When most people hear of someone with an eating disorder they almost automatically assume the person has a problem with food. Eating disorders are not a sign that a person has a problem with food, rather eating disorders are actually only the symptoms of underlying problems in that person's life. With proper treatment, people can fully recover.

Anorexia Norvosa

Anorexia is characterized by a significant weight loss resulting from excessive dieting. Most women and an increasing number of men are motivated by the strong desire to be thin and a fear of becoming obese. Anorexics consider themselves to be fat, no matter what their actual weight is. Often anorexics do not recognize they are underweight and may still "feel fat" at 80 lbs. Anorexics close to death will show you on their bodies where they feel they need to lose weight. In their attempts to become even thinner, the anorexic will avoid food and taking in calories at all costs, which can result in death. An estimated 10 to 20% will eventually die from complications related to it.

Anorexics usually strive for perfection. They set very high standards for themselves and feel they always have to prove their competence. They usually always put the needs of others ahead of their own needs. A person with anorexia may also feel the only control they have in their lives is in the area of food and weight. If they can't control what is happening around them, they can control their weight. Each morning the number on the scale will determine whether or not they have succeeded or failed in their goal for thinness. They feel powerful and in control when they can make themselves lose weight. Sometimes focusing on calories and losing weight is their way of blocking out feelings and emotions. For them, it's easier to diet then it is to deal with their problems directly. Anorexics usually have low self-esteem and sometimes feel they don't deserve to eat. The anorexics usually deny that anything is wrong. Hunger is strongly denied. They usually resist any attempts to help them because the idea of therapy is seen only as a way to force them to eat. Once they admit they have a problem and are willing to seek help, they can be treated effectively through a combination of psychological, nutritional and medical care.

Signs and Symptoms

Noticeable weight loss

Becoming withdrawn

Excessive exercise

Fatigue

Always being cold

Muscle weakness

Obsession with food, calories, recipes

Excuses for not eating meals (ie. ate earlier, not feeling well)

Unusual eating habits (ie. cutting food into tiny pieces, picking at food)

Noticeable discomfort around food

Complaining of being "too fat", even when thin

Cooking for others, but not eating themselves

Restricting food choices to only diet foods

Guilt or shame about eating

Depression, irritability, mood swings

Evidence of vomiting, laxative abuse, diet pills or diuretics to control weight

Irregular menstruation

Amenorrhea(loss of menstruation)

Wearing baggy clothes to hide weight loss

Frequently checking weight on scale

Fainting spells and dizziness

Difficulty eating in public

Very secretive about eating patterns

Pale complexion (almost a pasty look)

Headaches

Perfectionistic attitude

Feelings of self worth determined by what is or is not eaten

No known physical illness that would explain weight loss

Physical/Medical Complications

Fatigue and lack of energy

Amenorrhea(loss of menstruation)

Skin problems

Dizziness and headaches

Dehydration

Shortness of breath

Irregular heartbeats

Cold hands and feet

Bloating

Constipation

Hair loss

Stomach pains

Decreased metabolic rate

Edema (water retention)

Lanugo(fine downy hair)

Loss of bone mass

Kidney and liver damage

Electrolyte imbalances

Osteoporosis

Insomnia

Anemias

Infertility

Depression

Cathartic colon(caused from laxative abuse)

Low potassium (most common cause of nocturnal cardiac arrest)

Cardiac arrest and death

Bulimia

Bulimia is characterized by a cycle of binge eating followed by purging to try and rid the body of unwanted calories. A binge is different for all individuals. For one person a binge may range from 1000 to 10000 calories, for another, one cookie may be considered a binge. Purging methods usually involve vomiting and laxative abuse. Other forms of purging can involve excessive exercise, fasting, use of diuretics, diet pills and enemas.

Bulimics are usually people that do not feel secure about their own self worth. They usually strive for the approval of others. They tend to do whatever they can to please others, while hiding their own feelings. Food becomes their only source of comfort. Bulimia also serves as a function for blocking or letting out feelings. Unlike anorexics, bulimics do realize they have a problem and are more likely to seek help.

Signs and Symptoms

Binge eating

Secretive eating (food missing)

Bathroom visits after eating

Vomiting

Laxative, diet pill or diuretic abuse

Weight fluctuations (usually with 10-15 lb range)

Swollen glands

Broken blood vessels

Harsh exercise regimes

Fasting

Mood swings

Depression

Severe self-criticism

Self-worth determined by weight

Fear of not being able to stop eating voluntarily

Self-deprecating thoughts following eating

Fatigue

Muscle weakness

Tooth decay

Irregular heartbeats

Avoidance of restaurants, planned meals or social events

Complains of sore throat

Need for approval from others

Substance abuse

Ipecac abuse

Physical/Medical Complications

Fatigue and lack of energy

Amenorrhea(loss of menstruation) and irregular menstruation

Dizziness

Headaches

Dehydration

Constipation and diarrhea

Shortness of breath

Irregular heartbeats

Depression

Tears of esophagus

Hair loss

Stomach pain and bloating

Erosion of teeth enamel

Chronic sore throat

Kidney and liver damage

Parotid gland enlargement

Electrolyte imbalances

Cathartic colon (caused from laxative abuse)

Edema (swelling of hands and feet)

Low blood pressure

Chest pains

Development of peptic ulcers and pancreatitis (inflammation of the pancreas)

Gastric dilation and rupture

Abrasions on back of hands and knuckles

Anemias

Cardiac arrest and death

Myths Realities
Only teenage girls suffer from eating disorders. Many eating disorders do begin in the teenage years, but children, men, older women and just about anyone can fall victim to this terrible disorder.
You can never fully recover from an eating disorder. Recovery takes a long time, but with hard work and the proper treatment, you can fully recover from your eating disorder.

Men with eating disorders are always gay. Someone's sexual preference has nothing to do with them developing an eating disorder.

Eating disorders are solely a problem with food. With all eating disorders, weight is the focus of life. By focusing on food, weight and calories, a person is able to block out or numb painful feelings and emotions. Some use food as a way to comfort themselves. Eating disorders are NOT a problem with food. They are in fact only a symptom of underlying problems.

Bulimics always purge by vomiting. Not all bulimics try to rid themselves of the calories they have consumed by vomiting. Purging can take the form of laxatives, diuretics, exercising, or fasting.

You can always tell someone is anorexic by their appearance. Not all anorexics look like the extreme cases shown on talk shows, etc. Some anorexics may be anywhere from 5 to 15 lbs. underweight. They look thin, but they do not have what society considers to be the "anorexic" look. Just because someone does not look emaciated, does not mean they are not anorexic or that their health is not in danger.

Anorexics do not eat candy, chocolate, etc. Many anorexics do avoid such foods, but some do eat them on a regular basis. If an anorexic decides to only allow him/herself 300 calories a day, they may very well choose to eat a chocolate bar, candy, etc.

Anorexics do not binge or purge Many anorexics will go on occasional binges and purge. Some anorexics can become so fearful of any food or drink that they will purge whatever they put into their system, including water.

You cannot die from bulimia. Bulimics are at a high risk for dying, especially if they are purging, using laxatives and doing excessive exercise. Many bulimics have died from cardiac arrest which is usually caused by low potassium or an electrolyte imbalance. Others have dies from a ruptured esophagus.

People with eating disorders do this to hurt their family and friends. People with eating disorders are doing this to themselves. They are usually very upset when they know the people around them are worried or hurt by their eating disorder.

Compulsive eating is not an eating disorder. It is very much an eating disorder and is just as serious as anorexia and bulimia.

Compulsive eaters are just lazy people. Compulsive eating is a way to cope just like anorexia and bulimia are. A person uses food as a way to comfort or numb themselves, block out feelings and emotions, etc. They are not lazy! They are people in emotional pain trying to cope using the only way they know how. Like anorexia and bulimia, they need proper treatment to overcome it. They do not need to be sent to health spas and diet clinics.

People cannot have more than one eating disorder. Many people have more than one eating disorder. It is very common for someone to suffer with more than one eating disorder. That just proves that the eating behaviors are only the symptoms, not the problem.

Getting Help

One of the hardest steps to take when you have an eating disorder is to admit to yourself that you have one. Once you can do that and decide you want help, you are faced with another step of having to reveal this to another person. Since most people with eating disorders feel embarrassed and ashamed, the thought of telling someone can be terrifying. We fear how they will react when we tell them. We constantly ask ourselves, "Will they believe me?", "Will they be angry with me?", Will they leave me?", "Will I be locked up somewhere?" or "Will they think that I am crazy?" Those are only a few of the many questions that will probably go through your mind when you are getting ready to tell someone.

When taking this step, be sure that you chose to tell someone whom you trust and feel comfortable talking with. Many people start by telling a close friend or their family doctor. If you can open up to your family, you may chose to tell your spouse, a parent, a sibling, an aunt, etc. first. If you have a hard time opening up to your family but want to tell them, you can always have a friend or therapist with you when you tell them.

Before we tell someone, many of us spend hours trying to predict how that person will react. It is important to remind yourself that it is impossible for you to predict how anyone will react. Many people put off telling anyone because they usually have convinced themselves that anyone they tell will get upset, yell at them or abandon them. The thought of telling someone can be so terrifying that our minds will predict the worst case scenario of how people will react and try to convince you never to tell anyone. Once again, it is impossible to predict how anyone will react. The only way you can find out is by taking the risk and revealing your eating disorders to someone.

When you first tell someone, there is usually an initial reaction. The person may be surprised, shocked, upset, worried or they may cry. Some may have already seen the signs and know that you do have an eating disorder. The person you tell may not be sure how to respond to you. They many not say anything or they may ask you a lot of questions. No matter what the reaction is, remember that this person may need a few days to process the information you just gave them. When telling someone, I feel it is important to bring information about eating disorders to give to that person. That way they can have the chance to read and educate themselves about what eating disorders are and how to be helpful to you. After a few days of them reading and thinking about what you said, they are usually better able to sit down and talk about it and they can begin to be part of your support system.

Unfortunately, we are not always faced with people who are understanding and can accept we have an eating disorder. When someone is not educate about eating disorders and has no understanding, they can sometimes be cruel and say hurtful things. It can be difficult to have that happen, but try to remind yourself that this person is just ignorant and is wrong if they treat you improperly. You can still give that person information to read and hope they learn something from it. Parents sometimes have a hard time accepting the fact that their child has an eating disorders. They many not want to accept it because they fear that it would be their fault and that they did something wrong. It can sometimes take family members a while before they can accept the eating disorder and be helpful and supportive. There are also people that will become scared and will not know what to do and they may try to avoid you. This is not your fault and you have done nothing wrong. They usually do this because they are not educated about eating disorders and do not know how to react or respond. When someone does not have an eating disorder, it is impossible for them to know what we go through and to understand. Sometimes if people do not understand, they tend to not want to accept it. If this is the case, tell the person that you do not expect them to understand, but you do want them to accept it so that they can be a support for you.

Telling someone takes a lot of courage and you should be proud of yourself each time you do it. Most people will also tell you that once they have told someone, they do feel an inner relief because they are no longer keeping the secret to themselves. Telling someone is also another step in recovery and it is a way to help break away from the shame that many people feel. It is always easier when someone reacts in a positive way and wants to help, but that is not always the case. If someone cannot accept you have an eating disorder and gets angry or just totally avoids the subject, remember that is not your fault or your responsibility. If they cannot accept it, that is something that they will have to deal with. We are only responsible for ourselves and we cannot control other people's reactions, thoughts and feelings.

There is not any one way to tell someone about your eating disorder. Sometimes just sitting down with someone and saying, "I have an eating disorder and I want to get help", is one way of getting it right out in the open. If you find it too difficult to say it verbally, you can always chose to write a letter to the person you want to tell and let them know that way. If you have decided to first tell a therapist, you can always chose to have the therapist present with you when you decide to talk to family members and friends. That way, the therapist could be there to answer questions, explain what eating disorders are, how they can be helpful to you and you may also feel more safe and comfortable having the therapist with you to support you in this step.

It is during this step that people usually find out which people are going to be part of their support system. By people's reactions and how they feel, you can decide for yourself which people you want to help and which people you do not want to help. It is always great when family members are supportive, but that does not always happen at first. It can be painful if you do not have their support, but remember that there are other people available to help you. Some people have no choice but to go outside the family to receive the help and support that they need during the recovery process. It is important that you do what is best for you and your recovery. Some people believe they can overcome this on their own, but I personally feel it is best to have as much support as you can, especially during the very difficult times. Friends, doctors and therapists can be a great support for you. If there is a support group in your town, be sure to check it out and see if it is something that you want to be involved in. Being with others that know and understand how you feel can be very helpful and provide you with wonderful support.

I know that revealing your eating disorder is very scary, but it is a step you need to take. Who you tell is your decision. Never allow anyone to try and force you to reveal this to someone you might not be ready to tell or who you do not want to know about it. Also remember that there is NO shame in having an eating disorder. The longer you are in recovery, the more you will see that you have nothing to be ashamed of and you will reach a point when it will not matter to you who knows. Instead of feeling ashamed, you will start to feel proud of yourself for not only admitting to the problem, but for seeking help and fighting this. Eating disorders can be overcome. If you want to recover, you can and will recover. Try not to rush your recovery. Recovery takes time and it can be a long road, but it is a road worth taking.

Options

Having a good support system will make your fight towards freedom a little easier and you will know that you are not alone. Your treatment should probably include individual, family and group therapy, support groups, and nutritional, in some cases medications and sometimes there is a need for hospitalization.

Individual Therapy - In individual therapy you will be able to develop a one-to-one relationship with your therapist. Once you begin to trust your therapist, you will be free to start releasing all the feelings that you have kept inside for so long. You will be able to start focusing on why you are doing this and what you need to do to stop. You will begin to understand why and how your eating disorder became your only means of coping, and you will learn new and healthier ways to cope. The frequency of visits will probably depend on the severity of the eating disorder. Some people are in daily therapy and others are in weekly therapy. The amount of visits will probably depend on you and your therapist.

Group Therapy - Group therapy can be very beneficial to someone trying to recover from an eating disorder. For the first time they are surrounded by others that know and understand exactly how they feel. For so long they probably felt like they were the only ones that had this problem, and now they know that they are not alone. Groups usually meet once a week and can discuss anything from the eating behaviors itself and finding ways to change the behaviors, to discussing the underlying issues causing the eating disorder. Group members can support one another and help each other to find ways to change their eating patterns and develop healthier ways to cope.

Family Therapy - Family therapy usually involves the people that are living with or very close to the person with the eating disorder. This could include parents, siblings, spouses and even grandparents. Usually an eating disorder indicates that there are problems within the family. Some problems could include martial problems, substance abuse, physical or sexual abuse, lack of communication, or difficulty in expressing feelings. All these issues can be discussed and worked on in family therapy. In order to solve these problems, the families must be willing to participate in therapy and be willing to make changes in their own behaviors.

Support Groups - Support groups are usually not run by a professional. Usually the leaders are people that have experienced an eating disorder themselves. The groups can meet anywhere from daily to once a month. Support groups can be very helpful to people with eating disorders because they realize that they are not alone and that recovery is possible. The members also help and support each other during difficult periods. Each support group is different. Some groups are free to discuss what they feel and others may pick a topic to be discussed at each meeting.

Medical Treatment - It's important that your health is monitored by a physician that is aware of your eating disorder. There are many physical complications that can result from the eating disorder. If left untreated, they can lead to serious health problems or death. I would also urge the person to be very open and honest about their eating behaviors and symptoms with their doctor to insure they receive the best medical treatment possible. It is also important that you are seeing a doctor who is familiar with eating disorders and treats them properly. If you are bulimic, you may want to see your dentist for a check up. Frequent vomiting can lead to tooth decay as a result of enamel erosion form stomach acids.

Nutritional Counseling - A part of your recovery should include nutritional counseling. Many people with eating disorders have no idea what "normal eating" really is and a qualified nutritionist will be able to help you develop a healthy eating pattern.

Medications - In some cases medication has been useful in treating eating disorders. Antidepressants such as Prozac, Paxil and Zoloft have been used in helping with signs of severe depression. Antidepressants can sometimes help a person binge/purge less frequently. Medication should not be used as the sole source of treatment. It should be combined with all areas of treatment.

Hospitalization - If the person's weight is extremely low or if they are bingeing/purging several times a day, hospitalization may be necessary. Sometimes a person needs more support then out patient therapy can provide. The hospital can provide them with a safe environment and help control the eating behaviors. If hospitalization is necessary, they should be admitted to a ward that is familiar with treating eating disorders. Psychiatric wards are usually not equipped to handle eating disorder patients and the person can sometimes feel worse while in there. Some hospitals do have units that specialize in treating eating disorders. These units should provide both psychological and physiological care.

Eating Disorders