Understanding Eating Disorders

Someone is said to have an eating disorder when she cannot control certain learned behaviors and/or poor habits having to do with food. It is hard to know what started first, the behaviors, the need for control, poor body image, or the obsession with weight or food. Two major types of eating disorders are anorexia nervosa and bulimia nervosa. Common features in all eating disorders include:

• A distorted body image — thinking you're overweight when you are normal or thin

• An obsession with weight, food or exercise

• Fear of gaining weight

A central fact of the disorder: People with anorexia nervosa do not see themselves as others see them. They have a distorted body image. The person looks in the mirror and sees someone who is overweight, even when she is undernourished.

Women with anorexia nervosa are starving themselves to death because they cannot see the reality of their bodies' thinness. Fear of gaining weight drives their behavior, so they refuse to eat or maintain their weight. Even when they confront physical problems due to significant weight loss, they continue to deprive themselves of food. These problems can include halting of menstrual periods (not uncommon in women who lose more than 15 percent of their ideal body weight); skin, hair and nail changes; and heart malfunction. Ten percent of people with anorexia nervosa will die from the disease.

In addition to dieting, women with anorexia nervosa may turn to binging and purging, obsessive exercise regimens, laxatives and diuretic medications or enemas to lose weight.

Bulimia nervosa is less visibly obvious because people with the disorder tend to be of normal weight, or even overweight. It is the person's behaviors that tip you off to a problem. Like anorexia, fear of gaining weight leads a bulimic to behaviors to compensate for caloric intake. These can include, vomiting, taking laxatives, and exercising obsessively. Binge eating, or being unable to control how much you eat, also can occur.

No Easy Cure

Diagnosis is only the first hurdle, even when a woman understands she has a problem and seeks treatment. Eating disorders are a challenge to overcome because people with eating disorders have a difficult time changing their behavior. Even if a person understands that her behavior is bad for her health, often she is unable to change, even when engaged in a treatment program with physicians and therapists. In fact, many people with eating disorders become good at hiding their illness and convincing people that they are trying to change.

Why is it so hard to change behaviors? Remember that for many people, the underlying reason for their eating and/or purging behaviors is the need to feel in control of their bodies. In some cases that begin in early adolescence, a girl loses weight or starves herself to the point of stopping her periods as a way to halt the changes that herald becoming a woman.

When helping someone with an eating disorder, it is important to refrain from taking that control away. Instead, empower the person to take control of her life by getting help. However, make sure she gets trained help - approach a resident counselor in a dorm, a teacher, a coach or your friend's parents. Don't try to handle a person with an eating disorder by yourself.

Determining Whether You Might Have a Problem

Several screening tools have been tested for eating disorders. None are perfect, but together, the following questions can help to alert you to a problem or potential problem:

1. Are you terrified of being overweight?

2. Have you gone on eating binges where you felt unable to stop?

3. Do you ever eat in secret?

4. Do you feel extremely guilty after eating?

5. Do you vomit or have the impulse to vomit after meals?

6. Have you ever used laxatives, diuretics or enemas to lose weight or compensate for overeating?

7. Do you feel that food controls your life?

If you answer yes to any of these questions, you should talk to a counselor, a close friend, a parent or your doctor to find out whether you might have disordered eating behaviors or even an eating disorder. Disordered eating behaviors and exercise patterns are more common than eating disorders. But they put you at risk of developing an eating disorder. These can include obsessive control of and attention to what you eat or how you exercise.

If you notice these patterns developing in yourself or your friends, make an effort to change these habits. Live a life focused on healthy habits rather than looks or image. Not only can you avoid developing the physical and emotional consequences of disordered eating behaviors, but you can be a happier person in the end.

In summary, when you see someone in need of help, before you act, remember that people with eating disorders often:

• Have a distorted body image

• Cannot easily change their behavior without help

• Want to maintain control of their body

• Need the help of a counselor, teacher, coach, trainer, parent or physician