Archive for September, 2005
Many sports demand low percentages of body fat. In general, men have more lean muscle tissue and less fatty tissue than women do. Males also tend to have higher metabolic rates than females because muscle burns more calories faster than fat does. So women, who in general carry more body fat than men, with slower metabolisms and smaller frames, require fewer calories than men do.
All of these factors mean that women gain weight more easily than men, and women have a harder time losing weight, and keeping it off, than men do. In addition, women have been taught to value being thin. Men, on the other hand, usually want to be big, powerful, and strong; therefore, men are under less pressure to diet than women are — and dieting is one of the primary risk factors for the development of an eating disorder.
* Special concerns: wrestlers and quick weight loss
Everyone who uses drastic and unhealthy methods of weight loss is at risk of dying or developing serious health problems, but the deaths of three college wrestlers in the latter part of 1997 triggered re-examination of the extreme weight-loss efforts common in that sport. Athletes in other sports have died too; runners and gymnasts seem to be at high risk. The deaths of three young men in different parts of the U.S. in the late 1990s has put the problem once again before the public.
News reports say that the three were going to school in North Carolina, Wisconsin, and Michigan. Authorities believe they were trying to lose too much weight too rapidly so they could compete in lower weight classes. The wrestling coach at Iowa State University has been quoted as saying, “When you have deaths like this, it calls into question what’s wrong with the sport. Wrestlers believe that, foremost, it’s their responsibility to make weight, and that mind set may come from the fact that they find themselves invincible.” They share that mind set with others who use dangerous methods of weight loss, both athletes and non-athletes.
Two of the young men were wearing rubber sweat suits while they worked out in hot rooms. One died from kidney failure and heart malfunction. The other succumbed to cardiac arrest after he worked out on an exercise bike and refused to drink liquids to replenish those he lost by sweating. One was trying to lose four pounds, the other six.
Wrestlers share a mentality with people who have eating disorders. They push themselves constantly to improve, to be fitter, to weigh less, and to excel. They drive themselves beyond fatigue. One coach reports that “wrestlers consider themselves the best-conditioned athletes that exist, and they like the fact they can go where no one’s gone before. The instilled attitude among these kids is that if they push and push, it’ll pay off with a victory.” No one expects to die as a consequence of weight loss, but it happens.
When a clamor arose for the NCAA to do something, to make rules prohibiting drastic methods of weight loss, a representative said, “We could make every rule in the book, but we can’t legislate ethics. That’s where the wrestlers and coaches have to put the onus on themselves.”
What price victory? It takes wisdom indeed to realize that in some circumstances the price is too high.
September 2nd, 2005
In a sense, eating disorders are diets and fitness or sports programs gone horribly wrong. A person wants to lose weight, get fit, excel in his or her sport, but then loses control and ends up with body and spirit ravaged by starvation, binge eating, purging, and frantic compulsive exercise. What may have begun as a solution to problems of low self-esteem has now become an even bigger problem in its own right.
* Statistics
Several studies suggest that participants in sports that emphasize appearance and a lean body are at higher risk for developing an eating disorder than are non-athletes or folks involved in sports that require muscle mass and bulk.
Eating disorders are significant problems in the worlds of ballet and other dance, figure skating, gymnastics, running, swimming, rowing, horse racing, ski jumping, and riding. Wrestlers, usually thought of as strong and massive, may binge eat before a match to carbohydrate load and then purge to make weight in a lower class.
One study of 695 male and female athletes found many examples of bulimic attitudes and behavior. A third of the group was preoccupied with food. About a quarter binged at least once a week. Fifteen percent thought they were overweight when they were not. About twelve percent feared losing control, or actually did lose control, when they ate. More than five percent ate until they were gorged and nauseated.
In this study, five and a half percent vomited to feel better after a binge and to control weight. Almost four percent abused laxatives. Twelve percent fasted for twenty-four hours or more after a binge, and about one and a half percent used enemas to purge.
Another research project done by the NCAA looked at the number of student athletes who had experienced an eating disorder in the previous two years. Ninety-three percent of the reported problems were in women’s sports. The sports that had the highest number of participants with eating disorders, in descending order, were women’s cross country, women’s gymnastics, women’s swimming, and women’s track and field events.
The male sports with the highest number of participants with eating disorders were wrestling and cross country.
* Male and female athletes: different risk factors
The female athlete is doubly at risk for the development of an eating disorder. She is subject to the constant social pressure to be thin that affects all females in western countries, and she also finds herself in a sports milieu that may overvalue performance, low body fat, and an idealized, unrealistic body shape, size, and weight. Constant exposure to the demands of the athletic subculture added to those bombarding her daily on TV, in movies, in magazines, and transmitted by peers, may make her especially vulnerable to the lures of weight loss and unhealthy ways of achieving that loss.
Males also develop eating disorders but at a much reduced incidence (approximately 90% female; 10% male). Males may be protected somewhat by their basic biology and different cultural expectations.
View Part II
September 2nd, 2005
* Binge eating disorder
A recent study reported in Drugs and Therapy Perspectives reports that about one percent of women in the United States have binge eating disorder, as do thirty percent of women who seek treatment to lose weight. In other studies, up to two percent, or one to two million adults in the U.S., have problems with binge eating.
* Eating disorders and substance abuse
About 72% of alcoholic women younger than 30 also have eating disorders. (Health magazine, Jan/Feb 2002)
* What about compulsive exercising?
Because anorexia athletica is not a formal diagnosis, it has not been studied as rigorously as the official eating disorders. We have no idea how many people exercise compulsively.
* Body dysmorphic disorder (includes muscle dysmorphic disorder)
Not yet an official diagnosis, but may achieve that status soon. BDD affects about two percent of people in the U.S. and strikes males and females equally, usually before age eighteen (70% of the time). Sufferers are excessively concerned about appearance, body shape, body size, weight, perceived lack of muscles, facial blemishes, and so forth. In some cases BDD can lead to steroid abuse, unnecessary plastic surgery, and even suicide. BDD is treatable and begins with an evaluation by a mental health care provider.
* Subclinical eating disorders
We can only guess at the vast numbers of people who have subclinical or threshhold eating disorders. They are too much preoccupied with food and weight. Their eating and weight control behaviors are not normal, but they are not disturbed enough to qualify for a formal diagnosis.
* Eating disorders in Western and non-Western countries
In a study reported in Medscape’s General Medicine 6(3) 2004, prevalence rates in Western countries for anorexia nervosa ranged from 0.1% to 5.7% in female subjects. Prevalence rates for bulimia nervosa ranged from 0% to 2.1% in males and from 0.3% to 7.3% in female subjects.
Prevalence rates in non-Western countries for bulimia nervosa ranged from 0.46% to 3.2% in female subjects. Studies of eating attitudes indicate abnormal eating attitudes in non-Western countries have been gradually increasing, presumably because of the influence, at least in part, of Western media: movies, TV shows, and magazines. Researchers conclude that the prevalence of eating disorders in non-Western countries is lower than that of Western countries, but it appears to be increasing.
September 2nd, 2005
What is binge eating disorder?
People with binge eating disorder often eat an unusually large amount of food and feel out of control during the binges. People with binge eating disorder also may:
* eat more quickly than usual during binge episodes
* eat until they are uncomfortably full
* eat when they are not hungry
* eat alone because of embarrassment
* feel disgusted, depressed, or guilty after overeating
What causes binge eating disorder?
No one knows for sure what causes binge eating disorder. Researchers are looking at the following factors that may affect binge eating:
* Depression. As many as half of all people with binge eating disorder are depressed or have been depressed in the past.
* Dieting. Some people binge after skipping meals, not eating enough food each day, or avoiding certain kinds of food.
* Coping skills. Studies suggest that people with binge eating may have trouble handling some of their emotions. Many people who are binge eaters say that being angry, sad, bored, worried, or stressed can cause them to binge eat.
* Biology. Researchers are looking into how brain chemicals and metabolism (the way the body uses calories) affect binge eating disorder. Research also suggests that genes may be involved in binge eating, since the disorder often occurs in several members of the same family.
Certain behaviors and emotional problems are more common in people with binge eating disorder. These include abusing alcohol, acting quickly without thinking (impulsive behavior), and not feeling in charge of themselves.
What are the health consequences of binge eating disorder?
People with binge eating disorder are usually very upset by their binge eating and may become depressed. Research has shown that people with binge eating disorder report more health problems, stress, trouble sleeping, and suicidal thoughts than people without an eating disorder. People with binge eating disorder often feel badly about themselves and may miss work, school, or social activities to binge eat.
People with binge eating disorder may gain weight. Weight gain can lead to obesity, and obesity raises the risk for these health problems:
* type 2 diabetes
* high blood pressure
* high cholesterol
* gallbladder disease
* heart disease
* certain types of cancer
What is the treatment for binge eating disorder?
People with binge eating disorder should get help from a health care provider, such as a psychiatrist, psychologist, or clinical social worker. There are several different ways to treat binge eating disorder:
* Cognitive-behavioral therapy teaches people how to keep track of their eating and change their unhealthy eating habits. It teaches them how to cope with stressful situations. It also helps them feel better about their body shape and weight.
* Interpersonal psychotherapy helps people look at their relationships with friends and family and make changes in problem areas.
* Drug therapy, such as antidepressants, may be helpful for some people.
Other treatments include dialectical behavior therapy, which helps people regulate their emotions; drug therapy with the anti-seizure medication topiramate; exercise in combination with cognitive-behavioral therapy; and support groups.
Many people with binge eating disorder also have a problem with obesity. There are treatments for obesity, like weight loss surgery (gastrointestinal surgery), but these treatments will not treat the underlying problem of binge eating disorder.
September 2nd, 2005
Can someone with bulimia get better?
Yes, a person with bulimia can get better. Different types of therapy have worked to help people with bulimia. This may include individual, group, and family therapy. A class of medicines, also used for depression, like Zoloft, has been effective when used with therapy. These medicines change the way certain chemicals work in the brain.
Can women who had bulimia in the past still get pregnant?
Bulimia can cause problems with a woman’s period. She may not get it every 4 weeks or it may stop. But researchers don’t think this affects a woman’s chances of getting pregnant after she recovers.
Does bulimia hurt a baby when the mother is pregnant?
If a woman with active bulimia gets pregnant, these problems may result:
* miscarriage
* high blood pressure in the mother
* baby isn’t born alive
* low birth weight
* low Apgar score, which are tests done after birth to make sure the baby is healthy
* during the delivery, they baby tries to come out with feet or buttocks first
* birth by C-section
* baby is born early
* depression after the baby is born
What should I do if I think someone I know has bulimia?
If you know someone with bulimia, you can help. Follow these steps from the National Eating Disorders Association:
1. Set a time to talk. Set aside a time to privately talk about your concerns with your friend. Be open and honest. Make sure you talk in a place away from distractions.
2. Tell your friend about your concerns. Tell your friend about specific times when you were worried about her eating or exercise behaviors. Explain that you think these things may show a problem that needs professional help.
3. Ask your friend talk about these concerns. She could talk to a counselor or doctor who knows about eating issues. If you feel comfortable, offer to help your friend make an appointment or go with her to her appointment.
4. Avoid conflicts or a battle of the wills with your friend. If your friend doesn’t admit to a problem, repeat your feelings and the reasons for them. Be a supportive listener.
5. Don’t place shame, blame, or guilton your friend. Do not use accusatory “you” statements like, “You just need to eat.” Or, “You are acting irresponsibly.” Instead, use “I” statements like, “I’m concerned about you because you refuse to eat breakfast or lunch.” Or, “It makes me afraid to hear you vomiting.”
6. Avoid giving simple solutions. Don’t say, “If you’d just stop, then everything would be fine!”
7. Express your continued support. Remind your friend that you care and want her to be healthy and happy.
September 2nd, 2005
What is bulimia?
Bulimia (buh-LEE -me-ah) nervosa, typically called bulimia, is a type of eating disorder. Someone with bulimia eats a lot of food in a short amount of time (called bingeing) and then tries to prevent weight gain by purging. Purging might be done in these ways:
* making oneself throw up
* taking laxatives, pills, or liquids that increase how fast food moves through your body and leads to a bowel movement (BM)
A person with bulimia may also use these ways to prevent weight gain:
* exercising a lot
* eating very little or not at all
* taking pills to pass urine
What causes it?
Bulimia is more than just a problem with food. Purging and other behaviors to prevent weight gain are ways for people with bulimia to feel more in control of their lives and ease stress and anxiety. While there is no single known cause of bulimia, many things may have a role in its development:
* Biology. There are studies being done to look at many genes, hormones, and chemicals in the brain that may have an effect on the development of, and recovery from, bulimia.
* Culture. Some cultures in the U.S. have an ideal of extreme thinness. Women may define themselves on how beautiful they are.
* Personal feelings. Someone with bulimia may feel badly about herself, feel helpless, and hate the way she looks.
* Stressful events or life changes. Things like starting a new school or job, being teased, or traumatic events like rape can lead to the onset of bulimia.
* Families. The attitude of parents about appearance and diet affects their kids. Also, a person is more likely to develop bulimia if a mother or sister has it.
What are signs of bulimia?
People with bulimia may be underweight, overweight, or have a normal weight. This makes it harder to know if someone has this disorder. However, someone with bulimia may have these signs:
Uses extreme measures to lose weight
* uses diet pills, or takes pills to urinate or have a bowel movement (BM)
* goes to the bathroom all the time after she eats (to throw up)
* exercises a lot, even during bad weather, tiredness, sickness, or injury
Shows signs of throwing up
* swelling of the cheeks or jaw area
* cuts and calluses on the back of the hands and knuckles
* teeth that look clear
Acts differently
* is depressed
* doesn’t see friends or participate in activities as much
Continue Reading about Bulimia
September 2nd, 2005
Can someone with anorexia get better?
Yes. People with this disorder can get better. The treatment depends on what the person needs. The person must get back to a healthy weight. Many times, eating disorders happen with other problems, like depression and anxiety problems. These problems are treated along with the anorexia and may involve medicines that help reduce feelings of depression and anxiety.
With outpatient care, the patient goes to the hospital during the day for treatment, but lives at home. Sometimes, the patient goes to a hospital and stays there for treatment. Different types of health care providers, like doctors, nutritionists, and therapists, will help the patient get better. These providers will help the patient regain the weight, improve physical health and nutrition, learn healthy eating patterns, and cope with thoughts and feelings related to the disorder. After leaving the hospital, the patient continues to get help from her providers. Individual counseling can also help someone with anorexia. Counseling may involve the whole family too, especially if the patient is young. Support groups may also be a part of treatment. Support groups help patients and families talk about their experiences and help each other get better.
Can women who had anorexia in the past still get pregnant?
It depends. Women who have fully recovered from anorexia have a better chance of getting pregnant. While a woman has active anorexia, she does not get her usual period and doesn’t normally ovulate, so it would be harder to get pregnant. However, she may get pregnant as she regains weight because her reproductive system is getting back to normal. After they gain back some weight, some women may skip or miss their periods, which can cause problems getting pregnant. If this happens, a woman should see her doctor.
Can anorexia hurt a baby when the mother is pregnant?
If a woman with active anorexia gets pregnant, the baby and mother can be affected. The baby is more likely to be born at a low weight and born early. The mother is more likely to have a miscarriage, deliver by C-section, and have depression after the baby is born.
What should I do if I think someone I know has anorexia?
If you know someone like Jen, you can help. Follow these steps from the National Eating Disorders Association:
1. Set a time to talk. Set aside a time to privately talk about your concerns with your friend. Be open and honest. Make sure you talk in a place away from distractions.
2. Tell your friend about your concerns. Tell your friend about specific times when you were worried about her eating or exercise behaviors. Explain that you think these things may show a problem that needs professional help.
3. Ask your friend talk about these concerns. She could talk to a counselor or doctor who knows about eating issues. If you feel comfortable, offer to help your friend make an appointment or go with her to her appointment.
4. Avoid conflicts or a battle of the wills with your friend. If your friend doesn’t admit to a problem, repeat your feelings and the reasons for them. Be a supportive listener.
5. Don’t place shame, blame, or guilt on your friend. Do not use accusatory “you” statements like, “You just need to eat.” Or, “You are acting irresponsibly.” Instead, use “I” statements like, “I’m concerned about you because you refuse to eat breakfast or lunch.” Or, “It makes me afraid to hear you vomiting.”
6. Avoid giving simple solutions. Don’t say, “If you’d just stop, then everything would be fine!”
7. Express your continued support. Remind your friend that you care and want her to be healthy and happy.
September 2nd, 2005
What is anorexia?
Anorexia (a-neh-RECK-see ah) nervosa, typically called anorexia, is a type of eating disorder that mainly affects girls and young women. A person with this disorder has an intense fear of gaining weight and limits the food she eats. She
* has a low body weight
* refuses to keep a normal body weight
* is extremely afraid of becoming fat
* believes she is fat even when she’s very thin
* misses three (menstrual) periods in a row—for girls/women who have started having their periods.
What causes it?
Anorexia is more than just a problem with food. It’s a way of using food or starving oneself to feel more in control of her life and to ease tension, anger, and anxiety. While there is no single known cause of anorexia, several things may contribute to the development of the disorder:
* Biology. Several biological factors, including genetics and other related hormones, may contribute in the onset the disorder.
* Culture. Some cultures in the U.S. have an ideal of extreme thinness. Women may define themselves on how beautiful they are.
* Personal feelings. Someone with anorexia may feel badly about herself, feel helpless, and hate the way she looks. She has unrealistic expectations of herself and strives for perfection. She feels worthless, despite achievements and perceives a social pressure to be thin.
* Stressful events or life changes. Things like starting a new school or job or being teased to traumatic events like rape can lead to the onset of anorexia.
* Families. People with a mother or sister with anorexia are more likely to develop the disorder. Parents who think appearance is very important, diet themselves, and criticize their children’s bodies are more likely to have a child with anorexia.
What are signs of anorexia?
A person with anorexia will have many of these signs:
* Looks a lot thinner
* Uses extreme measures to lose weight
* makes herself throw up
* takes pills to urinate or have a bowel movement (BM)
* takes diet pills
* doesn’t eat or follows a strict diet
* exercises a lot
* weighs food and counts calories
* moves food around the plate; doesn’t eat it
* Has a distorted body image
* thinks she’s fat when she’s too thin
* wears baggy clothes to hide appearance
* fears gaining weight
* weighs herself many times a day
* Acts differently
* talks about weight and food all the time
* won’t eat in front of others
* acts moody or depressed
* doesn’t socialize
Read Anorexia II
September 2nd, 2005
5. Make a commitment to exercise for the joy of feeling your body move and grow stronger, not to purge fat from your body or to compensate for calories eaten.
6. Practice taking people seriously for what they say, feel, and do, not for how slender or “well put together” they appear.
7. Help children appreciate and resist the ways in which television, magazines, and other media distort the true diversity of human body types and imply that a slender body means power, excitement, popularity, or perfection.
8. Educate boys and girls about various forms of prejudice, including weightism, and help them understand their responsibilities for preventing them.
9. Encourage your children to be active and to enjoy what their bodies can do and feel like. Do not limit their caloric intake unless a physician requests that you do this because of a medical problem.
10. Do whatever you can to promote the self-esteem and self-respect of all of your children in intellectual, athletic, and social endeavors. Give boys and girls the same opportunities and encouragement. Be careful not to suggest that females are less important than males, e.g., by exempting males from housework or childcare. A well-rounded sense of self and solid self-esteem are perhaps the best antidotes to dieting and disordered eating.
September 2nd, 2005
By: Michael Levine, Ph.D., and Linda Smolak, Ph.D.
Examine closely your dreams and goals for your children and other loved ones. Are you over-emphasizing beauty and body shape?
1. Consider your thoughts, attitudes, and behaviors toward your own body and the way that these beliefs have been shaped by the forces of weightism and sexism. Then educate your children about
(a) the genetic basis for the natural diversity of human body shapes and sizes, and
(b) the nature and ugliness of prejudice.
Make an effort to maintain positive, healthy attitudes & behaviors. Children learn from the things you say and do!
2. Examine closely your dreams and goals for your children and other loved ones. Are you overemphasizing beauty and body shape?
* Avoid conveying an attitude which says in effect, “I will like you more if you lose weight, don’t eat so much, look more like the slender models in ads, fit into smaller clothes, etc.”
* Decide what you can do and what you can stop doing to reduce the teasing, criticism, blaming, staring, etc. that reinforce the idea that larger or fatter is “bad” and smaller or thinner is “good.”
3. Learn about and discuss with your sons and daughters (a) the dangers of trying to alter one’s body shape through dieting,
(b) the value of moderate exercise for health, and (c) the importance of eating a variety of foods in well-balanced meals consumed at least three times a day.
* Avoid categorizing foods into “good/safe/no-fat or low-fat” vs. “bad/dangerous/ fattening.”
* Be a good role model in regard to sensible eating, exercise, and self-acceptance.
4. Make a commitment not to avoid activities (such as swimming, sunbathing, dancing, etc.) simply because they call attention to your weight and shape. Refuse to wear clothes that are uncomfortable or that you don’t like but wear simply because they divert attention from your weight or shape.
Continue Reading Part II
September 2nd, 2005
While eating disorders may begin with preoccupations with food and weight, they are most often about much more than food.
Eating disorders are complex conditions that arise from a combination of long-standing behavioral, emotional, psychological, interpersonal, and social factors. Scientists and researchers are still learning about the underlying causes of these emotionally and physically damaging conditions. We do know, however, about some of the general issues that can contribute to the development of eating disorders.
People with eating disorders often use food and the control of food in an attempt to compensate for feelings and emotions that may otherwise seem over-whelming. For some, dieting, bingeing, and purging may begin as a way to cope with painful emotions and to feel in control of one’s life, but ultimately, these behaviors will damage a person’s physical and emotional health, self-esteem, and sense of competence and control.
Psychological Factors that can Contribute to Eating Disorders:
* Low self-esteem
* Feelings of inadequacy or lack of control in life
* Depression, anxiety, anger, or loneliness
Interpersonal Factors that Can Contribute to Eating Disorders:
* Troubled family and personal relationships
* Difficulty expressing emotions and feelings
* History of being teased or ridiculed based on size or weight
* History of physical or sexual abuse
Social Factors that Can Contribute to Eating Disorders:
* Cultural pressures that glorify “thinness” and place value on obtaining the “perfect body”
* Narrow definitions of beauty that include only women and men of specific body weights and shapes
* Cultural norms that value people on the basis of physical appearance and not inner qualities and strengths
Other Factors that can Contribute to Eating Disorders:
* Scientists are still researching possible biochemical or biological causes of eating disorders. In some individuals with eating disorders, certain chemicals in the brain that control hunger, appetite, and digestion have been found to be imbalanced. The exact meaning and implications of these imbalances remains under investigation.
Eating disorders are complex conditions that can arise from a variety of potential causes. Once started, however, they can create a self-perpetuating cycle of physical and emotional destruction.
All eating disorders require professional help.
September 2nd, 2005
By Mayo Clinic staff
Eating disorders are characterized by a preoccupation with weight that results in severe disturbances in eating and other behaviors. These disorders include anorexia nervosa, bulimia nervosa and binge eating disorder.
* Anorexia nervosa. Essentially self-starvation, this disorder involves a refusal to maintain a minimally normal body weight. In severe cases, anorexia can be life-threatening.
* Bulimia nervosa. This involves repeated episodes of binge eating, followed by ways of trying to purge the body of the food or of expected weight gain. People can have this condition and be of normal weight.
* Binge eating disorder. This is characterized by frequent episodes of overeating without purging.
Other variations of eating disorders occur, such as purging without bingeing, chewing and spitting without purging, and anorexic behavior with less severe weight loss.
Most Americans with eating disorders are females between the ages of 12 and 25. Males can develop eating disorders, but generally less frequently. The exception is binge eating disorder, which appears to affect almost as many males as females.
Treatments for eating disorders may involve nutrition education, psychotherapy, family counseling and medications.
September 2nd, 2005
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