July 24, 2014

The Other Side of the Spectrum

Over two-thirds of the US population is overweight or obese, and those numbers are climbing. Obesity is an epidemic, and the growing number of chronic diseases related to it is staggering.

But what about the other side of the spectrum? The individuals, who in their quest to be thin, have starved themselves into a state of severe malnourishment, some close to death because of their obsession with the avoidance or purging of food? Less than 1% of the total population has an eating disorder (ED) such as anorexia nervosa or bulimia. Not nearly as big of an issue as obesity, right? Try telling that to the families and friends of the 10 million females and 1 million males in this country that have be diagnosed with an ED. Persons with an ED such as anorexia and bulimia are difficult to treat because their illness has less to do with food as it does with their mental state: their lack of confidence, their desire for perfection, their need for control, the belief that they are unattractive, unlovable.

It is critical to recognize ED behaviors in individuals as early as possible, and to provide professional assistance to those suffering in the form of a registered dietitian, family doctor, psychologist, psychiatrist and/or therapist. This team approach of health professionals is often recommended, and the support of family and friends is also of monumental importance. I have worked with several families concerning their nutrition. There is a fine line in encouraging children to eat healthfully without overeating. How does a parent find the balance? First, monitor your own attitude regarding food, body image, weight. Are you projecting positive words and actions, or negative ones? Children learn by example. Avoid labeling foods as “good” or “bad”-all foods can be enjoyed within moderation. Don’t reward with food, or punish with food. Avoid allowing only certain family members to eat certain foods-serve healthy meals and snacks that can be enjoyed by all.

What are some warning signs you should look for if you suspect a loved one is suffering from an ED? For anorexia nervosa: dramatic weight loss, preoccupation with weight, food and nutrition, refusal to eat certain foods, frequent comments about feeling “fat” despite weight loss, development of food rituals, consistent excuses to avoid mealtimes, excessive, rigid exercise regimen, withdrawal from usual friends and activities. For bulimics: evidence of binge-eating, including disappearance of large amounts of food in short periods of time, evidence of purging behaviors, including frequent trips to the bathroom after meals, signs and/or smells of vomiting, presence of wrappers or packages of laxatives or diuretics, unusual swelling of the cheeks or jaw area, calluses on the back of the hands and knuckles from self-induced vomiting, discoloration or staining of the teeth.

For more information on EDs, visit the National Eating Disorders Association at www.neda.org.