Eating Disorders and Body Image

What is an Eating Disorder?

An eating disorder is an unhealthy preoccupation or association with food. It can be present in the form of self starvation as in the case of Anorexia Nervosa, in consuming large amounts of food then excreting it from the body as in the case of Bulimia, or even in feeling guilty about eating food and taking measures such as working out or taking diet pills to counter the food eaten.

Anorexia (Source: www.nationaleatingdisorders.org)

Anorexia Nervosa is a serious, potentially life-threatening eating disorder characterized by self-starvation and excessive weight loss.

Anorexia Nervosa has four primary symptoms:

  • Resistance to maintaining body weight at or above a minimally normal weight for age and height
  • Intense fear of weight gain or being “fat” even though underweight.
  • Disturbance in the experience of body weight or shape, undue influence of weight or shape on self-evaluation, or denial of the seriousness of low body weight.
  • Loss of menstrual periods in girls and women post-puberty.

Eating disorders experts have found that prompt intensive treatment significantly improves the chances of recovery. Therefore, it is important to be aware of some of the warning signs of anorexia nervosa.

Warning Signs of Anorexia Nervosa:

  • Dramatic weight loss.
  • Preoccupation with weight, food, calories, fat grams, and dieting.
  • Refusal to eat certain foods, progressing to restrictions against whole categories of food (e.g. no carbohydrates, etc.).
  • Frequent comments about feeling “fat” or overweight despite weight loss.
  • Anxiety about gaining weight or being “fat.”
  • Denial of hunger.
  • Development of food rituals (e.g. eating foods in certain orders, excessive chewing, rearranging food on a plate).
  • Consistent excuses to avoid mealtimes or situations involving food.
  • Excessive, rigid exercise regimen--despite weather, fatigue, illness, or injury--the need to “burn off” calories taken in.
  • Withdrawal from usual friends and activities.
  • In general, behaviors and attitudes indicating that weight loss, dieting, and control of food are becoming primary concerns.

Anorexia nervosa involves self-starvation. The body is denied the essential nutrients it needs to function normally, so it is forced to slow down all of its processes to conserve energy. This “slowing down” can have serious medical consequences.

Health Consequences of Anorexia Nervosa:

  • Abnormally slow heart rate and low blood pressure, which mean that the heart muscle is changing. The risk for heart failure rises as heart rate and blood pressure levels sink lower and lower.
  • Reduction of bone density (osteoporosis), which results in dry, brittle bones.
  • Muscle loss and weakness.
  • Severe dehydration, which can result in kidney failure.
  • Fainting, fatigue, and overall weakness.
  • Dry hair and skin, hair loss is common.
  • Growth of a downy layer of hair called lanugo all over the body, including the face, in an effort to keep the body warm.

Statistics About Anorexia Nervosa:

  • Approximately 90-95% of anorexia nervosa sufferers are girls and women (American Psychiatric Association, 1994).
  • Between 0.5-1% of American women suffer from anorexia nervosa.
  • Anorexia nervosa is one of the most common psychiatric diagnoses in young women (Hsu, 1996).
  • Between 5-20% of individuals struggling with anorexia nervosa will die. The probabilities of death increases within that range depending on the length of the condition (Zerbe, 1995).
  • Anorexia nervosa has one of the highest death rates of any mental health condition.

Anorexia nervosa typically appears in early to mid-adolescence.

Bulimia (Source: www.nationaleatingdisorders.org)

Bulimia Nervosa is a serious, potentially life-threatening eating disorder characterized by a cycle of bingeing and compensatory behaviors such as self-induced vomiting designed to undo or compensate for the effects of binge eating.

Bulimia Nervosa has three primary symptoms:

  • Regular intake of large amounts of food accompanied by a sense of loss of control over eating behavior.
  • Regular use of inappropriate compensatory behaviors such as self-induced vomiting, laxative or diuretic abuse, fasting, and/or obsessive or compulsive exercise.
  • Extreme concern with body weight and shape.

Eating disorder specialists believe that the chance for recovery increases the earlier bulimia nervosa is detected. Therefore, it is important to be aware of some of the warning signs of bulimia nervosa.

Warning Signs of Bulimia Nervosa:

  • Evidence of binge-eating, including disappearance of large amounts of food in short periods of time or the existence of wrappers and containers indicating the consumption of large amounts of food.
  • Evidence of purging behaviors, including frequent trips to the bathroom after meals, signs and/or smells of vomiting, presence of wrappers or packages of laxatives or diuretics.
  • Excessive, rigid exercise regimen--despite weather, fatigue, illness, or injury--the need to “burn off” calories taken in.
  • Unusual swelling of the cheeks or jaw area.
  • Calluses on the back of the hands and knuckles from self-induced vomiting.
  • Discoloration or staining of the teeth.
  • Creation of complex lifestyle schedules or rituals to make time for binge-and-purge sessions.
  • Withdrawal from usual friends and activities.
  • In general, behaviors and attitudes indicating that weight loss, dieting, and control of food are becoming primary concerns.

Bulimia nervosa can be extremely harmful to the body. The recurrent binge-and-purge cycles can impact the entire digestive system and purge behaviors can lead to electrolyte and chemical imbalances in the body that affect the heart and other major organ functions.

Health Consequences of Bulimia Nervosa:

  • Electrolyte imbalances that can lead to irregular heartbeats and possibly heart failure and death. Electrolyte imbalance is caused by dehydration and loss of potassium and sodium from the body as a result of purging behaviors.
  • Inflammation and possible rupture of the esophagus from frequent vomiting.
  • Tooth decay and staining from stomach acids released during frequent vomiting.
  • Chronic irregular bowel movements and constipation as a result of laxative abuse.
  • Gastric rupture is an uncommon but possible side effect of binge eating.

About Bulimia Nervosa:

  • Bulimia nervosa affects 1-2% of adolescent and young adult women.
  • Approximately 80% of bulimia nervosa patients are female (Gidwani, 1997).
  • People struggling with bulimia nervosa will often appear to be of average body weight.
  • Many people struggling with bulimia nervosa recognize that their behaviors are unusual and perhaps dangerous to their health.

Bulimia nervosa is frequently associated with symptoms of depression and changes in social adjustment.

Body Image (Source: www.nationaleatingdisorders.org)

Body image is how you see yourself when you look in the mirror or picture yourself in your mind.

Body image is . . .

  • How you see yourself when you look in the mirror or when you picture yourself in your mind.
  • What you believe about your own appearance (including your memories, assumptions, and generalizations).
  • How you feel about your body, including your height, shape, and weight.
  • How you sense and control your body as you move. How you feel in your body, not just about your body.

Negative body image is . . .

  • A distorted perception of your shape--you perceive parts of your body unlike they really are.
  • You are convinced that only other people are attractive and that your body size or shape is a sign of personal failure.
  • You feel ashamed, self-conscious, and anxious about your body.
  • You feel uncomfortable and awkward in your body.

Positive body image is . . .

  • A clear, true perception of your shape--you see the various parts of your body as they really are.
  • You celebrate and appreciate your natural body shape and you understand that a person`s physical appearance says very little about their character and value as a person.
  • You feel proud and accepting of your unique body and refuse to spend an unreasonable amount of time worrying about food, weight, and calories.
  • You feel comfortable and confident in your body.

People with negative body image have a greater likelihood of developing an eating disorder and are more likely to suffer from feelings of depression, isolation, low self-esteem, and obsessions with weight loss.

We all may have our days when we feel awkward or uncomfortable in our bodies, but the key to developing positive body image is to recognize and respect our natural shape and learn to overpower those negative thoughts and feelings with positive, affirming, and accepting ones.

Accept yourself -- Accept your body.

How to help a friend or loved one with an eating disorder or body image issues (Source: www.nationaleatingdisorders.org)

You cannot force someone to seek help, change their habits, or adjust their attitudes. You will make important progress in honestly sharing your concerns, providing support, and knowing where to go for more information!

If you are reading this handout, chances are you are concerned about the eating habits, weight, or body image of someone you care about. We understand that this can be a very difficult and scary time for you. Let us assure you that you are doing a great thing by looking for more information! This list may not tell you everything you need to know about what to do in your specific situation, but it will give you some helpful ideas on what to do to help your friend.

  • Learn as much as you can about eating disorders. Read books, articles, and brochures.
  • Know the differences between facts and myths about weight, nutrition, and exercise. Knowing the facts will help you reason against any inaccurate ideas that your friend may be using as excuses to maintain their disordered eating patterns.
  • Be honest. Talk openly and honestly about your concerns with the person who is struggling with eating or body image problems. Avoiding it or ignoring it won’t help!
  • Be caring, but be firm. Caring about your friend does not mean being manipulated by them. Your friend must be responsible for their actions and the consequences of those actions. Avoid making rules, promises, or expectations that you cannot or will not uphold. For example, “I promise not to tell anyone.” Or, “If you do this one more time I’ll never talk to you again.”
  • Compliment your friend’s wonderful personality, successes, or accomplishments. Remind your friend that “true beauty” is not simply skin deep.
  • Be a good role model in regard to sensible eating, exercise, and self-acceptance.
  • Tell someone. It may seem difficult to know when, if at all, to tell someone else about your concerns. Addressing body image or eating problems in their beginning stages offers your friend the best chance for working through these issues and becoming healthy again. Don't wait until the situation is so severe that your friend's life is in danger. Your friend needs as much support and understanding as possible.

Remember that you cannot force someone to seek help, change their habits, or adjust their attitudes. You will make important progress in honestly sharing your concerns, providing support, and knowing where to go for more information! People struggling with anorexia nervosa, bulimia nervosa, or binge eating disorder do need professional help. There is help available and there is hope!

Other Resources:

  1. Food Addicts In Recovery Anonymoushttp://www.foodaddicts.org
  1. Multiservice Eating Disorders Association www.medainc.org