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Counseling Services - Eating Disorders

Eating Disorders

Introduction

Due to cultural ideals of feminine beauty, young women feel a strong desire to be thinner than their bodies naturally tend to be. As a result, they change their eating patterns and they may develop eating disorders. The most common eating disorders are Anorexia Nervosa and Bulimia. Both eating disorders are more common among young adults than at any other age.

What Causes an Eating Disorder?

  • Feelings of inadequacy
  • Depression
  • Anxiety
  • Loneliness
  • Troubled family
  • Personal relationships
  • Our culture
  • Long-standing psychological, interpersonal, and social conditions

What is Anorexia Nervosa?
Anorexia Nervosa is characterized by extreme restriction of food in pursuit of thinness. Anorexia Nervosa is a serious psychological and physiological disorder. Anorexia Nervosa has the following characteristics:

  • Weight is at least 15% below average body weight.
  • Out of control eating behavior: compulsive fasting, excessive exercise, and bingeing and purging may be present.
  • Intense fear of weight gain and feeling fat.
  • Life is food centered.
  • Rituals about eating that appear strange to others.
  • Medical complications as a result of their behavior: malnutrition, loss of menstrual cycle, kidney problems, bone loss and even death in some cases.
  • The anorexic restricts eating to the point of emaciation.
  • The anorexic may exercise constantly and take laxatives or diuretics to lose weight.
  • The most common ages of onset are 11 and 18, the beginning and ending of adolescence.
  • The disorder is mostly diagnosed in the upper middle class. However, both rich and poor can develop the disorder.
  • Even though anorexics are extremely thin and underweight, most insist that they are not hungry or thin.
  • With psychological help about 1/3 of all anorexics get better. About 20% die of the disorder.
  • Approximately 60% of all anorexics also develop bulimia.

What is Bulimia?
Bulimia is binge-eating followed by self-induced vomiting or the use of laxatives. Bulimia has the following characteristics:

  • The disorder usually begins in late adolescence and early adulthood.
  • It is not easily recognized by others because bulimics may be of normal weight or a little overweight.
  • Bulimics are aware of the problem and try to keep it a secret.
  • Bulimics may become depressed, guilty, and disgusted with their binge-purge cycles. Yet they will not stop the behavior.
  • Eating large amounts of food in a relatively short amount of time (i.e., a bulimic may eat a jumbo bag of chips, a gallon of ice-cream and then two boxes of cookies.)
  • Preoccupation and obsession with food, body image and appearance.
  • Hiding, hoarding and stealing food.
  • Medical problems resulting from behaviors include: tooth decay, stomach and digestive distress, loss of normal bowel functions, electrolyte imbalance, malnutrition and death.
  • Feeling out of control over their behavior with associated guilt/shame.
  • Eating often serves to avoid their feelings; bulimic people report feeling numb or in a fog while they are in the middle of a binge.

Binge Eating Disorder

  • People with this disorder are frequently overweight, and may be obese due to excessive eating.
  • Larger proportions of Binge Eating Disorder patients are males (-30% of the people with this disorder are men.)
  • Medical complications: cardiovascular, kidney and respiratory problems, and high blood pressure are common.
  • Eating to numb feelings and provide comfort.

Compulsive Overeating

  • Hiding and hoarding food.
  • Wide range in weight from normal to obese, with high test proportion of people with this disorder being overweight.
  • Person usually feels fat and ugly, regardless of actual weight.
  • Consuming more than one is hungry for with no control over eating behavior.
  • Preoccupation with losing weight.

Effects of Eating Disorders
Anorexia Nervosa

  • Loss of approximately 30% of body weight leading to emaciation.
  • Irregular or complete loss of menstrual period.
  • Dry skin, and hair loss.
  • Growth of fine body hair.
  • Death.
  • Withdrawal and isolation.

Bulimia

  • Abdominal pain due to overeating.
  • Heart and kidney problems.
  • Excessive constipation.
  • Digestive problems.
  • Swollen salivary glands.
  • A tear in the esophagus.
  • Diarrhea.
  • Feelings of depression, guilt, self-disgust and loss of control.
  • Loneliness and isolation.
  • Frequent weight fluctuation.


Ways to Help

Talk openly and freely and ask direct questions about the person's eating patterns. Listen to what is said and treat it seriously. Do not add to the person's guilt by nagging about eating/not eating or gossiping about the person among your friends.  Encourage the person to seek professional help. Give the person time to talk and encourage him/her to verbalize feelings. Ask clarifying questions. Listen carefully and accept what is said in a non-judgmental manner.

If a person denies the problem, becomes angry, or refuses treatment, understand that this is often part of the illness. You could possibly say, "I know you can refuse to go for help, but that will not stop me from worrying about you or caring about you. I may bring this up again to you later, and maybe we can talk more about it then." Follow through on that -- and on any other promise you make. Do not argue about whether there is or is not a problem - power struggles are not helpful. Perhaps you can say, "I hear what you are saying and I hope you are right that this is not a problem, but I am still very worried about what I have seen and heard, and that is not going to go away."

Do not try to be a hero or a rescuer; you will probably be resented. If you do the best you can to help on several occasions and the person does not accept it, stop. Remind yourself you have done all it is reasonable to do. Eating disorders are stubborn problems, and treatment is most effective when the person is truly ready for it. You may have planted a seed that helps them get ready.
If you are concerned that the eating disorder is severe or life threatening, enlist the help of a doctor, therapist, counseling center, relative, friend, or roommate of the person before you intervene. Present a united and supportive front with others.

Provide information about resources for treatment. Offer to go with the person and wait while he/she has their first appointment with a counselor, physician, or nutritionist. Ask them to consider going for one appointment before they make a decision about ongoing treatment.

Eating disorders are usually not emergency situations, but if the person is suicidal or otherwise in serious danger, GET PROFESSIONAL HELP IMMEDIATELY.

 

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