Student Health Service
Concerns with weight and size are not unique to individuals with an eating disorder. Certainly in a society such as ours that is obsessed with thinness it is understandable that at times these concerns may encourage young women to develop an unhealthy relationship with food. It is also understandable why success at dieting, as well as ones appearance can be seen as a measure of self-esteem. The distinction between concerns about size and shape, and having an actual eating disorder is sometimes difficult to discern. While anorexia (self-starvation) and bulimia (bingeing and purging) are most commonly associated with eating disorders, many individuals have what we call disturbed eating patterns that do not constitute an actual eating disorder. Even so, these disturbed eating patterns can be a source of concern, and may require attention.
What will be described next are some of the characteristics of eating disorders and how they may manifest themselves. Keep in mind however that whether these characteristics actually constitute an eating disorder will depend on the degree to which they exist and interfere with ones life.
Women make up 90% of those with eating disorders. While women will be referred to in the following descriptions, these same behaviors are seen in men who have eating disorders.
Intense Concerns with Weight and Shape:
Women with eating disorders tend to be preoccupied with body size. Thoughts about your body may intrude in your life making it difficult to concentrate on anything else. This preoccupation with body size tends to be linked with an idealization of thinness and with dissatisfaction with ones own body. Some women tend to have a distorted view of their body, feeling fat when they are actually under their natural weight. These women may also feel an intense fear of gaining weight and may do anything to avoid it. This is especially true of those with anorexia nervosa.
Preoccupation with body size, dissatisfaction with one's own body, idealization of thinness when joined with the importance of body size and self-esteem all contribute to women experiencing an intense need to control their weight. Weight control measures can become the primary focus of one's daily life, interfering with other activities.
Extreme Practices of Weight Control:
Typically the most common method of weight control is to restrict the quantity and the types of foods eaten. This can be done by following a particular diet, eliminating foods thought to be considered fattening, skipping meals totally, counting 'fat' grams, periodic fasting, and /or increasing one's exercise. The need to follow these restrictions creates intense feelings of guilt for any perceived deviation. It can also create situations in which someone is so deprived that once they 'break' their diet they tend to eat large quantities of previously restricted foods, in what becomes a 'binge'. This can cause further, more stringent restriction to compensate for the dietary lapse. Soon a vicious cycle is established.
Some women become so distressed by their inability to stick to their diet that they may resort to various purging techniques in an effort to compensate. Self-induced vomiting is one method some women use to 'undo' the damage they feel they have done by overeating, or just from eating more then they feel they 'should'.
Misuse of laxatives is another purging technique that women may use to relieve the bloated feeling they experience after a binge or after eating anything they feel deviated from their 'diet'. While the laxatives may result in feeling less bloated, they do not in fact spare many calories. Fluids are lost, not calories, defeating the intended purpose.
Compulsive exercise is actually another method of purging. Certainly not all women who exercise regularly have eating disorders, but many do. Exercise is a healthy, stress reducing activity that is considered part of maintaining a sense of wellness. This changes however, when the goal of exercise is primarily to change ones shape and it is excessive, consuming several hours each day. Sometimes a clue may be the extreme guilt associated with missing one's regular exercise or the need to compensate for excessive calorie consumption by exercising.
All methods of purging whether through self-induced vomiting, misuse of laxatives, compulsive exercise, fasting, or diuretics can cause serious physical problems. These can include erosion of tooth enamel, tears in the esophagus, chronic sore throats, digestive problems, anemia, constipation, stomach cramps. They can also cause life-threatening problems like dehydration, fluid imbalances that lead to irregular heartbeats and sudden death. What makes this situation more dangerous, is that purging behavior often becomes addictive, making it very difficult to stop without help.
Binge eating is another common feature associated with extreme dieting practices. It is a cardinal symptom of bulimia nervosa though it can also be present in anorexia. It is actually a normal response of the body to chronic restrictive dieting. Binge eating typically consists of eating large quantities of calorie dense foods and is often done in secrecy. It is tends to be associated with feelings of guilt and shame. Once again this behavior becomes habit forming making it extremely difficult to break the diet-binge cycle.
Deviations from Normal Weight:
The most extreme result of self-imposed starvation is anorexia nervosa. This exists when a woman's weight falls below the level necessary for the body to function in a healthy manner. When this occurs, a woman often stops menstruating and may develop thin bones (osteoporosis). She does not have the necessary body fat to maintain normal hormonal functioning. While a woman can appear to function normally even with extreme weight loss, this loss can be life threatening. The long-term consequences are also quite serious, leaving a woman infertile and prone to stress fractures from thin bones.
Other side affects from anorexia can include hair loss (though some develop fine body hair to maintain body temperature), dry skin, fatigue, constipation, susceptibility to infection, low heart rate and blood pressure resulting in dizziness, and difficulty maintaining body temperature. Mental function can also be impaired creating mood changes, irritability, depression, and difficulty concentrating.
Keep in mind that disordered eating can vary in severity, and may not develop into actual anorexia or bulimia. The key to avoiding the progression is to recognize that a problem may exist and know where to go to get the appropriate help. The following resources are available for anyone who has a problem or simply wants to talk about healthy eating.
The Student Health Service: You can make an appointment to meet with a nurse practitioner who specializes in eating disorders and their physical complications.
The Counseling Center: You can see a therapist to discuss emotional concerns related to eating.
The Wellness Connection: You can see a registered dietitian to discuss healthy eating and nutrition concerns.