Eating Disorders

Many Americans believe that thinner is better. People with eating disorders believe it so deeply that their weight and dieting success become the measure of their self-esteem. Thinking that eating is the cause and result of many of their problems, they become trapped in a vicious cycle of repeated, ritualistic, and rigid behavior focused on food.

Symptoms of Eating Disorders

The most common eating disorders include anorexia nervosa (self-starvation), and bulimia (binging and purging). Some experts also consider compulsive overeating an eating disorder.

Anorexics are often thin to point of emaciation, but are afraid to gain weight. They may have symptoms caused by severe weight loss: dry skin and hair, cold hands and feet, general weakness, constipation, amenorrhea (loss of menstrual periods). As the weight loss progresses, more severe problems may develop such as increased susceptibility to infections, stress fracture, ketosis (severe chemical imbalances), and weaknesses of the heart muscle that can lead to death.

Bulimics may be of average or slightly above average weight, usually do most of their binging and purging secretly, and have rapid weight gains and losses. They purge through self-induced vomiting, abusing laxatives and diuretics, fasting, or over-exercising, and are subject to medical problems caused by their purging methods as well as their eating habits. Medical problems include dehydration, constipation and digestive disorders, severe dental problems, and muscle weakness. As bulimia progresses, ulcers and life-threatening heart irregularities may develop.

Many anorexics may periodically binge and purge like bulimics. They suffer from a combination of anorexic and bulimic symptoms.

Compulsive overeaters are usually overweight and may become obese. As their weight increases they may begin to suffer from shortness of breath, high blood pressure, and joint problems. If they become severely obese, their problems can progress to osteoarthritis and life-threatening disorders such as heart and gall bladder diseases and diabetes.

Signs of Eating Disorders

People with eating disorders spend a lot of time thinking about eating, food, weight, and body image - they may count and recount the calories in their meals, weigh themselves many times a day, and place themselves on severely restricted diets, regardless of their weight. They often "feel fat" when their weight is normal or abnormally low, or feel uncomfortable after consuming a normal-sized or small meal. Generally, they categorize foods as "good" or "bad", and make judgments about themselves based on how well they control what they eat. Believing that others also are judging them based on their control of food, they frequently feel anxious eating when people are around.

What Causes Eating Disorders

Cultural and psychological issues, personality traits, and learned behavior all contribute to eating disorders. In addition, some people may have biochemical imbalances that make them prone to these disorders.

American culture encourages people to base self-worth on body weight and shape - if you aren't as thin as a fashion model or as muscular as a fitness fanatic, you may see yourself as a less valuable person. At the same time, food is often used as a source of love and comfort, and eating is an important part of social events. The resulting confusion can lead to conflict about why and when to eat.

People with eating disorders are often subject to depression, anxiety, and low self-esteem. They generally are perfectionists who feel inadequate, ashamed, and guilty when they don't measure up to their own standards - standards that are often unrealistic and based on rigid, black/white, either/or thinking.

An eating disorder is also a learned coping skill used to rechannel, avoid, or forget emotions - anger, sadness, anxiety, or even joy - that feel too threatening. This behavior may be learned from family or peers. Often, a parent of someone with an eating disorder abuses food, alcohol, or other drugs.

Why Can't I Just Stop?

A few people can stop their eating disorders by themselves and never have relapses. But, because many factors contribute to these disorders, most people need help. The most successful treatments usually combine several forms of therapy, possibly including: behavior modification, individual, group, and family psychotherapy; and participation in self-help groups. Hospitalization may be necessary for people whose symptoms are particularly severe, and drug therapy may be useful for any underlying long-term depression and anxiety. In addition, many people with eating disorders benefit from education about their basic nutritional needs in conjunction with other forms of help.

Although repeated or long-term treatments may be necessary, eating disorders are controllable.

Do I have a Problem?

Many people go on diets or overeat once in a while. If you think your eating is getting out of control or that food is playing too big a part in your life, use the questions below to help evaluate your behavior and pinpoint potential problems.

Answer Yes or No :

1. I constantly think about eating, weight and body-size.
2. I become anxious prior to eating.
3. I am terrified about being overweight.
4. I don't know when I'm physically hungry.
5. I go on eating binges and can't stop eating until I feel sick.
6. I often feel bloated or uncomfortable after meals.
7. I spend a lot of time daydreaming about food.
8. I weigh myself several times each day.
9. I exercise too much or get very rigid about my exercise plan.
10. I believe that being in control of food shows other people that I can control myself.
11. I have taken laxatives or forced myself to vomit after eating.
12. I believe food controls my life.
13. I feel extremely guilty after eating.
14. I eat when I am nervous, anxious, lonely, or depressed.
15. I don't think I look good in my clothes.
16. Because of my weight and appearance, I'm more uptight than I'd like to be around people who I find sexually attractive.

Look at your answers carefully - if you decide that your eating habits are making you sick or simply keeping you from enjoying life, it may be time to make some changes. Keep in mind, however, that the ways you use food come from your cultural heritage, psychological makeup, and years of habit. Speak to a nutritionist or counselor on campus or in your community.

Helping a Friend

If you think a friend may have an eating disorder, you can help by taking the following steps:

• Discuss your concerns with a professional. Learn about eating disorders and available local resources. Your campus or community counseling center is a good place to start. You might use the "Do I Have A Problem?" checklist above to help evaluate the situation before consulting a professional.
• Talk to your friend. Keep the discussion informal and confidential, and focus on your concerns about your friend's health, not weight or appearance. Explain how the problem is affecting your relationship. Mention that eating disorders can be treated successfully. If your friend is able to acknowledge the problem, suggest some resources.
• Realize that you may be rejected. People with eating disorders often deny their problem because they are afraid to admit they are out of control. Don't take the rejection personally, and try to end the conversation in a way that will allow you to come back to the subject at another time.
• Know your limits. If you sense that you are getting angry or impatient, back off. And don't take on the role of counselor or food monitor - it's inappropriate and ineffectual.

For more information, contact Counseling and Psychological Services at 621-3334.