Eating disorders take over family life

As American parents continue to obsess about their own weight and diet, it is hardly surprising that eating disorders among children and adults have risen to crisis levels.

Eating disorder sufferers become lonely and driven to keep their disorder a secret. They irritate easily, and can be extremely rigid, determined to keep their own small rituals and rules. The father of one girl said, “She has withdrawn into her own world. She’s lonely and is missing out on all the fun and exciting things during her teenage years . . . I have cried many times over this.”

An estimated ten million people in the United States suffer from eating disorders, including about 10 percent of high school and college-age youth, 90 to 95 percent of them female. Estimates are that anorexia nervosa affects about one percent and bulimia nervosa one to three percent of high school girls. In the third category called other eating disorders, noted eating disorder specialist Michael Levine, PhD, Professor of Psychology Kenyon College in Gambier, Ohio, finds prevalence rates of 2 to 13 percent of middle school and high school girls.

Recovery can be long and difficult. Fewer than half of patients with severe disorders recover well. Death rates are relatively high, with an estimated mortality of 15 to 20 percent for anorexia and bulimia. Yet health agencies and the public have failed to come to grips with the severity and extent of eating disorders. They are often ignored by health agencies, even in the Healthy People 2010 report, which sets the health agenda for the nation.

Families of eating disordered youth and adults are in a difficult situation. They see their child or family member behaving in destructive ways and feel helpless and frustrated. They may try to gain control over what she eats, policing washrooms and searching drawers for diet pills or laxatives. The eating disorder takes over and dominates family life.

As the malnourished body shuts down in anorexia nervosa, changes occur in behavior, perception, thinking, mood and social interaction. One of the most striking features is how intently the person is preoccupied with food, even though she eats very little and is in semi-starved condition. She may develop odd eating rituals, positioning food and cutting it into small pieces, chewing a certain number of times. Many of the bizarre behaviors common to anorexia, once thought to be caused by pre-existing psychopathy, are now recognized as the result of severe food restriction and semi-starvation.

(Excerpted from Underage and Overweight: Our Childhood Obesity Crisis – What Every Family Needs to Know, page 85-86.).

Eating disorder crisis

(ANAD) Eating disorders are rampant in our society, yet few states in the nation have adequate programs or services to combat anorexia nervosa, bulimia and compulsive eating. Only a small number of schools and colleges have programs to educate our youth about the dangers of eating disorders.

Every state in our nation and thousands of schools have extensive programs aimed to prevent alcoholism and drug abuse. The value of such programs, especially education programs, has been proven and accepted for school curricula. The immense suffering surrounding eating disorders, the high cost of treatment, and the longevity of those illnesses make it imperative that vastly expanded education programs be implemented to prevent anorexia nervosa and related disorders.

Since 86 percent of victims report the onset of their illness by age 20, education programs should focus on younger ages in order to maximize preventive efforts.

According to a ten year study by ANAD (the National Association for Anorexia Nervosa and Associated Eating Disorders), eating disordered patients report the following:

Age at onset of illness
• 86% by the age of 20
• 10% by 10 years or younger
• 33% between ages of 11-15
• 43% between ages of 16-20

Duration of illness/ mortality
• 77% duration of 1-15 years*
• 30% duration 1-5 years
• 31% duration 6-10 years
• 16% duration 11-15 years
• It is estimated that 6% of serious cases die
• Only 50% report being cured 

Other statistics offered by the Academy for Eating Disorders (AED):

• Eating disorders are among the top four leading causes of burden of disease in terms of life lost through disability or death.
  
• Up to 10 percent of women with anorexia nervosa may die due to anorexia-related causes.
  
• Risk of death among individuals with anorexia is 12 times greater than their same age peers without anorexia.
  
• Health consequences such as osteoporosis (brittle bones), gastrointestinal complications and dental problems are significant health and financial burdens throughout life.

NEDA ( the National Eating Disorders Association) reports that 50% of teen girls have a significant eating disturbance at some point in their adolescence.

These national organizations urge federal and state governments to undertake and develop educational programs to help prevent eating disorders.

Inexplicably, U.S. health agencies keep no statistics on eating disorders, despite the fact they provide a minutiae of statistics and information on obesity and virtually every other health condition and disease. Ten million people have eating disorders, compared to 4.5 million for Alzheimer’s, yet Federal funding is only $12 million for eating disorders compared with $647 million for Alzheimer's disease. Eating disorders have the highest fatality rate of any mental illness.

Dysfunctional eating disrupts
normal life

Along the continuum between normal eating on the one hand and clinical eating disorders on the other is a disturbed type of eating behavior that is all too prevalent today, especially among girls and women. As it moves across the continuum, growing more frequent and intense, it becomes increasingly disruptive of normal life. ( See the Eating Behavior Chart in Women Afraid to Eat, page 56-57.)

These are people who try not to eat, or they eat too much with no awareness of body signals of hunger or satiety. Often they alternately eat and binge to relieve anxiety, anger, loneliness, boredom, to numb pain, for comfort, or to gain pleasure. But instead of feeling better, eating is likely to make them feel worse. After eating they feel guilty, ashamed, uncomfortably full, regretful or, still unsatisfied, fear triggering a binge. There may be a sense of loss of control and the inability to stop eating.

This kind of eating is called dysfunctional because it is detached from the normal function of eating to satisfy hunger and nourish the body. Instead, the purpose of eating for the dysfunctional eater is to be thin, to reshape the body, or to relieve stress. Instead of being regulated by normal controls of hunger and satiety, it is regulated by external controls. This type of eating behavior is also called disordered eating, restrained eating, disturbed or emotional eating or, for the frequent dieter, chronic dieting syndrome.

Thus, dysfunctional eating is chaotic — dieting, fasting, bingeing, skipping meals — or it may be consistently eating much less or much more than your body wants or needs.

There’s a lot of this kind of eating going on in homes these days. Many mothers are serious dieters with an intense thinness drive. Dads are struggling to diet as well, and children are learning to restrict their eating as young as six or seven, or even earlier. Foods are vilified or feared in the family. Dinner table talk comes to focus on calories, fat, what’s good for you, what’s not – if indeed, there are sit-down meals in the home at all.

Studies suggest that dysfunctional eaters may include at times the 50 to 80 percent of girls and women in the United States who say they’re trying to lose weight. Increasingly, they are joined by about one-fourth of teenage boys and men who are changing their eating habits in response to new advertising pressures that promote the lean, muscular male body.

Dysfunctional eating includes three general patterns.

(Excerpted from Women Afraid to Eat: Breaking Free in Today’s Weight-Obsessed World, by Francie M. Berg. Additional information is available in Children and Teens Afraid to Eat and Underage and Overweight.)

Normal Eating: Are you a normal eater? PDF

Are You a Dysfunctional Eater?

Eating behavior assessment. If you answer YES to 3-4 of these questions, you may be a dysfunctional or disordered eater. The more YES answers you give the farther along you’ll be on the Eating Behavior continuum from normal eating toward clinical eating disorders. (Excerpted from Women Afraid to Eat: Breaking Free in Today’s Weight-Obsessed World, by Francie M. Berg, pg 54. See also the Eating Behavior Chart, p 56-57.)

Eating disorder organizations
and support groups

There are many helpful eating disorder organizations and websites, both large and small. Most of them link to one or more of these four major organizations.

NEDA – National Eating Disorders Association

NEDA is the largest not-for-profit organization in the United States working to prevent eating disorders and provide treatment referrals to those suffering from anorexia, bulimia and binge eating disorder and those concerned with body image and weight issues.

The NEDA Network is collaboration between other organizations and the National Eating Disorders Association with the purpose of providing a unified voice of strength, advocacy and support in the fight against eating disorders. Its legislative a dvocacy efforts bring people together to fight for improved access to care.

NEDA serves as an information clearinghouse, disseminating the latest and most accurate resources and educational materials regarding eating disorders and providing referrals to treatment and educational services. It provides programs, products and services that support the elimination of eating disorders.

The organization sponsors National Eating Disorders Awareness Week each year in late February, which reaches millions through the country’s largest collaborative eating disorders awareness outreach campaign. It also operates a Media Watchdog program, created to improve media messages about size, weight and beauty. The program brings students, educators, health professionals, parents, eating disorders sufferers, and concerned consumers together to encourage companies and advertisers to send healthy media messages about body shape and size.

NEDA operates the nation's first toll-free eating disorders information and referral helpline staffed by trained volunteers (800-931-2237). http://www.nationaleatingdisorders.org

2008 NEDA Conference: "Break the Silence: Tools for Help, Hope and Healing"
September 18-20, 2008 – Austin, TX. www.myneda.org

ANAD – National Association for Anorexia Nervosa and Associated Eating Disorders

ANAD, the oldest eating disorder organization in the U.S., was launched in 1976 as a small support group in the home of.Vivian Meehan, a nurse and ANAD's president. Today, from its headquarters in Highland Park, IL, this organization answers thousands of hotline calls each year.

The small support group Meehan founded in her home, as a desperate attempt to understand and cope with her daughter’s anorexia nervosa, went on to establish support groups throughout the world. At present there are over 350 groups in the nation and in 18 foreign countries. They provide support and self-help for the individuals and families affected by eating disorders. They are always free of charge, with volunteer assistance and staffing.

ANAD’s main concern from its inception has been to provide support groups for families affected by an eating disorder. The groups offer information and resources, support and hope for recovery. They are a forum for discovering that no person is alone – other people have similar problems and feelings.

Most support groups are led by health professionals in the field or by lay people far in their recovery with a professional sponsor. They are not intended to replace therapy, but ideally serve as an adjunct to therapy. They are to be safe havens for those seeking support and understanding. Leaders receive training and ongoing support from the ANAD office. A variety of approaches are used with the recommendation of using ANAD's philosophy and Eight Step Approach as a basic foundation.

With a focus on education, ANAD launched the first national conference in 1979.  Hundreds of volunteers, many of them health professionals, offer their services and continue to provide conferences, seminars, workshops and presentations across the nation. ANAD's School Guidelines reaches thousands of schools throughout the country to help faculty prevent, identify and intervene in eating disorders. Contact ANAD for help, support, or more information about eating disorders (847-831-3438). http://www.anad.org/

AED – Academy for Eating Disorders

The Academy for Eating Disorders is an international, multidisciplinary professional organization that provides cutting-edge professional training and education, inspires new developments in eating disorders research, prevention, and clinical treatments, and is the international source for state-of-the-art information in the field of eating disorders.

Full members are professionals who hold an advanced degree, meeting the degree requirements in their field, and are trained and have experience in the field of eating disorders. Affiliate members may be professional or lay people interested in the field of eating disorders who are involved in public or professional activities related to eating disorders.

The Academy’s mission is to be an international transdisciplinary professional organization that promotes excellence in research, treatment and prevention of eating disorders. It publishes the International Journal of Eating Disorders, and the Academy for Eating Disorders Newsletter, and holds an annual international conference and seminars. It provides education, training and a forum for collaboration and professional dialogue. http://www.aedweb.org

NEDIC – National Eating Disorder Information Centre (Canada)

NEDIC is a non-profit organization founded in 1985 to provide information and resources on eating disorders and food and weight preoccupation across Canada. The Mental Health Programs and Services division of the Ontario Ministry of Health and Long Term Care has mandated NEDIC to provide information about issues related to eating disorders, including up-to-date information on what treatment is available.

The organization develops and disseminates information and resources nationwide in Canada, through schools, community groups and professional bodies on the prevention of disordered eating, promotion of positive body image, and healthy lifestyles. A major goal is to inform the public about eating disorders and related issues. NEDIC sponsors prevention and awareness campaigns including Canada's Eating Disorder Awareness Week (annually the first full week in February) and International No Diet Day (May 6).

A telephone helpline provides information on treatment and support (416-340-4156 in Toronto/GTA; 1-866-NEDIC-20 or 1-866-63342-20 across Canada). http://www.nedic.ca/

Preventing and healing dysfunctional eating and eating disorders

Eating disorders are complex and multi-factoral. Professional therapy is likely needed. As a parent, sufferer or friend don't hesitate to ask for help. The organizations listed above can help provide information and referrals.

However, people need to be aware that ordinary dieting, of itself, is considered a major risk factor for the development of an eating disorder. It is often said that dieting is a necessary but not sufficient condition for the development of an eating disorder. So it may be healthier in the long run not to start the first diet that starts one down the path to dysfunctional, disordered eating and can lead to clinical eating disorders.

Preventing or recovery from dysfunctional eating, then, may be an important key in preventing eating disorders. What's needed is to restore or maintain Normal Eating in your own life and to promote it for others.

Normal Eating: Are You a Normal Eater? PDF