Eating Disorder
An eating disorder is a psychiatric illness characterized by an extreme desire to be thin and an intense fear of weight gain. The fear of weight gain is so great that the individual may feel compelled to either limit food intake to dangerously small amounts or to use other compensatory methods (e.g., laxatives or vomiting) to control weight. The onset of an eating disorder typically occurs during preadolescence or adolescence. There is a particular risk for an eating disorder to develop in middle level school, when students experience dramatic physical changes, are trying to establish their personal identity, and are concerned—often above all else—with being accepted by their peers. Eating disorders are currently clas- sified into two types: anorexia nervosa and bulimia nervosa. Researchers are also investigating another condition, known as a binge-eating disorder, which can be associated with obesity. There also are a number of more obscure eating disorders or conditions that have not been classified in the Diagnostic and Statistical Manual of Mental Disorders, such as anorexia ath- letica (obsessive exercising) and night- eating syndrome, for which there is lit- tle or only emerging research. Following are descriptions of a few of the most common eating disorders:
Anorexia nervosa. This disorder is characterized by a refusal to maintain a minimally normal body weight, which is defined as at least 85% body weight compared to the national norms. There are two types: the restricting type and the binge-eating and purging type. Restricting-type anorexics limit their food intake so severely that their bodies experience starvation. Many restricting-type anorexics initially feel a euphoria that is referred to as the dieter’s high, which eventually disap- pears and is replaced by a constant depressed mood. Binge-eating and purging-type anorexics use inappropri- ate compensatory behaviors, such as self-induced vomiting, after eating.
Bulimia nervosa. Reoccurring episodes of binge eating followed by uch inappropriate compensatory behaviors as self-induced vomiting; misusing laxatives, diuretics, or other medications; fasting; or excessive exer- cise distinguish this disorder. Bulimia is diagnosed twice as often as anorexia, but unlike individuals with anorexia, individuals with bulimia maintain a fairly average body weight, making it difficult to detect on the basis of appearance alone. Individuals with bulimia are more likely to seek out treatment for their illness than those with anorexia.
Binge-eating disorder. An individ- ual with a binge-eating disorder binges in the same way as a individual with bulimia, but does not compensate for the binge. A binge is typically com- posed of foods that are high in fat and sugar content. Although most individ- uals with a binge-eating disorder tend to be obese, some do manage to main- tain an average weight by alternately binging and starving.
Disordered eating. Disordered eating refers to such eating behaviors as restrictive dieting, binging, or purging that occur less frequently or are less severe than those required to meet the full criteria for the diagnosis of an eat- ing disorder.
Anorexia nervosa. This disorder is characterized by a refusal to maintain a minimally normal body weight, which is defined as at least 85% body weight compared to the national norms. There are two types: the restricting type and the binge-eating and purging type. Restricting-type anorexics limit their food intake so severely that their bodies experience starvation. Many restricting-type anorexics initially feel a euphoria that is referred to as the dieter’s high, which eventually disap- pears and is replaced by a constant depressed mood. Binge-eating and purging-type anorexics use inappropri- ate compensatory behaviors, such as self-induced vomiting, after eating.
Bulimia nervosa. Reoccurring episodes of binge eating followed by uch inappropriate compensatory behaviors as self-induced vomiting; misusing laxatives, diuretics, or other medications; fasting; or excessive exer- cise distinguish this disorder. Bulimia is diagnosed twice as often as anorexia, but unlike individuals with anorexia, individuals with bulimia maintain a fairly average body weight, making it difficult to detect on the basis of appearance alone. Individuals with bulimia are more likely to seek out treatment for their illness than those with anorexia.
Binge-eating disorder. An individ- ual with a binge-eating disorder binges in the same way as a individual with bulimia, but does not compensate for the binge. A binge is typically com- posed of foods that are high in fat and sugar content. Although most individ- uals with a binge-eating disorder tend to be obese, some do manage to main- tain an average weight by alternately binging and starving.
Disordered eating. Disordered eating refers to such eating behaviors as restrictive dieting, binging, or purging that occur less frequently or are less severe than those required to meet the full criteria for the diagnosis of an eat- ing disorder.
Symptoms
Physical Symptoms
• Weight loss or a significant fluctuation in weight in a short period of time • Abdominal pain
• Feeling full or bloated
• Feeling faint or feeling cold
• Dry hair or skin, dehydration, blue hands/feet • Lanugo hair (fine body hair)
Behavioral Symptoms
• Dieting or chaotic food intake (binging and restricting)
• Pretending to eat, throwing away food
• Exercising for long periods (exercising for hours every day) • Constantly talking about food
• Frequently making trips to the bathroom
• Wearing baggy clothes to hide a very thin body
• Self-injury
Emotional Symptoms
• Complaints about appearance, particularly about being or feeling fat • Feelings of sadness or making comments about feeling worthless
• Depression
• Perfectionist attitudes
• Family conflicts
Prevalence
Females. Recent estimates are that 3%–10% of young women between the ages of 15 and 29 will develop a clinically diagnosed eating disorder (Polivy & Herman, 2002). Research suggests that about 1% of female ado- lescents have anorexia nervosa and about 4% of college-age females have bulimia. About 1% of women have binge-eating disorders, but about 30% of women who seek weight-loss treat- ment also have binge-eating disorders (Anorexia Nervosa and Related Eating Disorders Inc., 2004). However, the incidence figures are difficult to verify because subclinical eating problems or disordered eating are commonly not diagnosable. Current estimates suggest that disordered eating may occur in 30% of girls and 16% of boys (Scott & Sobczak, 2002).
Males. Although eating disorders appear to be far more common in females, men and boys do suffer from anorexia, bulimia, and binge eating. It appears that in the past 20 years the number of men with eating disorders has increased, and it is estimated that there is 1 man with anorexia or bulim- ia for every 10–15 women with anorexia or bulimia, 1 man with anorexia for every 4 women with anorexia, and 1 man with bulimia for
• Weight loss or a significant fluctuation in weight in a short period of time • Abdominal pain
• Feeling full or bloated
• Feeling faint or feeling cold
• Dry hair or skin, dehydration, blue hands/feet • Lanugo hair (fine body hair)
Behavioral Symptoms
• Dieting or chaotic food intake (binging and restricting)
• Pretending to eat, throwing away food
• Exercising for long periods (exercising for hours every day) • Constantly talking about food
• Frequently making trips to the bathroom
• Wearing baggy clothes to hide a very thin body
• Self-injury
Emotional Symptoms
• Complaints about appearance, particularly about being or feeling fat • Feelings of sadness or making comments about feeling worthless
• Depression
• Perfectionist attitudes
• Family conflicts
Prevalence
Females. Recent estimates are that 3%–10% of young women between the ages of 15 and 29 will develop a clinically diagnosed eating disorder (Polivy & Herman, 2002). Research suggests that about 1% of female ado- lescents have anorexia nervosa and about 4% of college-age females have bulimia. About 1% of women have binge-eating disorders, but about 30% of women who seek weight-loss treat- ment also have binge-eating disorders (Anorexia Nervosa and Related Eating Disorders Inc., 2004). However, the incidence figures are difficult to verify because subclinical eating problems or disordered eating are commonly not diagnosable. Current estimates suggest that disordered eating may occur in 30% of girls and 16% of boys (Scott & Sobczak, 2002).
Males. Although eating disorders appear to be far more common in females, men and boys do suffer from anorexia, bulimia, and binge eating. It appears that in the past 20 years the number of men with eating disorders has increased, and it is estimated that there is 1 man with anorexia or bulim- ia for every 10–15 women with anorexia or bulimia, 1 man with anorexia for every 4 women with anorexia, and 1 man with bulimia for
What To Do?
Unfortunately, it is difficult to treat advanced cases of eating disorders. The prognosis for recovery is best when an eating disorder is diagnosed and treated early. Treatment requires a combination of medical interventions and psychotherapy and can take an extended period of time. One recent review of the treatment literature found that one-third of individuals with an eating disorder continue to meet clinical diagnostic criteria for an eating disorder five years after their initial diagnosis.
The role of school personnel in supporting students who have been diagnosed with an eating disorder depends entirely on the individual treatment plan developed by the student’s treatment team (e.g., physician, mental health professional, and nutri- tionist) and parents. Because school staff members are not equipped to treat eating disorders and students’ privacy is paramount, staff members’ involvement is often limited. However, staff members can be aware of stu- dent’s needs and identify someone that the student should go to if he or she needs help.
Taken from: NASP online
The role of school personnel in supporting students who have been diagnosed with an eating disorder depends entirely on the individual treatment plan developed by the student’s treatment team (e.g., physician, mental health professional, and nutri- tionist) and parents. Because school staff members are not equipped to treat eating disorders and students’ privacy is paramount, staff members’ involvement is often limited. However, staff members can be aware of stu- dent’s needs and identify someone that the student should go to if he or she needs help.
Taken from: NASP online
Resources
There are many resources and community supports available to address such concerns:
4 Girls Health http://www.4girls.gov
4 Girls Health was created to help girls between the ages of 10 and 16 learn about health, growing up, and other issues they may face.
Anorexia Nervosa and Related Eating Disorders, Inc. (ANRED) http://www.anred.com ANRED is a nonprofit organization that provides information about anorexia ner- vosa, bulimia nervosa, binge-eating disorder, and other food and weight disorders.
Body Positive--http://www.bodypositive.com
Body Positive’s mission is to empower people of all ages to celebrate their natural size and shape instead of what society promotes as the ideal body.
Eating Disorders Awareness and Prevention (EDAP) http://www.nationaleatingdisorders.org
EDAP provides information to individuals affected by eating disorders as well as information about innovative prevention and education programs. Healthtouch Online http://www.healthtouch.com. Healthtouch brings together valuable information from trusted sources on such topics as medications, health, diseases, supplements, and natural medicine.
American Obesity Association (AOA) http://www.obesity.org/subs/childhood/prevention.shtml AOA provides resources, statistics, research, and advocacy information on preventing and treating obesity in adults and children.
National Eating Disorders Association (NEDO) http://www.kidsource.com/nedo. NEDO’s mission is to eliminate eating disorders and
body dissatisfaction through education, referral and support services, advocacy, training, and research.
4 Girls Health http://www.4girls.gov
4 Girls Health was created to help girls between the ages of 10 and 16 learn about health, growing up, and other issues they may face.
Anorexia Nervosa and Related Eating Disorders, Inc. (ANRED) http://www.anred.com ANRED is a nonprofit organization that provides information about anorexia ner- vosa, bulimia nervosa, binge-eating disorder, and other food and weight disorders.
Body Positive--http://www.bodypositive.com
Body Positive’s mission is to empower people of all ages to celebrate their natural size and shape instead of what society promotes as the ideal body.
Eating Disorders Awareness and Prevention (EDAP) http://www.nationaleatingdisorders.org
EDAP provides information to individuals affected by eating disorders as well as information about innovative prevention and education programs. Healthtouch Online http://www.healthtouch.com. Healthtouch brings together valuable information from trusted sources on such topics as medications, health, diseases, supplements, and natural medicine.
American Obesity Association (AOA) http://www.obesity.org/subs/childhood/prevention.shtml AOA provides resources, statistics, research, and advocacy information on preventing and treating obesity in adults and children.
National Eating Disorders Association (NEDO) http://www.kidsource.com/nedo. NEDO’s mission is to eliminate eating disorders and
body dissatisfaction through education, referral and support services, advocacy, training, and research.