Why Eating Disorders Happen

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Eating disorders such as anorexia and bulimia commonly occur in people with low self-esteem; they feel they are not "good enough." They believe that thinness will make them into better and almost perfect people. The truth is that a thinner body does not make a person better, just smaller. There is simply less of the person to love. The individual is the same person, just obsessed, withdrawn, and tired. And when someone severely restricts food, he or she loses muscle, strength, and stamina. This is not the way to become a star athlete.

The risk of developing an eating disorder seems to increase dramatically when an athlete with low self-esteem is physically beautiful, has traits of perfectionism, and tends to be hypercritical and anxious. Add to the scenario a mother who may have had (or still has) food and weight issues, and her daughter becomes a prime target for developing a fullblown eating disorder.

Athletes with eating disorders are less available to their friends. After all, when a person is constantly exercising and counting calories (calories eaten at meals, calories burned during exercise, calories saved by skipping lunch, calories about to be eaten at dinner, and so on) as well as counting fat grams and sit-ups, his or her brain has little energy left to manage bigger issues, such as life's problems and relationships. The anorexia or bulimia creates a smokescreen that masks the underlying issues.

What Is Anorexia?

People with anorexia nervosa tend to either consistently restrict food or restrict and then binge and purge. The American Psychiatric Association's definition of anorexia includes the following characteristics*:

  • Intense fear of gaining weight or becoming fat, even though underweight
  • Disturbance in the way a person experiences his or her body (i.e., claiming to feel fat even when emaciated), with an undue influence of body weight or shape on self-perception
  • Weight loss to less than 85 percent of normal body weight or, if during a period of growth, failure to make expected weight gain leading to 85 percent of that expected
  • Refusal to maintain body weight over a minimal normal weight for age and height
  • Denial of the seriousness of the current weight loss
  • Absence of at least three consecutive menstrual cycles
  • Adapted from American Psychiatric Association, 1994, Diagnostic and statistical manual of mental disorders, 4th ed. (Arlington, VA: American Psychiatric Association), 251-252.

If you think that you or someone you know might have anorexia, look for these signs and symptoms:

Signs and Symptoms of Anorexia

  • Significant weight loss
  • Loss of menstrual periods
  • Loss of hair
  • Growth of fine body hair, noticeable on the face and arms
  • Cold hands and feet and extreme sensitivity to cold temperature
  • Layers of baggy clothing to hide thinness (and keep warm)
  • Wearing sweaters in summer heat because of feeling cold all the time
  • Light-headedness
  • Inability to concentrate
  • Low pulse rate
  • Hyperactivity; compulsive exercise beyond normal training
  • Recurrent overuse injuries and stress fractures
  • Comments about being fat; distorted body image
  • Expression of intense fear of becoming fat
  • Nervousness at mealtimes; avoids eating with friends or in public
  • Food rituals, such as cutting food into small pieces and playing with it
  • Antisocial behavior; isolates from family and friends
  • Excessive working or studying, compulsiveness, and rigidity
  • Extreme emotions: tearful, uptight, oversensitive, restless

What Is Bulimia?

The person with the purging type of bulimia nervosa may purge by self-induced vomiting and by misusing laxatives, diuretics, or enemas. With the nonpurging type of bulimia, the person uses other inappropriate compensatory mechanisms to prevent weight gain after a binge, such as fasting or exercising excessively. The definition used by the American Psychiatric Association includes these aspects*:

• Recurrent episodes of binge eating, characterized by

  1. eating an unusually large amount of food in a discrete period of time (the amount eaten is larger than most people would eat during a similar time period and under similar circumstances) and
  2. feeling out of control during the eating episode (unable to stop eating or control what and how much is eaten)
  • Compensating for the food binge to prevent weight gain, such as inducing vomiting; misusing laxatives, enemas, or other medications; fasting; or exercising excessively
  • Binge eating and purging, on average, at least twice a week for three months
  • Evaluating self-worth according to body shape and weight
  • Adapted from American Psychiatric Association, 1994, Diagnostic and statistical manual of mental disorders, 4th ed. (Arlington, VA: American Psychiatric Association), 252-253.

If you think that you or someone you know might have bulimia, look for these signs and symptoms:

Signs and Symptoms of Bulimia

  • Weakness, headaches, dizziness
  • Frequent weight fluctuations because of alternating binges and fasts
  • Swollen glands that give a chipmunklike appearance
  • Difficulty swallowing and retaining food; damage to throat
  • Frequent vomiting
  • Damaged tooth enamel from exposure to gastric acid when vomiting
  • Petty stealing of food or stealing of money to buy food for binges
  • Strange behavior that surrounds secretive eating
  • Disappearance after meals, often to the bathroom to "take a shower"
  • Running water in the bathroom after meals to hide the sound of vomiting
  • Extreme concern about body weight, shape, and physical appearance
  • Ability to eat enormous meals without weight gain
  • Compulsive exercise beyond normal training
  • Depression
  • Bloodshot eyes

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