Eating Disorders

• What Are Eating Disorders?
• Types of Eating Disorders
• Warning Signs
• Causes of Eating Disorders
• Treatment
• How to Help a Friend
• Further Help and Information

What are Eating Disorders?

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Many college women believe that thinner is better. Some women may become so convinced of this that their self-esteem centers around their ability to control their weight. Believing that their happiness and escape from problems is tied to maintaining control over their body shape and size, they become trapped in a cycle of repeated, ritualistic, and rigid behaviors focused on food. This cycle can result in death. It has been estimated that at least 3 - 6% of those with an eating disorder will die from complications.

Social factors often reinforce eating disorders. For example, very slim, perfectly toned bodies are often portrayed in our society as the ideal. Additionally, society's focus on control and perfectionism as methods for success also reinforce eating disorder behaviors.

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Types of Eating Disorders

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There are several different types of eating disorders:

Anorexia
Anorexia is characterized by gradual self-starvation and involves keeping one's weight 15% or more below expected weight. It may include compulsive exercise and laxative or diuretic abuse. As a person with anorexia begins to lose weight, they feel powerful and in control. They may refuse to give up dieting because it is a source of positive feelings. Individuals with anorexia develop a distorted view of their appearance. Although they are underweight, they see themselves as fat. They may focus on a particular part of their bodies such as their stomach or thighs, and may continue to lower their goal weight.

As the person with anorexia loses weight, changes occur in the body's functioning, such as loss of menstrual periods, digestive problems, lowered heart rate and blood pressure, cold hands and feet and insomnia. The person is also more susceptible to health problems such as infections, stress fractures, severe chemical imbalances and heart failure. Depression and difficulty concentrating are also common in anorexia. Depression may precede the development of an eating disorder and contribute to its onset, or it may be a consequence of poor nutrition.

Bulimia
Bulimia is a cycle of uncontrolled bingeing on food, followed by purging through vomiting or the use of laxatives and diuretics. Purging is seen as a quick solution for preventing weight gain. The binge-purge cycle quickly becomes an addictive process that is difficult to control and that can result in feelings of guilt and helplessness. Shame and feeling out of control increase emotional distress that then leads to more bingeing and purging as a means of soothing that distress. In this way, the addictive cycle is perpetuated by the feelings of comfort and relief provided by bingeing and purging.

People with bulimia may have normal weight or may be slightly overweight. They may binge and purge in secret and thereby escape detection. Physical signs of bulimia may include puffiness in the cheeks or under the chin caused by swollen salivary glands, abnormal menstrual periods and excessive cavities and gum disease resulting from erosion of tooth enamel. The physical effects of bulimia can be serious. Damage to the esophagus, teeth, throat and digestive tract are common. Kidney failure and seizures are also possible. In later stages, ulcers and heart irregularities may develop. Depression is also common with bulimia.

Combined Anorexia and Bulimia
Some individuals show symptoms of both anorexia and bulimia. They may be emaciated and use starvation as well as the binge-purge cycle to achieve weight loss. Depression is common with eating disorders. The depression may precede the eating disorder and contribute to its onset or may result from the eating disorder.

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Warning Signs

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• Preoccupation with food and weight
• Social isolation
• Secretively about eating
• Using food to change or moderate feelings
• Compulsion about exercise
• Perfectionism
• Eating very slowly, cutting food into very small pieces
• Avoiding activities involving food or avoiding eating with others
• Going to the bathroom frequently, during or after meals
• Using laxatives or diuretics
• Hoarding food
• Eating large amounts of food in one sitting
• Depression related to food abuse
• Frequent medical problems connected to weight loss or fluctuations
• Intense fear of gaining weight
• Denial of hunger

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Causes of Eating Disorders

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Eating disorders are caused by multiple factors. A combination of social and cultural influences, disturbed family relationships, low self-esteem, genetics, and faulty learning about nutrition and physiology all contribute to their development. Although eating disorders have existed throughout history, they are increasing in modern western culture.

Social Factors often reinforce eating disorders. For example, very slim, perfectly toned bodies are often portrayed in our society as the ideal. Additionally, society's focus on control and perfectionism as methods for success also reinforce eating disorder behaviors. Confusion and conflict over gender roles and expectations have also been thought to contribute to the increase in the prevalence of eating disorders.

Biological Factors such as an inherited predisposition to depression and mood swings may also contribute to the development of eating disorders. Antidepressant medication has been found to be helpful to some individuals.

Psychological Factors also play a strong role in eating disorders. Low self-esteem and problems with self-assertion are often characteristic of individuals with eating disorders. Individuals with anorexia and bulimia have often been described as "model children" who are intelligent, high achieving and perfectionistic. They have unrealistic expectations for themselves and view life in absolutes or "black and white", "all or nothing" thinking. Rituals and obsessions with food and weight are sometimes used to distract the person from thinking about other worries and problems.

Family Factors including family backgrounds that stress either very high expectations or provide little opportunity for developing a sense of mastery and control are known to contribute to the development of eating disorders. Control over weight and eating may be an attempt to gain control over life or life circumstances when a person has felt little control in the past.

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Treatment

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The first step in overcoming an eating disorder is for the person to acknowledge that her eating patterns are problematic. If you have an eating disorder, getting competent, professional help is important in preventing damage to your body. Because eating disorders can be fatal, professional help is important. Treatment should include both medical and psychological help. A physical exam, understanding good nutrition, and participating in psychotherapy are important parts of the recovery process. Many individuals who do not meet full criteria for an eating disorder, but who show many similar characteristics can also benefit from treatment thereby preventing the future development of an eating disorder.

Recovery takes commitment, time and hard work. Asking for help is not an admission of failure, but is the first step in recovery. Those who do recover know the benefits that come from a healthier body, improved self-esteem and increased ability to cope with the challenges of life.

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How to Help a Friend

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Some do's and don't for helping a friend or family member include:

Do :

• Approach the person gently but honestly. Keep the conversation supportive and confidential. Focus on your concerns for her health rather than her weight and appearance. Give referrals. Do not try to change her behavior yourself. Focus on the unhappiness as the reason your friend could benefit from help. Point out how tired, anxious or depressed she's been lately. Emphasize that it doesn't have to always be that way.
• Be supportive. Be available to listen with understanding and encourage here to get help. Let her know you care.
• Be yourself. Share your own feelings and struggles. Be open and real.
• Remember that a person with an eating disorder is just that - first a person and only secondarily a person who has problems with food.
• Focus on positive reinforcement of her strengths and worthwhile activities. This adds to feelings of self-worth.
• Recognize that recovery may be a slow process and may involve setbacks.
• Give non-judgmental feedback. Use "I" statements such as, "I worry about you when you never join us at dinner."
• Model healthy eating patterns.

Do Not:

• Tell her she's crazy, blame her or gossip about her.
• Focus on her weight or eating habits.
• Ignore or reject her.
• Try to solve her problems or control her behavior.
• Nag, lecture, spy or monitor her behavior.
• Analyze or interpret.
• Reinforce obsessions with food and weight by engaging in lengthy discussions about them.
• Take responsibility for her problems. Be open, honest and caring but recognize when to back off.
• Let yourself be convinced that the person doesn't have a problem. The problem exists and there is hope.

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Further Help and Information

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The BYU Counseling and Career Center offers free personal counseling for full-time BYU students. There are a number of professionals with a variety of theoretical perspectives who offer individual psychotherapy. Group therapy is also available. For information about these or other services, call 422-3035.

Edreferral.com is a website that promotes social attitudes that enhance healthy body image and works to overcome the idealization of thinness that contributes to disordered eating. They provide information about, and treatment resources for all forms of eating disorders.

RESERVE LIBRARY, HBLL 48 HOUR RESERVE

EATING DISORDERS

Body Image Workbook (Cash)	........................	BF 697.5 .B63 C 1997
Dying to be Thin (Sacker)	........................	RC 552 .A5 S23 1987
Feeding the Hungry Heart: The Experience of Emotional Eating (Roth)	........................	RC 552 .C65 R657 1993
Intuitive Eating (Tribole & Resch)	........................	RM 222.2 .T717 2003
Overcoming Binge Eating (Fairburn)	........................	RC 552. C65 F35 1995
When Love is Food (Roth)	........................	RC 552 .C65 R66 1992

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