Eating Disorders Finding Balance on the Battlefield

1. Eating DisordersFinding Balance on the Battlefield

2. Types of Eating Disorders • Anorexia (also known as anorexia nervosa) is the name for simply starving yourself because you are convinced you are overweight. If you are at least 15 percent under your normal body weight and you are losing weight through not eating, you may be suffering from this disorder. • Bulimia (also known as bulimia nervosa) is characterized by a secretive cycle of binge eating followed by purging. Bulimia includes eating large amounts of food--more than most people would eat in one meal--in short periods of time, then getting rid of the food and calories through vomiting, laxative abuse, or over-exercising. • Binge Eating (also known as COMPULSIVE OVEREATING) is characterized primarily by periods of uncontrolled, impulsive, or continuous eating beyond the point of feeling comfortably full. While there is no purging, there may be sporadic fasts or repetitive diets and often feelings of shame or self-hatred after a binge. People who overeat compulsively may struggle with anxiety, depression, and loneliness, which can contribute to their unhealthy episodes of binge eating. Body weight may vary from normal to mild, moderate, or severe obesity.

3. Severity of Eating Disorders • Eating disorders are serious problems and need to be diagnosed and treated like any medical disease. If they continue to go untreated, these behaviors can result in future severe medical complications that can be life-threatening. • Eating disorders involve serious disturbances in eating behavior, such as extreme and unhealthy reduction of food intake or severe overeating, as well as feelings of distress or extreme concern about body shape or weight.

4. Anorexia Fear of weight gain Excessive Weight Loss Denial of hunger and refusal to eat Excuses to avoid meals Talk about food all the time View self as fat even when very thin Excessive or compulsive exercising Depression, isolation Menstrual periods stop or don’t start Bulimia Preoccupation with food and calories Secret eating, hoarding food Feeling out of control Bathroom trips immediately after eating Eating enormous meals without weight gain Binge eating, then purging by vomiting, laxatives, diuretics, fasting or diet pills Dental problems from acid on teeth Warning Signs

5. I'm so fat. Girls with eating disorders can't see what's real. Protect your daughter by giving her real world examples of a healthy body image. Emphasize her real assets, like intelligence and talent. And if you even suspect she may have an eating disorder, get real help. Anorexia, bulimia and binge eating are real illnesses that can cause serious damage, even death. To raise healthy daughters, we all need to get real. Eating Disorders Are Illnesses, Not Choices

6. Health Consequences of Anorexia • Health Consequences of Anorexia Nervosa:In anorexia nervosa’s cycle of self-starvation, the body is denied the essential nutrients it needs to function normally. Thus, the body is forced to slow down all of its processes to conserve energy, resulting in serious medical consequences. • Abnormally slow heart rate and low blood pressure, which mean that the heart muscle is changing. The risk for heart failure rises as the heart rate and blood pressure levels sink lower and lower. • Reduction of bone density (osteoporosis), which results in dry, brittle bones. • Muscle loss and weakness. • Severe dehydration, which can result in kidney failure. • Fainting, fatigue, and overall weakness. • Dry hair and skin; hair loss is common. • Growth of a downy layer of hair called lanugo all over the body, including the face, in an effort to keep the body warm.

7. Health Consequences of Bulimia • Health Consequences of Bulimia Nervosa:The recurrent binge-and-purge cycles of bulimia can affect the entire digestive system and can lead to electrolyte and chemical imbalances in the body that affect the heart and other major organ functions. • Electrolyte imbalances that can lead to irregular heartbeats and possibly heart failure and death. Electrolyte imbalance is caused by dehydration and loss of potassium, sodium and chloride from the body as a result of purging behaviors. • Potential for gastric rupture during periods of bingeing. • Inflammation and possible rupture of the esophagus from frequent vomiting. • Tooth decay and staining from stomach acids released during frequent vomiting. • Chronic irregular bowel movements and constipation as a result of laxative abuse. • Peptic ulcers and pancreatitis.

8. Health Consequences of Binge Eating • Health Consequences of Binge Eating Disorder:Binge eating disorder often results in many of the same health risks associated with clinical obesity. • High blood pressure. • High cholesterol levels. • Heart disease as a result of elevated triglyceride levels. • Type II diabetes mellitus. • Gallbladder disease.

9. Facts About Eating Disorders • The prevalence of anorexia nervosa among women ranges from 0.5% to 3.7% in various studies. For bulimia nervosa among women, it ranges from 1.1% to 4.2%. Eating disorders are more commonly seen among females, with a male/female ratio of 1:9. Patients with eating disorders are more likely to suffer from major depression, obsessive-compulsive disorder, social anxiety disorder, and alcohol and drug abuse.

10. Con’t Facts About Eating Disorders • In the United States, as many as 10 million females and 1 million males are fighting a life and death battle with an eating disorder such as anorexia or bulimia. Approximately 25 million more are struggling with binge eating disorder (Crowther et al., 1992; Fairburn et al., 1993; Gordon, 1990; Hoek, 1995; Shisslak et al., 1995).

11. Early Interventionof Male Eating Disorders • Eating disorders do not discriminate on the basis of gender. Men can and do develop eating disorders. • Learn about eating disorders and know the warning signs. Become aware of your community resources (treatment centers, self-help groups, etc.). Consider implementing an Eating Concerns Support Group in a school, hospital, or community setting to provide interested young men with an opportunity to learn more about eating disorders and to receive support. Encourage young men to seek professional help if necessary. • Understand that athletic activities or professions that necessitate weight restriction (e.g., gymnastics, track, swimming, wrestling, rowing) put males at risk for developing eating disorders. Male wrestlers, for example, present with a higher rate of eating disorders than the general male population (Andersen, 1995). Coaches need to be aware of and disallow any excessive weight control or body building measures employed by their young male athletes. • Talk with young men about the ways in which cultural attitudes regarding ideal male body shape, masculinity, and sexuality are shaped by the media. Assist young men in expanding their idea of “masculinity” to include such characteristics as caring, nurturing, and cooperation. Encourage male involvement in traditional “non-masculine” activities such as shopping, laundry, and cooking.

12. Cont’d Male Eating Disorders • Demonstrate respect for gay men, and men who display personality traits or who are involved in professions that stretch the limits of traditional masculinity; e.g., men who dress colorfully, dancers, skaters, etc. • Never emphasize body size or shape as an indication of a young man’s worth or identity as a man. Value the person on the “inside” and help him to establish a sense of control in his life through self-knowledge and expression rather than trying to obtain control through dieting or other eating disordered behaviors. • Confront others who tease men who do not meet traditional cultural expectations for masculinity. Confront anyone who tries to motivate or “toughen up” young men by verbally attacking their masculinity; e.g., calling names such as “sissy” or “wimp.” • Listen carefully to a young man’s thoughts and feelings, take his pain seriously, allow him to become who he is. • Validate a young man’s strivings for independence and encourage him to develop all aspects of his personality, not only those that family and/or culture find acceptable. Respect a person’s need for space, privacy, and boundaries. Be careful about being overprotective. Allow him to exercise control and make his own decisions whenever possible, including control over what and how much he eats, how he looks, and how much he weighs.

13. Seeking Treatment • Eating disorders are serious health conditions that can be both physically and emotionally destructive. People with eating disorders need to seek professional help. Early diagnosis and intervention significantly enhances recovery. If not identified or treated in their early stages, eating disorders can become chronic, debilitating, and even life-threatening conditions. • What does treatment involve? The most effective and long-lasting treatment for an eating disorder is some form of psychotherapy or psychological counseling, coupled with careful attention to medical and nutritional needs. Ideally, this treatment should be tailored to the individual and will vary according to both the severity of the disorder and the patient's particular problems, needs, and strengths. Treatment is Available. Recovery is Possible.

14. Cont’d Seeking Treatment • Psychological counseling must address both the eating disordered symptoms and the underlying psychological, interpersonal, and cultural forces that contributed to the eating disorder. Typically care is provided by a licensed health professional, including but not limited to a psychologist, psychiatrist, social worker, nutritionist, and/or medical doctor. Care should be coordinated and provided by a health professional with expertise and experience in dealing with eating disorders. • Many people with eating disorders respond to outpatient therapy, including individual, group, or family therapy and medical management by their primary care provider. Support groups, nutritional counseling, and psychiatric medications under careful medical supervision have also proven helpful for some individuals. • Hospital Based Care (including inpatient, partial hospitalization, intensive outpatient and/or residential care in an eating disorders specialty unit or facility) is necessary when an eating disorder has led to physical problems that may be life-threatening, or when it is associated with severe psychological or behavioral problems. • The exact treatment needs of each individual will vary. It is important for individuals struggling with an eating disorder to find a health professional they trust to help coordinate and oversee their care.

15. Eating disorders are illnesses with a biological basis modified and influenced by emotional and cultural factors. The stigma associated with eating disorders has long kept individuals suffering in silence, inhibited funding for crucial research has created barriers to treatment. Because of insufficient information, the public and professionals fail to recognize the dangerous consequences of eating disorders. While eating disorders are serious, potentially life threatening illnesses, there is help available and recovery is possible.