Eating Disorders

Everybody eats. We do so both because we need to and because we enjoy it. However, as with all human behavior, there are huge differences between people. Some eat more, some eat less, some put on weight easily, and others do not. And some people go to such extremes that they harm themselves, by eating too much or too little. As a result they may harm their health and come to the attention of doctors. Although it is easier to talk about them as different conditions, individual patients often suffer from symptoms of both. Indeed, it often happens that bulimia develops after a period of months or years of anorexic symptoms.

Women suffer from these disorders 10 times as often as men, and so this paper refers to the sufferer as 'she'. Although often thought of as adult problems, these disorders most often start in the teenage years while the sufferer is still at home. Symptoms of having an eating disorder are:

Anorexia

Fear of fatness

Under-eating

Excessive loss of weight

vigorous exercise

Monthly periods stop

Anorexia usually starts in the mid-teens and affects 1 fifteen-year-old girl in every 150. Occasionally it may start earlier, in childhood, or later, in the 30s or 40s. Girls from professional or managerial families are perhaps more likely to develop it than girls from working-class backgrounds. Other members of the family have often had similar symptoms. Nearly always, anorexia begins with the everyday dieting that is so much a part of teenage life. About a third of anorexia sufferers have been overweight before starting to diet. Unlike normal dieting, which stops when the desired weight is reached, in anorexia the dieting and the loss of weight continue until the sufferer is well below the normal limit for her age and height. The tiny amount of calories that she is taking in may be disguised by the quantities of fruit, vegetables and salads that she eats. Also, she will often exercise vigorously or take slimming pills to keep her weight low. Moreover, in spite of her own attitude to eating, she may take an avid interest in buying food and cooking for others. Although technically the word anorexia means 'loss of appetite', sufferers with anorexia actually have a normal appetite, but drastically control their eating. As time wears on, however, the teenage girl with anorexia may also develop some of the symptoms of bulimia. She may then make herself sick or use laxatives as ways of controlling her weight. Unlike sufferers from 'pure' bulimia, her weight will continue to be very low. Some symptoms of bulimia are:

Bulimia

Fear of fatness

Binge-eating

Normal weight

Irregular periods

Vomiting and/or excessive use of laxatives

This condition usually affects a slightly older age group, often women in there early to mid-twenties who also have been overweight as children. It will affect 3 out of every 100 women at some time in their lives. Like anorexics, people with bulimia suffer from an exaggerated fear of becoming fat. Unlike women with anorexia the bulimic woman usually manages to keep her weight within normal limits. She can do this because, although she tries to lose weight by making herself sick or taking laxatives, she also 'binge eats'. This involves eating, in a very short time, large quantities of fattening foods that she would not normally allow herself. For example, she might get through numerous packets of biscuits, several boxes of chocolates and a number of cakes in two hours or less. Afterwards she will make herself sick, and feel very guilty and depressed. This bingeing and vomiting may raise or lower her weight by up to 10Ib within a very short period of time. It is extremely uncomfortable, but for many it becomes a vicious circle that they cannot break out of. Their chaotic pattern of eating comes to dominate their live.

If someone has become excessively thin and her periods have stopped, it makes sense for her to try to get back to somewhere near an acceptable weight. To help with this, both she and her family will first need information. What is a 'normal' weight for her? How many calories are needed each day to get there? For many sufferers, the most important question is, "How can I make sure that I don't shoot past that weight and become fat? In anorexia, the patient has excessive control of her eating. How can she ease up? For youngsters still living at home, it is the parents' job to watch over the food that is eaten, at least for a while. This involves both making sure that she has regular meals with the rest of the family, and that she gets enough calories. Mounds of lettuce can be very deceptive. It is also important that the family see the psychiatrist regularly both to check on weight and for support, as having an anorexic in the family can be extremely stressful. For most sufferers it will be important to discuss things that may be upsetting them - boys, school self-consciousness, family problems, etc. Only if these simple steps do not work, or if the weight loss threatens life, is admission to hospital usually considered. In-patient treatment consists of much the same combination of dietary control and talking, only in a much more structured environment.

Eating disorders are serious illnesses. Illnesses that can kill easily. If you or anyone you know has an eating disorder, remember you need to get help before it is too late.