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| |    Eating Disorders: Overview by Robert Needlman, M.D., F.A.A.P. reviewed by Robert Needlman, M.D., F.A.A.P. What do you do when your normal-sized 10-year-old decides that she's fat and needs to be on a diet? Should you be concerned when your 15-year old starts to exercise all day long in order to get in shape? Many children and teenagers have unhealthy attitudes about food and their bodies. It can be tough, however, to know when these attitudes actually become psychiatric eating disorders. As a parent, you don't need to be an expert on anorexia and bulimia. But if you have a basic understanding of these disorders, you'll be able to reduce the risk for your children and get help early on if they need it. Anorexia and bulimia The term "eating disorder" usually refers to anorexia nervosa or bulimia nervosa. The main feature of anorexia is compulsive dieting with severe weight loss. The main feature of bulimia is out-of-control eating (binging) followed by vomiting or other means to limit weight gain (including overuse of laxatives). Both disorders involve serious psychological disturbances. Scientists don't know exactly why some people develop these disorders while others do not, though new research suggests that genetics plays a role. Of course, it doesn't help that our culture places tremendous pressure on women to be slim. Television and women's magazines, in particular, bombard us with images of unnaturally thin women and unnaturally muscular men. Many people come to believe that there is something wrong with them if they don't look this way. Even girls in elementary school feel this pressure strongly-as many as 60 percent of girls as young as 10 or 11 may believe that they are too fat and should diet. Eating disorders are fairly common. Anorexia and bulimia strike somewhere between 2 percent and 9 percent of women (the actual numbers are hard to know, since people with eating disorders often hide them). While most eating disorders occur in women between the age of 12 and 25, it's important to remember that about 5 to 10 percent of people with eating disorders are male. Addicted to thinness One way to look at eating disorders is as a form of addiction--not to a drug, but to the act of dieting or bingeing on food. Like alcohol or drug addiction, the eating disorder starts out as something that seems positive (losing a little weight is good; getting a little loose with a drug feels good, too, at first). In some people, bingeing and dieting are attempts to self-treat depression or psychological trauma. Initially, this approach seems to work. But then the addiction takes over, controlling every aspect of the person's life. Just as the alcoholic is always thinking about how to get his next drink, the anorexic is always thinking about how to get rid of the next few ounces of body weight; the bulimic is always thinking about how to lose a few pounds, or feeling ashamed about a recent binge. A person with an eating disorder cannot simply decide to stop having the disorder, any more than a person with drug addiction can decide to simply stop using. While some women say that they have overcome eating disorders on their own, my sense is that this is rare. In almost all cases, eating disorders require professional treatment, often by a team of professionals, including physicians, psychologists, nutritionists, and others. Recovery is rarely quick or easy. However, with therapy and hard work, people with eating disorders can lead positive, healthy lives. The articles in this section talk more about anorexia nervosa and bulimia, and about ways to prevent their development.
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