Eating Disorder Resource

When I was very young and very foolish,
I used to hope that I would get the disease called anorexia nervosa.

I thought that was a romantic disease that would solve my problem of chubbiness.

I never really had a full-blown eating disorder. But I was way too obsessed with my weight and the things I eat
To the point that I had a problem enjoying life.

Now I know better, but I still see victims of the belief system in which
Thinness = Beauty = True Love = Happiness = A Successful Life

I feel sad for them, and very angry toward the social pressures that pushed adolescent girls into their perpetual diets.
And their perpetual feeling of unworthiness.

Below I have compiled some of the facts of eating disorders and the websites I got them from.

The ANRED Site ( http://www.anred.com )

Warning signs of eating disorders

Food behaviors

1.The person skips meals, takes only tiny portions, will not eat in front of other people, eats in ritualistic ways, and mixes strange food combinations. May chew mouthfuls of food but spits them out before swallowing. Grocery shops and cooks for the entire household, but will not eat the tasty meals. Always has an excuse not to eat -- is not hungry, just ate with a friend, is feeling ill, is upset, and so forth.

2. Becomes "disgusted" with former favorite foods like red meat and desserts. Will eat only a few "safe" foods. Boasts about how healthy the meals s/he does consume are. Becomes a "vegetarian" but will not eat the necessary fats, oils, whole grains, and the denser fruits and veggies (such as sweet potatoes and avocados) required by true vegetarianism. Chooses primarily low-fat items with low levels of other nutrients, foods such as lettuce, tomatoes, sprouts, and so forth.

3. Usually has a diet soda in hand. Drastically reduces or completely eliminates fat intake. Reads food labels religiously. If s/he breaks self-imposed rigid discipline and eats normal or large portions, excuses self from the table to vomit and get rid of the calories.

4. Or, in contrast to the above, the person gorges, usually in secret, emptying cupboards and refrigerator. May also buy special binge food. If panicked about weight gain, may purge to get rid of the calories. May leave clues that suggest discovery is desired -- empty boxes, cans, and food packages; foul smelling bathrooms; running water to cover sounds of vomiting; excessive use of mouthwash and breath mints; and in some cases, containers of vomit poorly hidden that invite discovery.

5. Sometimes the person uses laxatives, diet pills, water pills, or "natural" products from health food stores to promote weight loss. May abuse alcohol or street drugs, sometimes to deaden appetite, sometimes to escape emotional pain, and usually in hopes of feeling better, at least temporarily.


Appearance and body image behaviors

1. The person loses, or tries to lose, weight. Has frantic fears of weight gain and obesity. Wears baggy clothes, sometimes in layers, to hide fat, hide emaciation, and stay warm. Obsesses about clothing size. Complains that s/he is fat even though others truthfully say this is not so. S/he will not believe them.

2. Spends lots of time inspecting self in the mirror and usually finds something to criticize. Detests all or specific parts of the body, especially breasts, belly, thighs, and buttocks. Insists s/he cannot feel good about self unless s/he is thin, and s/he is never thin enough to satisfy her/himself.


Exercise behaviors

1. The person exercises excessively and compulsively. May tire easily, keeping up a harsh regimen only through sheer will power. As time passes, athletic performance suffers. Even so, s/he refuses to change the routine.

2. May develop strange eating patterns, supposedly to enhance athletic performance. May consume sports drinks and supplements, but total calories are less than what an active lifestyle requires.


Thoughts and beliefs

1. In spite of average or above-average intelligence, the person thinks in magical and simplistic ways, for example, "If I am thinner, I will feel better about myself." S/he loses the ability to think logically, evaluate reality objectively, and admit and correct undesirable consequences of choices and actions.

2. Becomes irrational and denies that anything is wrong. Argues with people who try to help, and then withdraws, sulks, or throws a tantrum. Wanting to be special, s/he becomes competitive. Strives to be the best, the smallest, the thinnest, and so forth.

3. Has trouble concentrating. Obsesses about food and weight and holds to rigid, perfectionistic standards for self and others.

4. Is envious of thin people in general and thinner people in particular. Seeks to emulate them.

5. Note: Not all, but a subset of people with eating disorders think they do not deserve to eat or enjoy tasty food. They starve, stuff, or purge in deliberate attempts to punish themselves. They may also cut their flesh or otherwise hurt themselves. Some want to become increasingly debilitated, even suffer the indignities of tube feedings and IVs, and eventually weaken and die. They see this not as a cry for help or attention, or an attempt to control their lives, but as well-deserved punishment for misperceived flaws and misdeeds. Their extreme self-hatred must be dealt with in therapy if they are to recover.


Feelings

1. Has trouble talking about feelings, especially anger. Denies anger, saying something like, "Everything is OK. I am just tired and stressed." Escapes stress by turning to binge food, exercise, or anorexic rituals.

2. Becomes moody, irritable, cross, snappish, and touchy. Responds to confrontation and even low-intensity interactions with tears, tantrums, or withdrawal. Feels s/he does not fit in and therefore avoids friends and activities. Withdraws into self and feelings, becoming socially isolated.

3. Feels inadequate, fearful of not measuring up. Frequently experiences depression, anxiety, guilt, loneliness, and at times overwhelming emptiness, meaninglessness, hopelessness, and despair.


Self-harm and self-injury

1. In some people the above mentioned feelings are overwhelming, too many and too strong to be endured. To cope, to release the pain, to escape it, to distract themselves, some people hurt their bodies. They cut their flesh or burn it. They bang their heads or swallow foreign objects. They report that while they are engaged in self-harm, they experience peace, tranquility and calm -- a sense of being grounded after feeling tossed about by chaos and misery -- at least for a while, until stress and tension mount again.

2. In some cases, past trauma (especially sexual abuse) has been so devastating that all feelings have been numbed. Then the person self-injures in order to feel something, anything.

3. In spite of appearances, the person who self-injures is not consciously trying to commit suicide. Neither is s/he "only" seeking attention. Self-harm is frequently a symptom of Borderline Personality Disorder, a problem that often co-exists with an eating disorder. Treatment is available and can be combined with treatment for an eating disorder. Evaluation by a mental health care provider is essential. Since people who hurt themselves can inadvertantly create a medical crisis, sooner is better than later.


Social behaviors

1. Tries to please everyone and withdraws when this is not possible. Tries to take care of others when s/he is the person who needs care. May present self as needy and dependent or conversely as fiercely independent and rejecting of all attempts to help. Anorexics tend to avoid sexual activity. Bulimics may engage in casual or even promiscuous sex.

2. Person tries to control what and where the family eats. To the dismay of others, s/he consistently selects low-fat, low-sugar non-threatening -- and unappealing -- foods and restaurants that provide these "safe" items.

3. Relationships tend to be either superficial or dependent. Person craves true intimacy but at the same time is terrified of it. As in all other areas of life, anorexics tend to be rigidly controlling while bulimics have problems with lack of impulse control that can lead to rash and regrettable decisions about sex, money, stealing, commitments, careers, and all forms of social risk taking.


Other behaviors

1. Eating disorders frequently occur in combination with other problems. All of the following deserve professional attention in their own right. When they appear in the company of an eating disorder, professional attention is even more necessary: alcohol abuse, abuse of prescription medications, abuse of recreational drugs, physical, emotional, or sexual abuse; threats of suicide or suicide attempts; cutting or other self-harm behaviors, rage attacks, placing oneself in dangerous situations, homicidal threats or attempts, stealing and other criminal acts, and any other behaviors that can logically be expected to bring harm to self or others.




Definitions of eating disorders

Anorexia nervosa: the relentless pursuit of thinness
Definition:

1. Person refuses to maintain normal body weight for age and height.

2. Weighs 85% or less than what is expected for age and height.

3. In women, menstrual periods stop. In men levels of sex hormones fall.

4. Young girls do not begin to menstruate at the appropriate age

5. Person denies the dangers of low weight.

6. Is terrified of becoming fat.

7. Is terrified of gaining weight even though s/he is markedly underweight.

8. Reports feeling fat even when very thin.

9. In addition, anorexia nervosa often includes depression, irritability, withdrawal, and peculiar behaviors such as compulsive rituals, strange eating habits, and division of foods into "good/safe" and "bad/dangerous" categories. Person may have low tolerance for change and new situations; may fear growing up and assuming adult responsibilities and an adult lifestyle. May be overly engaged with or dependent on parents or family. Dieting may represent avoidance of, or ineffective attempts to cope with, the demands of a new life stage such as adolescence.


Bulimia nervosa: the diet-binge-purge disorder
Definition:

1. Person binge eats.

2. Feels out of control while eating.

3. Vomits, misuses laxatives, exercises, or fasts to get rid of the calories.

4. Diets when not bingeing. Becomes hungry and binges again.

5. Believes self-worth requires being thin. (It does not.)

6. May shoplift, be promiscuous, and abuse alcohol, drugs, and credit cards.

7. Weight may be normal or near normal unless anorexia is also present.

8. Like anorexia, bulimia can kill. Even though bulimics put up a brave front, they are often depressed, lonely, ashamed, and empty inside. Friends may describe them as competent and fun to be with, but underneath, where they hide their guilty secrets, they are hurting. Feeling unworthy, they have great difficulty talking about their feelings, which almost always include anxiety, depression, self-doubt, and deeply buried anger. Impulse control may be a problem; e.g., shoplifting, sexual adventurousness, alcohol and drug abuse, and other kinds of risk-taking behavior. Person acts with little consideration of consequences.



Binge eating disorder
Definition:
1. The person binge eats frequently and repeatedly.

2. Feels out of control and unable to stop eating during binges.

3. May eat rapidly and secretly, or may snack and nibble all day long.

4. Feels guilty and ashamed of binge eating.

5. Has a history of diet failures

6. Tends to be depressed and obese.

7. People who have binge eating disorder do not regularly vomit, overexercise, or abuse laxatives like bulimics do. They may be genetically predisposed to weigh more than the cultural ideal (which at present is exceedingly unrealistic), so they diet, make themselves hungry, and then binge in response to that hunger. Or they may eat for emotional reasons: to comfort themselves, avoid threatening situations, and numb emotional pain. Regardless of the reason, diet programs are not the answer. In fact, diets almost always make matters worse. Information reported in the March 2002 New England Journal of Medicine suggests that for some, but not all, people a genetic flaw in combination with lifestyle factors can predispose to binge eating and subsequent obesity.


Anorexia athletica (compulsive exercising)
Not a formal diagnosis. The behaviors are usually a part of anorexia nervosa, bulimia, or obsessive-compulsive disorder.

1. The person repeatedly exercises beyond the requirements for good health.

2. May be a fanatic about weight and diet.

3. Steals time to exercise from work, school, and relationships.

4. Focuses on challenge. Forgets that physical activity can be fun.

5. Defines self-worth in terms of performance

6. Is rarely or never satisfied with athletic achievements.

7. Does not savor victory. Pushes on to the next challenge immediately.

8. Justifies excessive behavior by defining self as a "special" elite athlete.

9. Compulsive exercising is not an official diagnosis as are anorexia, bulimia, and binge eating disorder. We include it here because many people who are preoccupied with food and weight exercise compulsively in attempts to control weight. The real issues are not weight and performance excellence but rather control and self-respect.




Chewing and spitting
Definition

1. The person puts food in his/her mouth, tastes it, chews it, and then spits it out.

2. Some people think this is a separate eating disorder. It is not. It is a calorie-control behavior commonly seen in anorexia nervosa, and sometimes in bulimia and eating-disorder-not-otherwise-specified. The person is creative, allowing some experience and enjoyment of food but avoiding calories. Since essential nutrients are not incorporated into the body, chewing and spitting can be just as harmful to health as are starvation dieting and binge eating followed by purging.



Orthorexia nervosa
Not an official eating disorder diagnosis, but the concept is useful. The name was coined by Steven Bratman, M.D. to describe "a pathological fixation on eating "proper" or "pure" or "superior" food.

1.People with orthorexia nervosa feel superior to others who eat "improper" food, which might include non-organic or junk foods and items found in regular grocery stores, as opposed to health food stores.

2.Orthorexics obsess over what to eat, how much to eat, how to prepare food "properly," and where to obtain "pure" and "proper" foods.

3.Eating the "right" food becomes an important ,or even the primary, focus of life. One's worth or goodness is seen in terms of what one does or does not eat. Personal values, relationships, career goals, and friendships become less important than the quality and timing of what is consumed.

4.Perhaps related to, or a type of, obsessive-compulsive disorder