Teen Perspectives: The Devastation of Eating Disorders

by Laura Irons

Hello my name is Laura Irons and I am writing a teen interest column about the many health problems that threaten teens. There are many other teens, like myself, who encounter various health issues among our peers, and our own health issues as well, that hopefully I can get several guest writers for this Teen Perspective column. If you have ideas you would like to see discussed, or you would like to write a guest column e-mail Dawn Irons at editor@publichealthalert.com with "Teen Perspective" in the subject line.

My first column is going to be about eating disorders. Some people are constantly overeating, called Binge eating, and some people don't eat for days, called Anorexia, and some people eat, but only to throw up later, called Bulimia. Many girls suffer from these eating disorders for several reasons including bad self-image, low self-esteem, and peer pressure. Any of these reasons can cause an eating disorder as well as many other things.

Binge eating is different from normal appetite increases or overeating from time to time. People with a binge eating problems consume unusually large amounts of food on a regular basis. They often eat quickly, and they don't stop eating when they become full. It's a newly recognized condition that affects millions of people worldwide.

People with this disorder eat constantly what others would consider an abnormally large amount of food. They feel they have no control over what they eat or how much. Afterwards they usually feel disgusted with themselves and depressed. Binge eating is slightly more common with women, with 3 women affected for every 2 men.

The causes of a binge eating disorder are still unknown. Up to half of all people with binge eating disorders have a history of depression. Whether depression is a cause or the effect of binge eating disorders is still unclear. It may be unrelated. Many people report that anger, sadness, boredom, anxiety or other negative emotions can trigger a binge episode. Impulsive behavior and certain other psychological problems may be more common in people with binge eating disorders.

Binge eating can also lead to Diabetes, high blood pressure, heart attacks, heart failure, and certain types of cancer. People with binge eating disorders are extremely distressed by their binge eating. Most have tried to control it on their own but have not succeeded for very long. Some people miss work, school, or social activities to binge eat. Obese people with binge eating disorders often feel bad about themselves, are preoccupied with their appearance, and may avoid social gatherings. Most feel ashamed and try to hide their problem. Often they are so successful that close family members and friends don't know they binge eat.

Several studies have found that people with binge eating disorders may find it harder than other people to stay in weight loss treatment. Binge eaters also may be more likely to regain weight quickly. For these reasons, people with the disorder may require treatment that focuses on their binge eating before they try to lose weight.Even those who are not overweight are frequently distressed by their binge eating and may benefit from treatment.

Several methods are being used to treat binge eating disorder. Cognitivebehavioral therapy teaches patients techniques to monitor and change their eating habits as well as to change the way they respond to difficult situations. Interpersonal psychotherapy helps people examine their relationships with friends and family and to make changes in problem areas. Treatment with medications such as antidepressants may be helpful for some individuals. Self-help groups also may be a source of support.

Researchers are still trying to determine which method or combination of methods is the most effective in controlling binge eating disorders. Binge eating is also found in the eating disorder called Bulimia Nervosa. A person with bulimia usually has an episode of binge eating followed by the purging methods he/she has come up with to prevent weight gain. The bulimic person attempts to rid the body of the food by purging. Purging takes the form of self-induced vomiting, the use of diuretics (water pills), or the heavy use of laxatives.

There is also a non-purging type of bulimia. The person with the nonpurging type of bulimia will fast for prolonged periods or exercise intensely to keep from gaining weight. The bulimic is often concerned about body shape and has an intense fear of weight gain. Therefore, the characteristics associated with bulimia include binge eating followed by attempts to keep from gaining weight. Binge eating is described as the ingestion of excessive amounts of high caloric food. When bulimics binge, they feel out of control, and their serious attempt to keep from gaining weight by purging offers them a form of control. Following an episode of binge eating, bulimics may totally stop eating and fast for a day or more.

Frequently, the bulimic attempts to hide her abnormal eating patterns. Family members, friends, or medical caregivers may suspect an eating disorder and encourage the bulimic to seek professional help.

A mental health professional may diagnose bulimia by taking a careful personal history from the client/patient. It is important to the therapist to learn the details of that person's life. It is also very important not to overlook a physical illness that might mimic or contribute to this psychological disorder.

The diagnosis of bulimia is made when the history reveals that the person eats a large quantity of food within a two-hour period, which is followed by a sense of lack of control. The person then tries to prevent weight gain by inducing vomiting, overusing laxatives, using diuretics, and/or enemas. The person may also engage in fasting or excessive exercise. Also, the person with suspected bulimia will be overly concerned about body shape and weight. In order to make a diagnosis of bulimia, this behavior must occur at least twice a week for a period of three months.

Helping the individual establish a healthy body concept and learn correct eating habits is often used in treating bulimia. Usually this is accomplished through therapy, which includes an educational focus. Part of that education emphasizes the destructive nature of the bingeing and purging pattern. A cognitive behavior approach, group therapy, family therapy, and/or the use of medications may be used. Most patients with bulimia can be treated as outpatients.

Another more common eating disorder is Anorexia. Anorexics have a problem keeping their body weight in a normal range or even above a minimal weight level considered to be healthy.

The first type of anorexia, called restricting, is found in those anorexics who severely limit their caloric intake and/or who exercise to excess to cause weight loss. The second type of anorexia, called binge-eating/purging, is found in those anorexics who eat in binges and then purge the body of the ingested food either by selfinduced vomiting, the ingestion of large quantities of laxatives, the overuse of diuretics and enemas to rid the body of food.

Anorexics don't see themselves like other people see them. They fear weight gain, and they work hard to stay thin.

In most cases anorexics actually lose weight. Weight loss usually occurs because of a severe reduction in caloric intake. In addition, weight loss is achieved by selfinduced vomiting, the use of diuretics (water pills), and the use of laxatives. Many anorexics also exercise to excess in an attempt to burn calories.

Anorexia is usually diagnosed when the young person is between the ages of 15 and 20 years. It is quite common for the first signs of anorexia to appear following a personally stressful event during adolescence. People in their 20's and 30's may have anorexia however, it is rare to see anorexia in an individual over 40 years of age.

Individuals with anorexia do not worry about their weight loss. Therefore, they generally do not seek professional help. Parents, other relatives, or friends are often responsible for getting the necessary help for the family member suffering from anorexia. The diagnosis of anorexia is made when the anorexic either loses fifteen percent (15%) of their weight or when the growing child fails to acquire eighty-five percent (85%) of the minimal weight for their particular age and height. As mentioned above, young people with anorexia do not see themselves as overly thin, and they gain a great sense of achievement by keeping themselves trim.

A history of excessive exercise, selfinduced vomiting, and the overuse of laxatives or diuretics helps the mental health professional make a diagnosis of anorexia.