family and friends, can affect
how she feels about body weight. For instance, frequent talk about being thin
and dieting may put pressure on a person to be thin. Being teased about being
overweight by family and friends can lead to low self-esteem and unhealthy
eating in young girls and women. Also, young people who are involved in sports
or activities that emphasize thinness (modeling, dancing, long distance running,
gymnastics) are more likely to develop eating disorders.
The
three most common types of eating disorders are:
·
Anorexia
nervosa
- starving yourself by eating very little or nothing at
all. People who have this condition can have a strong fear of body fat and
weight gain. To stay thin, a person may diet, fast, or exercise too much. Taking
laxatives, diuretics, or enemas to rid the body of food is also common. Women
with anorexia can have menstrual periods that are not regular, or none at all.
Girls with anorexia often get their periods later than girls who don't have this
illness. People with this illness may think they are overweight, even when they
are very skinny. The process of eating becomes an obsession, or
something you can't stop thinking about. Eating habits develop that are not
normal, such as staying away from food and meals, picking out only a few foods
and eating these in small amounts, or carefully weighing out food portions to
eat. People with anorexia may also check their body weight a lot.
Anorexia can cause the same types of problems that happen when a person is
starving. The lack of food can cause a person to become very thin, develop
brittle hair and nails, dry skin, and a low pulse rate, become not able to stand
the cold, and suffer from constipation and sometimes diarrhea. It can also
affect a person's blood count, causing mild anemia, reduce muscle mass, stop a
woman's menstrual period, and lead to swollen joints. Lack of calcium, due to a
poor diet, places anorexics at higher risk for osteoporosis (bone thinning)
later in life. Many people with this illness have depression, anxiety, and
problems with alcohol or drugs. The most serious problems include death from
starvation, the heart stopping, or suicide.
·
Bulimia
nervosa -
when a person binges, or eats an extreme amount of food
all at once and then purges - vomits, takes laxatives or diuretics
(water pills) - to rid the body of food. Exercising to excess and fasting can
also occur to make sure no weight is gained after binge eating. People with this
eating disorder feel no control during the times they are eating to excess. This
illness most often starts in the late teenage years or early adult life. Like
anorexics, people with bulimia have extreme worry about food, body weight, and
body shape. Many bulimics binge and purge in secret, and still keep a normal
body weight. By doing so, a person can often hide this illness for years.
Feelings of disgust and shame after binge eating are common, as well as feelings
of relief after purging. Eating binges can happen once or twice a week or as
much as a few times a day. They can be triggered by depression, boredom, or
anger. The need to binge and purge can be constant or can happen once in a
while, with periods of time where no bingeing occurs.
Health problems from bulimia are mostly related to electrolyte imbalance
(when the amounts of sodium and potassium in the body become too much or too
little) and repeated purging behaviors. Purging causes the body to lose
potassium, which can damage heart muscle and increase a person's risk for heart
attack. Frequent vomiting can inflame the esophagus (tube that connects
the throat with the stomach) and damage tooth enamel. Other problems caused by
bulimia include scarring on the back of fingers from pushing them down the
throat to cause vomiting, loss of or change in menstrual periods, and no sex
drive. People with this illness can have trouble dealing with and controlling
impulses, stress, and anxiety. They may also have depression, obsessive-compulsive
disorder (an illness where you have unwanted thoughts and behaviors you
can't stop repeating), and other mental illnesses. Problems with alcohol and
drugs is not uncommon. Bulimics are also likely to be anorexic.
·
Binge
eating disorder (BED)
- when a person can't control the desire to overeat and
often keeps the extreme eating a secret. People with this eating disorder feel
no control during the times they are eating to excess. During binge eating, a
person may eat more quickly than normal, eat until feeling discomfort, eat large
amounts of food when not hungry, and eat alone. Unlike bulimia and anorexia, a
person doesn't try to rid the body of extra food by doing things like vomiting,
fasting, or exercising to the extreme. Because of this, many people who have
this illness are overweight. A person can feel disgust, shame, and guilt during
a binge, which can lead to bingeing again, causing a cycle of binge eating. Like
with anorexia, people with BED can fear gaining weight, want to lose weight, and
dislike the way their bodies look. BED most often starts in the late teenage
years or early adult years. Some experts believe BED is the most common eating
disorder. The illness often develops soon after extreme weight loss from a diet.
BED can be hard to diagnose and can be mistaken for other causes of obesity
(being overweight). People with BED are often overweight because they maintain a
high calorie diet without exercising. Medical problems can happen, like those
found with obesity, such as high cholesterol levels, high blood pressure, and
diabetes. BED also increases a person's risk for gallbladder disease, heart
disease, and some types of cancer. People with BED often suffer from depression.
There
are two other types of eating disorders. Eating disorder not otherwise
specified (EDNOS) is the name for disorders of eating that don't fit into
one of the three disorders described above. With EDNOS, a person has some form
of abnormal eating but not all the symptoms needed to be diagnosed with an
eating disorder. For instance, a person with EDNOS may purge themselves after
eating, but do so with less frequency or intensity than someone who has bulimia.
Because
many people with eating disorders keep them a secret, their conditions can go
unnoticed for long periods of time, even years. With anorexia, signs such as
extreme weight loss are easier to see. But, bulimics who can stay at their
normal body weight may be better able to hide their illness. Family members and
friends may notice some of the warning signs of an eating disorder.
A
person with anorexia may:
·
Eat
only "safe" foods, low in calories and fat.
·
Have
odd rituals, such as cutting food into small pieces or measuring food.
·
Spend
more time playing with food than eating it.
·
Cook
meals for others without eating.
·
Exercise
to excess.
·
Dress
in layers to hide weight loss.
·
Spend
less time with family and friends.
·
Become
withdrawn and secretive.
A
person with bulimia may:
·
Become
very secretive about food.
·
Spend
a lot of time thinking about and planning the next eating binge.
·
Keep
making trips to the bathroom after eating.
·
Steal
food or hoard it in strange places.
·
Eat
to excess.
A
person with binge-eating disorder may:
·
Become
very secretive about food.
·
Spend
a lot of time thinking about and planning the next eating binge.
·
Start
eating alone most of the time.
·
Steal
food or hoard it in strange places.
·
Eat
to excess.
·
Become
overweight.
·
Become
withdrawn, not wanting to go out or see family and friends.
Eating
disorders can be treated and a person can return to a healthy weight. Success in
treating eating disorders is greatest when they are found early and treated
right away. The longer abnormal ways of eating go on, the harder it is to
overcome the disorder. Plus, more damage is done to the body over time, which
can result in serious health problems.
There
is no one, or best, way to treat these complex disorders. Most people with
eating disorders are treated by a team of health care providers and receive
medical care, psychotherapy (sometimes called "talk therapy"), and
nutritional counseling. Professionals who provide psychotherapy can be
therapists, psychologists, psychiatrists, social workers, or counselors. Types
of psychotherapy include cognitive-behavioral therapy (changes how a
person thinks about, and then reacts to, a situation that makes them anxious or
fearful) family therapy, and group therapy. In some cases, a person may need to
go into the hospital or into an in-patient or residential program. Medication is
also sometimes used to treat the disorder and prevent relapse (or keep it from
coming back). Certain antidepressants, called selective serotonin reuptake
inhibitors or SSRIs, have been shown to help maintain weight and reduce
anxiety for people with anorexia and bulimia. Training to build self-esteem can
also be helpful.
