Section One

Common Health Problems

Eating Disorders

“One night, I sat and watched my roommate enjoy eating a bagel with cream cheese and drinking hot chocolate. I wish I could enjoy food that much. I take hours contemplating calories before I can put anything in my mouth.”
– Angelina R., University of Texas

Five to 10 million adolescent girls and women have an eating disorder. About 1 million males do. The 3 most common eating disorders are anorexia nervosa, bulimia nervosa, and binge eating disorder. These eating disorders are a coping mechanism. They result in an obsession with food and/or weight; anxiety around eating; guilt; and severe and adverse effects on psychological and physical health. Eating disorders are very serious health problems.

Signs & Symptoms

For Anorexia Nervosa

  • Loss of a significant amount of weight in a short period of time.
  • Intense, irrational fear of weight gain and/or of looking fat. Obsession with fat, calories, and weight.
  • Distorted body image. Despite being a normal weight for height and age, the person feels and sees himself or herself as fat.
  • A need to be perfect or in control in one area of life.
  • Marked physical signs. These include loss of hair, slowed heart rate, low blood pressure, and feeling cold due to decrease in body temperature. In females, menstrual periods can stop.

For Bulimia Nervosa

  • Repeated acts of binge eating and purging. Purging can be through vomiting; taking laxatives, water pills, and/or diet pills; fasting; and exercising excessively to “undo” the binge.
  • Excessive concern about body weight.
  • Being overweight, underweight, or normal weight.
  • Dieting often.
  • Dental problems, mouth sores, and a chronic sore throat.
  • Spending a lot of time in bathrooms.
  • Because of binge-purge cycles, severe health problems can occur. These include stomach damage, an irregular heartbeat, and kidney and bone damage.

For Binge Eating Disorder

  • Periods of continuous and sporadic eating that are unrelated to hunger.
  • Impulsive binging on food without purging.
  • Repeated use of diets or sporadic fasts.
  • Weight can range from normal weight to mild, moderate, or severe obesity.

Causes & Risk Factors

No specific cause has been found for these eating disorders. They affect persons from all socio-economic classes, ages, genders, and ethnic cultures. Risk factors include:

  • Possible biological and genetic links, including a family history of eating disorders.
  • Pressure from society to be thin.
  • Personal and family pressures.
  • A history of sexual, physical, or alcohol abuse.
  • Fear of starting puberty or of sexual relations.
  • Pressure for athletes to lose weight (sometimes quickly to qualify for an event) or to be thin for competitive sports.
  • Chronic dieting.

Treatment

The earlier the condition is diagnosed and treated, the better the outcome. Treatment includes:

  • Counseling. This can be in individual, family, group, and/or behavioral therapy.
  • Support groups.
  • Medication.
  • Nutrition therapy.
  • Outpatient treatment or hospitalization.

Questions to Ask

Did you binge and purge, fast, diet, and/or exercise on purpose to lose more than 10 pounds and do you have any of these problems?

  • An intense fear of gaining weight or of getting fat.
  • You see yourself as fat even though you are at normal weight or are underweight.
  • You diet and exercise in excess after reaching your goal weight.
if yes, see provider
if no, proceed to next question

Do you have episodes of eating a large amount of food within 2 hours and can’t control the amount of food you eat or stop eating? And, do you do at least 3 of these things?

  • Eat very fast.
  • Eat until you feel uncomfortable.
  • Eat when you are not hungry.
  • Eat alone due to embarrassment.
  • Feel depressed, disgusted, and/or guilty after you overeat.
if yes, see provider
if no, proceed to next question

Do you hoard food, induce vomiting, and/or take laxatives and/or water pills right after meals?

if yes, see provider
if no, proceed to next question

With abnormal eating, do you have 2 or more of these problems?

  • Rapid tooth decay.
  • Low body temperature. Cold hands and feet.
  • Thin hair (or hair loss) on the head. Baby-like hair growth on the body.
  • Problems with digestion. Bloating. Constipation.
  • Three or more missed periods in a row or delayed onset of menstruation.
  • Times when you are depressed, euphoric, and/or hyperactive.
  • Tiredness or tremors.
  • Lack of concentration.
if yes, see provider
if no, use self care

Self-Care

Eating disorders need professional help.

To Help Prevent an Eating Disorder

  • Learn to accept yourself and your body. You don’t need to be or look like anyone else. Spend time with people who accept you as you are, not people who focus on “thinness.”
  • Know that self-esteem does not have to depend on body weight.
  • Eat nutritious foods. Focus on whole grains, beans, fresh fruits and vegetables, low-fat dairy foods, and lean meats.
  • Commit to a goal of normal eating. Realize that this will take time. It will also take courage to fight fears of gaining weight.
  • Don’t skip meals. If you do, you are more likely to binge when you eat.
  • Avoid white flour, sugar and foods high in sugar and fat, such as cakes, cookies, and pastries. Bulimics tend to binge on junk food. The more they eat, the more they want.
  • Get regular moderate exercise 3 to 4 times a week. If you exercise more than your doctor advises, do non-exercise activities with friends and family.
  • Find success in things that you do. Hobbies, work, school, etc. can promote self-esteem.
  • Learn as much as you can about eating disorders from books and places that deal with them.
  • To help their children avoid eating disorders, parents should promote a balance between their child’s competing needs for independence and family involvement.

If You Have an Eating Disorder

photo of student raising her hand

Support groups can be very helpful for persons with an eating disorder.

  • Follow your treatment plan.
  • Attend counseling sessions and/or support group meetings as scheduled.
  • Identify feelings before, during, and after you overeat, binge, purge, or restrict food intake. What is it that you are hoping the food will do?
  • Set small goals that you can easily reach. Congratulate yourself for every success. This is a process. Accept setbacks. Learn from them.
  • Talk to someone instead of turning to food.
  • Learn to recognize your personal rights and to state how you feel. You have the right to say no and the right to express your feelings and your opinions. You have the right to ask that your needs are met.
  • Keep a journal of your progress, feelings, and thoughts, but not about what you eat. The journal is just for you, not for others to read or judge. This is a safe place to be honest with yourself. The journal can also help you identify your “triggers” so that you can deal with them in the future.
  • Don’t let the scale run your life. Better yet, throw out the scale!

For more information, contact:

Your school’s Student Health Service, Student Counseling or Mental Health Service

National Eating Disorders Association  |  206.382.3587  |  www.nationaleatingdisorders.org

Something Fishy Web Site on Eating Disorders  |  www.something-fishy.org