Anorexia Nervosa is characterized by excessive weight loss through self-starvation and sometimes through purging. Purging includes vomiting, using laxatives, and exercising excessively.Symptoms include:
- Refusal to maintain a normal weight
- Intense fear of weight gain
- Obsessive preoccupation with weight and shape
- Loss of menstrual periods
- Distorted body image
Bulimia Nervosa is characterized by cycles of binge eating followed by purging, usually done in secret. The individual’s weight may range from below to above average, so it may be harder to detect.Symptoms include:
- Repetitive cycles of bingeing and purging
- Feeling out of control of food intake
- Purging after bingeing via self-induced vomiting, laxatives, diet pills, diuretics, excessive exercise, or starvation
- Obsessive preoccupation with weight and shape
In addition, some people may have a mixture of anorexia and bulimic symptoms without qualifying for either diagnosis. They may engage in compulsive overeating or bingeing without purging. Preoccupied and significantly distressed about their eating habits, they may gradually gain weight to the point of obesity. Many people have both symptoms of anorexia and bulimia. Men are most likely to lose weight or to purge by excessively exercising.
Eating Disorders “Eat Up” Relationships
Eating disorders are consuming. They consume the individual in obsessive, negative thinking and behaviors, and they consume the individual’s relationships with family members, loved ones, and life. This is partially due to the effects of starvation. When people are not adequately nourished, they think about food constantly, sometimes even dreaming about it. They also become depressed, isolated, and tired. They avoid relationships because they often feel others pressure them to eat. They are physically depleted, and feel compelled to engage in eating disordered behaviors.
Loved ones find eating disorders extremely difficult to understand and accept. Seeing someone you love starve or damage her or his body is stressful. Often, parents, spouses, and others begin to become intrusive in their efforts to get the person to eat or to stop purging. Soon, the individual may see these loved ones as enemies trying to control her or him rather than help.
Eating disorders may develop if a person has no other way to speak or represent feelings. Frequently family dynamics, problematic communication patterns, losses, or stresses like abuse have contributed to negative feelings the person could not deal with directly. It is never a simple matter that can be solved by just telling the person to eat. The symptoms have become the individual’s way to avoid facing problems more directly or are an attempt to feel in control when the rest of life feels out of control.
Feed Your Relationship by Getting Help
Although eating disorders vary in severity from mild to life-threatening, they usually don’t go away by themselves. People with eating disorders often fear getting help because it could be seen as a sign of weakness. Loved ones can help break through that by being open to getting help themselves and by examining how they or other family relationships or issues may have contributed. In a family, both fathers and mothers need to be involved in treatment. This challenge needs to be shared.
Serious Distress Signals
- Fasts or severely restricts food intake
- Hides or sneaks food
- Spends excessive time in the bathroom after meals
- Vomits, takes laxatives, diet pills or other medications to lose weight
- Has lost a significant amount of weight
- Is tired and depressed
- Can’t concentrate
- Has irregular periods, swollen glands or joints, broken blood vessels or bloodshot eyes.
- Wears layers of clothes even in warm weather
- Faints or passes out
When these or other signs are present, professional help is urgently needed. Make an appointment with a physician and with an expert in eating disorders to find out how serious this is and to design a treatment plan that will help you cope.
Usually people with eating disorders need an interdisciplinary approach, including individual and family or couples therapy, nutritional counseling, medical monitoring, and sometimes medications or group therapy. Depending on the severity, inpatient, day hospital, residential treatment, or even tube-feeding or intravenous fluids may be necessary.
The sooner someone gets treatment, the more likely it is that person will recover. Get help soon. Treatment is effective. As many as 75 percent of those afflicted by anorexia or bulimia will recover. The remaining 25 percent will be chronically ill and some will die. Family or marital therapy significantly improves the possibility of recovery. Family members and loved ones need to understand that the problem is not a simple one. Advice to “just eat” won’t help. The eating and body image issues cover up much more complicated feelings. The eating disorder is an illogical system of thoughts and behaviors, and is an attempt to solve deep self-esteem and identity problems and gain a sense of control over one’s life. But, remember that there is hope and effective treatment for eating disorders.
The text for this brochure was written by Margo Maine, PhD.
From the American Association for Marriage and Family Therapy, www.aamft.org