What are Eating Disorders

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Eating Disorders:
A General Guide for Teens

Eating disorders are more common in cultures focused on weight loss and body image. Body dissatisfaction and dieting may lead to unhealthy and dangerous eating behaviors. Sometimes, these eating patterns can lead to eating disorders. Fortunately, there has been an increased awareness about these types of illnesses. Eating disorders are treatable. There are resources and specialists that can help!

What are eating disorders?
There are three types of eating disorders: anorexia nervosa, bulimia nervosa, and ED-NOS (Eating Disorders Not Otherwise Specified). Young women with these disorders often have an intense fear of gaining weight and a distorted body image. The phrase "body image" means the thoughts and feelings people have about their physical appearance. Young women with eating disorders may start to eat less because they are afraid of gaining weight. Sometimes they binge (overeat, consuming very large quantities of food) and sometimes purge this food (by self inducing vomiting, over-exercising or using laxatives). Eating disorders affect a person's physical and emotional health. They are very dangerous illnesses and can be fatal if they are not treated.

What is anorexia nervosa?
People with anorexia nervosa do not eat enough to keep their body working properly. They lose too much weight and become weak and unhealthy because of a poor diet. Often, people with anorexia exercise too much trying to burn up the food they eat. They "feel fat" even when they are losing weight. They may convince themselves and those around them that they are not hungry. People with anorexia sometimes take diet pills to control hunger and to try to lose weight. These pills often make girls feel anxious or nervous. Others may drink beverages with caffeine, which can give a false sense of energy. People with anorexia often have emotional issues such as low self-esteem and obsessive thoughts and behaviors. The key elements of anorexia nervosa are: losing weight below a normal weight, having disordered thoughts about one's body size, and being fearful of becoming fat.

Girls with anorexia may have dizziness, heart problems, low blood pressure, low temperature and fainting spells. Anorexia causes hair and fingernails to become brittle and loss of hair on the head. Dry skin, dehydration, and constipation are also symptoms of anorexia. People with anorexia often feel depressed, tired and cold. Anorexia also causes lanugo, which is the growth of soft furry hair on face, back and arms. Anorexia can result in slow or stunted growth. Menstrual periods usually stop since there is not enough estrogen to maintain the body's normal function. Not having enough estrogen or other hormones can lead to osteoporosis or weak bones. The combination of osteoporosis and over exercising can lead to stress fractures.

If you have these symptoms you are at risk for serious health problems and you should contact a health care provider immediately.

What is bulimia nervosa?
Bulimia nervosa is another type of eating disorder. Girls who have bulimia often binge, eating a lot of food out of control even if they are not hungry. People with bulimia often feel they have no control over their eating. After bingeing, people feel guilty and anxious and then they want to get rid of food by vomiting or by exercising. People with bulimia may eat in private and hide what they eat from others or eat until they are uncomfortable and exhausted. This illness can make people feel afraid or ashamed.

What are some of the health problems that girls with bulimia face?
Girls with bulimia may suffer from serious electrolyte problems, irregular menstrual periods, dehydration, swollen face, sore throat, tooth decay, dry, flaky skin, upset stomach, heartburn, constipation, depression, or weight fluctuations. Low potassium levels, from the body losing too much potassium from vomiting, can lead to serious heart arrhythmias and even death.

Bulimia is hard to detect from looking at a person since the health problems a teen may suffer from are not as obvious as with anorexia. For example, someone may have a normal weight, but still have bulimia. Also, they may be secretive about their eating habits so that even their family and friends are not aware that they have a problem. Bulimia is serious and can cause permanent damage to the teeth, stomach, digestive track, and heart.

What is EDNOS (Eating Disorder Not Otherwise Specified)?
EDNOS is short for Eating Disorder Not Otherwise Specified. EDNOS is an illness in which someone has some, but not all, of the symptoms of anorexia or bulimia. For example, young women struggling with EDNOS may only binge eat or they may have periods of restrictive eating (days or months) followed by periods of overeating or binge eating. They may be at a very low weight, but not have anorexia because they still get their menstrual period. Or young women with EDNOS may maintain a stable weight that is within a medically safe range, but still have many of the other symptoms and medical complications of eating disorders.

What causes eating disorders?
There are many different theories regarding the causes of eating disorders. Most likely, eating disorders are caused by a combination of psychological, family, genetic, environmental and social factors.

An individual may have a family history of mood disorders such as depression. Eating disorders are often associated with feelings of helplessness, sadness, anxiety, and the need to be perfect. This can cause a person to use dieting or weight loss to provide a sense of control or stability.

Teens who participate in competitive sports that emphasize thinness or artistic activities, such as ballet, running, gymnastics, or skating, are more likely to develop an eating disorder.

Family stress of any kind can also be a significant factor contributing to the development of these illnesses. Dealing with difficult transitions, loss, or teasing about weight from friends or family may trigger eating disorders.

What do I do if I think I may have an eating disorder?
If you think that you may have an eating disorder, it is very important that you talk to your health care provider immediately! If you are too nervous or scared to contact your health care provider on your own, try talking to an adult who is someone you trust like a parent, teacher, relative, or family friend. They can help you to make sure that you receive the help you need. Even if it is scary to get help for an eating disorder, your life may depend on it!

What do I do if I think my friend has an eating disorder?
It can be very hard to talk to a friend who you think has an eating disorder. Often times, people who have eating disorders are in denial and do not want to talk about their problems. They may get defensive or upset with the people in their lives who try to get them help. Do not let these reactions prevent you from trying to help someone you care about.

Remember you can make a difference by helping a friend confront her illness and seek treatment. Many people who get treatment for anorexia or bulimia are able to do so because of the support from others in their lives. It is often very hard for people with this illness to make a phone call or come in for their appointments. They often need friends and family to take the first steps for them.

You may want to think about how to approach your friend. If you feel that you can't approach your friend, you may just want to share the information with a trusted adult and have them get help for your friend. It is helpful to have names and numbers of eating disorder resources (see Related Links below) to give your friend so she can take the steps to get help. You may want to talk with someone first such as an adult or another friend to find out more information.

You may need to give your friend some time after you confront her about your concerns. Do not expect that your friend will immediately be able to understand you or accept help right away. Dealing with eating disorders can be challenging and may take a long time. Being honest and patient with your friend will make it easier for you to support her. But most importantly, remember to tell an adult such as a parent or teacher if you are worried about a friend.

How are eating disorders treated?
Since eating disorders are usually a medical and psychological problem, treatment usually includes working with a team of specialists: a therapist, a nutritionist, and a doctor or nurse practitioner. Treatment is individualized to fit a teen's specific needs.

What does a medical doctor do to treat an eating disorder?
A doctor keeps track of a person's medical health by checking height, weight, blood pressure, pulse, and temperature. It may be necessary to draw blood for certain lab tests, to make sure the chemicals in the body called electrolytes are stable. Electrolytes are the sodium, potassium, chloride, and carbon dioxide levels in your body. Electrolytes keep the heart and body working properly. The doctor may recommend that a person stay in the hospital for a few days if the medical condition is unstable or dangerous.

The doctor may also order special tests such as an EKG to monitor heart rhythm and a bone density test (DEXA) to see if osteoporosis is present. The doctor discusses treatments such as healthy eating, weight stabilization, calcium intake, vitamin supplements, exercise, estrogen replacement, and antidepressant medication. A nutritionist and therapist are often consulted by the doctor.

What does a therapist do to treat an eating disorder?
The goal for a young woman with an eating disorder is to improve her body image, and self-esteem, and address other emotional issues. If you have an eating disorder, you may discover that you have other problems in your life such as depression, obsessive compulsive disorder, or substance abuse. You may explore feelings of sadness, anxiety, or anger with your therapist. Therapy provides the time and space where you can confidentially discuss your needs, your goals, and your understanding of the eating problem. Therapy helps to explore eating disordered thinking and behaviors and develop specific strategies to become healthy. Parents often need a therapist or a group for support and education surrounding eating problems.

Family therapy can be an important part of getting well if family tensions, difficult relationships, or poor communication exist. In the family treatment meeting, the family members can talk about problems and develop solutions and coping skills.

Group therapy is also a very effective way of getting well. Many people find that talking with other people who have had an eating disorder is helpful, because they can share stories, coping strategies, and feelings.

Can medication help an eating disorder?
Often medications are prescribed as part of the treatment for an eating disorder. Depression, anxiety, and obsessive compulsive disorder commonly exist as part of this illness. A doctor will prescribe and monitor the medicine.

Can a nutritionist help to treat an eating disorder?
A nutritionist can help you to create a safe eating plan and answer questions about food. In a culture obsessed with dieting, and striving for the "perfect" body, people get many mixed messages about food and health. A nutritionist can discuss the harmful myths regarding food and diet and help guide you to healthy eating and healthy living! It is very important to work with a nutritionist who has experience working with teens and young women with eating disorders.

I'm worried about developing an eating disorder—what can I do?
Having a positive self-image, eating a healthy diet, and exercising for fitness and enjoyment will help you to maintain a healthy balance in your life and decrease your risk of developing an eating disorder. The following tips are good ways to stay healthy, build a good body image, and to feel better about who you are.

• Identify and respect everything about yourself- the inside and the outside.
• Be yourself, don't try to look like models in magazines.
• Try not to think or talk about weight, calories, and food.
• Try to make eating a positive experience: eating fuels both your body and mind!
• Don't diet! Try to eat healthy foods.
• Work on ways to cope with negative feelings, such as talking to friends or family, listening to music, or doing crafts. Practicing healthy ways to deal with stress may help you avoid using food to deal with emotions.

What can we do as a society to prevent eating disorders?
It is important for us to look at our attitudes and behaviors in our own lives to help us understand how we can prevent eating disorders in our culture. Teasing and harassment about weight and body shape often leads young women to develop eating disordered behaviors. Conversations and activities that focus only on thinness, weight, and dieting can be harmful.

Magazines, movies, and the tobacco industry promote unrealistic role models for beauty and weight. Often, we are presented with only one image of beauty in the movies, magazines, and on TV. This image is usually one that is unnaturally thin and unlike most women. It is important to realize that we are all meant to be different shapes and sizes.

The dieting industry also may push us to try and change our bodies into something we are not. Most young women have come to accept dieting as a part of growing up, yet dieting and restricting calories can cause serious psychological and physiological consequences such as the inability to focus at school, tiredness, and depression. Girls who diet actually are more likely to gain weight then those who don't diet.

Accepting these unreasonable standards to measure bodies may create eating disordered thinking and behaviors and generally low self-esteem. It is very difficult to avoid or fight back against the industry that places these ideas in our head, but we can try! Together we can reverse the social environment and mind-set that creates eating disorders!

What are some of the advances in eating disorders treatment and prevention?
Many researchers are working to figure out how to treat eating disorders. New therapies and medications to prevent osteoporosis, the mood disorders, and hormonal problems associated with eating disorders are being studied. The development of new school curricula promoting awareness around eating disorders as well as healthy attitudes about body image and food is aimed at the prevention of eating disorders. In addition, there is a national effort to offer screening to adolescents and young adults for eating disorders in community health centers and schools so they can get help early. Many health professionals and researchers are striving to prevent eating disorders and to find new treatments.