An 11-year-old girl comes home from school and tells her parents she thinks she’s fat.  A college freshman rarely goes to the cafeteria and spends most of her spare time exercising.  A woman goes through the drive-thru at her favorite fast food restaurant on her way home from work and orders a “combo meal” to eat before she gets home to have dinner with her family.  The scenarios are different, yet they all have something in common.  Each of these individuals may have an eating disorder.

It is estimated that 1 out of 100 females between the ages of 10-20 have anorexia nervosa.  Along with this, 1 out of 25 college-aged females experience bulimia.  Eating disorders do not affect women only, however.  Ten percent of individuals with eating disorders are male.  Eating disorders are not just about food.  They are about body image, self-esteem, relationships, perfectionism, compulsiveness/impulsiveness, and control. Due to medical complications, eating disorders are the deadliest mental illness. In this issue, we will be looking at the types of eating disorders, symptoms of eating disorders and warning signs.  In the next issue, we will explore health consequences and risk factors for eating disorders.

Anorexia nervosa is probably the most well known eating disorder.  Symptoms of anorexia include:

· Self-starvation or purging

· Excessive weight loss (85% of ideal body weight)

· Intense fear of gaining weight

· Loss of menses

· Extreme concern and distortion with body weight and shape

· Counting calories or watching food intake closely

Bulimia nervosa is another common eating disorder.  One misconception about this type of eating disorder is that the individual is underweight.  Individuals with bulimia are often normal weight or overweight.  The most common symptoms of bulimia include:

· Secretive cycle of bingeing and purging (a binge is eating a larger amount of food than normal in a specific time frame.  The person often feels out of control during the binge.  Purging is a way to get rid of food or calories.  People often purge through vomiting, but may also purge through excessive exercise, laxatives, diuretics or diet pills.)

· Frequent dieting

· Concern and distortion with body weight and shape

· Bingeing and purging occurs at least twice a week for three months

The third type of eating disorder is similar to bulimia but without purging.  It is known as Binge Eating Disorder.  Symptoms of binge eating disorder include:

· Periods of uncontrolled, impulsive or continuous eating

· No purging

· May fast sporadically or diet

· Shame and self-hatred after binge

· Variable body weight

Treatment for eating disorders is multi-faceted.  With all the mental and medical issues related to eating disorders, it is important to treat individuals with psychotherapy and medical management.  It is not unusual to also include nutritionists in treatment to assist in recovery. 

Recovery from an eating disorder is possible.  Statistics show that with treatment, 60% of individuals with an eating disorder will make a full recovery.  Twenty percent of individuals who receive treatment will partially recover, while the remaining 20% do not recover.  In fact, even with treatment, 2-3% of individuals with an eating disorder will die.  Without treatment, however, this number increases to 20%.

In order to get appropriate treatment to lead to recovery, it is important to know the warning signs of eating disorders.  Some warning signs include:

· Preoccupation with size and food

· Playing with food

· Using restroom after meals

· Excessive exercise

· Hiding body under baggy clothes

· Doing less activities where food is involved

· Using water to disguise hunger

· Laxative or diet pill use

If you suspect someone may have an eating disorder, the following may be helpful:

· Approach individual with concern

· Discuss what you’ve observed and why this concerns you

· Encourage medical check-up along with psychotherapy with a trained eating disorder therapist

· Talk to the individual’s parents or other adult

· Remember the eating disorder is not just about food

· Encourage positive body image activities

While the number of individuals struggling with eating disorders may be high, with proper intervention, these individuals can learn to have a normal relationship with food again.

Anorexia nervosa is probably the most well known eating disorder.  Symptoms of anorexia include:

· Self-starvation or purging

· Excessive weight loss (85% of ideal body weight)

· Intense fear of gaining weight

· Loss of menses

· Extreme concern and distortion with body weight and shape

· Counting calories or watching food intake closely

Bulimia nervosa is another common eating disorder.  One misconception about this type of eating disorder is that the individual is underweight.  Individuals with bulimia are often normal weight or overweight.  The most common symptoms of bulimia include:

· Secretive cycle of bingeing and purging (a binge is eating a larger amount of food than normal in a specific time frame.  The person often feels out of control during the binge.  Purging is a way to get rid of food or calories.  People often purge through vomiting, but may also purge through excessive exercise, laxatives, diuretics or diet pills.)

· Frequent dieting

· Concern and distortion with body weight and shape

· Bingeing and purging occurs at least twice a week for three months

The third type of eating disorder is similar to bulimia but without purging.  It is known as Binge Eating Disorder.  Symptoms of binge eating disorder include:

· Periods of uncontrolled, impulsive or continuous eating

· No purging

· May fast sporadically or diet

· Shame and self-hatred after binge

· Variable body weight

Treatment for eating disorders is multi-faceted.  With all the mental and medical issues related to eating disorders, it is important to treat individuals with psychotherapy and medical management.  It is not unusual to also include nutritionists in treatment to assist in recovery. 

Recovery from an eating disorder is possible.  Statistics show that with treatment, 60% of individuals with an eating disorder will make a full recovery.  Twenty percent of individuals who receive treatment will partially recover, while the remaining 20% do not recover.  In fact, even with treatment, 2-3% of individuals with an eating disorder will die.  Without treatment, however, this number increases to 20%.

In order to get appropriate treatment to lead to recovery, it is important to know the warning signs of eating disorders.  Some warning signs include:

· Preoccupation with size and food

· Playing with food

· Using restroom after meals

· Excessive exercise

· Hiding body under baggy clothes

· Doing less activities where food is involved

· Using water to disguise hunger

· Laxative or diet pill use

If you suspect someone may have an eating disorder, the following may be helpful:

· Approach individual with concern

· Discuss what you’ve observed and why this concerns you

· Encourage medical check-up along with psychotherapy with a trained eating disorder therapist

· Talk to the individual’s parents or other adult

· Remember the eating disorder is not just about food

· Encourage positive body image activities

While the number of individuals struggling with eating disorders may be high, with proper intervention, these individuals can learn to have a normal relationship with food again.