Walking down my mother’s lane in Vermont recently, brought back memories of my college years. Tears came to my eyes as I remembered what my own mother had accused me of. She said I was thin enough to be a model and asked why I always wore loose fitting clothing. Then she accused me of using drugs because I had lost 20 pounds during my first semester of college.
How could my own mother think I was thin? I was not thin—I was fat, and ugly, too. Even my baby book had said I was the “homeliest baby the doctor had ever delivered,” although my mother wrote next to the insert, “but she is cute as a bug’s ear.”
I had hidden my arms, not because of drugs but because of a rash related to my eating disorder. I lived with anorexia nervosa and bulimia nervosa for 12 years, and with my exercise addiction for more than 17. Now, recovered for more than 20 years, I am a certified eating disorder specialist and have a passion to educate others.
There are many myths about eating disorders. We often hear people say, “If I only had an eating disorder for a month” or “eating disorders are in your head, just eat.” Tragically, between five and 10 million women and girls in the U.S. suffer from eating disorders as well as more than a million men. While current data say that 90 percent of those with eating disorders are women, counselors have seen a rise in the number of men seeking treatment. It is now estimated that men may actually make up as much as 25 percent of the cases of eating disorders. Eating disorders affect everyone: kids, college students, every race and socioeconomic status, males, females, athletes and non-athletes, and even the elderly.
Eating disorders include anorexia nervosa, bulimia nervosa and binge eating. Anorexia nervosa is a life-threatening disorder in which a person has dramatic weight loss, fear of body fat and refuses to maintain a healthy weight. They may eat very little (200-600 calories a day) or alternate between purging, exercising obsessively and fasting.
Bulimia nervosa is an eating disorder characterized by binging on food then purging to cleanse one’s body of the food. Individuals suffering from this disorder may purge by vomiting, using laxatives, diuretics or enemas to lose weight. Not all bulimics vomit—some restrict food, fast or exercise excessively. Binge eating is eating a large amount of food in a short period of time or continuously eating. There is no purging, but there may be on-and-off fasts or repeated diets. Binge eating is almost as prevalent in men as in women.
Recently, muscle dysmorphia has been increasing among young men of high school age through their thirties, and is also seen in women. It is characterized by the perception of not being “big enough.” Many have strict diets, work out excessively, use supplements or steroids and are obsessed with how their body looks.
So what causes eating disorders? There is no one cause but many factors: physical/biological, psychological, familial and sociocultural. Research is emerging every day concerning the biological and genetic causes of eating disorders. It has been determined that there is probably not one gene controlling this disorder, but multiple genes combined with the interaction of environmental factors. Eating disorders run in families: research has determined that eating disorders have a heritability rate of 50 to 80 percent, similar to schizophrenia and depression. Depression, obsessive/compulsive behavior, anxiety disorders and substance abuse appear more frequently in families with eating disorders. Relatives of eating disorder patients are eight times more likely to develop an eating disorder than the general population.
Dysfunctional families are often blamed for eating disorders, as well as a culture that emphasizes thinness. Although culture and family may be two triggers, research has shown that eating disorders are associated with alterations of brain chemicals and hormones. Therefore, while the psychological explanation (low self-esteem and society’s pressure to be thin) is important, it is not enough to explain anorexia nervosa and bulimia nervosa completely.
Since these disorders primarily occur in girls and women, most beginning in adolescence, researchers are exploring genes that control hormone production. Other researchers are looking at personality characteristics that may be hard-wired in the brain, such as anxiety and obsessive traits.
Despite the advances in research, these disorders remain the deadliest psychiatric illness, killing or contributing to the deaths of thousands each year. Eating disorders are not a fad or something to ignore for months. Approximately five to 10 percent of cases end up dying prematurely, often from suicide or medical complications. The good news is that around 90 percent recover, although in-patient treatment facilities have demonstrated that it may take as long as seven years. The earlier eating disorders are recognized and treatment is begun the more likely the person is to recover.
Based on national statistics, we can estimate that there are 400-500 students at Plymouth State suffering from eating disorders, exercise addiction and/or muscle dysmorphia. To address this often-hidden issue, PSC has celebrated National Eating Disorders Awareness Week for the last four years with “Love Your Body Week.” As coordinator, I work with our health education majors, other student groups and a faculty and staff committee to offer programs that have included theater performances, art shows, seminars, mind-body activities, a Body Fair, a chocolate reception and viewing of our BARBIE (Banish All Ridiculous Body Image Expectations) mannequin. In the last few years, between 600 and 800 people attended a variety of activities. We have been invited to make presentations at various national conferences around the country. This program is so successful because students are planning the event for other students.
Last spring Southwest Airlines and Pan American Airlines each donated two roundtrip airline tickets to help us raise money for eating disorder awareness and prevention activities for 2003. Students raised more than $3,600 for prevention activities for the Plymouth area. For spring we hope to have a workshop to train teachers and health professionals about eating disorders. We are also planning our fifth PSC Love Your Body Week and will offer a new three-credit graduate class on eating disorders.
Prevention and early detection are the keys to success in treating eating disorders. People who have recovered from an eating disorder often say they heard from concerned people for years that they needed to seek help. One day, one of those concerned caring voices took hold inside them. Hearing voices of love, respect and concern repeatedly was part of the process of their recovery. If you know someone whose behavior concerns you, don’t pass it off as a phase. It is very important to get qualified medical help as soon as possible.
Reprinted with the permission of Plymouth Magazine. Winter 2003.