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American society has a fascination with food and weight. We have a great abundance of food in this country and an "ideal" physical standard that insists on a thin body type. The dominant white American culture presents the only pretty girl or woman as a thin one. (Black and Hispanic teenagers enjoy a much more inclusive and healthier definition of beauty, but may still on occasion have eating disorders.) Our culture encourages a very early emphasis on diet and physical appearance.
In recent years, efforts have been made to replace our emphasis on thinness with an emphasis on fitness. While those efforts have helped, it is clear that many young women have not "bought" the message. They still feel they must be thin to be acceptable or successful in society. If you care about a young girl or woman who suffers from an eating disorder, you will quickly become aware of the many messages about the desirability of thinness in our society.
Eating disorders are most common in industrialized societies, where food is abundant. Girls and women make up the vast majority of individuals suffering from eating disorders. Most eating disorders start somewhere between the ages of 14 and 18. They rarely occur in women over forty, although a woman who had an eating disorder as a girl may certainly still have symptoms that reflect that history.
There are two basic ways girls with eating disorders try to maintain low body weight:
- restricting weight by fasting or excessive exercise or
- over-eating or binge eating and then purging, through self-induced vomiting, or the use of laxatives, diuretics or enemas
In anorexia nervosa, the girl or woman refuses to maintain a body weight at or above a minimal normal weight for her age and height. In general, she weighs less than 85 percent of what might be expected for her age, height and period of growth. She has an intense fear of gaining weight and becoming fat, despite the fact that she is underweight.
She is confused about her weight and shape, being overly critical of her body and denying the seriousness of her low body weight. It is usually very difficult to change her perceptions of being overweight or her denial of the medical consequences. Often, normal menstrual cycles cease because of low body weight. Anorexia is a very serious illness that can result in serious medical complications. It results in death in more than ten percent of those afflicted.
The individual suffering from Bulimia nervosa has recurrent episodes of binge eating. Binge eating is defined as eating, in a particular period of time, an amount of food that is clearly larger than most people would eat during a similar period of time and under similar circumstances. There is also a feeling of a lack of control over eating during the episode.
Once binge eating has occurred, she usually tries to compensate for the additional calorie intake by self-induced vomiting, or misuse of laxatives, diuretics or other mediations. Bingeing and purging occur, on average, at least twice a week for at least three months. A bulimic girl or woman may be normal weight or overweight. Her health is still at risk. For example, self-induced vomiting may erode her tooth enamel. Her bowel function may be impaired by laxatives. As in anorexia, self-evaluation is heavily dependent upon perceived weight.
Most girls and women with eating disorders do their best to conceal them. It may be difficult for you to know if someone you care about has an eating disorder. Here are some common symptoms:
- excessive weight loss in a relatively short period of time
- continuation of dieting although excessively thin
- dissatisfaction with appearance; belief that the body is fat, although underweight
- loss of monthly menstrual periods
- unusual interest in food; the development of strange eating rituals
- eating in secret
- an obsession with exercise
- serious depression
- bingeing-consumption of large amounts of food
- bingeing but no noticeable weight gain
- vomiting or use of drugs to stimulate vomiting, bowel movements or urination
- disappearance into the bathroom for long periods of time (to induce vomiting)
- abuse of drugs or alcohol
Relapses are common in eating disorders. However, there are several good treatment approaches to both anorexia and bulimia. Hospitalization may be necessary for anorexia. Both anorexia and bulimia may improve with antidepressant medications. Education about good eating patterns is almost always helpful, as is family therapy for women still living at home.
If you think you are suffering from an eating disorder, or you have a friend or relative who is suffering from an eating disorder, you can discuss treatment options by calling the Stressline at (317) 338-4800.
Disclaimer: This material is intended for the purpose of general education. It is not comprehensive. It will not substitute for the evaluation and intervention of a mental health professional.
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