“Oh, Sarah, you’re back from studying at the library?”
“Yeah, Mom, I went straight to the library after school, just like you wanted me to.”
“That’s good. Next time you’ll get that A in Math like you should. Do you want dinner, honey?”
“No thanks, Mom, I ate already.”
“Are you sure, Sarah?”
“Umm… yeah.”
Sarah is a 13 year-old pre-teen who is going through some challenging times. She just started the 7th grade and the pressures of her parents to do well in school, to gain attention among her peers, and the images of runway models in her issues of Seventeen magazine are starting to negatively affect the way she eats. In order to keep from gaining weight Sarah is starting her “diet” that changes with her mood from eating beyond the point of satiety, to accompanied periods of starvation. She feels out of control as she binges on sweets and fast food, but then is overcome with loneliness and self-hatred for binging. However, Sarah does not think she has a serious eating problem because she isn’t vomiting like bulimics do, and she is not rail thin like many anorexics. Sarah isn’t aware of it, but she is indeed suffering from an eating disorder. It is as serious as bulimia nervosa and anorexia nervosa and termed Binge Eating Disorder or Compulsive Eating Disorder. As Sarah’s story shows, eating disorders are complex conditions that are not only about one’s diet but also involve behavioral, emotional, psychological, interpersonal, and social factors.
Eating Disorders: What Are They?
a) A psychological disorder
b) family pressured
c) culturally pressured
d) a behavioral disorder
e) is life-threatening
f) all of the above
Well, believe it or not, eating disorders are (f), all of the above.
A person with an eating disorder may think that he or she is simply trying to lose a few pounds, but there is a point when dieting becomes so extreme that it interferes with everyday life. It is then considered a problem that is usually a result of many long-standing factors. Like for Sarah, it can start from a number of places - from family life to the media – anything can trigger it. This is mostly due to the fact that an eating disorder is psychological as it is behavioral.
How are Eating Disorders Psychological?
Eating disorders can be termed as “mental illnesses” because from a psychiatrist’s perspective, it is a sort of sickness of the mind manifested in a person’s behavior. It is considered a sickness because it is something that is described by symptoms specific to the disorder, and can be cured through therapy –for eating disorders, either drug therapy or various psychological therapies.
Specific eating disorders include:
· Bulimia Nervosa – characterized by cycles of over-eating (binging) and vomiting or using laxatives (purging) to get rid of the food before the body absorbs what was eaten.
· Anorexia Nervosa – characterized by extreme dieting (i.e., starvation or purging) with a goal of emaciation.
· Binge Eating Disorder – characterized by periods over-eating and struggles with depression, anxiety, and loneliness. (May also be called Eating Disorders Not Otherwise Specified)
All of these disorders further share the characteristics of feelings of being overweight or fatter than they actually are (even if they are underweight)
What Causes Eating Disorders?
Eating disorders are the result of a number of factors. There isn’t a single cause for it. They include cultural and family factors, emotional and personality disorders, and even chemical imbalances (and for different particular disorders, a combination of these causes).
· For family influences these can be both through genetic and environmental influences. Like in the case of Sarah, there was an over-involved mother, who was also critical and worrying about her daughter’s weight. Genetics influence one’s the likelihood of someone being anorexic, for example, but researchers are still looking for a possible inherited factor for this.
· For emotional disorders, such the most common – depression and anxiety – it is unclear as to whether they are the cause, the effect, or both of eating disorders.
· Cultural influences definitely play an important part, especially in the Western part of the world where food is in abundance, competitive sports are big, and advertisements display models with unobtainable figures as the ideal body type for women especially.
How Can Eating Disorders Be Spotted Before It’s Too Late?
Symptoms of Bulimia Nervosa:
· Preoccupation with food and abuse of laxatives, diet pills, and drugs that induce vomiting or reduce fluids,
· Compulsive exercising, as with anorexics,
· Broken blood vessels in the eyes from vomiting, swollen salivary glands at corners of mouth,
· Cavity-filled teeth, erosion of tooth enamel, rashes and pimples on skin
Symptoms of Anorexia Nervosa:
· The most noticeable symptom – major weight loss,
· Infrequent or no menstruation, bloated stomach,
· Dry skin covered with fine hair, sometimes swollen or cold hands and feet
· Confused thinking, poor memory, and lack of judgment.
Also almost all people with eating disorders have a distorted body image.
What are the Positive off-set factors to treatment?
Because this is largely a psychological factor, the first step and perhaps the most important is to admit the eating disorder, from both the patient and their family who will be critical in his or her recovery. However, this may be the most difficult step to take. For anorexics, it is also critical in their belief that emaciation is neither normal nor attractive; for bulimics, that purging is the only way to maintain an acceptable weight.
How about the negative on-set factors? The factors that can bring eating disorders on again are again, attributable from all areas of environment (family, culture, society), and the individual’s own mind (that starvation or purging is OK to keep weight off).
How can Therapy Help?
Therapy is in the form of either psychological therapy or drug therapy, or even both. Psychological therapy is in the form of hard work from the individual and his or her family and friends to realize the problem and try to change their outlook in certain areas. Bulimics are best treated with a combination of cognitive therapy and antidepressants. Anorexics on the other hand, are best treated with family or individual supportive therapy. Severe anorexics, however, may need medical attention initially. Therapy is not always quick or always simple. But the good news is that studies show most anorexic patients and even more bulimic patients can recover. They only need to take that first step, and then slowly start living again.