Eating Disorders and Body Image Disturbance

Along with the following information, we encourage you to examine why so many people are Dying to Be Thin.

The most common eating disorders on college campuses are Anorexia Nervosa and Bulimia. Persons with Anorexia Nervosa deliberately attempt to lose weight through self-starvation. Even though they may be extremely underweight, they see themselves as "fat," deny any problem with their eating habits, and will resist any efforts made to get them to eat or return to a more healthy weight.

 Persons with Bulimia engage in frequent, often daily binge eating in which they eat very large amounts of food, often in secret. They will then try to counteract the binge by purging, which may involve self-induced vomiting, use of laxatives, or prolonged fasting and exercise. Persons with Bulimia feel out of control in the cycle of bingeing and purging. Both of these disorders occur more frequently in young women, with Bulimia being the more common. It is estimated that one in twenty college-age women have an eating disorder. Both disorders may have serious medical consequences.

 While many persons with Anorexia Nervosa or Bulimia deny the problem and are reluctant to seek help, they often come to the attention of friends and family. A direct, caring, and nonjudgmental expression of concern about their health by friends and family is often a vital first step in enabling persons with eating disorders to seek appropriate treatment. Help is available in the form of individual psychotherapy, medical and nutritional counseling, and self-help support groups. With proper help, persons with an eating disorder can learn to stabilize their eating patterns, maintain a healthy weight, and become less preoccupied with food.

 Many Americans believe that thinner is better. People with eating disorders believe it so deeply that their weight and dieting success become the measure of their self-esteem. Thinking that eating is the cause and result of many of their problems, they become trapped in a vicious cycle of repeated ritualistic and rigid behavior focused on food.

The most common eating disorders include anorexia nervosa (self-starvation), and bulimia (bingeing and purging). Some experts also consider compulsive overeating an eating disorder.

Anorexics are often thin to the point of emaciation, but are afraid to gain weight. They may have symptoms caused by severe weight loss: dry skin and hair, cold hands and feet, general weakness, constipation and digestive problems, insomnia, and amenorrhea (loss of menstrual periods). As the weight loss progresses, more severe problems may develop such as increased susceptibility to infections, stress fractures, ketosis (severe chemical imbalances), and weaknesses of the heart muscle that can lead to death.

 Bulimics may be of average or slightly above average weight, usually do most of their bingeing and purging secretly, and have rapid weight gains and losses. They purge through self-induced vomiting, abusing laxatives and diuretics, fasting, or overexercising, and are subject to medical problems caused by their purging methods as well as their eating habits. Medical problems include dehydration, constipation and digestive disorders, severe dental problems, and muscle weakness. As bulimia progresses, ulcers and life-threatening heart irregularities may develop.

Many anorexics may periodically binge and purge like bulimics. They suffer from a combination of anorexic and bulimic symptoms.

Compulsive overeaters are usually overweight and may become obese. As their weight increases they may begin to suffer from shortness of breath, high blood pressure, and joint problems. If they become severely obese, their problems can progress to osteoarthritis and life-threatening disorders such as heart and gall bladder diseases and diabetes.

What is food abuse? Overeating---binge eating---trash diets ---fad dieting---fasting. These are only a few samples of the ways people may use and abuse food. We are continually confronted in newspapers, magazines and TV, with ads imploring and encouraging us to buy, prepare and eat all kinds of food and beverages. The single easiest method to enjoy the "good life" is to eat, eat, eat! To eat in abundance and whatever one chooses has become a benchmark of success, an outward symbol that one has arrived. At the same time we are encouraged and often pressured by others and ourselves to be thin and maintain perfect figures. We seem to be assaulted by food merchandisers at one moment and by fashion designers and figure salons the next. It boils down to the conflict between enjoying great quantities and varieties of food, while at the same time remaining pencil thin. The paradox is hard to manage for many people, and often results in one of the eating problems identified above.

The anxious striving to be thin is supported by an irrational societal belief, which goes something like this: "being thin equals happiness and success." The irrationality of this belief becomes apparent, as we objectively look around us and notice that some thin people are unhappy while some heavy people are quite happy and content. Most importantly, people come in a variety of body types! This understanding can help us to begin to re-evaluate our own relationship to food. 

• Overeating: A tendency to consume more calories than is necessary to maintain normal body weight. This problem is often triggered by stress and may be physiologically based or a result of learned eating habits.
• Trash Diets: By "trash" we mean the steady consumption of questionably nutritious foods such as chips, soda, candy, cake, or cookies in quantities that account for a high percentage of a person's daily caloric intake.
• Fasting: A person may fast for reasons other than diet, but in this context we mean the avoidance of all caloric intake for periods of hours or days as means of weight control.
• Fad Dieting: The practice of consuming only one food or food group (i.e. fruits) or beverage (water) as a means of weight control. May include periods of fasting , with or without diet pills.
• Binge Eating: The tendency to consume large amounts of food (in excess of 2000 calories) at one time. The occurrence may be accidental or premeditated. If premeditated the binge may be followed by purging, using laxatives and diuretics, or fasting to avoid weight gain. This is known as bulimia.

Most everyone has tended to misuse food at one time or another, in one of the ways just described, and most of us have tried one or more techniques for weight control. Can you place yourself in any of these categories? Do you tend to combine one or more such as overeating followed by fasting, or bingeing on certain foods following a fad diet of cauliflower and prune juice?!

Take a moment to listen to these strategies and judge for yourself just how much food interferes with your daily routines. Just how disruptive to your life is food and eating? Note which of the following statements apply to you.

1. I daydream a lot each day about food.
2. If I get nervous or anxious while I'm studying I go to the refrigerator to look for food.
3. I'm preoccupied with my weight and my appearance and don't think I look good in my clothes.
4. I'm more uptight than I would like to be around others because of my weight/appearance.
5. I'd like to start an exercise program but I'm embarrassed about how I would look in a swim suit or jogging shorts.
6. I tend to deal with feeling lonely and depressed by eating.

This is only a sample of what people say or do to themselves in the process of relating to food. Do several of these statements apply to you? As stated earlier we all abuse food from time to time. However if several of the terms apply to you, and you find food and the preoccupat ion with food interfering with positive life choices and activities, then you may have an approach to eating which you want to alter.

Here are some general tips which can help you break the food, self-hate, guilt and more food cycle.

1. Refuse to buy into societal expectations about food consumption and appearance. Learn to live moderately and value maintenance of good health over external appearance. Question advertisements you see about appearance and food.
2. Try to be creative about everyday life. Are there new skills you would like to learn or new interests you can develop? Learn to be more assertive, if you need to be. Sometimes binge eating is just an inappropriate way of "stuffing down" anger. Expand your creativity with a new hobby like pottery or photography.
3. Renew your interest in other people. Try to become less preoccupied with yourself, your performance and your appearance.
4. Engage in regular, vigorous exercise. Find a partner to share an exercise program.
5. Find ways to lead a more calm relaxed life. Consider meditation, yoga, relaxation training and other stress reducing activities.

As you can see, some problems in eating can be helped by changing your routine way of doing things. Successful management of food may also involve altering the way you think about food, yourself or societal expectation s about appearance. It also involves developing a permanent pattern of good eating habits which work for you. 

Strategies

Here are some specific strategies to consider. If overeating is your problem: buy limited amounts of food. Don't overstock. Eat slowly. Take twice as much time to eat as you have been. Give yourself permission to stop when you feel full. Fix your plate before sitting down to eat. Do not put extra food on the table. Eat in a different room of your apartment or house. Break up routine habit patterns. Always leave something on your plate uneaten. Allow yourself a small, nutritious snack before bedtime if you want one. Don't read or watch TV while eating.

And if you are into "trash" dieting, here are other strategies: Educate yourself about good nutrition. Eat breakfast, lunch and dinner at regular times. Stabilize your eating habits around healthy foods. Avoid impulse buying at the grocery store. Make a shopping list. Stick to it. Keep healthy snacks at home such as different kinds of fruit and juices. Allow yourself an occasional bag of chips or similar food as you begin to eat more healthily.

If fasting is your problem, these hints might help: question your reasons for your need to be thin. Are there people in your present or past who want you to be thin? Ask yourself, "Why?" Cutting back a bit in a well-balanced nutritional program will lead to more consistent weight control than fasting. Fasting is always followed by a desire to overeat or gorge. A fast which lasts more than a day, sometimes less, may result in negative physical symptoms such as headache, dizziness, fainting and problems concentrating. Moreover, fasting, laxatives, diet pills, and purging can also lower your metabolism. Paradoxically, then you burn fewer calories from the food you eat, thereby working against the very thing you want to achieve.

Many of the same points that were made about fasting hold true for the person who tries exotic diets as a habitual way of relating to food. However, a couple of points might be made.

1. Begin to look back over time and notice the pattern of your dieting schemes. Why haven't they worked? Are you looking for magic?
2. Educate yourself about good nutrition.
3. Agree with yourself to eat three, well-balanced moderate meals a day with a reasonable exercise program for 3 to 6 months. See what happens!

Those of you who are food bingers might want to ask yourself the question "Are there people in my past who insisted that I not eat the foods I binge on and insisted I be thin?" How much anger is there in a binge? Begin to learn that you are in contr ol of your life now and can eat whatever you want. You have that choice. Learn about nutrition and begin to eat three well-balanced meals or perhaps 5 smaller ones throughout the day. Allow yourself to have a small portion of the food yo u like to binge on. Again you are the one who controls how much, when, where. Eat slowly, taste the food. Give yourself permission to stop when you feel full.

Feeling guilty after a binge often leads to a purge which keeps the vicious cycle going. The above tips and strategies may help you in understanding how you personally relate to food and how you might remedy or eliminate problematic eating habits. Accept the full feeling of the binge and learn from it.

Helping a Friend

1. Discuss your concerns with a professional. Learn about eating disorders and available local resources. Your campus or community counseling center is a good place to start.

2. Talk to your friend. Keep the discussion informal and confidential, and focus on your concerns about your friend's health, not weight or appearance. Explain how the problem is affecting your relationship. Mention that eating disorders can be treated successfully. If your friend is able to acknowledge the problem, suggest some resources.

3. Realize that you may be rejected. People with eating disorders often deny their problem because they're afraid to admit they're out of control. Don't take the rejection personally. and try to end the conversation in a way that will allow you to come back to the subject at another time.

4. Know your limits. If you sense that you're getting an gry or impatient, back off. And don't take on the role of counselor or food monitor--it's inappropriate and ineffectual.

A Note to Athletes

What the evidence does show is crash dieting can make you more prone to injury. And it's difficult to give your best if you feel tired, dizzy, irritable, or depressed-all side-effects of rapid weight loss. In a ddition, dieting and weight obsession can lead to anorexia and bulimia.

At some points in your athletic career you may realistically need to slim down. If you determine, with advice from your medical practitioner, that you do need to lose weight, set a realistic goal generally not more than two pounds a week. The United States Olympic Committee says that weight loss is only beneficial to an athlete if "the weight goal and rate of weight loss are realistic and the diet is balanced."

• "BodyLove: Learning to Like Our Looks -- and Ourselves .. A Practical Guide for Women." Author: Rita Freedman, Ph.D. Harper & Row, Publishers, 1989 An exploration of the conflicts women have about their appearance along with step-by-step information as to how we can learn to like our looks and ourselves.
• "Breaking Free From Compulsive Eating." By Geneen Roth.
• "Fat is a Feminist Issue (2 vols., 1982) by Susie Orbach. New York: Berkley Books. A psychological exploration of why so many women are compulsive overeaters.
• "Making Peace With Food: Freeing Yourself from the Diet/Weight Obsession." By Susan Kano. Harper & Row Publishers, 1989. A self-help guide by a woman who struggled with and overcame her own disordered eating behaviors. Contains education on weight and nutrition, self-love and values, and a section for offering support to someone struggling with dieting/weight.
• "The Secret Language of Eating Disorders: The Revolutionary New Approach to Understanding and Curing Anorexia and Bulimia." By Peggy Claude-Pierre. Times Books, 1997. A book describing the author's successful program for treating eating disorders, including myths about eating disorders, the 'negative mindset' of individuals with disordered eating, and stages of recovery.

More information and help is available on the Cornell campus through the Counseling Center (ext. 4292) and through the Student Health Center (ext. 4292).