HEALTH MATTERS
By: Dr. Melinda Parisi
This is the third in a three-part series examining women’s relationship to food, female body image and eating disorders. February 23-March 1 is National Eating Disorders Awareness Week.
As we’ve examined in the first two parts of this series, it is not uncommon for individuals to form unhealthy relationships with food and many women have distorted body images. If these aspects of life and perception are not addressed, they may worsen, developing into full-fledged eating disorders.
Eating disorders, including anorexia nervosa and bulimia nervosa, are far from glamorous. For those who suffer from them, day-to-day life can be filled with sadness, guilt, and worry. Both anorexia and bulimia are serious, life-threatening disorders.
Anorexia is a disorder characterized by extreme weight loss due to self-starvation and/or excessive exercise. Of all psychiatric disorders, anorexia has the highest mortality rate, due to medical complications or suicide. Those suffering from anorexia are below a minimally normal body weight and intensely afraid of fat, have a distorted body image, and for women, have menstrual irregularities.
Bulimia is characterized by episodes of binge eating followed by some form of compensatory behavior meant to control weight. These behaviors might include self-induced vomiting, laxative abuse, extreme exercise and/or fasting.
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"On any given day, 25 percent of American men and 45 percent of American women diet. However, what has become normal behavior is not without risk." Melinda Parisi, Ph.D.
Program Director, Eating Disorders Unit The Medical Center at Princeton |
Those who suffer from anorexia or bulimia are at high risk for developing a number of medical complications, including:
significant cardiac problems;
gastrointestinal problems;
kidney problems;
osteoporosis;
electrolyte imbalance, and
tooth decay and esophageal damage due to stomach acids erosion.
Women in our society are particularly prone to eating disorders, in part because they are so identified with their bodies and aware of the ways that others respond to them. Food and weight are not the central problems, but often one way of managing or expressing strong emotions.
For example, a woman who is struggling with depression, anger, or other strong emotions may focus on her body rather than the source of these feelings. Some people stumble on this solution accidentally, finding that their emotions diminish when they overeat or restrict their food intake. Some individuals feel more in control of themselves when following a strict dieting regimen.
There is little doubt that societal pressures play a role in the development of eating disorders. On any given day, 25 percent of American men and 45 percent of American women diet. However, what has become normal behavior is not without risk.
Many serious eating problems may begin with a diet. The National Eating Disorders Association notes that 35 percent of "normal dieters" progress to pathological dieting. Of those, 20 to 25 percent progress to having partial or full-syndrome eating disorders.
Given the popularity of models, recording stars, and actors, it is hard to ignore the notion that thinness equates with beauty and desirability in American culture. The barrage of images in magazines and on screen present unrealistic expectations for the majority of women, though. The average American woman is 5’4" tall and weighs 140 pounds. The average American model is 5’11" tall and weighs 117 pounds. Most fashion models are thinner than 98 percent of American women.
However, cultural issues don’t tell the whole story. Eating disorders stem from a variety of emotional, social, biological and familial issues. There is no one "cause" of an eating disorder.
Eating disorders can be treated most effectively when interventions occur early. Warning signs may be seen in a person’s affect, mood, thinking and social relatedness.
The following are warning signs that formal treatment may be needed:
Preoccupation with food, weight or appearance;
Dissatisfaction with one’s body, sometimes coupled with a distorted perception of body shape and signals and a sensitivity to changes in body weight;
Feelings of depression, fatigue, distraction or lack of motivation;
Withdrawal from family or friends, especially during events that involve food;
Visibly noticeable weight loss, sometimes in a short period of time;
Signs of purging, such as frequent bathroom visits after meals;
Binge eating;
Engaging in excessive exercise, and
Menstrual irregularities.
It is important to state that although the majority of people who suffer from eating disorders are girls and women (numbering 5 to 10 million in the United States), one million men and boys currently share this diagnosis. This is no small number and except for menstrual irregularities, males exhibit the same signs and symptoms.
It is not often easy to predict who will develop an eating disorder, but this person will eventually exhibit signs and will require help. Early intervention is key.
If you or someone you know is at risk, please seek evaluation at a program specializing in the treatment of eating disorders, such as The Medical Center at Princeton’s Eating Disorders Program.
Melinda Parisi, Ph.D., is program director for The Medical Center at Princeton’s Eating Disorders Unit. For more information about this program, call (609) 497-4490. This article was prepared in collaboration with Lorraine Seabrook.

