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Monday, January 29, 2001 Eating disorders due to self-imageBy ALYCE KLEIN | News-Journal Correspondent Every year millions of people in the United States are affected by serious and sometimes life-threatening eating disorders. They affect people of all races, professions, and educational and social levels. Eating disorders can jeopardize health, families, friendships, careers and education. Although the disorders affect both sexes and people of all ages, more than 90 percent of those afflicted are adolescent and young adult women. Girls are developing eating disorders at increasingly tender ages. Research shows children as young as preschool discuss weight and the desire to be thin and report body shape as important in their personal identity. The media is often blamed for the increasing social pressure to have an unrealistic "ideal" body shape. In reality, these images in the media are heavily made- up and airbrushed to perfection. Meanwhile, diet and fashion industries have revolutionized our view of beauty, in part teaching our young people they are not good enough unless they are dangerously thin. Most of the industry's marketing is to adult women but children are constantly exposed not only to the advertising itself but also to their parent's discussions, behaviors and attitudes that result from it. Children learn that weight, especially being thin, is very important and this is the value upon which they judge themselves and others. According to Karen Samuels, a licensed psychologist who has practiced in the Daytona Beach area for the past 10 years, eating disorders are a growing problem. "We have an epidemic of young people who have a problem with disordered eating and body image, self- esteem, and relational issues. There is an epidemic of dissatisfaction with one's self, and a large amount of pressure on appearance and body as a measure of success," Samuels said. "By age 8, many children think that they are fat and feel unhappy with their bodies." Samuels explained the sedentary lifestyle many children lead today, busy schedules and both parents working have all contributed to a nation of increasingly overweight children. This leaves a child with low self-esteem, feeling inadequate, angry, isolated and lonely. To cope with the incredible pressure, children may turn to compulsive overeating, under eating (anorexia nervosa), and binging and purging (bulimia nervosa), in order to feel in control. People with anorexia nervosa intentionally starve themselves. It causes extreme weight loss, which the National Institute of Health defines as at least 15 percent below normal body weight. It is estimated that the disorder effects approximately 1 percent of adolescent girls, with half of those eventually developing bulimia, according to the University of Maryland School of Medicine. Some of the signs of anorexia include impotency in men, a loss of the monthly period in women, a sudden change in weight or eating patterns, guilt and a preoccupation with exercise, food, calories, or weight. Laxative, diuretic or supplement abuse is another obvious sign of problems. Anorexia has the highest mortality rate of any other psychiatric disorder, with one in 10 cases leading to death from starvation, suicide, heart failure or other serious complications. Bulimia nervosa, on the other hand, is a destructive pattern of overeating followed by purging the excess calories by vomiting, abusing laxatives or diuretics, using enemas or over exercising. All of this can lead to life-threatening electrolyte imbalances, organ damage and heart failure. It is estimated that 2 to 3 percent of young women develop the disorder, but it can occur in men and older women. Bulimics often maintain normal or above normal body weight and hide their problem from others for years. The dentist is often the first to diagnose bulimia, because the acid from the stomach eventually erodes tooth enamel. Stomach acid also can cause inflammation and scarring of the esophagus, and swelling in the glands near the cheeks. Another sign is scarring on the back of the hands from fingers being pushed down the throat to induce vomiting. Experts say that bulimics are not only purging calories, they are purging the words and emotions they find difficult to express. Another warning from experts: Those who wait until after the age of 30 to get help may find it more difficult to change this deeply ingrained behavior. Dr. Pam Carbiener, obstetrician-gynecologist with Halifax OB-GYN Associates, explained abusing syrup of epicac to induce vomiting, as few as 20 times, can cause enough damage to the heart that a transplant is needed. "Kids as young as 9, 10 and 11 are dying from eating disorders," said Carbiener. "Public awareness needs to get out there -- to parents who are inadvertently causing their children's eating disorder, by telling them `you need to be on a diet; you need to lose weight.' The mother and father who are constantly dieting and monitoring body fat percentages should understand their message is very dangerous. It teaches adolescents that they need to be Barbie-like. If they do not have a tiny waistline and thin hips, something is wrong with them. The end result is that kids are literally dying to be thin." An integral part of the treatment team for people with eating disorders is the registered dietician. Cindy Liebler, nutrition therapist with Halifax Medical Center, helps patients who are referred to her to develop a more positive relationship with food. "Eating disorders are very complex," said Liebler. "When food is the enemy, there is no positive relationship with food. There are often control issues with food that must be dealt with, and this requires a team approach." Liebler starts her clients off slowly, by talking about food and, when necessary, working below minimal standards to get them to consume some nutrients. When that does not work, tube feeding or intravenous nutrition is necessary to keep the patient alive. Another type of disordered eating that that can cause deadly complications is binge eating, estimated to affect 2 percent of the general population. This disorder can cause obesity, which is defined as being 20 percent above normal weight. The binge eater is at risk for high cholesterol, high blood pressure, diabetes, gallbladder disease, heart disease and some types of cancer. "I try to help patients who are obese to become aware of trigger foods that may cause them to over- eat," Liebler said. She teaches all her clients with eating disorders about healthful eating, and guides them in taking baby steps toward recovery. She has found that the most effective way to begin is by reteaching food lessons, along with setting reasonable and achievable goals. Carbiener explained many families and people with eating disorders try to seek out treatment. In this community, however, there is not enough money available to adequately provide support for them, she said. "We need organized facilities with money to back them," said Carbiener. "Helping people with an eating disorder and their families to heal is a long and arduous task, requiring psychotherapy, nutrition management, an examination for physical damage, relapse prevention and, sometimes, hospitalization. Many of the formal groups that provided support to people in the Orlando and Daytona areas no longer exist because of lack of funding." During February, Carbiener and other professionals in the community will be meeting to discuss how, with the available resources, needs of people with eating disorders and their families can be met. They anticipate a public forum during March or April, Carbiener said, to find out what the public wants and needs, as well as the scope of the problem in our area. The road to recovery could be long, but is within reach. Professionals in the area are hopeful that a better support system for those with eating disorders and their families will be in place in the future. The first step is to work toward prevention by raising public awareness through education. Ways to prevent eating disordersLet children know that appearance is not the most important aspect of self-worth or identity through your words and actions. Talk to children; let them know that their feelings and thoughts are important. Provide more praise for the inside of children, and less for the outside. Talk to children about advertising and educate them about how false it actually is, as well as how you feel about it. Talk health rather than weight with children. Be careful not to be critical of your own or other people's bodies, children adopt the behavior that they see. Signs of an eating disorder: Loss of monthly menstrual period HICI Special Report — Weighing In: Does American Culture Encourage Eating Disorders? |
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