When we refer to "eating disorders" we think of medically defined/named compulsive eating patterns. The lines that divide the "eating disorders" from one another, as well as from "dieting" are blurry. In fact, most women with eating disorders begin by dieting. (Though, in actuality, only 25% of anorexics and 40% of bulimics are actually "overweight" before the onset of an "eating disorder," which usually occurs in the late teens.)

"Eating Disorders" are an increasingly common problem for women in college. The female to male ratio of eating disorders is 10:1. This is not surprising, given the emphasis on "the ideal body" and that food is an area that women can control in our lives and in society.

ANOREXIA NERVOSA

Anorexia is a serious, life-threatening disorder of self starvation with wide ranging physical and psychological components. The name Anorexia Nervosa is actually a misnomer-it means lack of appetite. Usually, the anorexic woman is obsessed with the idea of eating food but denies her hunger and does not eat and/or binges, then vomits or takes laxatives.

Physical symptoms of Anorexia include:

  • 20-25% loss of body weight
  • Loss of menstrual period (amenorrhea)
  • Excessive constipation
  • Loss of hair on head
  • Growth of a fine body hair
  • Intolerance to cold temperatures--always feeling cold
  • Low pulse
  • Low blood pressure
  • Lethargy
  • Dizziness, feeling weak and fainting

Some Behavioral Signs of Anorexia Are:

  • Intense fear of becoming fat doesn't diminish when weight is lost
  • Distorted body image--feeling "fat" even when very thin
  • Refusal to maintain a stable body weight
  • Constant preoccupation with food and/or dieting
  • Developing strange rituals around eating and food such as cutting food into tiny pieces, measuring everything before eating extremely small amounts, or intense involvement in cooking for and watching others eat
  • Denied hunger
  • Hyperactivity or compulsive exercise
  • Use of laxatives and/or diuretics
  • Attempts to cover all of the body, even in very warm weather
  • Extreme moodiness
  • Social isolation
  • Strong feelings of insecurity, loneliness, inadequacy and helplessness

BULIMIA

Bulimia is a severe disorder characterized primarily by a recurrent pattern of eating behavior that includes episodes of binge eating-i e eating a large quantity of food in a relatively short period of time, usually less than 2 hours and at least 3 of the following

  • Eating high calorie food during a binge
  • Eating secretly
  • Binges followed by stomach pains, sleeping or vomiting
  • Constantly trying to lose weight by strict dieting, vomiting, laxatives or diuretics
  • Weight going up or down more than 10 pounds due to binging or fasting
  • Feeling out of control after eating
  • Fear of not being able to stop eating voluntarily
  • Irregular menstrual cycle
  • Swollen glands

Some danger signs of Bulimia are:

  • Depression and self-criticism
  • Fear of fat
  • Excessive talk about food and calories
  • Secret eating
  • Eating enormous amount of food in one sitting but not gaining weight
  • Frequent trip to the bathroom for long periods of time (especially following meals)
  • Being nervous or agitated if someone or something prevents being alone after eating
  • Bloodshot eyes, especially after being where vomiting can take place (eg bathroom)
  • Abusing drugs or alcohol or stealing regularly
  • Constipation
  • Puffiness in the face, red eyes, and runny nose
  • Red, raw knuckles

Some psychological traits of bulimia may be:

  • Low self esteem
  • Difficulties with intimate relationships
  • Confused feelings about sexuality
  • The tendency to isolate self
  • Hypersensitivity to criticism
  • Feelings of powerlessness
  • Need to control depression
  • Need for outside approval
  • Obsession with food, weight and appearance
  • Repression of emotions, especially anger
  • Feelings of emptiness, worthlessness, helplessness, and hopelessness
  • Lacking the language to describe and discuss emotions

PHYSICAL EFFECTS OF ANOREXIA AND BULIMIA

The physical effects of repeated vomiting and laxative abuse can include:

  • Tearing of the lining of the esophagus or stomach
  • Strain on the heart due to loss of potassium
  • Dehydration
  • Dizziness
  • Muscle cramping and weakness
  • Fatigue
  • Digestive problems
  • Kidney failure
  • Broken blood vessels in the face and eyes
  • Tooth decay
  • Irregular menses or amenorrhea

All eating disorders are extremely dangerous Not only do their effects distort perception, concentration, and self esteem, but they can lead to irreversible physical destruction. The semistarvation and dehydration that result from anorexic or bulimic activities can cause the following to happen:

  • Loss of muscular strength
  • Loss of endurance
  • Decreased oxygen utilization
  • Decreased aerobic power
  • Loss of coordination
  • Impaired judgement
  • Reduced blood volume
  • Loss of blood flow to kidneys
  • Loss of all muscle glycogen (the energy stored in muscles and other organs)
  • Reduced heart function
  • Electrolyte loss (electrolytes are needed for heart, nerve and kidney function)
  • 6-10% of all patients with a diagnosis of anorexia or bulimia die as a result of starvation, cardiac arrest and suicide

"Eating Disorders" are serious problems and should be treated as such. Therapy and support groups for people with anorexia and/or bulimia are available both on and off campus.

OTHER FACTORS

LESBIANS AND EATING DISORDERS 

      Because the lesbian subculture is often described as challenging
      prescribed, heterosexist norms of beauty, the assumption might be
      that lesbians are more accepting of their bodies and less likely
      to be eating disordered While only a few studies have been done,
      preliminary findings report that while lesbian women diet less, it
      is more common for them to binge eat than heterosexual women.
      Dieting may be seen as a cooptation by the heterosexual standards
      of beauty and health Even as a lesbian woman may identify with
      communities that profess self-acceptance, she is still part of
      this greater culture that values thinness and beauty in women

FAMILY/ALCOHOL 

      It has been shown that the prevalence of depression is 3 times
      higher in families of anorexics and bulimics than the general
      population Alcohol, drug and sexual abuse has also been found to
      be significantly higher in families of people with eating
      disorders The characteristics found in compulsive eaters are
      similar to children of dysfunctional families and adult children
      of alcoholics (ACoAs) There are many functions that are served by
      an eating disorder in such a type of family It can become a
      woman's identity, something that is hers and hers alone in a
      family without individual boundaries It is her way to express all
      of the emotions deemed ''bad" by the family She can find the
      nurturing and dependability she lacks in the family [For more
      information on ACoAs, see Chapters 2 and 4.]

VIOLENCE 

      Another factor sometimes found in women with eating disorders is
      that they have been the survivors of rape or incest. [See Chapter
      8 for more about the way the experience of sexual violation can
      change a woman's life.] An eating disorder can become an ingenious
      survival mechanism for a child locked in a world where she feels
      that she has no control and that people can't be trusted.

HELPING OTHERS/HELPING OURSELVES

WHAT DO I DO IF I THINK A FRIEND HAS AN EATING DISORDER?

  • Remember, you are not responsible for her and cannot change her. You can only help her to help herself and be there for her.
  • SPEAK UP-anorexia and bulimia are serious, life threatening diseases and can signal an underlying depression. They should be treated by professionals.
  • Be supportive. Approach her gently but persistently. Don't expect her to admit her problem right away, but listen to her.
  • Give her a list of resources for help. Even if she may not use it now, she may use it later
  • Focus on her unhappiness, rather than the eating disorder as the reason she could benefit from help. Tell her you are worried because she seems down and emphasize that it doesn't have to be that way.
  • Don't deal with it alone. Confide in a trusted member of her family or Health Services. If she gets angry at you, tell her you must involve other people because you care about her and want her to be okay.
  • Talk to someone about your own emotions if you need to. This is a tough problem and you need and deserve support also. [See the resource list for groups for friends and families of people with "eating disorders."]

If you have a problem with food and eating, it is most important that you do not feel guilty or alone. You will find most people you talk to will have had some exposure to the issues involved. Bulimia and Anorexia have more immediate health risks involved, and you should seek professional help. The nutritionists and Mental Health workers at Health Services have experience dealing in these matters. .