Eating Disorders

Eating disorders include extreme emotions, attitudes, and behaviors surrounding weight and food issues, and are experienced by both women and men. They include anorexia nervosa, bulimia nervosa, and binge eating disorder. All are serious emotional and physical problems that can have life-threatening consequences.
Eating Disorders can occur at any age, but they most commonly begin during the teen years. Going away to college can almost be defined as a risk factor for developing an eating disorder in a young person who feels uncomfortable about his/her body and is not sure how s/he is going to 'fit in' and make new friends on campus.

How Do Eating Disorders Start and Develop?
What starts as a desire to lose a few pounds or engage in healthier eating according to the latest low fat or low carb diet can “start the ball rolling” for the development of eating disorders. In addition, food is a comfort and can act as a sedating drug for some who turn to it in order to deal with the anxieties of academic and college social life. The challenge of restricting food offers another focus of energy and attention that’s straightforward and measurable at a time when life may feel too complex and overwhelming. Controlling food and weight may feel like a major accomplishment and provide a sense of control. Students may receive positive attention for their weight loss, which further reinforces their interest in losing even more weight. For some vulnerable students, the dieting mind set and dieting behaviors as well as use of purging methods such as laxatives, vomiting and excessive exercising can become a vicious and increasingly entrenched cycle. It can feel like a 24-hour obsession that leads to loss of focus for other aspects of their life.

The Basic Facts: Descriptions of the various eating disorders

Anorexia Nervosa is characterized by self-starvation and excessive weight loss.
Symptoms include:

• Refusal to maintain body weight at or above a minimally normal weight for height, body type, age, and activity level.
• Intense fear of weight gain or being "fat."
• Feeling "fat" or overweight despite dramatic weight loss.
• Loss of menstrual periods.
• Extreme concern with body weight and shape.

Bulimia Nervosa is characterized by a secretive cycle of binge eating followed by purging. Bulimia includes eating large amounts of food -- more than most people would eat in one meal -- in short periods of time, then getting rid of the food and calories through self-induced vomiting, laxative abuse, or over-exercising. People with bulimia are most often within 10 lbs. of normal weight, but may also appear over or under weight.
Symptoms include:

• Repeated episodes of bingeing and purging (2 or more a week).
• Feeling out of control during a binge and eating beyond the point of comfortable fullness.
• Purging after a binge, typically by self-induced vomiting, abuse of laxatives, diet pills and/or diuretics, excessive exercise, or fasting.
• Frequent dieting.
• Extreme concern with body weight and shape.

Compulsive Overeating (binge eating disorder) is characterized primarily by periods of uncontrolled, impulsive, or continuous eating beyond the point of feeling comfortably full. While there is no purging, there may be sporadic fasts or repetitive diets and feelings of shame or self-hatred after a binge. People who overeat compulsively may struggle with anxiety, depression, and loneliness, which can contribute to their unhealthy episodes of binge eating. Body weight may vary.

Other Eating Disorders can include some combinations of the signs and symptoms of anorexia, bulimia, and/or compulsive overeating. While these behaviors may not be clinically considered a full syndrome eating disorder, they can still be physically dangerous and emotionally draining.

What should I do if I think someone has an eating disorder

If you are worried about a friend, the first thing you must realize is that you cannot force someone to get help or change her or his attitudes or behaviors. What you can do is honestly share your concerns, provide support, and help her or him get more information and find out what kind of help is available. The following suggestions have been found to be most useful in dealing with a friend with an eating disorder.
Learn as much as you can about eating disorders. Read books, articles, and brochures. Search the 'net'. Know the differences between facts and myths about weight, nutrition, exercise, and eating disorders. For example, many people believe that everyone with an eating disorder is very thin. This is true of people with anorexia nervosa, but most people with bulimia nervosa or binge eating disorder are close to normal weight. It IS a fact that regular vomiting causes the enamel on the inside of the teeth to erode, and that this is permanent damage. Sometimes concern about their teeth is what motivates people to get help in the early stages of bulimia.
Honestly Express Your Concerns.

• Ignoring or avoiding the problem won't help. People who have recovered say that it was important that friends and family members kept trying to get through to them and kept delivering the same message over and over, because at some point, the messages began to get through.
• Use a calm, supportive, non-confrontational, but direct approach. Choose a peaceful time for a talk. Give a few examples of behaviors that have made you worry, using "I" statements. For example:
• "I'm concerned about you because you refuse to eat at breakfast or lunch."
• "I've heard you throwing up in the bathroom; it scares me. Let's get help."
• "I'm sorry, but I'm not going to work out with you any more because I feel like I'm helping you abuse yourself."
• Explain that you feel these behaviors may mean that s/he has a problem that needs professional help.
• Avoid getting into a battle of wills with your friend. If s/he refuses to acknowledge the problem, restate your feeling and the reasons for them, and continue to be open and available as a supportive listener. For example: "I know you say that I shouldn't be concerned and that I should mind my own business. But I am concerned and that is my business. In fact, to help me deal with that concern, I've consulted a doctor and a therapist."
• Caring about the person doesn't mean being manipulated by her/him. People with eating disorders often deny their problem, especially in the early stages of the disorder. Even if they are willing to admit it to themselves, they may deny the problem to others, for fear of being forced into treatment before they are ready to give it up.
• Avoid accusational "you" statements. For example
• "You have to eat something!"
• "You're out of control, you must be crazy!"
• Avoid simplistic solutions. For example: "Why don't you just stop? Then everything would be fine!"

Tell Someone: If you have done everything you can, and your friend is not responding, it is time to tell a trusted adult. Consider telling his/her parents, a teacher, doctor, counselor --- anyone who may be able to help your friend AND help you. Being close to someone with an eating disorder is a stressful and scary place to be. You shouldn't feel you have to solve the problem yourself. If you decide you want to tell your friend what you plan to do, you might say something like this: "Look, I think we're both at risk for getting caught up in some dangerous spiral here. I've been talking, and you've been tuning me out and insisting that there's nothing wrong. I'm really scared because I believe that something is very wrong and I'm so afraid of losing you. This is too much for me to handle alone, so I'm going to have to tell __________."

Eating disorder behaviors usually start out as a solution to a problem (allaying the fear of being fat), but end up becoming an enormous problem in their own right. Help is available; there is hope! If you are concerned for yourself or a friend, feel free to call the Eastern Illinois University Counseling Center at 581-3413 for a consultation.

Self-Help Resources
On the Web
Nationaleatingdisorders.org

Recommended Reading
French toast for breakfast
Surviving an Eating Disorder