Do You have an Eating Disorder?
Here are a few facts you need to know
Natenshon, MA, LCSW, GCFP
What eating disorders are about -
Eating disorders, contrary to popular belief, are not principally about
food, eating, or weight management. The assumption is that anorexics
under-eat and bulimics overeat and purge, but the issues are much more
integrative and complex. Anorexia nervosa and bulimia nervosa, different
manifestations of the same disease syndrome, are characterized by a
preoccupation with weight and body shape, a pathological fear of becoming
fat, erratic or inadequate food intake, and the inability to regulate
eating. Eating is a metaphor for
how we live; the person who cannot regulate food invariably has difficulty
regulating other spheres of life as well.
The person who fears weight gain is certain to be fearful of other
elements of life pivotal to problem definition, problem-solving and the
creation of a sense of autonomy and well-being.
Driven by emotions, needs, and values, the eating disordered individual
feels powerless, inadequate and fearful turns to behaviors and symptoms
which create the illusion of being
in control, establishing a pseudo-sense of security and predictability in an
unstable world. Ultimately, the disorder
takes control and makes a victim of its host. The eating disordered
individual does not know how to “feed” or care for himself or herself, in
more ways than one. With recovery comes an expanded emotional capacity to
cope with all aspects of life, beyond food and eating.
The classic eating disorders; Definitions
Anorexia Nervosa is a pathological
fear of being fat, accompanied by food restriction and at times, purging and
over-exercising. It is generally accompanied by a distorted body image, the
absence of the menses, and moodiness, anxiety, or irritability.
Bulimia Nervosa is the repeated
cycle of out of control bingeing accompanied by purging or by fasting or
excessive exercise to compensate for the intake of calories. Bulimics
typically abuse laxatives, diuretics or diet pills and typically struggle
with co-occurring addictions and mood disorders.
Binge-Eating Disorder of
Compulsive Overeating is characterized by eating when not hungry or without
regard to physiological cues. With binge eating episodes, patient report the
inability to stop or to control the behavior. Deprivation-sensitive binge
eating arises out of the hunger of excessive dieting or food restriction;
addictive or dissociative binge eating is the practice of self-medicating or
self-soothing, with behaviors evoking tranquility or numbness.
EDNOS eating disorders not otherwise specified,
are eating disorders that fail to meet established clinical diagnostic
criteria for frequency, duration, or juxtaposition vis-à-vis other symptoms
as defined by the DSMIV. EDNOS
make up more than half of ED cases and is rarely diagnosed, making the 11
million known victims of ED in the U.S. today but the tip of an iceberg.
The following distinct aspects of eating dysfunction must be in place for
behaviors to qualify as clinical eating disorders.
aspect may include weight loss, amenorrhea, fainting, cold intolerance,
aspect may include dieting, secretive eating, binge eating, eating
disregulation or rituals, compulsive exercise, laxative, diet pill or
diuretic abuse, impaired relationships, etc.
aspect may include depression, anxiety, low self-esteem, fear of weight
gain, body image distortion, etc.
aspect may include withdrawal and social isolation.
invariably be a genetic predisposition for your child to have developed
this disorder. Generally, those with predispositions to the onset of
eating disorders will have eating disorders, addictions, alcohol or
substance abuse, perfectionism or obsessive compulsive disorders in
their extended families.
Things you may not have
known about eating disorders –
Eating disordered individuals typically are of normal weight, and often
appear to be the picture of health. Paragons of self-discipline, they
typically excel at academics, sports, and other activities.
Eating disorders are diseases, which in the vast majority of cases are
Dieting or food restriction is the worst way to lose weight and can be
harmful to the metabolism.
Parents are not responsible for causing eating disorders in their children.
Parents and patients do not need to wait until symptoms of eating disorders
have become full-blown and prominent before feeling free to take action. An
educated hunch should serve as motivation enough to seek assistance.
Eating disorder treatment and recovery are unique in many ways. As examples,
addressing these integrative disorders requires simultaneously addressing
the wide variety of issues that the eating disorder encompasses. These
include physiological, psychological, behavioral and nutritional issues.
In eating disorder recovery, the patient can expect to feel worse before
(s)he can feel better.
The stakes are high with eating disorders, as these are the most lethal of
all the mental health disorders.
Not every eating quirk represents an eating disorder. The distinction
between disease and benign idiosyncrasy lies in the purpose and compulsivity
behind the behaviors for the individual. When the use of food goes beyond
efforts to achieve satiety, fueling, or sociability, the writing may be on
Eating disturbances in the very young child may be the result of anxiety and
compulsivity, and/or the child’s imitating significant adult role models. In
comparison, issues of control, identity, self-esteem, coping and problem
solving largely drive adolescent and adult eating disorders.