What You Need to Know about Eating Disorders

It often starts as a simple desire to lose weight, but the diet soon takes over your life. All you think about is food, yet you're afraid to eat. Afraid to be fat. Afraid to lose control. Sometimes you do eat, and then often the eating turns into an uncontrolled binge. Ashamed and disgusted, you purge the food through vomiting or laxatives or even by using the stair climber for an hour. You know something isn't right, and you're afraid. Yet you don't know what to do.

Eating disorders are dangerous, and can lead to malnutrition, dehydration, electrolyte imbalances, muscle wasting, neurological impairment, rupture in the esophagus, sudden low blood pressure, osteoporosis, loss of menstrual cycle (amenorrhea), erosion of tooth enamel, irregular heart beat and even death.

Disordered eating is estimated to affect five to10 million girls and women and one million boys and men. To deal with this crisis, we need to understand disordered eating and know where to go for help.

Types of disordered eating

Anorexia nervosa
Anorexia often begins with a need to control surroundings, low self-esteem and the fear of becoming fat. Obsessive dieting leads to starvation. And controlling the amount of food eaten becomes a major source of control for everything else that goes on in life. Typical symptoms of anorexia are obsessive exercise, calorie and fat gram counting, restriction of food, denial of hunger, use of coffee or smoking to avoid eating and an overwhelming concern with body image. People with anorexia never see themselves as thin. In their eyes, they are always fat, no matter how little they weigh.

Bulimia
Bulimia involves a cycle of uncontrolled binge eating followed by purging. A person with bulimia will purge by using laxatives, inducing vomiting, exercising compulsively or fasting. The binge-purge cycle can be triggered by hunger, stress, depression, anxiety or other emotions. Typical symptoms include binge-purge episodes, a feeling of lack of control over eating and life in general, strict exercise and dieting guidelines, use of laxatives, diuretics or diet pills and a poor self-image.

Compulsive overeating People who feel they are ''addicted'' to food and often find themselves using food to satisfy emotional needs such as stress, depression, or anger may be compulsive overeaters. They typically do not follow overeating with purging but often berate themselves for not being able to follow a diet, have low self-esteem and feel ashamed of themselves. Eating to satisfy a void in your life or as a way to cope with feelings has a strong underlying psychological element that needs to be addressed.

Combinations
It's not uncommon for someone to restrict her food intake compulsively (anorexia) for a period of days or weeks, then suddenly start eating large amounts of food followed by purging (bulimia). Sometimes people use exercise as a method to purge. It's often more socially accepted to run an additional two miles because you ate a cookie than to make yourself vomit, but the reason behind the purge is the same. Symptoms of anorexia, bulimia and compulsive overeating often go together.

If you think you have an eating disorder:
• Admit you have a problem and that you need help to solve it.
• Tell someone about your feelings. Talk with a friend, teacher, counselor, physician, pastor or parent. Talking about your feelings with someone you trust is crucial.
• Find a doctor who is well informed about eating disorders. Disordered eating can lead to medical problems that need to be addressed.
• Assemble a treatment team that consists of a therapist, a dietitian and perhaps a support group. You can't beat eating disorders on your own, and there are always numerous issues that need to be addressed. Find professionals you feel comfortable with who can help you through your journey toward recovery.

What can I do to help?

If your friend, spouse or child has an eating disorder, of course you want to help. These methods will help both of you through the recovery process:
• You can't force an anorexic to eat, or prevent a bulimic from binging and purging. Don't even try.
• Remember that disordered eating really isn't about food. It's about emotional pain and low self-esteem. Focusing on food as the answer only complicates matters.
• If you have a child under 18 with an eating disorder, you are responsible for making sure they receive treatment. They probably will refuse to visit a physician, therapist or dietician, since a big part of eating disorders is denial and fear.
• If you're a friend, spouse or parent of someone over 18 with an eating disorder, the most important thing you can do is listen. Listen to what she says, show concern and encourage her to seek effective therapy.

Resources

There are numerous online resources for people with eating disorders and those who want to help. Some of my favorites:
• The Something Fishy Website on Eating Disorders includes a variety of useful information as well as chat rooms and support. It should be your first stop.
• Mirror Mirror is a complete site that offers information on finding treatment help, living with someone with an eating disorder, and specific sections for children, teens, older women, etc.
• Eating Disorders Awareness and Prevention has extremely useful information, statistics and resources.

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