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Eating Disorders: The Quest for the "Perfect Body" can be Deadly

BY KATRINA E. STACKHOUSE,

SOUTHERN HEALTH CONTRIBUTOR

"It's funny really, well, maybe not literally funny, but I really don't know when my struggle with anorexia began.

"I guess I had been dealing with it for a while. I remember the rest of my family being so skinny. I remember being in first grade and not wanting to eat because I was constantly thinking, "why am I so fat?" It was always so normal for me; I didn't even realize I had an eating disorder until I started college.

"As I said before, my entire family is slim. They've never had to worry about being overweight. I have a very slow metabolism...if I even looked at chips or French-fries, I'd gain a pound. My mom used to take me walking when I was younger to try to help me shed the extra weight.

Eventually I started working out for hours a day on my own, but it seemed like nothing worked.
"I was always the fat kid in my mind. Looking back, I really was fairly thin; I just wasn't as thin as my mother and my sister. It didn't help that I have had bouts with depression throughout my life that have left me feeling out of control. Food seemed to be the only thing in my life I could control."

- Suzanne Milano, a Southern Illinois University student studying cinema, photography, radio and television.

The National Eating Disorders Association (NETA) states that as many as 10 million females and one million males in the United States are fighting a life and death battle with an eating disorder.

Eating disorders (ED) as defined by NETA are illnesses with a biological basis, modified and influenced by emotional and cultural factors. The most common types of ED are Anorexia Nervosa, Bulimia Nervosa, and Binge/Compulsive Eating Disorder.

In the United States, eating disorders are more common than even Alzheimer's disease and many young women and men battle with it on a daily basis.

Anorexia Nervosa

According to the American Psychiatric Association, approximately 90-95 percent of anorexia nervosa sufferers are girls. Anorexia is one of the most common psychiatric diagnoses in young women, typically appearing in early to mid-adolescence.

"Anorexia Nervosa is characterized by a refusal to eat or maintain a healthy weight for one's age, height, size," explains Nancy Albus, assistant clinical director and individual therapist at Castlewood Treatment Center, a residential treatment facility and day hospital program for individuals needing treatment for eating disorders.

"There is also an intense fear of being fat in spite of being at a low or normal weight," says Albus. "Anorexia is like a self imposed starvation. Often the individual starts out restricting a certain type of food and as the disease takes hold, more and more foods become restricted."
"Soon the individual is powerless and so fearful of so many foods that they are unable to physically put the food in their mouth," she adds.

Binge Eating

Binge eating or Compulsive Over-eating, is the second type of eating disorder. This disorder indicates that a person eats an amount of food that is significantly larger than most individuals would eat during one sitting. Binge Eating is often done without thought to hunger or fullness.

"It isn't eating or grazing on food, but eating large amounts of carbohydrates or high calorie food and being unable to control its consumption," says Albus.

"Binge eaters usually have strong feeling of being out of control and use food to fill in voids they feel inside. The individuals use secrecy to hide and cover their symptoms. Food is their source of comfort," she adds.

NETA estimates that the prevalence of binge eating is estimated to be approximately one to five percent of the general population, affecting women slightly more often than men. NETA also estimates that about 60 percent of people struggling with binge eating disorders are female and 40 percent are male. Like other forms of ED, binge or compulsive eating is often associated with symptoms of depression.

Bulimia

Bulimia is the third common eating disorder in which one over eats and then releases the food from their body by either regurgitation or through the use of laxatives.

"With bulimia, an individual eats either a normal amount or too much food and purges through vomiting, laxatives, or over-exercising," explains Albus. "Some people will consume so much food that they are actually in pain because of the amount of consumption."

According to NETA, bulimia nervosa affects one to two percent of adolescent and young adult women with approximately 80 percent of them being female. Unlike anorexia, people struggling with bulimia nervosa will often appear to be of average body weight.

Persons suffering from bulimia nervosa are frequently associated with symptoms of depression and struggle with social adjustment.

How Do They Begin?

"Eating disorders are serious and can, for some, be life threatening," explains Albus. "It starts as a person's attempt to cope with life and can be brought on by a stressful situation or trauma like a death, rape, or abuse."

"It can also be an individual's way to cope with life. In this instance the person uses the refusal of food or the intake of food for comfort or control because they feel so powerless in their everyday lives," Albus adds.

She also notes that for many, an eating disorders can start with "disordered eating," which stems from the disruption of the normal eating cycle as a way to lose a few pounds.

"Often we see these type of eating patterns emerge as people rush to get in shape for a special event like a spring break trip or a wedding," says Albus. "With disordered eating the individual receives a lot of attention for weight loss and desires more."

"Disordered eating can very quickly become an obsession which can then lead to an eating disorder. When a person's attitudes about food and weight lead to very rigid eating and exercise I see this as the possible buds or seeds leading to a disorder for some."

"Others can have disordered eating patterns which never lead to an eating disorder," Albus says.

Who Suffers from Eating Disorders?

When we imagine the prototype for this type of behavior, the general public is often quick to assume that these issues only affect small populations of young, White women and teens; as they are the poster faces of ED as represented by the media.

However, experts state that this stereotype is highly inaccurate. Eating disorders affect men and women as well as minorities.

It has been speculated that women from racial and ethnic minority groups identify with alternative standards of beauty, in comparison to the standard, so they may be less susceptible to ED.

According to NETA, over the past few years, there has been increasing evidence of disordered eating occurring among racial and ethnic minorities in the United States. In a study confirming the fact that minorities also struggle with ED, the Minnesota Adolescent Health Study found that dieting was associated with weight dissatisfaction, perceived overweight, and low body pride in all ethnic groups.

"While any person may develop an eating disorder, those at highest risk are adolescent females," says Kimberly Darnstaedt, the director of the Youth and Family Division, at Franklin-Williamson Human Services. "In general, about 10 percent of the patients seeking treatment for eating disorders are male."

"It should be noted however, that the eating disorders experienced by these males show little difference from those experienced by their female counterparts. In addition to age and gender risks, there are also certain groups of athletes that are particularly vulnerable to eating disorders. These include gymnasts, runners, dancers, and wrestlers. All of these sports place a high importance on weight restriction," Darnstaedt adds.

Some Causes

With such a high number of Americans suffering from this condition, many wonder what specific factors cause eating disorders. Research suggests that eating disorders begin with some type of biological, social, or emotional trigger, but there have been no concrete causes.

"There is no one cause for eating disorders," says Darnstaedt. "The research suggests that eating disorders have many contributing factors which include psychological factors."

"Some of these factors include low self-esteem, feelings of lack of control, and depression or anxiety," Darnstaedt adds.

"From a biological perspective, there is some evidence suggesting that eating disorders have a genetic factor as they often run in families. There also appears to be some specific biochemical imbalances common among eating disorder patients."

Darnstaedt suggests that social and cultural factors can also lead to the emergence of an eating disorder. As our society becomes more and more obsessed with personal appearance many people struggle with negative self-image.

"The social/cultural factors most commonly linked to eating disorders are the cultural pressures to be thin and a high societal value (placed) on physical perfection," Darnstaedt says.
"Other factors can include family problems, problems with peers or history of physical or sexual abuse," she adds.

Effects on Oral Health

In addition to the harm one can causes their body, eating disorders also have harmful effects on one's oral health. According to NETA, up to 89 percent of bulimic patients show signs of tooth erosion that is usually associated with regurgitation.

The harmful habits and nutritional deficiencies that often accompany disordered eating can have severe consequences on one's dental health resulting in the loss of tissue and erosive lesions on the surface of teeth; changes in the color, shape, and length of teeth; and increased sensitivity to temperature and pain.

"Changes in the mouth are one the first physical signs of an eating disorder," says Julie Horn, a registered dental hygienist, at Family and Cosmetic Dentistry of Southern Illinois located in Herrin.

"Specifically, bulimia is very damaging to your dental health; it causes the erosion of your tooth's enamel," says Horn. "This erosion is caused by disruptions of your mouth's PH balance, which should normally be at 5.0 at all times for optimal oral health."

Horn adds that in addition to erosion, persons with ED may need to undergo reconstructive processes to get their teeth back to their original condition. "If a person has been bulimic for two years or more, the erosion will begin on their back molars, eventually they may even need veneers," Horn adds.

Treatment

There are many treatment options available for those who suffer from an eating disorder. "Treatment for eating disorders ranges from individual counseling and nutrition therapy to intensive inpatient treatment," Darnstaedt explains. "Because an eating disorder can have devastating effects on the body, severe cases may result in the need for hospitalization in an acute care medical facility."

Darnstaedt notes that not all cases can be handled swiftly; some cases can be extremely treatment resistant and can take months or years to treat. In these cases, long-term residential treatment may be required.

Facilities like Castlewood Treatment Center located in St. Louis, MO offer a safe and comprehensive option for recovery from eating disorders.

"We have all of our clients evaluated to determine the best place to treat their eating disorder," says Albus. "Our residential program is very intense and runs every day." "Treatment for ED depends on the intensity of the eating disorder. Outpatient treatment with a therapist or psychiatrist, who has experience in the treatment of eating disorders, is the first place to start."

"Usually a dietician is also a part of the outpatient program to help establish a healthy meal plan and address any exercise issues. If that doesn't appear to be enough then the next level of care would be an Intensive inpatient Program," Albus adds.

For more information about eating disorders, their symptoms, and treatment resources please contact the National Eating Disorders Association on their website at www.NationalEatingDisorders.org, or contact Castlewood Treatment Centers at 1-888-822-8938 or visit them online at www.castlewoodtc.com.

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posted by Cheryl Levesque @ 4:11 PM