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Anorexia & Bulimia

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It is normal for you to worry about your personal appearance, both in terms of how you look to others and your self-image. This is especially true in regards to weight. When efforts to obtain the “perfect” weight get out of control and turns into unrealistic goals, it can lead to anorexia or bulimia.

What Are Anorexia and Bulimia?

Anorexia nervosa and bulimia nervosa are actually variations of the same disorder, more formally termed “restricting type anorexia nervosa” and “binge-eating/purging type anorexia nervosa.” Both conditions are caused by a morbid fear of gaining weight. For simplicity, this article will use the more popular terms, anorexia nervosa and bulimia nervosa.

Ironically, although “anorexia” is defined as a loss of appetite, individuals with this eating disorder spend a great deal of time thinking about food, some hiding it in secret caches in their homes or carrying supplies of candy everywhere. Meals become an elaborate ritual during which they cut their food into tiny pieces, arrange and rearrange it on their plates, and finally hide it in their pockets.

For you to be diagnosed with anorexia nervosa, you must either refuse to maintain an appropriate body weight or fail to gain the amount of weight that you should while growing. You may be diagnosed with anorexia nervosa when your weight loss is caused by a drastic reduction in the amount of food that you eat, particularly high-carbohydrate and fatty foods.

Binge-eating, on the other hand, is referred to as voluntary vomiting (known as purging) and use of laxatives or diuretics. This condition is defined as the inability to control your obsession with food. Bulimics tend to excessively exercise to the point of injury as a way to control or limit weight gain.

How Prevalent are Anorexia and Bulimia?

Anorexia_BulimiaThe prevalence for eating disorders, like anorexia and bulimia are very high. As many as 70 million people worldwide grapple with anorexia or bulimia, including an estimated one in every 200 women. Men are not immune to anorexia and bulimia; approximately 10 to 15 percent of those diagnosed with an eating disorders is male.

Celebrities such as Paula Abdul, Jane Fonda, Nadia Comaneci, Joan Rivers, Princess Diana and Elton John have all reported suffering from eating disorders. Many people know about Karen Carpenter, who died from complications of anorexia.

Those whose livelihoods depend on their appearance are at particular risk. Here’s a link to “Anorexia’s Living Face”, a poignant and informative interview with Isabelle Caro, an Italian model who took part in the fashion industry’s campaign against eating disorders. http://youtu.be/VS2mfWDryPE

What Causes Anorexia and Bulimia?

There is no single reason why a person develops an eating disorder. Social pressures, the need to be “perfect” and/or cultural beliefs that a thin body represents attractiveness are all contributing factors. This influence does not all come from peers, the media or the fashion industry; studies have shown that a family’s emphasis on physical appearance can adversely affect children and teens. Some experts say that individuals diagnosed with anorexia and/or bulimia also display the symptoms of major depression and other mood disorders. There has also been some evidence that a malfunction of the hypothalamus, the area of the brain that regulates appetite, may underlie these disorders.

What Treatments Are Available For Eating Disorders?

Only 1 in 10 women and men seek treatment for their eating disorder. This is partly because many anorexics and bulimics do not think that they have a problem. In addition, these individuals tend to adamant about reaching an unrealistic ideal weight. Furthermore, treatment for these disorders can be very expensive, ranging from $500 to $2000 a day with successful treatment requiring from three to six months of inpatient care.

One of the most effective methods of treating anorexia and bulimia is cognitive behavior therapy.  With cognitive therapy, you learn that your ideas about weight are inaccurate.  You also learn how to identify destructive thought processes related to the disorder.  The behavioral aspects of therapy can involve a system of rewards.  For example, a patient with anorexia may be deprived of all stimuli and many comforts – such as TV, magazines, and be required to wear a hospital gown instead of normal attire.  If the patient eats a certain amount of food or gains weight, then he/she will be rewarded with one of these removed stimuli/comforts.

The two goals of treatment are to eliminate or at least modify eating patterns that are placing patients in physical danger and address and change the beliefs and emotions that lead to those disordered eating patterns. In terms of therapy, recovery frequently requires the involvement of family and friends.  In a recent study, the recovery goals of the young clients were very modest. One adolescent said that all she wanted was to be “a normal weight whatever that may be and feel comfortable with it,” while another stated that she hoped to “feel comfortable eating whatever food [she] wanted.”

Where Can I Find Help With My Eating Disorder?

In the United Kingdom, Beat (Beating Eating Disorders) offers helplines, online support and links to local services at http://www.b-eat.co.uk/.  In the United States, the National Eating Disorders Association (http://www.edap.org/) offers similar services as well as information about upcoming conferences and other awareness-raising events.

The danger of death from the complications of anorexia and bulimia is very real. The National Association of Anorexia and Associated Disorders asserts that only 10 to 40% of people with an eating disorder recover completely from the condition and between 5 and 10% of those diagnosed with disordered eating patterns die within 10 years.

References:

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (Revised 4th ed.). Washington, DC

Darcy, A. M., Katz, S., Fitzpatrick, K. K., & Forsberg, S. (2010). All better? How former anorexia patients define recovery and engaged in treatment. European Journal of Eating Disorders, 18, 260-270.

The Renfrew Center Foundation for Eating Disorders. (2003). Eating disorders 101 guide: A summary of issues, statistics and resources. Retrieved from  http://www.renfrew.org.