To Your Health:

Eating Disorders

By Nancy DiMarco, Ph.D.

At the annual meeting of the American College of Sports Medicine in St Louis, I came upon a fellow member who had developed an eating disorder. She was skeleton thin, her hair was wispy without any sheen and she was wearing a sweater while St Louis was experiencing 90-plus degree weather.

How do these things begin and how do they have such a tenacious hold on their captives?

Eating disorders are real, treatable medical problems and not caused by lack of self-will or desire. When self-critical thoughts and emotions about appearance and food affect eating and interfere with normal body functioning and normal body composition, that person is a candidate for a full-blown eating disorder.

The three most common types of eating disorders are anorexia nervosa, bulimia nervosa and binge eating disorder.

With anorexia nervosa, the individual deprives him or herself of food, striving to be thin. Their weight drops well below normal for their age and height. And in women, their menstrual cycle stops for three consecutive months.

Persons with bulimia nervosa often show signs of weight fluctuations but rarely the extreme weight loss of anorexia. Bulimia nervosa is characterized by binge eating often followed by purging — vomiting, laxative use, enemas, diuretic use or compulsive exercising. Although bulimia is not as “noticeable” because the person usually maintains a normal body weight, it is as dangerous as anorexia. Persons struggling with either anorexia or bulimia have a distorted body image.

Symptoms of binge-eating disorder can include recurrent episodes of eating much faster than normal, eating past the point of feeling comfortable, eating when not hungry, eating alone because of embarrassment about how much food you are consuming and then feeling disgusted with yourself for what you have just done. Purging behaviors, however, do not follow binge-eating disorder. Many people with this disorder are overweight.

A fourth type of eating disorder involves persons who do not meet all the diagnostic criteria for any specific eating disorder. For example, women who meet all the criteria of anorexia but have regular menstrual periods, or meet all the criteria of bulimia except that binge eating or purging behaviors occur less than twice a week. Accompanying the eating disorder, these persons are often depressed, anxious and may practice substance abuse.

There is no one factor that contributes to the onset of an eating disorder, but rather a grocery list of associated conditions. Examples include family expectations or pressures to succeed (even subtle ones), physical, emotional and even sexual abuse, perfectionist personality traits, dieting and elite performance in competitive sports such as gymnastics, rowing, running or wrestling.

What are the consequences of eating disorders? The following list is definitely not exhaustive but includes the most important ones.

Dehydration often occurs as the condition advances; the brain can atrophy and elicit such symptoms as dizziness, fainting, confusion, agitation, difficulty concentrating and loss of memory.

Anorexia may lead to delayed growth and puberty, loss of the menstrual cycle which often leads to low bone mass, irregular heartbeat, slow heart rate, dangerously low blood pressure and body temperature, low white cell count, chronic constipation, hair loss and nail destruction. Close medical supervision or even hospitalization is often required.

The major medical complications found in bulimics include electrolyte imbalances that can often provoke heart arrhythmias, menstrual cycle irregularities, enlarged parotid glands caused by the constant vomiting, destruction of dental enamel and cavities because of the presence of hydrochloric acid from the stomach in the mouth and bowel problems often associated with excess laxative use or performing enemas.

Obesity is the chief, long-term medical complication of bulimia that can then lead to a whole host of problems including high blood pressure, diabetes, and heart disease. The most severe consequence is death.

Between 5 to 10 million women and up to 1 million men in the United States are in a life or death battle with an eating disorder, according to the National Institute of Mental Health. One athlete who lost her battle with eating disorders was Christy Heinrich.

In 1988, a U.S. gymnastics judge told the elite gymnast that she was too fat and should lose weight if she wanted to be a member of the Olympic team. Idle comments from individuals in powerful positions are often all that is needed to push a vulnerable athlete over the edge into an eating disorder.

Christy resorted to anorexia and bulimia that eventually claimed her life at age 22. Christy weighed 47 pounds and when she died of multiple organ failure.

Dr. Nancy DiMarco is a research professor in the Department of Nutrition and Food Sciences, the nutrition coordinator for the Institute for Women's Health and coordinator of the master's program in Exercise and Sports Nutrition at Texas Woman's University. She can be reached at ndimarco@twu.edu.

Anorexia Danger Signs

• Significant weight loss
• Continual dieting
• Poor body image or saying she is fat even after weight loss
• Fear of weight gain
• Lack of menstrual cycle
• Preoccupation with food, calories, nutrition and/or cooking
• Eating in isolation
• Compulsive exercise
• Insomnia
• Brittle hair and nails
• Fine body hair
• Cold all the time/ wearing extra clothing
• Depression and social withdrawal

Bulimia Danger Signs

• Binge eating
• Purging by dieting, fasting, vomiting, exercise
• Abuse of laxatives, diuretics
• Frequent use of bathroom after meals
• Calluses on fingers from frequent vomiting
• Teeth erosion/cavities
• Swollen cheeks or glands
• Preoccupation with body weight
• Depression or mood swings
• Heartburn
• Abuse of drugs/alcohol/sex/ shoplifting

If any of these are noticed, please seek help immediately. The sooner treatment is initiated, the sooner that individual can be on the road to recovery.

For Further Information Contact:

Roy Kron
Director of News and Information
Tel: (940) 898-3456
e-mail: rkron@twu.edu