Don't we all diet? When does a little preoccupation with weight and food point to an eating disorder? Anorexia and bulimia are on the rise and seem to affect the girls and young women who "have it all." How can we recognize the signs and, most importantly, what can we do to help people with eating disorders?
In a society that always seems to focus on beauty and perfection as a measure of one's success, it is easy to get swept up in the romantic notion of body idealism. Suddenly our young girls think that a healthy and strong body is a fat body, and they go to drastic and dangerous means to lose weight. What often starts out as a seemingly harmless diet can spiral into obsessive, out of control weight loss.
What is an Eating Disorder?
With so many things in life, there can be a fine line between normal and abnormal. Black and white merge into shades of gray. Yet when the line is crossed, the results can be shattering. There is no doubt that people of all ages tend to focus on food in our society. It has become the norm to hear women, especially, complaining about their hips or their thighs or muttering about how skinny or heavy another woman may be. Who isn't dieting at one time or another? Who hasn't experienced that sense of bliss when deciding to start the dreaded diet in just one more day?
However,
when food and eating become a constant preoccupation,
when weight loss is perceived as the only way to achieve happiness,
and a good day is defined solely by which clothes fit or how much willpower you were able to muster,
there is a problem larger than the need to get into shape.
An eating disorder exists when food is used in an extreme way to cope with painful feelings. It becomes the symptom of a much bigger problem.
When you no longer care about, or can control, the harm that you are doing to your body as you spiral down the never-ending journey to get just a little thinner, or when the need to compulsively eat everything you can get your hands on is larger than life, you are among the ever-growing group of people with eating disorders.
What is Anorexia Nervosa?
Anorexia translates to "loss of appetite" and though this may appear to be what is going on with an anorexic, it couldn't be further from the truth. Anorexics have not lost their appetites. They have made a willful decision to stop eating (or to eat almost nothing) in order to lose weight. The persistent hunger, which is often physically painful, is also a euphoric reminder of their powerful control. As their bodies seem to melt away, these feelings of power and control escalate. Anorexia nervosa is a disorder that often starts in the teenage years and affects many more girls than boys. It is important to note, however, that there are young children and adults who also suffer from this illness. It is dangerous, it is ugly, and it is life-threatening.
Basic Signs of Anorexia
A body weight of about 85% (or less) of what would be considered normal
A deliberate and obsessive starvation plan
Lying about, denying, and hiding the truth
Terror at the thought of gaining weight
Outward denial of hunger
Compulsive and relentless exercising
Feelings of being fat as part of a distorted body perception
Amennoriah (cessation of normal menstrual periods)
Inability to stay warm
Hair loss (sometimes)
Possible lanugo growth (fine hair over body)
Why Anorexia?
It is hard to understand deliberate, ongoing starvation in girls who seem to have it all. Quite often, anorexics are those girls of solid socioeconomic status who appear to be happy and successful. They are the good students, the kids involved in community activities, the athletes. And yet, something is terribly wrong.
Different theories exist as to why anorexics start the diet that unravels the façade of happiness. At an age where life seems to spin out of control, the body becomes one area where total control can be gained. The diet may start out as the means to lose a few pounds, but it becomes addictive. Anorexics seek perfection, and as skin wraps tighter and tighter over bone, they get closer to their goal, but never close enough.
Can't We Just Make Her Eat?
It seems illogical that in this day and age, we can watch a child slip away through willful starvation when she is surrounded by food and a concerned family. An anorexic cannot stop losing weight, because she is terrified that once she stops, the process will reverse itself, and she will not be able to stop eating. Her distorted body image and ritualistic behaviors keep her imprisoned on a track of starvation. She will lie about what she has eaten in order to protect her mission. Anorexics are sneaky. They hide food, they discard food, and they often purge their systems if they lose control, or are forced to eat food.
You cannot "just make her eat" because she plans each minute, each hour and each day around "not eating." The problem is bigger than a plate of food and a stern tone.
Health Risks: Anorexia
Electrolyte imbalance (due to mineral loss)
Growth failure
Heart arrhythmias
Atrophied bones
Abnormal body temperature
Osteoporosis
Bulimia (the development of)
Death
What Is Bulimia?
Bulimia nervosa is characterized by the binge and purge cycle. Excessive quantities of food are eaten in short time spurts. This is immediately followed by a sense of calm or fulfillment, and shortly thereafter transformed into guilt and shame. Binge eating is then "handled" by discarding the food, through laxatives, enemas, self-induced vomiting, diuretics, or extreme exercise.
Bulimia is a secret disorder. You can't see if somebody has it, and she (or he) probably won't volunteer the information. There is a tremendous amount of shame involved, feelings of loss of control and anxiety, and an inability to stop. It is an obsessive, addictive behavior that causes more and more physical harm with each episode.
Therefore, in contrast to anorexia where one can see a body wasting away, bulimia is much harder to recognize. It is a "private" disorder. No one is uncontrollably consuming thousands of calories and then excusing herself to vomit while socializing with friends. Bulimics will often deny that they are suffering from this disorder.
Basic Signs of Bulimia
Preoccupation with body weight / size / appearance
Running to the bathroom after meals
Depression, anxiety
Irregular periods
Dental complications
Bloodshot eyes
Sore knuckles and throat (from self-induced vomiting)
Swollen glands
Exhaustion
Why Bulimia?
Bulimia wasn't recognized as its own disorder until the 1980s. Bulimics generally have a preoccupation with body size and ideal image. Eating large amounts of comfort food momentarily numbs stress and depression. However, once that basic calm passes, bulimics are left feeling ashamed and guilty.
Bulimia tends to affect high achievers with excessive anxiety about their weight and appearance. Differing theories exist as to why people get hooked on the binge and purge syndrome, but some research points to an altered brain chemistry that may place people at higher risk for eating disorders in general.
Terrible Ten
Bulimia is believed to affect 10% of college women.
About 10% of those diagnosed with bulimia are men.
10% of people with bulimia will die from related complications.
It can be terrifying to watch a loved one in the clutches of an eating disorder. There is no doubt that support and patience play a large role in recovery. More often than not, professional help is required. Whether healing can begin through counseling or hospitalization, action must be taken.
Eating disorders are often like a swinging pendulum. Initially, the intensity and dangerous behaviors are large like the full, wide action of a pendulum. Emotions and setbacks are experienced on a large scale. Through time and treatment, and the effort to recover, a middle ground is found. The pendulum swings diminish and represent a safer, happier, and more knowledgeable place.
Don't
Pretend nothing is wrong
Be afraid to confront the individual you are worried about
Do
Let the person know you care
Listen to what she has to say
Help her find appropriate help through counselors and physicians
A Heightened Awareness
It is important, that as a society, we stop romanticizing these disorders. We often see pictures of celebrities splashed across the covers of leading magazines, as yet another entertainer falls victim to an eating disorder. Our young girls sometimes perceive this as a glamorous, if not exotic, place to be.
Education needs to step it up and show what anorexia really looks like. As young girls starve themselves to unbelievable dimensions, and hair falls out in tufts, we see a haunting image that is drastically different than the movie star looking just a bit waiflike in her gown…
Sticks and stones may be less harmful than the wrong words at the wrong time.
Insensitive comments and teasing can do a lot more damage than we sometimes realize. The father teasing his daughter about a little baby fat, or the mother telling her daughter how pretty she could be if she just lost five pounds, may be contributing to a growing internal conflict. These words, which may seem benign to the speaker, just may carry the punch to push a young girl into the depths of extreme action.
Shift the focus
As parents we need to shift the focus and check our value systems. Celebrating our girls for their talents and intelligence, for their kindness and potential will help them to see that the possibility within them goes far beyond the reflection staring back at them in the mirror.