Unspoken Stigmas: Eating Disorders - Warning Signs and Aid

 

Many people might be surprised to hear that the most fatal mental disorder is anorexia nervosa. According to the American Journal of Psychiatry, anorexia nervosa has an estimated mortality rate of between four and ten percent, higher than the death rate for people with schizophrenia or bipolar disorder.

Even more troubling is the fact that according to the Renfrew Center Foundation for Eating Disorders, 25% of college-age women use bingeing and purging as weight-management techniques, and over 24 million people suffer from an eating disorder (anorexia nervosa, bulimia, and binge-eating disorder) in the United States. Despite the prevalence of eating disorders today, research published in the International Journal of Eating Disorders indicates that only 1 in 10 men and women with eating disorders receive treatment, and only 35 percent of people that receive treatment for eating disorders get treatment at a facility specializing in the treatment of eating disorders.

Two of the most common and well-known eating disorders are anorexia nervosa and bulimia nervosa (others include Binge Eating Disorder and Other Specified Feeding or Eating Disorder). It is important to recognize the symptoms and warning signs of these disorders and to understand how to help someone that may be struggling with an eating disorder.

Anorexia nervosa is characterized by self-starvation and excessive weight loss. Symptoms include inadequate food intake, intense fear of weight gain, obsession with weight, taking extreme measures to prevent weight gain and low self-esteem directly linked to body image. Anorexia can involve bingeing and purging, where one consumes a large amount of food very rapidly and then tries to get rid of the ingested food through self-induced vomiting, laxatives, and/or diuretics (water pills).

Warning signs of anorexia include dramatic weight loss, anxiety about gaining weight, frequent comments about feeling overweight despite weight loss, consistent excuses to avoid mealtimes, extreme exercise regimen, denial of hunger, development of food rituals and withdrawal from friends and family. When left untreated, anorexia can have dire health consequences, both emotionally and physically. Because the body is not getting the nutrients it needs to function, it has to slow down all its processes to conserve energy. This can lead to serious medical consequences, including an abnormally slow heart rate, low blood pressure, reduction of bone density, muscle loss and weakness, severe dehydration, fainting and fatigue and hair loss. Anorexia has been linked to depression and can increase risk of suicide.

Treatment for anorexia involves psychotherapy and counseling as well as nutritional and medical counseling, sometimes even inpatient care, depending on the severity of the case. An early diagnosis and immediate treatment can significantly help recovery and help avoid adverse health effects. Without treatment, anorexia can become chronic, debilitating, and life-threatening.

Bulimia nervosa is an eating disorder that involves cycles of bingeing and behaviors that prevent weight gain, often self-induced vomiting. Warning signs of bulimia nervosa involves evidence of binge eating such as the disappearance of large quantities of food, evidence of purging behaviors such as frequent trips to the bathroom after meals, extreme exercise regimen, swelling of the cheeks or jaw area, calluses on the back of the hands and knuckles, discoloration of teeth, obsession with food, weight loss, and dieting, development of rituals around bingeing and purging and withdrawal from friends and activities.

Bulimia can have devastating effects on the human body: the binge-and-purge cycle is extremely damaging to the entire digestive system and purging causes electrolyte imbalances, which can in turn cause irregular heartbeat and even death. Bulimia can also lead to inflammation and rupture of the esophagus, tooth decay and staining from stomach acids in the mouth during self-induced vomiting, chronic irregular bowel movements due to laxative abuse, as well as gastric rupture.

Many people assume that those with eating disorders are skinny or seem underweight. However, this is not the case, as many people struggling with bulimia appear to be of average weight. Treatment for bulimia may be similar to treatment for anorexia in that it primarily involves psychological counseling, including interpersonal therapy and cognitive-behavioral therapy and nutritional help. Depending on the length and severity of the disorder, the patient may need to be treated for some of the adverse effects of bulimia — such as dehydration or electrolyte imbalance — before the disorder is addressed. Medications may be used in conjunction with psychotherapy to reduce binge-purge cycles and to treat conditions often associated with eating disorders, such as depression and anxiety.

Eating disorders can be very difficult to treat and recovery may take months or years. Because of the severe health problems they can cause, as well as the likelihood of an eating disorder worsening without treatment, it is extremely important to seek treatment if you are struggling with an eating disorder, or to help a friend get the treatment he or she needs if you suspect he or she might have an eating disorder.

If you think someone you know may be struggling with an eating disorder, try to find a way to meet with that person one-on-one.

Make sure you communicate your concern for their well-being, citing specific examples of times when you felt that their eating or exercise behaviors were worrisome or extreme. Make sure you do not accuse him or her of anything: avoid placing shame, blame or guilt. Instead, offer your support and use “I” statements. Let him or her know that there are resources both at Middlebury College and in the community that can help.

Parton Health Center has resources to help those who might be struggling with an eating disorder, and if you think someone you know may have an eating disorder, you can meet with a staff member at Parton Health Center who can educate you and help coach you as you prepare to talk to your friend. The counseling center can be reached at 802-443-5141 and can provide information on local nutritionists, support groups, and private practitioners. You can also call the National Eating Disorder Association’s toll-free, confidential help-line during weekday business hours at 1-800-931-2237.