As a woman, I have seen this one swept under the rug far too often. Me? I’m an open book. But I feel that this needs to be spoken of more, and people need to teach their children more. Back in the 80’s we had those cheesy after school specials that taught us how scary these were. Unfortunately, it didn’t help us to open up about it. Today, in the age of computers, I see so very little talk about eating disorders. So let’s help rectify that…
Anorexia: http://www.allianceforeatingdisorders.com/portal/dsm-anorexia#.VSHpC5NTvIU
DSM-5 Diagnostic Criteria
1. Restriction of energy intake relative to requirements leading to a significantly low body weight in the context of age, sex, developmental trajectory, and physical health.
2. Intense fear of gaining weight or becoming fat, even though underweight.
3. Disturbance in the way in which one's body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight.
Bulimia: http://www.allianceforeatingdisorders.com/portal/dsm-bulimia#.VSHrDJNTvIU
DSM-5 Diagnostic Criteria
- Recurrent episodes of binge eating characterized by BOTH of the following:
- Eating in a discrete amount of time (within a 2 hour period)large amounts of food.
- Sense of lack of control over eating during an episode.
- Recurrent inappropriate compensatory behavior in order to prevent weight gain (purging).
- The binge eating and compensatory behaviors both occur, on average, at least once a week for three months.
- Self-evaluation is unduly influenced by body shape and weight.
- The disturbance does not occur exclusively during episodes of anorexia nervosa.
Binge Eating Disorder: http://www.allianceforeatingdisorders.com/portal/dsm-bed#.VSHsk5NTvIU
DSM-5 Diagnostic Criteria
- Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
- eating, in a discrete period of time (for example, within any 2-hour period), an amount of food that is definitely larger than most people would eat in a similar period of time under similar circumstances
- a sense of lack of control over eating during the episode (for example, a feeling that one cannot stop eating or control what or how much one is eating)
- The binge-eating episodes are associated with three (or more) of the following:
- eating much more rapidly than normal
- eating until feeling uncomfortably full
- eating large amounts of food when not feeling physically hungry
- eating alone because of feeling embarrassed by how much one is eating
- feeling disgusted with oneself, depressed, or very guilty afterward
- Marked distress regarding binge eating is present.
- The binge eating occurs, on average, at least once a week for three months.
- The binge eating is not associated with the recurrent use of inappropriate compensatory behavior (for example, purging) and does not occur exclusively during the course Anorexia Nervosa, Bulimia Nervosa, or Avoidant/Restrictive Food Intake Disorder.
Feeding or Eating Disorders Not Elsewhere Classified: http://www.allianceforeatingdisorders.com/portal/osfed#.VSHwZJNTvIU
- Atypical anorexia nervosa: All of the criteria for anorexia nervosa are met, except that despite significant weight loss, the individual's weight is within or above the normal range.
- Bulimia nervosa (of low frequency and/or limited duration): All of the criteria for bulimia nervosa are met, except that the binge eating and inappropriate compensatory behaviors occur, on average, less than once a week and/or for less than 3 months.
- Binge-eating disorder (of low frequency and/or limited duration): All of the criteria for binge-eating disorder are met, except the binge eating occurs, on average, less than once a week and/or for less than 3 months.
- Purging Disorder: Recurrent purging behavior to influence weight or shape (e.g., self-induced vomiting, misuse of laxatives, diuretics, or other medications) in the absence of binge eating.
- Night eating syndrome: Recurrent episodes of night eating, as manifested by eating after awakening from sleep or by excessive food consumption after the evening meal. There is awareness and recall of the eating. The night eating is not better explained by external influences such as changes in the individual's sleep-wake cycle or by local social norms. The night eating causes significant distress and/or impairment in functioning. The disordered pattern of eating is not better explained by binge-eating disorder or another mental disorder, including substance use, and is not attributable to another medical disorder or to an effect of medication.
That is a great deal of information to take in, isn’t it? The thing to remember is this: Eating Disorders are REAL, and they are dangerous. These can cause major damage not just to a person’s body, but to the family as well.
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Media doesn't help, with all these photoshopped pictures of models and celebrities on everything from books to movies. “Thigh gap” is really a thing people worry about. (Forget asking, I have thunder thighs. I can’t walk through the desert in corduroys without starting a fire.) The stress these days is too much on size and not enough on quality. My 6yo is listed as obese, yet if she were 12 and the same weight and height, she’d be perfect. There is something very wrong with this system!
Bullying doesn’t help. It adds pressure on people to present a picture perfect image consistently. It simply isn’t possible.
Is it any wonder our children are committing suicide by food? Because, truly, that is what this is. It is self-harm in its most basic form, and it is swept under the rug daily.
The two we do hear about most are anorexia nervosa and bulimia. The rest listed above? How many of you knew all of those classifications existed? It is my aim to educate not just myself, but all of you as well.
Anorexia is, simply, refusing to eat. Caloric intake is closely monitored, and they try to go as far as they can between meals as possible, taking only enough to ease the pain of hunger, in order to continue losing weight they don’t need to lose. They may even over-exercise in order to burn off the few calories they do eat.
Some warning signs may include:
- Significant weight loss
- Distorted body image
- Intense fear/anxiety about gaining weight
- Preoccupation with weight, calories, food, etc.
- Feelings of guilt after eating
- Denial of low weight
- High levels of anxiety and/or depression
- Low self-esteem
- Self-injury
- Withdrawal from friends and activities
- Excuses for not eating/denial of hunger
- Food rituals Intense, dramatic mood swings
- Pale appearance/yellowish skin-tone
- Thin, dull, and dry hair, skin, and nails
- Cold intolerance/hypothermia
- Fatigue/fainting
- Abuse of laxatives, diet pills, or diuretics
- Excessive and compulsive exercise
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Understand, please, that these behaviors are NOT HEALTHY! This type of behavior is not good for your health, and can lead to some nasty side effects.
Health Complications May Include
- Amenorrhea (cessation of menstrual cycle)
- Abnormally slow and/or irregular heartbeat Low blood pressure
- Anemia
- Poor circulation in hands and feet
- Muscle loss and weakness (including the heart)
- Dehydration/kidney failure
- Edema/swelling
- Memory loss/disorientation
- Chronic constipation
- Growth of lanugo hair (fine, white hair similar to that on a newborn baby)
- Bone density loss/Osteoporosis
We are talking heart, liver, kidney, reproductive, and bone damage. Brain damage. This is nasty shit here. But as bad as the physical damage can be, so can the damage to the family.
Bulimia, in its simplest definition, is binging and purging. Someone diagnosed as bulimic will binge, eat until they are overfull, then purge everything they took in, either by throwing up or taking laxatives, or both.
Some warning signs of bulimia may include:
- Binging and purging
- Secretive eating and/or missing food
- Visits to the bathroom after meals
- Preoccupation with food
- Weight fluctuations
- Self-injury
- Excessive and compulsive exercise regimes — despite fatigue, illness, or injury
- Abuse of laxatives, diet pills, and/or diuretics
- Swollen parotid glands in cheeks and neck
- Discoloration and/or staining of the teeth
- Broken blood vessels in eyes and/or face
- Calluses on the back of the hands/knuckles from self-induced vomiting
- Sore throat
- Heartburn/reflux
- Feelings of shame and guilt
- Self-criticism and low self-esteem
- High levels of anxiety and/or depression
Jessie’s daughter, Sophie, was diagnosed with bulimia 2 years ago at the age of 13. Her story is a hard one, and one I refuse to cut apart here. Jessie tells her heart wrenching story quite well on her own.
It started off rather subtle. Random bouts of refusing to eat because she was either not hungry at the moment, or suddenly hated what I made for diner, despite previously loving it— and late night binging. I’m not talking about a quick snack like a bologna sandwich, but full out egg sandwiches with cheese and hash browns, cheeseburgers and fries, even pancakes and eggs. Full meals. And to make it worse, she didn’t eat but a bite or two! I would get so mad because she was not only eating so late at night, which I told her was unhealthy, but she was also wasting food. But I allowed it most of the time because I felt guilty she hadn’t eaten her supper. So I let her cook and eat at will.
After a few weeks she seemed to develop constant stomach problems. Diarrhea, pain, and vomiting all hours of the day and night, even at school. I took her to the doctor, worried. Of course, the first thing I mentioned to the doctor was her appetite at night. I hate to say it, but I was pissed about it. Even after I had told her to quit stuffing her face at night, she continued to anyway. So I snitched on her to the doctor in hopes the good ol’ doc would take my side. The doc did, and because preliminary exams and test showed there was nothing abnormal going on with Sophie medically, concluded that her late night eating (usually heavy in grease), even if just a bite or two, wasn’t settling in her stomach right, causing the diarrhea and vomiting.
I resigned to staying up late, to ensure she’d stop sneaking into the kitchen to eat. I felt shitty for it, like I was starving my child. But I had to, she was still getting sick and I blamed the food. Over the next few doctor appointments through the next three months, nothing changed. She was still getting sick, and this time, it wasn’t from eating greasy meals at night. I was certain. I began to suspect the worst. Stomach cancer, ulcers, female cancers…anything to explain the sickness. Even the school nurse had noticed and was riding my ass.
It wasn’t until the fourth or fifth appointment it dawned on me that Sophie feared the scale. Her eyes would tear up when she stepped on the scale, she’d even argued once that being weighed all the time was stupid and she didn’t want to. The realization there was something serious going on in her head hit me when she stepped off of the scale the last time and asked the nurse “Should I weigh that much still after all the puking I’ve been doing?”
The nurse, having known Sophie practically since birth, got real silent, her eyes round with concern. “How many times do you vomit a day, Sophie?”
Sophie refused to answer, just shrugging. The nurse took us to the exam room and left us. A few minutes later, the doctor came in. She didn’t look happy. She began to ask questions about my daughter’s diet. Truthfully, I was insulted—being accused of neglect. It took me a few minutes to realize they were setting Sophie up.
But the real shocker happened when Sophie finally broke down and admitted she was the reason she’d gotten so sick. She admitted that she enjoyed food too much, and her best attempts to not eat at all to lose weight only made her hungrier. So she began doing the next best thing to not eating… barfing. And not just with her finger at the back of her throat, but with Ipecac Syrup as a stimulant. She’d take a swallow every morning and every night to keep up the purge. It took the doctor all of two seconds to sigh and diagnose Sophie with bulimia. Unfortunately, the use of Ipecac Syrup at a constant level had damaged my daughter’s stomach lining, and it would take almost a year to repair that damage. Although, it will never be completely the same. She still suffers from random fits of pain and sickness to this day.
Jessie covers some effects of bulimia here, but let me also include a list of others.
- Electrolyte imbalances that can lead to irregular heartbeat and seizures
- Edema/swelling
- Dehydration
- Vitamin and mineral deficiencies
Gastrointestinal problems
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- Chronic irregular bowel movements and constipation
- Inflammation and possible rupture of the esophagus
- Tears in the lining of the stomach
- Chronic kidney problems/failure
- Tooth decay
But, again, they fail to mention the toll this takes on the family. Again, Jessie gives the best description possible to what happens inside the family unit when faced with an eating disorder.
Honestly, I was furious! My first words were “Are you stupid?” It didn’t dawn on me that my daughter had a serious mental illness at this point. Yes. Bulimia is a mental illness, for those who don’t realize it. All I could hear was she was making herself sick, and could have killed herself. I looked her over, not understanding what the hell was going on inside that obviously messed up head of hers. She is beautiful, perfect. How in the world could she think so little of herself? But obviously, she didn’t believe it.
If I could take my stupid question back, I would for the obvious reason above. What Sophie did wasn’t out of idiocy or on a whimsy. I know now she was suffering.
Sophie received some pretty heavy therapy and counseling, including a week stay in a mental facility for teens. This was to not only ensure she was eating and not throwing up anymore, but to monitor her body as she began the recovery from the Ipecac abuse, and also outline a plan for further counseling.
She still sees a counselor every three months, along with a regular “weigh in” appointment with her pediatrician.
Food is the center of many families. Holidays, birthdays, vacations, and even just family time baking cookies. Even after two years of no relapse, I can’t trust Sophie not to binge and purge. If she gets up after a meal, I follow. Even her older sister and brothers spy if I can’t. It can lead to a lot of tension, because she is aware of what we are doing.
Aside from special occasions, goodies are rarely brought into the house. And if they are, I make sure I never buy more than needed for one serving per kid and adult. Once it’s opened, there is no more for later. Fruits and veggies are always on hand for snacking, and we no longer cook with grease. If the family decides we need a greasy meal, we visit a greasy spoon kind of restaurant for an occasional meal. As a whole, no one in the family eats after 8 pm, therefore there is no temptation to grab a late night burger for Sophie. Also, all medications, even the freaking Tum-Tums are locked up where only I, their dad, and grandma know the combo.
The best advice I can give is to realize that it is a mental illness. Your family member isn’t just suffering from bad feelings, or feelings of inadequacy. They are experiencing a disillusion that robs them of not only self-esteem, but themselves. Understand that they can rationalize abusing their body while they slowly kill themselves just to be “perfect” is not something they do lightly. It took me a while to realize that Sophie knew what she did was dangerous, but she would rather face that danger, and yes, even death, to achieve what she believed was the only option she had to become what everyone else deemed as ideal.
As a mother, I felt like a failure, and still do. I hate that I can’t trust her anymore, and even though I still let her enjoy an occasional weekend at a friend’s, I panic all the time. Luckily, the parents of her friends are supportive and keep an eye on her for me. But still, I worry.
I also often wonder if there was something I said or did to induce her illness. Did I not tell her enough how beautiful she is? How perfect she is? I know I did, a lot, but did she not believe me? Could the one time I teased her about having a big butt been the start of it all? What could I have done to prevent it? But mostly, what happens when she’s grown and I can no longer protect her from herself?
Go ahead, take a moment to dry those eyes. I’ve read it over several times and still find myself tearing up. And to Jessie: I’m sure many would agree with me, you are not a bad mother! I’d hug you if I could, but we’ll have to stick with virtual hugs for now.
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- Eating large quantities of food, without purging behaviors, when not hungry
- Sense of lack of control over eating
- Eating until uncomfortably/painfully full
- Weight gain/fluctuations
- Feelings of shame and guilt
- Self-medicating with food
- Eating alone/secretive eating
- Hiding food
- High levels of anxiety and/or depression
- Low self-esteem
May I say, BED does not always mean the the person binging is fat. This could, I believe, also include people having trouble gaining weight, those who think they are too skinny. Yes, those people exist, though we rarely see it.
Unfortunately, BED has health risks as well, besides just the obvious weight fluctuations. Obesity does not mean BED is present, though. Be careful when trying to self-diagnose, you may not have all the facts. Some medical complications of BED include:
- Overweight or obese
- Type II Diabetes
- Osteoarthritis
- Lipid abnormalities (Including increased cholesterol)
- Increased blood pressure
- Chronic kidney problems
- Gastrointestinal problems
- Heart disease
- Gallbladder disease
- Joint and muscle pain
- Sleep apnea
As I preach with any disorder, respect to the people and families affected by these disorders must be given when writing about them. These are serious and real disorders, and cause so very much damage to the individual as well as the family and friends. Research the disorder you choose thoroughly. Read stories written by those who have lived and are living with them.
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And we do need more heroes and heroines with these disorders. We need people writing about this, we need more spotlight on something that can so deeply affect so many. But most of all, we need to rid these disorders of the shameful stigma they seem to have grown. There is no shame to being diagnosed with an eating disorder!
And let me say it again, to make sure it sticks: There is no shame in being diagnosed with an eating disorder!
Shame means there is some sort of ability to not do the action. The problem here is that the ability isn’t quite there. These people often know they are doing wrong. They know it will hurt them. Yet they can’t seem to stop themselves. It is not an attention seeking device, or a way to purposely embarrass their families. Many times it can be inherited.
People with eating disorders need love, understanding, compassion, and support. Therapy is often needed to help cope with the anxieties and depressions that often come with the eating disorder. But support from family and friends is needed. Love, and understanding.
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Blaming the media does nothing, either. Sure, they show us pictures that are photoshopped and make these pictures seem like they are perfection. However, would media be behaving like this if we didn’t allow it? What are our behaviors on social media? Do we continue to repost these pictures with comments on how beautiful, perfect, and desirable these photoshopped pictures are? Our own behaviors, our social media actions, and even our shopping habits form what the media shows us. Buying magazines of these photoshopped men and women encourage the media. Sales are booming, so why change?
I digress (and now have ideas for three more posts). If, for some reason, you believe you or a family member or friend has an eating disorder, I beg of you to seek help. I’ve found the following websites via Goggle. These are just a sample of the wealth of information and help available though. Of course, I have my usual disclaimer here.
Disclaimer: I am not a therapist. I have not taken any classes, nor do I have a degree. I am writing this from my standpoint based on my personal experiences and research. I beg of you, if you think you may have a Depressive Disorder, speak with a doctor immediately.
No matter what, suicide is not an option. If you are thinking of harming yourself, seek help. Talk to a doctor, go to the ER, or even call the National Suicide Prevention Lifeline: 1 (800) 273-8255
Find help here:
NEDA Help for those diagnosed as well as family
Eating Disorders Anonymous (EDA)
National Association of Anorexia Nervosa and Associated Disorders (ANAD)
Families Empowered and Supporting Treatment of Eating Disorders (F.E.A.S.T)
Bulimia.com Tons of resources for all
A Google search will pull up more resources, these are just a sampling of what is available.
NEDA Help for those diagnosed as well as family
Eating Disorders Anonymous (EDA)
National Association of Anorexia Nervosa and Associated Disorders (ANAD)
Families Empowered and Supporting Treatment of Eating Disorders (F.E.A.S.T)
Bulimia.com Tons of resources for all
A Google search will pull up more resources, these are just a sampling of what is available.
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