eating disorders

According to the National Eating Disorders Association (NEDA), as many as 10 million women and 1 million men in the United States are fighting for their lives as they struggle with anorexia and bulimia, while binge eating is estimated to affect 15 million people.

In recognition of the impact of eating disorders on so many lives, the last week in February has been designated as National Eating Disorders Awareness Week. This is the 25th year that the awareness week has been held.  The goal of the week is to educate both the public and health care professionals about the serious nature of eating disorders and to dispel some common myths about these diseases. To emphasize the widespread nature of eating disorders, this year's theme is "Everybody Knows Somebody."  

Not Just about Food and Not a Lifestyle Choice

One of the biggest myths about eating disorders that NEDA hopes to dispel is the belief that they are only about food and that they are lifestyle choices.  Anorexia, bulimia and binge eating are complex conditions that can involve psychological, biological and sociological issues.  A fixation on food and body weight is often rooted in the need to feel in control of one's life.  Many people with eating disorders need to feel in control because they suffered a trauma at some point in their life that made them feel out of control.  

Eating disorders can also be caused by a poor body image, a condition that is fueled by media images that connect beauty and desirability with a low body weight.  Although media messages about the importance of being thin may not cause eating disorders, the play a part in creating an environment where people become fixated on the size and shape of their bodies.  

Another common belief about eating disorders is that they are diseases of choice that can be easily overcome.  Like other mental illnesses such as depression, people who are affected by eating disorders did not choose to become ill.  Although people with eating disorders often appear to have many advantages in life, they are suffering from an illness that requires treatment.

Eating disorders are not always viewed as serious conditions, but in reality they have a higher mortality rate than any other mental illness.  Anorexia is the most deadly eating disorder, leading to death for 20 percent of people who have the disorder for more than 20 years.  People who don't die from eating disorders may experience dental problems, heart disease, gastrointestinal problems, infertility, organ failure and other severe medical complications from purging and starving. 
The misconceptions about eating disorders can prevent patients, family members and doctors from recognizing the illness and seeking treatment.  Through education and greater public awareness, NEDA hopes that more people will receive early and effective treatment for these deadly disorders.

In reality, more than 10 million American from all walks of life suffer from eating disorders that include anorexia, bulimia and binge eating.  According to a recent article in The New York Times, a surprising percentage of people with eating disorders are women in mid-life or older.

Judith Shaw, a 58-year-old yoga instructor, was approaching the age of 40 when a need for validation caused her to become obsessed with diet and exercise.  She began to spend hours each day working out at the gym, sacrificing family time in favor of exercise.  Even though her weight dropped to 85 pounds, no one in her life said anything about her weight loss and exercise obsession.  Her doctors praised her efforts at avoiding weight gain as she got older.  Finally, after two falls left Judith with a broken arm and pelvis, another yoga instructor begged her to start eating and get help.  Due to years of malnourishment, Judith had developed osteoporosis as well as anemia.

Some women over 40 with eating disorders were first diagnosed as young women and overcame the problem, only to suffer a relapse as they age.  An even greater number are like Judith Shaw and develop an eating disorder problem later in life.  For these adult women, gaining control over their weight and becoming stronger through exercise begins as a positive activity but becomes life-threatening when carried to an extreme. 

The Eating Disorders Program at the University of North Carolina at Chapel Hill has seen a shift in its patients from mostly adolescents to an even mix of teens and adults.  According to program director Cynthia Bulik, women in their 50s and 60s are influenced by American culture’s emphasis on slimness and the perfect body.  When it comes to anorexia, older women abuse their bodies in the same ways as teenagers.  Laxatives, a restricted diet and constant exercise are used to slim down and maintain a low body weight.

Eating disorders are often triggered by anxiety-inducing life changes.  For young women, this could be a divorce in the family or going away to college.  For more mature women, having a baby or seeing grown children move out of the house are stressful events that can lead to eating disorders.  Because these women appear to be functioning well in other areas of their lives, their eating and exercise problems go undetected.  Judith Shaw commented on her situation, “It was no one’s job to fix me, but I wish someone had said to me: ‘I miss you. You’re gone. You’re so obsessed.’ ”

Fortunately, most adult women with eating disorders respond well to the same type of treatment that is used for adolescents and young women.  It’s important to get help early in order to avoid the effects of bone loss and osteoporosis.  By working with therapists and nutritionists, a woman over 40 can begin to understand the origins of her illness and develop a more realistic body image.  Nutritional counseling will help her adopt healthier eating habits. 
In the case of Judith Shaw, art therapy helped her overcome her eating disorders.  Her art work related to body image is currently on display at Columbia University’s Center for Eating Disorders.  She is now 30 pounds heavier, but has shed the emotions that led to her anorexia. 
   

A new study has found that teenagers who suffer from eating disorders are more likely to harbor suicidal thoughts.  According to research published in the Archives of General Psychiatry, adolescents with eating disorders are also more likely to suffer from substance abuse and anxiety disorders.  Additionally, the research surprised even experts in the field when it revealed that more than half a million U.S. teens admit to having the symptoms of eating disorders. 

These findings come from a survey of more than 10,000 teenagers, the most comprehensive survey of its type ever completed in the U.S.  Researchers at the National Institute of Mental Health analyzed the survey data and reported these findings:

•    1.6% of teens surveyed suffer from binge-eating.  A binge-eater will compulsively consume large amounts of food without feeling hunger, then experience depression and guilt.
•    0.9% suffer from bulimia nervosa, which involves binge-eating with purging through self-induced vomiting, consumption of laxatives and over-exercising.
•    0.3% suffered from anorexia nervosa, which is characterized by self-starvation and excessive weight loss. 

Each of these eating disorders involves a preoccupation with body image and weight.  Depression is often a trigger for binge-eating disorders, while anorexia and bulimia may begin with a concern about being made fun of for being overweight.  The disorders affect both males and females.  While more girls than boys were found to have bulimia and binge-eating, an equal number of males and females suffering from anorexia. 
One of the most shocking findings of the research is that one third of the teens with bulimia reported having attempted suicide.  The research also revealed the link between eating disorders and substance abuse, a topic that has been studied by other researchers. As many as 50% of people suffering from anorexia and bulimia have been found to have substance abuse problems.  Alcohol, cocaine, amphetamines and tobacco are the most commonly abused substances among people with eating disorders.

Risk Factors for Eating Disorders

The Eating Disorders Coalition has reported that eating disorders have a higher mortality rate than any other mental illness, with about 20% of people with eating disorders eventually dying from their condition. 
Parents of teenagers should look for these risk factors for eating disorders:
•    Depression
•    Low self esteem
•    Negative peer pressure or bullying
•    Anxiety, inability to manage stress
•    Obsessive compulsive tendencies
•    History of abuse or trauma
•    Family history of eating disorders
•    Impulsiveness 

Seek Help for Teens with Eating Disorders

Many teenagers feel that there is a stigma associated with eating disorders.  Despite the support of friends and family, they may cover up the symptoms of their condition for years.  Parents who suspect that their teenager is suffering from an eating disorder should seek professional help immediately.  With professional rehabilitation, the odds of recovering from an eating disorder and any associated substance abuse disorders are greatly increased.