Written by Melissa N. Madeson, Ph.D.
For a large majority of people in the United States, achieving optimal health means losing a few pounds and becoming more physically active. However, 50,000 people in America die every year taking this advice to the extreme. Dieting is the most common behavior that leads to developing a full-blown eating disorder, which affects one in five women and 24 million Americans overall. While the national waistline is getting larger, our culture continues to foster an obsession with thinness and maintaining a “perfect” body, plastering the message on television, Internet videos, advertisements and magazine covers.
People with eating disorders such as anorexia nervosa and bulimia nervosa are often stigmatized and placed into stereotyped categories. While it is true that the majority (90 percent) of these eating disorders occur in (mostly Caucasian) females between the ages of 12 and 25, 10-15 percent of people suffering from them are male. Due to the stigma placed on having this label, that figure is probably much higher but not reported. Further, what most people do not understand is that there are fine lines between disordered patterns of eating and having a diagnosed eating disorder. All behavior related to eating disorders, whether it is diagnosed or not, usually begins as a psychological/emotional issue and manifests itself as a physical problem.
Anorexia nervosa is characterized by an intense fear of gaining weight, a distorted body image, a low body weight and, in women, the absence of three or more menstrual periods in a row. Anorexics tend to be severely underweight and malnourished, which can lead to long-lasting physical issues such as osteoporosis and problems with the heart and brain. Individuals with anorexia may also suffer from psychological issues like depression, anxiety, obsessive behavior, and/or substance abuse. Signs of anorexia include not eating or eating very little, weighing food and an obsession with counting calories, eating only certain foods and moving food around the plate (playing with food) rather than eating it.
Individuals with bulimia nervosa also fear gaining weight, want desperately to lose weight and are very unhappy with their body size and shape. However, unlike anorexics, they can have a normal BMI (normal body size or possibly even overweight). Bulimics eat large quantities of food in a short about of time (binging) and then take drastic measures to get rid of the food (purging). This may be done by throwing up, taking laxatives or diuretics and/or excessive exercise. Signs of bulimia are swollen cheeks or jaws, calluses or scrapes on the knuckles (from inducing vomit), broken blood vessels in the eyes, and teeth that look clear. The bulimic may also go to the bathroom immediately after each meal (to eliminate food) and, like anorexics, may also suffer from depression, anxiety, and/or substance abuse.
Causes for both of these disorders may be related to cultural pressure to be thin, but life changes and stressful events are often triggers as individuals try to cope with emotional issues by gaining control of at least one part of their life (weight or food). Biology and family are also thought to play a role in developing these disorders. Hormones, chemicals in the brain, genetics and the importance that family places on looks, developing bodies, diet and exercise can contribute to many forms of disordered eating.
Based on the obesity epidemic in America, it is not surprising that binge-eating disorder is now the most common eating disorder in the nation, affecting three percent of U.S. adults. Like bulimics, people with this disorder eat large amounts of food in short periods of time. However, binge eaters do not purge and therefore tend to be overweight or obese which can lead to other health problems such as type 2 diabetes, high blood pressure, elevated cholesterol, gallbladder and heart disease and many types of cancer. People with binge-eating disorder eat when they are not hungry or when they are full. Eating is usually done to fill an emotional void or deal with a psychological stressor. They typically eat alone and feel disgusted and depressed for overeating, creating a vicious cycle. Unlike the other eating disorders, binge eating is most commonly seen in an older population (46 to 55 years old), affects all ethnic groups, and is seen almost equally among men and women.
Whether you or someone you know has an eating disorder, or some form of disordered eating related to the symptoms described above, it is important to know that you are not alone and help is readily available. Cognitive behavioral therapy, nutritional counseling, and drug therapy have all been effective methods treating eating disorders. Understanding that these are complex emotional, physical and psychological issues is the first step to overcoming disordered patterns of eating. As a nation, we need to overcome the stigma and stereotypes associated with eating disorders, stop obsessing with body image, dieting and thinness and focus on a well-rounded concept of health. Further, it is critical to understand the devastating health consequences that eating disorders can lead to for both men and women, and encourage people to seek education and treatment. More information on these eating disorders and treatment is available at www.nationaleatingdisorders.org and www.aedweb.org.
View the full summer 2010 issue of the ACSM Fit Society® Page online.