Departments
Health Matters
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Week of 30 April 1999 |
Vol. II, No. 33 |
Health Matters
Warning signs: recognizing eating disorders
I suspect that my friend may have an eating disorder, but I'm not sure. What are the warning signs, and how can I help?
Recognizing an eating disorder can be difficult, but if you suspect your friend is suffering from one, advise her to seek help immediately.
While the percentage of young women suffering from full-blown anorexia nervosa and bulimia may seem low -- between 2 and 7 percent of adolescent females in the United States -- many more suffer from disordered eating. Up to 23 percent of females and 14 percent of males experience bingeing and purging behavior, which will lead to full-blown anorexia or bulimia if left untreated. Indeed, the diagnosed incidences of these disorders have already doubled within the last decade. While each disorder affects the body in different ways, they are equally dangerous and potentially fatal without prevention.
"It's very important for concerned friends and family to be vigilant if they suspect that a loved one is suffering from either anorexia or bulimia, or from behavior that may lead to these diseases," says Pauline Sheehan, M.D., associate professor of pediatrics at Boston University School of Medicine and director of the Teen and Tot Program at Boston Medical Center. "Ask the individual how she feels about herself to gauge the severity of the problem. If indeed there is a problem, get her in touch with her primary care physician. Having support from friends, family, and good role models is important. It's the first step on the road to recovery."
While both disorders result from distorted body image, low self-esteem, feelings of helplessness, obsession with food, and possibly depression, different types of girls are more likely to suffer from one or the other condition. Anorexics, who typically range in age from 13 to 18 years, often try to appear as "the perfect child." They are overachievers, have very high standards of performance, and tend to be quiet and reserved.
"Anorexia literally means lack of appetite, but these girls are in fact always extremely hungry. They are in a constant power struggle with their own bodies, desperate to control their hunger and deprive themselves of calories," Sheehan says. So strong is their preoccupation that they quickly become emaciated, stop having menstrual periods, have dry skin, and grow a furry hair called lanugo, common on babies, in an attempt to keep their bodies warm.
Signs of this disorder include losing an excessive amount of weight in a short period of time, exercising obsessively, performing rituals, such as cutting food into tiny bites, and refusing to eat with others.
Bulimia usually affects an older group of women, ranging in age from 15 to 24. These women, of average or slightly higher than average weight, cannot control their eating, and they develop cycles of bingeing and purging, during which they eat between 4,000 and 5,000 calories within a few hours (a fully grown adult needs approximately 2,500 calories for one day). After the episode, they force themselves to vomit or use drugs to purge themselves of the food. Extroverted women, bulimics may have grown up in families with alcoholism and crime problems, and they tend to maintain a normal weight. A history of sexual abuse has been identified in victims of both conditions, particularly in bulimics.
Symptoms include excessive exercising, secretive eating, and using the bathroom for long periods of time -- often running water to cover up the sounds of vomiting. Dental enamel eroded by stomach acid and lack of menstruation are other signs.
Do not delay in seeking help -- the earlier the problem is identified, the better the chance of recovery. Treatment typically involves several different specialists, such as an adolescent medicine physician, a psychiatrist or other mental health provider, and a nutritionist, working as a team. If the problem is severe, the patient may need to spend some time in a hospital. Some patients benefit from antidepressants or other psychotropic medications.
How long will the recovery take? "Recovery is not a quick process, taking as long as five years," Sheehan says. "Counseling is usually vital, as the victim has to increase her sense of self-worth. Until she does that, she's always at risk of reverting back to these eating disorders."
"Health Matters" is written in cooperation with staff members of Boston Medical Center. For more information about eating disorders or other health matters, call 638-6767.