A Starvation Sentence: Excessive Dieting

At the same time as obesity is becoming an epidemic in North America, so too are eating disorders, causing untold suffering for victims and their families. Although people sometimes say that they like to get anorexia so they could lose a few pounds, anyone who’s had an eating disorder or seen a friend or family member struggle with one knows they’re not something one should wish for. A few frightening facts:

Eating disorders are common. It’s estimated that 1 to 4 percent of adolescent girls and young women in the United States have a clinically diagnosed eating disorder (see below for what this means), and many more have subclinically disordered eating.

Eating disorders can affect anyone. Although eating disorders are more common among young, upper-middle class women, no group is immune—they affect women and men, young and old, rich and poor, and all ethnic groups.

Eating disorders have serious health consequences. Decreased immunity, decay and loss of teeth, hair loss, osteoporosis, cardiac arrhythmias and sudden death, stomach ulcers, bleeding and tears of the esophagus, constipation, anemia, and others.

Eating disorders can last a long time. About 50 percent report duration of more than six years.

Eating disorders are expensive to treat. Inpatient treatment can cost $30,000 or more a month, and many patients need to be hospitalized more than once.

Eating disorders can be fatal. About 6 percent of serious cases die, either from suicide, heart problems, or infections.

Eating Disorder or Disordered Eating?
A clinical diagnosis of anorexia nervosa or bulimia nervosa is made based on criteria established in the Diagnostic and Statistic Manual of Mental Disorders, 4th Edition. The Manual also lists diagnostic criteria for “eating disorder not otherwise specified” in which a clinical disorder is considered to be present, but all the criteria to diagnose anorexia nervosa or bulimia nervosa are not satisfied. For example, this might include a young woman who meets all criteria for anorexia except for exhibiting signs of amenorrhea (the absence or supression of menstruation), or someone who meets the criteria for bulimia except that binge eating occurs less than twice a week.

Beyond clinically diagnosed eating disorders, there is a wide spectrum of disordered eating, in which food and weight-related attitudes and behaviors are disturbed. Although not as medically dangerous as a clinical eating disorder, there are still great personal losses from devoting so much time and emotional energy to worries about weight, shape, and “good” or “bad” foods.

How can I tell if I may be developing an eating disorder?
The following questions describe behaviors and feelings that are common in people with eating disorders. Answering “yes” to a number of questions doesn’t make a diagnosis. But it could mean you are at risk, and should make you to think about getting more information and help.
____ Do you feel out of control when you eat?
____ Do others try to get you to eat more than you want to?
____ Do you feel powerful and in control when you abstain from eating?
____ Do you exercise to burn off the calories in the food you’ve eaten?
____ Do you avoid social events because there will be food present, or tell others you’ve “just eaten”?
____ Do you have an intense fear of gaining weight?
____ Are you secretive about your eating habits?
____ Do you feel fat, even though others say you are too thin?
____ Do you think about food almost constantly?
____ Do you prepare food for others and then avoid eating it?
____ Do you have food rituals? (i.e.: cutting foods into small pieces, eating only certain foods at certain times?)
____ Do you feel ashamed of your eating behaviors?
____ Do you use laxatives, diet pills, or diuretics as a method of weight control?
____ Do you feel angry when someone questions your weight and eating habits, or wish they’d just mind their own business?
____ Do you think you may have an eating disorder?

What can I do to help a friend or family member with an eating disorder?

• First of all, it’s important to remember that you can’t “fix” them—so it’s best not to try. Remember that the person won’t change until he or she wants to.
• Let your friend know that you are concerned, and suggest professional help—but don’t be surprised if they deny the problem.
• Listen when she or he wants to talk.