Eating Disorders By Jo Ann Telfer, PhD, RPsych It used to be that eating disorders were defined in very distinct and rigid terms. Professionals who work in this area now recognize this is not really accurate. Disordered eating behaviours are part of a continuum. Anorexia nervosa and bulimia nervosa exist along this continuum; so do binge-eating, yo-yo dieting, food obsessions and food preoccupations. The boundaries between these terms are open, and people with disordered eating behaviours will move back and forth along this continuum. Some may display symptoms of more than one category over the course of a day, week, month, or even years. The result of living anywhere along this disordered eating continuum is mental, physical and spiritual illness. In anorexia, for example, inadequate nutrition causes memory problems and impairs the ability to concentrate. Bulimics my suffer from sore throats and decaying teeth from repeated exposure to vomit in the mouth, and muscle weakness from insufficient protein in the diet. Lack of enthusiasm for life, depression, and faltering relationships are all signs of the spiritual illness brought on by the disordered eating patterns. Ironically, these strange eating patterns were started because their false promise was thinness and happiness. What causes women to develop these disordered eating behaviours? The contributing factors to eating disorders are usually placed into three categories: society, the family and the individual. It is important to understand the underlying causes of disordered eating patterns, since these must be addressed in treatment and prevention. Society Family The media plays a large part in spreading the If your parents over-emphasize weight, diet and body false message that it is possible to have a image or have disordered eating behaviors "perfect" body. Magazines, movies and television themselves, then you are more likely to have the all lead us to believe that once we have achieved same problems. Other parental characteristics that that "ideal" weight, shape or look, happiness will have been linked to eating disorders include follow. Another false assumption perpetuated by perfectionism, over-protectiveness, rigid parenting the media is that dieting is a normal human styles, and poor communication skills. A family activity that leads to permanent weight loss. In history of addiction or depression is also a fact, research shows that 95 to 98 per cent of contributing factor in eating disorders. those who diet gain back all the weight they have lost-and more-within two to five years. Individual Low self-esteem is the personality trait most highly associated with eating disorders. Women and girls who have a negative body image, are perfectionists and feel they are not in control of their lives are more likely to suffer from eating disorders. Other characteristics associated with disordered eating behaviours include a fear of growing up, a need for approval, and feelings of ineffectiveness. The Road to Recovery Recovering from eating disorders takes time -sometimes a long time. But the chances of recovery are greater if the eating disorder is identified early, before the behaviors become too entrenched. Professional help is essential, especially the help of professionals who are knowledgeable in the field of eating disorders. They will offer support by listening to feelings, allowing appropriate control, encouraging self- esteem, and focusing on some enjoyable aspects of life. Depending on the needs of those involved, the structure of the treatment will vary. It may include a physical assessment by a physician, individual therapy, group therapy, family therapy, dietetic counseling, or hospitalization. All treatment is aimed at establishing normal eating patterns, restoring and maintaining healthy weight, developing positive attitudes towards food and the body, and improving or changing any of the factors that may have contributed to causing the disorder. The job of family and friends is to provide support. If you suspect that someone you love has an eating disorder, it will help if you educate yourself about the eating disorder continuum and find out about the resources available in the community. Let your friend or family member know that you are concerned about her health and well-being, and suggest a visit to her doctor and some treatment options. Don't be surprised if she denies that she has a problem. But she may also admit that she is concerned about her own disordered eating habits and be relieved that someone has noticed. Whatever her response, be patient. Be a good role model by taking care of your own health. At the same time, be persistent about your concern. Don't focus on food by preparing a favourite meal for her, or remarking on how much she has (or hasn't) eaten. Avoid making comments about body weight, shape or size. People who are seriously affected by an eating disorder tend to turn even the most positive comments into messages that encourage more disturbed food rituals. Unfortunately, there is no proven treatment for eating disorders. Those who suffer from anorexia and bulimia may get better in the short-term but struggle with other disordered eating behaviours for years. Concentrating on prevention may do more to help individuals with eating disorders and those who are close to them. The following healthy and healing attitudes may decrease the incidence of eating disorders in the future. • Look at food for fuel and for fun. Food's • Do not diet yourself, and don't encourage main purpose is to supply us with energy anyone you know to go on a diet. Diets do while still being enjoyable. There are no not work and are almost always a precursor 'good' and 'bad' foods, but there are to eating disorders. Practice healthy eating, 'more healthy' and 'less healthy' choices. exercise and body acceptance Avoid using food as a reward, punishment, bribe, delay tactic, or time- filler. • Accept that people come in many • Become more critical of what you see in the shapes and sizes. Believe that "It's media, and teach others to do the same. We what's inside that counts." After all, it's are so accustomed to seeing "perfect" bodies the truth! Focus on your own and others' that it becomes difficult to believe it's achievements, relationships, hobbies, possible to be happy if we are anything but thoughts, and feelings, NOT on size, slender. Even models do not meet the weight and appearance. industry's exacting standards, and computer technology is often used to perfect them or remove any perceived "flaws." • A healthy self-esteem may be the best assurance against developing an eating disorder. Help yourself and others you care about to develop a positive self-esteem. This includes knowing and accepting yourself, using good communication skills, developing hobbies and leisure activities, and nurturing positive relationships. Many excellent books and classes are available to help you in this area. Disordered Eating Behaviours Anorexia nervosa is a refusal to maintain "normal" body weight, along with an extreme fear of gaining weight or becoming fat. Women and girls with anorexia nervosa become intensely focused on their weight, body shape, food, and calories. Bulimia involves binge-eating followed by purging to prevent weight gain. Purging behaviors include vomiting, laxative and/or diuretic abuse, fasting, or excessive exercise. Body weight and shape become the basis for self-esteem. Binge-eating disorder is characterized by consuming an unusually large amount of food rapidly and beyond the point of being full. The binge is accompanied by a sense of lack of control, extreme distress and disgust. It is not followed by purging. Yo-yo dieting is a practice of repeated periods of food restriction followed by non-restriction. The periods of non-restriction may be characterized by "normal" eating, but more often they are followed by bingeing-and feelings of guilt. Foods are labeled as "bad" or "good." The body responds to yo-yo dieting with changes in metabolism that lead to difficulty in maintaining normal weight. Food obsessions and preoccupations are behaviours where calories, fat grams, food additives, food content or restricting certain food groups become the focus of one's life. Up to 90 per cent of the day may be spent thinking about food, along with weight, size, shape or exercise.
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