When eating becomes a disorder

Eating disorders are usually complex and a hard battle to fight. But with a little help, you can get over them.

woman staring at foodAnorexia, bulimia and binge eating disorder are diseases of the mind, body and spirit and hence all these areas of dysfunction must be addressed for treating them.

These are not about food, body size and eating. The symptoms of these, however, are what catches people's attention and causes them to believe that if the symptoms are corrected, the person with the illness will be cured. But, the solution is much more complex and these disorders run immeasurably deeper than what one can see.

What's your problem?

There are three types of eating disorders according to DSM IV—the diagnostic statistical manual for psychiatric illnesses: Anorexia nervosa, bulimia nervosa, and EDNOS [eating disorder not otherwise specified]. Binge eating disorder is usually placed in the EDNOS category. With anorexia, there must be a weight loss of at least 15 per cent of the person's normal body weight, restrictive eating and amenorrhea [the loss of the normal menstrual cycle in women].

Binge eating disorder is very similar to bulimia [Bulimia is characterized by recurrent binge eating, followed by compensatory behaviours] with binges that sometime alternate with restrictive eating, but it is without the characteristic bulimic behaviours of purging through vomiting, excessive exercise or the abuse of laxatives, diuretics or diet pills. It is not unusual for someone with anorexia to progress to bulimia or binge eating at some time in their illness, or someone with those problems to become anorexic.

What causes it?

The strongest entree for an eating disorder is dieting. Those who never diet or severely restrict foods or number of times they eat are less likely to develop an eating disorder and more likely to maintain a normal body weight. For this reason, one of the strongest prevention approaches for eating disorders is to be aware of the various myths about dieting and healthy eating.

Food is not inherently either good or bad; what one 'does with it' may make it so.

Do you know the facts?

Dieting affects metabolism and continued dieting could lead to diet-induced obesity. Metabolism slows down in order to accommodate restricted eating [in a sense, we enter starvation mode]. When there is a return to 'normal' eating one will gain back all the lost weight, sometimes even more. Research shows that over 95 per cent of people who diet, gain back the weight they have lost.

Research also shows that weight cycling—the 'yo-yo' syndrome—is more harmful to the body than to remain stable in a slightly overweight state. Our bodies strive to reach our set-point range and that may not always be the ideal weight that we seek in our minds. Genetics, culture and race are the strongest determinants of body size and shape. Attempts to change what has been programmed into our individual make-up are futile and unrealistic.

How to identify the condition?

Here are a few signs and symptoms that can help determine whether you are suffering from an emerging or existing eating disorder.

  • You have a history of repeated dieting that may alternate with periods of bingeing and/or periods of fasting.
  • You have a pressing need to keep losing weight, even though you are already thin.
  • You have a hampered ability to objectively view your body size and having a distorted body image
  • You want to skip meals and when family or friends force you, you often lie that you ate at another place or another time.
  • You eat in secret during the night or when no one else is around because you don't want anyone to see how much you eat.
  • You eat a great deal of food at meal times and go to the bathroom following meals to purge.
  • You use laxatives, diuretics or diet pills to 'empty' your stomach so you don't get fat.
  • You often complain of stomach aches, diarrhoea, constipation or other gastrointestinal problems.
  • You exercise for hours to the exclusion of other activities under the excuse of staying fit.
  • Your have extreme mood swings.
  • You have expressed a desire to die or kill yourself because you are unhappy about yourself.
  • You are experiencing problems with interpersonal relationships, social isolation, concentration, memory, decision making and/or sleep.
  • You complain of chest pains, racing heart, sore throat, muscle cramps, dental problems, or always being cold.

If you notice any of these symptoms in someone you know, gently confront her/him in a loving, non-blaming and non-judgmental way. Tell her your concern and fear for her well being. Initially, she may fear that people are trying to take away her control and feel ashamed that others will think poorly of her. If she denies the problem, don't give up. Re-express your concern at a later time, if you still see signs and symptoms of the disorder.

Want to get over it?

A team treatment together with a therapist, nutritionist and medical doctor is the best way to overcome an eating disorder. When health problems manifest in acute or chronic cases, inpatient or intensive outpatient programmes may be necessary. If acceptable to the patient, getting the family and significant others involved [who are also suffering] will offer the best prognosis for recovery.

Uncovering the underlying issues—whether they are family problems, abuse, a poor sense of self and competency, depression, anxiety, loss—is usually a long process and the average length of treatment is 5 to 8 years with qualified providers. Early intervention is important.

How to uproot this problem?

Hectic schedules, misinformed beliefs and lack of time or desire to prepare healthy, balanced meals lead many to skip meals, eat fast food or consume highly processed and junk foods. Family meals have, for many, become a thing of the past as parents accommodate their children's extracurricular activities, sporting events, dance classes and work schedules. Lack of this very special family time not only contributes to disordered eating, but also robs them of valuable time for communication, support and intimacy.

Research has shown that children who participate in family meals do better in school and are less likely to get involved with drugs or alcohol. Teaching children good food habits at an early age is the only way to uproot such eating disorders in the generations to come.

For more info, visit www.nationaleatingdisorders.org

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Anita Sinicrope Maier, MSW, LSW, is the founder and executive director of The Pennsylvania Educational Network for Eating Disorders [PENED].

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