|Introduction||How Can You Be Sure?|
|What Is an Eating Disorder?||Signs of Eating Disorders|
|More Than Just Meals||How Social Workers Can Help|
|Why Do Eating Disorders Occur?|
In the women's dressing room in many clothing stores women of all shapes and sizes preen in front of three-way mirrors. Spinning around to see how they look from multiple angles, many often shake their heads in disgust, lamenting to their friends, the sales associates or to themselves about a body that is either too big, too small or just not right. For many reasons, they're completely dissatisfied with themselves.
Is it surprising then that one out of 10 American women will suffer from an eating disorder at some point in her lifetime? For adolescents, that number is one in five.
An eating disorder is a serious medical problem in which a sufferer becomes totally preoccupied with weight and exhibits severe eating behaviors. These behaviors can range from eating massive quantities of food to starving oneself. Often developing in adolescence or early adulthood, eating disorders can also occur during childhood or later in adulthood. These disorders include:
- Anorexia nervosa – Basically, this is self-starvation. Persons with anorexia have a distorted body image, viewing themselves as overweight even when they are dangerously thin. They may exhibit intense fear of gaining weight, and often deny the seriousness of their current weight loss or low body weight. Often they eat barely enough food to survive, for example, a solitary slice of dry toast all day. Some will also exercise excessively as a way of burning off dreaded calories.
- Bulimia nervosa – This involves episodes of binge eating followed by attempts to purge the body of food for fear of anticipated weight gain. People who have this disorder may have a normal weight. Even their closest relatives may not be aware of their behavior, which may involve vomiting up food after meals or taking dangerous quantities of laxatives.
- Binge eating disorder – This involves a frequent episode of overeating without purging. A binge eater may wake up at night to secretly raid the refrigerator, or binge publicly.
While these are the primary eating disorders, there are others. These include: purging without binging, anorexic behavior with a less severe weight loss and chewing and spitting out food without actually swallowing or purging.
While women are the primary sufferers of eating disorders, men are diagnosed too. In fact, an estimated 5 to 15 percent of those with either anorexia or bulimia and an estimated 35 percent of those with binge eating disorders are male. The exception is binge eating disorder, which seems to affect men and women equally.
It is estimated that nearly 10 million women and one million men in the United States suffer from anorexia and bulimia. Another 4 million are estimated to suffer from binge eating disorder.
Most chilling of all is the mortality rate – those who suffer with anorexia are more likely to die from complications because of it than from any other mental illness. According to the American Psychological Association, between 5 to 20 percent of anorexics will die as a result of complications from the disorder.
Eating disorders rarely involve just food. People often use food as a coping mechanism to help them feel in control when feelings or situations seem overwhelming. Starving, for example, is a way for those with anorexia to feel more in control of their lives, which ultimately eases their tension, anger, and anxieties. The same is true for those with bulimia.
People with negative body image have a greater likelihood of developing an eating disorder and are more apt to suffer from feelings of depression, isolation, low self esteem, and obsessions with weight loss.
The reasons are complex. No single factor is to blame. Clearly, our thin-obsessed culture in the United States plays a part. Despite the professional and societal advances women have made in the last few decades, many still define themselves primarily by their appearance and how physically attractive they are. The pressure is on to be thin.
But for most people with eating disorders, the reasons are more complex than simply societal pressures. People who feel helpless, worthless or have poor self-esteem are more likely to suffer, as are those who are depressed or have anxiety disorders.
Stressful life events can also contribute to the onset of an eating disorder. These can include moving to a new city, starting a new job, divorce, or the death of a loved one.
Researchers are studying the possibility of a genetic connection to eating disorders. They are also examining the effect of brain chemicals on the development of eating disorders.
Detecting an eating disorder can be difficult. The symptoms – limiting food intake, compulsively exercising and expressing unhappiness with body weight – are frequently considered normal in our culture. Many who engage in these behaviors may not feel they have a problem at all. However, it is easy for these "habits" to spin out of control and become a potentially-life threatening eating disorder.
If left untreated, or if a given treatment is not effective, eating disorders can cause serious physical problems including low blood sugar, pancreas and liver damage, heart failure, osteoporosis, heart rhythm problems, thought impairment and ultimately to death.
- A preoccupation with weight, counting calories, grams and dieting
- Body weight less than 85% of that expected
- A refusal to eat certain foods such as carbohydrates
- Frequent remarks about feeling fat or overweight despite weight loss
- A denial of hunger
- Intense fear of gaining weight or becoming fat, even though underweight
- Regular excuses to avoid mealtimes or social situations involving food
- Development of rituals involving food, e.g. eating foods in a certain order, excessively chewing
- Excessive exercise regimen – despite the weather, fatigue, illness, or injury
- Withdrawal from normal friends and activities
Unfortunately, people suffering from eating disorders may find it uncomfortable to even admit to themselves that they have a problem, much less seek out help from a trained professional.
Many social workers, particularly those working within a school system, are trained to initially spot young men and especially women who may be suffering from an eating disorder. Many are trained to create treatment plans.
Encouragingly, eating disorders are highly treatable, usually with a combination of approaches by a team of professionals. In addition to evaluations by a physician and nutritionist, interventions can include some form of psychotherapy (talk therapy), which can define the underlying issues, group therapy, family therapy, and referrals for medication evaluation if depression or anxiety is a factor.
If a social worker does not specialize in eating disorders, he or she should know how to link those in need with the best resources to treat the disorder. The sooner treatment starts, the better, as eating disorders can have serious and sometimes life-threatening medical and emotional consequences. Although treatments don't have instant results, persons who are able to get help from qualified professionals can have hope for recovery and a healthy future.
For additional information, go to these sites:
- National Institute of Mental Health
- Academy for Eating Disorders
- National Eating Disorders Association
- About Eating Disorders
- Eating Disorder Current Trends
- Eating Disorders: Your Options
- Eating Disorders: How Social Workers Help
- Eating Disorder Tip Sheets
- Resources for Eating Disorders
- Eating Disorder Real Life Issues