Eating Disorders: What a Parent Should Know

Now that the kids are back in school, I thought this would be a good time to highlight a troubling issue among adolescents and young women. While many adolescents struggle with body image and healthy eating habits to some degree, extreme focus on body image and/or food could be a sign of an eating disorder. An eating disorder is a serious issue, with startling health implications, up to and including death.

People with eating disorders experience serious disturbances in their eating patterns, such as a severe and unhealthy reduction in their food intake or overeating, as well as extreme concern about body shape or weight. Eating disorders usually develop during adolescence or early adulthood. As with most mental illnesses, eating disorders are not caused by just one factor but by a combination of social, psychological and biological factors. Eating disorders are not due to weak willpower or bad behavior … rather, they are real, treatable illnesses. The most prevalent types of eating disorders are anorexia nervosa and bulimia nervosa.

A parent or a concerned friend may ask: who has eating disorders? Women are much more likely than men to develop an eating disorder. Only an estimated 5 to 15 percent of people with anorexia or bulimia are male. Often, these males are involved in sports that have a specific focus on weight and body composition, like wrestling and gymnastics. It has been estimated that as many as 3.7 percent of woman suffer from anorexia nervosa in their lifetime, with about 1% of adolescents suffering from it at any one time. Research has shown that 4.2 percent of women experience bulimia nervosa in their lifetime. About 50 percent of people who have had anorexia develop bulimia or bulimic patterns.

What should parents or concerned friends be looking for in regard to signs and symptoms?

Anorexia Nervosa—Extreme weight loss and believing that one is fat despite excessive thinness are key features of anorexia. The following behaviors are signs that a person may have anorexia:

• Skips meals, takes tiny portions, will not eat in front of others, or eats in ritualistic ways
• Always has an excuse not to eat
• Will only eat a few “safe,” low-calorie, low-fat foods
• Loses hair, looks pale or malnourished, wears baggy clothes to hide thinness
• Loses weight yet fears obesity and complains of being fat despite excessive thinness
• Detests all or specific parts of the body, insists she or he cannot feel good about self unless thin
• Exercises excessively and compulsively
• Holds to rigid, perfectionist standards for self and others
• Withdraws into self and feelings, becoming socially isolated
• Has trouble talking about feelings, especially anger

Bulimia Nervosa—People who have bulimia regularly binge-eat and then attempt to prevent gaining weight from their binge through purging (e.g., vomiting, abusing laxatives, exercising excessively). The following are signs of bulimia:

• Binges, usually in secret, and empties cupboards and refrigerator
• Buys “binge food” (usually junk food or food high in calories, carbohydrates and sugar)
• Leaves clues that suggest discovery is desired: empty food packages; foul-smelling bathrooms; running water to cover sounds of vomiting; use of breath fresheners; poorly hidden containers of vomit
• Uses laxatives, diet pills, water pills or “natural” products to promote weight loss Abuses alcohol or street drugs to deaden appetite or escape emotional pain
• Displays a lack of impulse control that can lead to rash and regrettable decisions about sex, money, commitments, careers, etc.

As stated above, eating disorders are caused by a combination of social, psychological and biological factors. Social and psychological factors include low self esteem, pressure from others to be thin, cultural norms to be attractive promoted by the media, use of food as a coping mechanism, rigid thinking ( e.g. “being fat is bad”), an over -controlling family and history of sexual abuse. Biological factors include a genetic predisposition to eating disorders (as well as depression and anxiety) and a deficiency or excess of certain brain chemicals called neurotransmitters, especially serotonin.

Other issues often complicate an eating disorder. Mental illnesses such as depression, anxiety and alcohol/drug addiction are sometimes found in people with eating disorders. Some of these disorders may influence the development of an eating disorder, and some are consequences of it. Many times, eating and co-occurring disorders reinforce each other, creating a vicious cycle.

Left untreated, eating disorders can cause an array of health complications, including malnutrition, muscle atrophy, dry skin, dental problems, insomnia , low blood pressure, diabetes, organ failure and heart attack, just to name a few. The mortality rate among people with anorexia is 12 times higher than the death rate among females’ ages 15 to 24 from all other causes.

Fortunately eating disorders are treatable. The sooner they are diagnosed and treated, the better the prognosis. That is why it is important that as parents or caring friends we are knowledgeable about this important topic. Eating disorders require a comprehensive, long-term treatment plan that usually involves individual or family therapy, and may include medication and even hospitalization. Unfortunately, many people with eating disorders will not admit they are ill and frequently refuse the help of others. Awareness and support from family and friends is vital to successful recovery.

For more information concerning this and other mental health matters please contact the Mental Health Association of Essex County at 973-509-9777 or reach us on-line at www.mhaessex.org.