Eating disorders are growing problems in our society, so for the past 20 years there has been a week commemorating eating disorder awareness. In 2007, the key message for National Eating Disorders Awareness Week was “Be comfortable in your genes. Wear jeans that fit the REAL you.” Along with the slogan, there was a project called “The Great Jean Giveaway” accompanying Eating Disorder Awareness Week to encourage people donate their jeans that do not fit and trade for a pair that do fit them comfortably. Giving away our ill-fitting jeans is a metaphor to encourage each of us to give up the struggle of trying to fit into clothes that are not meant for our bodies shape or size. The message was also trying to promote the word genes in the message to underscore the importance of genetic variables’ influence on our shape and size, and to emphasize the increasing amount of data that is being found to support that eating disorders, along with other mental illness, have a strong genetic component and are not merely choices.
Eating disorders are among the most fatal mental illnesses, so signs and symptoms of eating disorders are important to understand in order to help in early identification and treatment. The National Eating Disorders Association (2006) indicates that an estimated 5-20% of those who have anorexia nervosa will not survive complications associated with it. However, people who receive treatment have a lowered mortality rate ranging from 2-3% (Anorexia Nervosa and Related Eating Disorders, Inc., 2006).
The most common eating disorders are anorexia nervosa and bulimia nervosa. Diagnostic criteria for social workers identifying eating disorders are:
Anorexia nervosa
• Obsessive thoughts about food
• Restrictive food intake
• Refusal to maintain normal body weight of 85% or more of standard BMI
• Amenorrhea (loss of menses for over 3 months)
• Intense fear of gaining weight
• Body image disturbance which unduly impacts self conceptBulimia Nervosa
• Recurrent binge eating in which the individual feels out of control or eats more than a typical person would eat at a sitting
• Frequent binge eating and compensatory behaviors occurring at least 2x a day for 3 months
• Recurrent inappropriate compensatory behaviors to prevent weight gain, such as purging, compulsive exercise, laxative, diuretic use, or other inappropriate compulsive behaviors
• Self concept is overly influenced by body sizeCommon signs and symptoms of eating disorders include (taken from www.somethingfishy.org):
• Anorexia/Bulimia
• Dramatic weight loss in a relatively short period of time.
• Wearing big or baggy clothes or dressing in layers to hide body shape and/or weight loss.
• Obsession with weight and complaining of weight problems (even if "average" weight or thin).
• Obsession with calories and fat content of foods.
• Obsession with continuous exercise.
• Frequent trips to the bathroom immediately following meals (sometimes accompanied with water running in the bathroom for a long period of time to hide the sound of vomiting).
• Visible food restriction and self-starvation.
• Visible bingeing and/or purging.
• Use or hiding use of diet pills, laxatives, ipecac syrup (can cause immediate death!) or enemas.
• Isolation. Fear of eating around and with others.
• Unusual Food rituals such as shifting the food around on the plate to look eaten; cutting food into tiny pieces; making sure the fork avoids contact with the lips (using teeth to scrap food off the fork or spoon); chewing food and spitting it out, but not swallowing; dropping food into napkin on lap to later throw away.
• Hiding food in strange places (closets, cabinets, suitcases, under the bed) to avoid eating (Anorexia) or to eat at a later time (Bulimia).
• Flushing uneaten food down the toilet (can cause sewage problems).
• Vague or secretive eating patterns.
• Keeping a "food diary" or lists that consists of food and/or behaviors (i.e., purging, restricting, calories consumed, exercise, etc.)
• Pre-occupied thoughts of food, weight and cooking.
• Visiting websites that promote unhealthy ways to lose weight.
• Reading books about weight loss and eating disorders.
• Self-defeating statements after food consumption.
• Hair loss. Pale or "grey" appearance to the skin.
• Dizziness and headaches.
• Frequent sore throats and/or swollen glands.
• Low self-esteem. Feeling worthless. Often putting themselves down and complaining of being "too stupid" or "too fat" and saying they don't matter. Need for acceptance and approval from others.
• Complaints of often feeling cold.
• Low blood pressure.
• Loss of menstrual cycle.
• Constipation or incontinence.
• Bruised or calluses knuckles; bloodshot or bleeding in the eyes; light bruising under the eyes and on the cheeks.
• Perfectionistic personality.
• Loss of sexual desire or promiscuous relations.
• Mood swings. Depression. Fatigue.
• Insomnia. Poor sleeping habitsIt is important for us to educate people about the signs and symptoms of eating disorders as well as the dangers. Treatment is typically multidisciplinary including psychiatrists, nutritionists, individual therapists, and family therapists. It is important that we support National Eating Disorders week by passing along the information and learning more about these deadly illnesses. For more information about eating disorders and their treatment you can contact Dr. Tara Arnold at 404-964-6629.
References:
American Psychiatric Association, 1994. Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Washington, D.C., American Psychiatric Association.
Anorexia Nervosa and Related Eating Disorders, Inc., 2006. "Statistics: How Many People Have Eating Disorders?" <http://www.anred.com/stats.html> (accessed 22 December 2006).
National Eating Disorders Association, 2006a. "Anorexia Nervosa." <http://www.edap.org/p.asp?WebPage_ID=286&Profile_ID=41142>>; (accessed 21 December 2006).
The Something Fishy Website on Eating Disorders, 2006. “Anorexia Nervosa”. <http://www.somethingfishy.org> (accessed 22 December 2006).
The Something Fishy Website on Eating Disorders, 2006. “Bulimia Nervosa”. <http://www.somethingfishy.org> (accessed 22 December 2006).