David Prescott, Ph.D.

The approach of summer often brings a heightened awareness of our bodies, cultural pressures to adopt a certain look or shape, and our eating habits.  For some people this can be a time to develop better overall health habits related to eating.  For others, body image and eating habits are nagging but manageable problems.  However for still other people, preoccupation with food and guilt about eating becomes a significant psychological problem.  Eating disorders, such as anorexia nervosa, can be potentially life threatening and typically require professional help.

What are the Types of Eating Disorders?  There are three major types of eating disorders. 

• Anorexia Nervosa involves having a distorted body image where a person sees themselves as overweight even when they are dangerously thin.  People with anorexia have an intense fear of gaining weight, and often develop unusual habits such as refusing to eat around other people.  Anorexia usually occurs in women, and is often accompanied by infrequent or absent menstrual periods.

• Bulimia Nervosa involves eating excessive quantities of food, sometimes in secret, then trying to purge the body of the food and calories by using laxatives, vomiting, exercising or diuretics.  People with bulimia nervosa usually feel ashamed and disgusted as they binge, yet also feel relieved of tension once the binge-purge cycle is complete.

• Binge Eating Disorder involves frequent episodes of excessive, out-of-control eating.  However, there is no attempt to purge the body of excess calories.

What Causes Eating Disorders?  Many people believe that American society is largely to blame for the high rate of eating disorders, since we emphasize thinness and appearance to an extreme degree. 

Adolescent and young women account for 90 percent of eating disorder cases according to the National Institute of Mental Health. Other factors which appear to play a role include:

• Personality traits like low self-esteem, perfectionism, or feeling helpless.
• Family relationships that involve excessive teasing about appearance, or excessive emphasis on dieting or controlling food intake.
• Other psychological disorders like depression, anxiety disorders, or substance abuse.
• It is important to understand eating disorders as a treatable psychological disorder, rather than a failure of will or lack of behavioral control.

Does Treatment for Eating Disorders Work? Eating disorders don't usually go away by themselves. Many people with eating disorders are reluctant to ask for help, because of the secrecy involved, their embarrassment, or a sense that they "should know better."  However, since eating disorders can cause serious physical problems (like anemia, tooth decay, and hair and bone loss) as well as severe emotional distress, getting help is vitally important.
Treatment for anorexia typically involves collaboration with a nutritionist, physician, and psychologist or other psychotherapist.  Counseling can help modify distorted body image or beliefs about food and eating.  Family therapy helps to correct problematic relationships or undue pressures about controlling food or achievement in general.  Treatment for bulimia often involves interrupting the binge-purge cycle by developing healthier eating habits (e.g., not skipping meals) or finding healthier ways to decrease stress and tension.  For all types of eating disorders, treatment takes time.  However, the sooner treatment starts, the easier it is to make changes. 
Where else can I find help? 
Information about eating disorders is available at:

o American Psychological Association (www.apa.org)
o National Institute of Mental Health (www.nimh.nih.gov)
o National Eating Disorders Association (www.edap.org)
Information about mental health and substance abuse, including eating disorders is available at:
• Acadia Hospital – 1-800-640-1211 or www.acadiahospital.org