A variety of complex factors is involved in why people develop such unhealthy relationships with food in the first place
By: Melinda Parisi, Ph.D. in Collaboration with Gloria N. Beck
Despite an unprecedented rise in obesity in this country, American culture is obsessed with being thin.
Every day the American public is bombarded with images of impossibly thin models or celebrities, with information on fad diets and the message that being thin is tantamount to perfection. Is it any wonder, then, that so many Americans fall prey to eating disorders?
Many people occasionally worry about their weight, but for people with an eating disorder, these worries become an obsession that threatens not only their well-being, but their lives, as well.
According to the National Eating Disorders Association, as many as 10 million girls and women and 1 million men in this country battle eating disorders such as anorexia, bulimia or binge eating. While it can affect men and women at any age, it is most prevalent in adolescent girls and young women in their 20s.
On the surface, overcoming an eating disorder seems like it should be as straightforward as resuming normal eating habits. In reality, however, dealing successfully with these potentially life-threatening illnesses is similar to dealing with an addiction it is anything but simple.
A variety of complex factors is involved in why people develop such unhealthy relationships with food in the first place and the reasons have little, if anything, to do with food. Eating disorders are typically more about power than food.
Rigidly controlling weight and what is eaten, or not eaten, can offer those who feel powerless and out-of-control a newfound sense of power and competence. Engaging in abnormal or ritualistic eating habits, such as eating extremely slowly; cutting food into tiny pieces; taking very small bites, or mixing odd foods together, can also become a way of coping with stress or anxiety.
In fact, many people who are diagnosed with an eating disorder suffer from feelings of inadequacy, low self-esteem or helplessness. People who are perfectionists the compulsive straight-A student or star athlete may also be more prone to developing an eating disorder. Fears associated with growing up and poor body image can also add to one’s susceptibility. Anorexia, bulimia or bingeing may also become a way to cope with depression, bipolar conditions or other mood disorders.
Interpersonal factors can also play a part in the development of eating disorders. The symptoms can become a means of self-expression within difficult or dysfunctional family relationships for example, relationships that are either full of conflict or conflict-avoidant. The illness and its symptoms offer a voice, a means of expressing one’s feelings through actions rather than words.
In addition, some people may be more susceptible to eating disorders because of a predisposition in their biological makeup.
According to the National Eating Disorders Association, scientists have recently uncovered an imbalance in certain chemicals in the brain that control hunger, appetite and digestion in some individuals with eating disorders, which suggests a possible biochemical or biological cause. Recent studies have shown that genetics may be a factor in the development of the condition.
Whatever complex interplay of biological, social or psychological factors might be at the root of the problem, it is important to recognize the signs of an eating disorder and to seek prompt treatment.
Much like an addiction, the compulsive behaviors associated with conditions such as anorexia, bulimia and binge eating can become part of every aspect of a person’s life and identity. At this point, it becomes more difficult to give up abnormal eating behaviors, and there is a greater resistance to treatment. Time is a key factor. The longer an eating disorder goes untreated, the more difficult it is to cure.
Rapid weight loss, a preoccupation with food, weight or appearance, and repeatedly indicating dissatisfaction with body image are all signs to watch out for. Mood swings, depression, fatigue or a lack of motivation resulting from poor nutrition can be signs there is a problem. Compulsive exercise (such as working out despite an illness or during bad weather), frequent bathroom visits after meals or social withdrawal particularly from events that involve food are other red flags. For girls, unexplained irregularities with menstruation may also signal a possible eating disorder.
If you suspect that someone you love has an eating disorder, early intervention is important. Have them evaluated by an experienced eating disorders specialist. The most successful treatment involves a multidimensional approach that not only treats the physical symptoms of the disorder, but strives to uncover the root of the problem by identifying underlying issues, and by working through how the eating disorder relates to them.
Treatment for eating disorders varies, but typically involves individual and family counseling to help patients and their family members to learn healthier ways to cope with the issues in their lives. For example, teaching assertiveness skills and the means of communicating more effectively can improve the patient’s self-esteem and offer a newfound sense of competence and control. Treatment may also include medication for patients suffering from depression, anxiety or other associated symptoms. Nutritional counseling and general medical followup are a crucial part of the cure.
It is important to realize that although eating disorders are complex mental and behavioral health issues, and that these disorders can be life threatening, there is reason for hope. With early detection, prompt intervention and comprehensive treatment, people with an eating disorder can recover. If you or a loved one need assistance, or for more information about eating disorders, call the Eating Disorders Program at University Medical Center at Princeton, (609) 497-4490.

