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Sunday, May 5, 2002 The key to anorexia is to catch it earlyBy LYDIA HINSHAW | News-Journal Staff Writer Anorexia nervosa's causes and remedies are complex and poorly understood, but experts agree on one thing. It is extremely important to catch and treat it early. "This is a terrible disease, and it does have a mortality rate," says Dr. Raul Zimmerman, a family physician with a special interest in eating disorders. "The earlier you pounce on it, the better chance you have. In some ways it's like a cancer -- it gets to a certain stage and it's incurable." Carmen Gardner often told family and friends that if anorexia isn't caught and treated within two years it will be too late. In Carmen's own case, her parents did get her professional counseling within that window, or pretty close, and still she died of the disease after a 20-plus-year struggle. Dr. Karen Samuels, a psychologist who specializes in eating disorders, says there is no simple deadline, but studies show that the longer the disease has progressed, the longer it will take to reverse it. A patient who gets no treatment for five years, for example, is more likely to require five years or more of psychological and nutritional counseling, and medical care, to recover. The good news is, anorexia can be beaten. "Recovery does happen," says Samuels. "In fact, it happens in almost all cases. But the earlier you intervene, the better." But anorexia is a closet disease, often shrouded in secrecy and shame. Samuels says that doctors often don't pick up on eating disorders in their patients because they don't ask the right questions. Anorexics and their parents alike often deny the problem. It is simply unbelievable to most people that an adolescent, often an academically gifted one, would purposely starve herself (a high percentage of victims are female). Anorexia is difficult to talk about to friends and family because to most people, the answer is so simple, a no-brainer. "Telling an anorexic to 'just eat' is about the same as telling a clinically depressed person to 'just go out and have fun,'" says Zimmerman, director of the family practice residency program at Halifax Medical Center. "It's about as helpful as telling an obese patient to just quit eating," adds Samuels. Carmen Gardner did not go public with her condition while she was alive, but nevertheless she felt a responsibility to do what she could to help others. Two or three times, she volunteered to speak to resident physicians in Halifax Medical Center's family practice program about how they should talk to anorexic patients. "It was a powerful presentation," says Zimmerman, who is the director of the family practice program. "She spoke imploringly," says Samuels. "I think it was hugely important. I really applauded her courage and willingness to speak out." In her own family, Carmen saw a bit of herself in her niece, Sarah, a fifth-grader. "Carmen and I talked a lot about my daughter, who has a lot of perfectionist tendencies and is involved in competitive dance," says Karen Skinner, Carmen's sister. "That's a lot of triggers, and we're ever-vigilant. Carmen wanted us to watch and be careful." When young Sarah was being bullied by a couple of other students at school in 2000, Carmen advised moving her to another class, which Skinner did at midyear. Carmen had often felt set apart and isolated as a child because of her grades, her running and her kindhearted nature. "Carmen said that once all the bad thoughts get into your head," Skinner says, "there is no way to get rid of them." Eating Disorder SymptomsANOREXIA NERVOSA BULIMIA NERVOSA HICI Special Report — Weighing In: Does American Culture Encourage Eating Disorders? |
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