CATEGORY: HTH Health
By M. Scott Morris
People with eating disorders are well versed in deception.
A girl with anorexia nervosa becomes highly skilled at cutting and dicing food on her plate while managing to eat next to nothing.
Someone with bulimia nervosa fills herself up at the table then excuses herself for a visit to the bathroom where she induces herself to vomit.
A person with binge eating disorder waits until no one else is around before he consumes large amounts of food that leave him bloated and uncomfortable.
“They’re such secretive illnesses. They can go on for years before being discovered,” said Sally West, counselor in the adolescent unit at North Mississippi Medical Center’s Behavioral Health Center.
The longer an eating disorder is kept secret, the more chance a person has of developing serious health problems that, if left untreated, could result in death.
“We’ve seen kids as young as 12 years old who’ve had heart damage (from malnutrition resulting from anorexia),” said Holly Wroten, educational therapist in the Behavioral Health Center’s adolescent unit. “They’re hurting their bodies.”
According to the National Institute of Mental Health, approximately 1 percent of adolescent girls develop anorexia nervosa, which generally begins around the time of puberty, though adults are certainly not immune.
“Starvation is what it looks like sometimes,” said Joyce Cole, clinical psychologist with the Behavioral Health Center. “They tend not to recognize the seriousness of the disorder.”
Anorexia usually starts as a diet. The person loses some weight and enjoys the compliments, but a downward spiral can begin.
“The message even from an early age is thin is the way to go,” Cole said.
For people with anorexia, there seems to be no such thing as too thin. In an ironic twist, they tend to hide their thinness with bulky, layered clothing.
“We’ve had them in (the Behavioral Health Center) at 65 pounds and still wanting to weigh 45 pounds,” West said.
The weight loss comes at a cost, including heart problems, dementia, infertility, shrinking of internal organs and electrolyte imbalance.
“A lot of them end up in the emergency room after passing out at school,” West said. “It can take a crisis for people to realize there’s a problem.”
Bulimics don’t necessarily resemble starved super models. They can even be a bit overweight. The National Institute of Mental Health estimates the illness affects 2 to 3 percent of young women.
The process of binge eating and purging is a way to cope with emotional issues, Wroten said.
“Bulimia is a feelings disorder,” she said. “They say, ‘My life feels so out of control,’ and they binge. Once they get rid of the food, for a while, it makes them feel better.”
Wroten said it is common for someone with bulimia to abuse alcohol and other drugs. Bulimia is regularly diagnosed in patients who are seeking treatment for drug abuse.
“We notice that after they eat, they go straight to the bathroom,” Wroten said. “That’s how you spot them.”
Bulimia causes many of the same health problems as anorexia. The illness also causes tooth and gum damage, esophageal and digestive tract problems, distended abdomen and callused fingers caused by using fingers to trip the gag reflex.
Binge eating affects 2 percent of the general population, though it affects more women than men. It’s much like bulimia without the purging aspect.
“Folks have talked about having binges in response to depression, anxiety and stress,” Cole said. “The main issue is loss of control over consumption of food and this almost preoccupation with food.”
Alcohol and drug abuse can accompany binge eating. Most people with the disorder are obese and have a history of weight fluctuations.
Research indicates the disorder occurs in as many as 30 percent of people participating in medically supervised weight control programs.
How to help
Treatment is available for all three eating disorders, but first people must seek help. Some might need a gentle push in the right direction.
“Sometimes we are reluctant to be honest with folks about what we see going on with them. We don’t really know what to do or what to say to the person,” Cole said. “It’s important to be honest with folks and express your serious concerns.”
When someone seeks treatment, they can expect therapy sessions and nutritional counseling. If underlying problems such as depression and anxiety are present, they can be treated with medication.
Wroten said treatment is provided on an outpatient or inpatient basis. Anorexics with severe weight loss are more likely to be admitted for treatment.
“When it’s that bad, we’ve got to medically stabilize them,” she said.
An important factor in overcoming an eating disorder is family involvement, West said.
“It’s not always possible, but family therapy is very important,” she said. “The more they work together, the better chance she has at getting well.”
Cole said eating disorders and family life resemble the question about the chicken and the egg.
“Did the family create the eating disorder or is it responding to the disorder?” she said. “Sometimes the focus is so much on the eating that you forget there are underlying emotional issues.”
Family involvement serves another vital function.
“Family members help take away the stigma,” Cole said. “You’re communicating to the person that it’s OK to get help. That means so much.”
If you answer “yes” to any of the following questions, you could be suffering from an eating disorder:
– Do you binge on large amounts of food while feeling out of control?
– Do you obsessively worry about preventing the calories you take in from turning into fat?
– To control or lose weight, do you use laxatives or water pills?
– Do you exercise excessively?
– Do you avoid social or other functions to keep to an eating or exercising schedule?
– Do you avoid eating in front of others so they won’t see the amount of food you eat or don’t eat?
– Have you noticed menstrual irregularities?
– Do you feel guilt or shame about eating?
North Mississippi Medical Center’s Behavioral Health Center will present “Body Image and the Beauty Myth” at 6 p.m. today (Thursday).
Also, free body image screenings will be offered today and Friday from 8 a.m. to 4:30 p.m. at the facility, located at 4579 South Eason Blvd. No appointment is necessary. Participants can answer a written questionnaire and meet one-on-one with a mental health professional.
An informative video on eating disorders including anorexia nervosa, bulimia nervosa and binge eating disorder will be available.
For more information, call NMMC’s Behavioral Health Center at 1-800-843-3375.