Eating Disorders Series: Anorexia

Anorexia is perhaps the most well-known eating disorder.  Horrifying images of ultra-thin celebrities have graced tabloid covers in recent years under sensationalized headlines about rehab and breakdowns.  But alongside these tabloids, there are often “family” or “women’s” magazines touting the latest weight-loss strategies.

These diametrically opposed ideas do nothing to help people understand the dangers of eating disorders and obsessive dieting.  Society continues to cling to the image of an “ideal body” while millions of men and women suffer in silence as they struggle with body image and the myriad underlying causes of eating disorders.

To understand anorexia, it helps to know the clinical definition.  The following criteria must be met for an “official” diagnosis of anorexia:

  • maintaining a body weight that is less than 85% of the expected or healthy weight for a person’s height
  • intense fear of being fat or gaining weight even when the person is already underweight
  • distorted perception of body image that makes it difficult for the person to admit that he or she is losing too much weight
  • in women, the absence of a menstrual period for at least three consecutive cycles

Although these qualifications are standard guidelines for diagnosis, attempting to fit anorexia into such a specific mold can be problematic.  Many people may already be engaging in dangerous behaviors long before they reach the point of “official” diagnosis or qualify as underweight.  By then, irreversible damage may already have been done.

Warning signs of anorexia can appear long before a person meets the official criteria.  The combination of symptoms is different for each person, but typical ones include:

  • intense fear of gaining weight
  • deliberate skipping of meals, overexercising, or undereating in an attempt to lose weight
  • obsession with weighing oneself
  • scrutiny of certain body parts for a disproportionate amount of time
  • pushing food around, hiding food, or rearranging food to make it appear as though it’s being eaten when it isn’t
  • fear of certain foods or irrational refusal to consume certain foods
  • irrational “compensation” when it is perceived that too much food has been consumed, i.e. adding an extra hour of exercise after eating a cookie
  • fixating on caloric intake or intake of certain nutrients such as fat, often to the point of distraction

The terrifying thing about many of these symptoms is that they can begin as seemingly harmless dieting strategies.  Reasonable calorie restriction for weight loss involves calorie counting, which requires the dieter to have a more intense focus on food and food labels.  This coupled with society’s already disproportionate fixation on food, weight, and body shape may lead to obsession, beginning the slippery slope from diet to disordered eating to full-blown eating disorder.

Like all eating disorders, anorexia is rarely just about food or weight.  The difference between someone who stops dieting after reaching their target weight and someone who becomes anorexic involves many underlying factors:

  • obsession with body image, be it through the media or an ideal that is modeled in the home
  • a need for control
  • dissatisfaction with oneself, one’s lot in life, or one’s current situation
  • a history of abuse
  • a family history of eating disorders or other mental illness
  • underlying depression and anxiety or suppressed negative emotions

Whatever the case, in anorexia and other eating disorders, food and weight are simply the mediums in which people attempt to deal with other, deeper life problems.

If left untreated, anorexia can lead to osteoperosis, reduced body temperature, muscle weaknss, cardiovascular complications, digestive complications, and more.  The severity of the disease is real, with one of the highest mortality rates of all mental health conditions.  Between 5% and 20% of anorexics die of complications from the disease, depending on the severity and duration.

Between 0.5% and 1% of American women currently suffer from anorexia.  If that seems like a low number, consider the hundreds of millions of people who live in the US.  Even taking into account the divide between genders, it still amounts to millions of people struggling with anorexia every day.  And although 90-95% of anorexia cases appear in females, it is far from a “woman’s disease.” As many as 10% of anorexics are men.  With up to 60% of Americans on a diet every day and no end in sight when it comes to societal weight fixation, it’s likely that anorexia will continue to be a disturbing trend among both genders.

Dryden-Edwards, Roxanne, MD. “Anorexia Symptoms, Causes, Treatment – How is anorexia diagnosed.” MedicineNet. 1 Dec 2010.
NIMH – Anorexia Nervosa.” National Institute of Mental Health. 1 Dec 2010.
Anorexia Nervosa.” National Eating Disorders Association. 2005. 1 Dec 2010.
Factors that may Contribute to Eating Disorders.” National Eating Disorders Institute. 2004. 1 Dec 2010.
Statistics: Eating Disorders and Their Precursors.” National Eating Disorders Institute. 10 Feb 2008. 1 Dec 2010.

Eating Disorders Series: An Introduction to Disordered Eating

A while back, I came across an article on orthorexia that upset me a great deal.  The gist of it was that orthorexia is a myth created to make healthy eaters look crazy.  Throughout the article, the author misconstrued the qualifications of true orthorexia and failed to grasp the severity of the symptoms that make it different from run-of-the-mill healthy eating.  My initial response was to write my own article on the disease, but lately I’ve been feeling the need to get more in-depth with the entire subject of eating disorders.

To say that orthorexia, or any eating disorder, is a myth is to do a great disservice to people who suffer from very real, very dangerous diseases.  Better-known eating disorders such as anorexia and bulimia affect as many as 10 million women and 1 million men in the US alone¹.  Factor in other disordered eating behaviors and the number jumps to 24 million².  These diseases are real, they’re serious, and they can be deadly.  They affect not only a person’s bodily health, but also his or her mental health, personal relationships, and ability to function in everyday life.  And they are sadly misunderstood.

My goal with this and future posts in this series is to educate about these disorders both through statistical facts and personal experiences.  I spend a lot of my time on this blog sharing pictures of food–as well I should, as it’s largely a food blog–and not much about what goes on when I’m not cooking up a storm.  But before I became a foodie, I was an anorectic with bulimic tendencies.

It started innocently enough, as these things often do, with a legitimate attempt to lose a few extra pounds.  I’ve never been overweight, per se, but I’ve been uncomfortable, and that’s what I was aiming to fix.  I lost about eight pounds and felt better.  Losing five more made me feel even better, and by the time I hauled myself out of denial, I’d lost 24 pounds and was addicted to laxatives.  I was terrified of condiments, sweeteners, and any beverage that had calories.  I wouldn’t taste things I was cooking or lick my fingers when I was baking because I was afraid of consuming extra calories.  I wasn’t emaciated, but I was sick.

The scary thing is that there are a lot of people, women and men, walking around with the same problems I had, problems that society frequently condones.  Everywhere we go, we’re fed conflicting messages of deprivation and excess.  Advertisements try to get us to eat at certain restaurants or order certain dishes without regard for whether or not it’s a good choice.  Magazine articles and TV diet “gurus” launch ever-changing campaigns against “evil” foods and flood the popular consciousness with new tips and tricks on how to lose all the weight that was gained by eating the food touted in advertisements.  There is so much conflicting information out there about health, wellness, body image, and just about everything else relating to food that it can be dizzying at times.

None of this outright causes eating disorders, but it doesn’t help much, either.  Eating disorders are complex diseases, and even the smallest trigger can push a person over the line.  I don’t want to give the impression that eating disorders are all about food, because they’re not; but food is what these diseases revolve around.  Whatever else is going on, it gets expressed in the way an eating disordered person relates to food and what they ultimately do to themselves as a result.

This is going to be a heavy series, so I don’t know how often I’ll add to it, but it’s something I think needs to be put out there.

1 – “Statistics: Eating Disorders and Their Precursors.” National Eating Disorders Association. 2005
2 – Eating Disorders Statistics. The Alliance For Eating Disorders Awareness. 2005