Eating Disorders ...
 
What are eating disorders? Eating disorders are generally characterized by obessional thinking about eating and an overwhelming fear of gaining weight. A child with an eating disorder will often follow bizarre rituals to avoid eating or to lose weight, even if they are already seriously underweight. Some of these behaviors can lead to chronic health problems which can ultimately threaten and even end their life. Two of the most common eating disorders are called anorexia nervosa and bulimia nervosa. Some children have symptoms of both. Anorexia Nervosa ... Put plainly, anorexia nervosa is self-starvation. It effects mostly females between 14 and 18 years of age but cases in young males are on the increase. If your is child 15% or more under the average weight for their age and build, he or she may be anorexic. Talk to your doctor. Anorexics are intensely afraid of getting fat, so much so they will avoid food or only eat "safe" foods ... low calorie, fat free foods ... until they become dangerously thin. They can also attempt to lose or keep off pounds by abusing laxatives, diet pills and exercise. Anorexics have a distorted view of their bodies. They see fat where no one else can, as if they are always seeing themselves in a carnival mirror. They may have an excessive need for control; rejecting food and losing weight may give them the feeling like they have control over their lives. Changes or new demands in their lives makes them afraid they can't handle them. They can also be overly self-critical, have an over-developed need to be "perfect," and see normal body size as disgusting. Their self-esteem is often low, causing them to compensate by over-achieving and trying to get everyone to like them. An anorexic cannot stop dieting or exercising, even if everyone tells them they are much too thin.  Behaviors to watch for include: eating only low-calorie and low-fat foods; spend more time playing with their food on their plate instead of eating; cooking only for others; and, cutting their food up into tiny pieces. They may exercise constantly; wear clothes too large to hide their thinness; develop rituals to avoid thinking about food or their hunger; isolate themselves from family and friends; and, become anxious or angry if their exercise routine is disturbed. Some may cause themselves to vomit after eating or abuse laxatives so they won't absorb the food they do eat. The anorexic becomes self-absorbed and totally focused on staying thin. Although presented with all the evidence they are underweight and even dying, the anorexic remains in denial of having an eating disorder. This makes anorexia more difficult to treat. The health consequences of anorexia can include kidney failure and liver damage, anemia, low blood pressure, and heart failure, particularly if they are using emetics ... substances that make them vomit, like Epicac . Physical changes can include: signs of malnutrition, i.e. bones sticking out, ribs showing, and a "shrunken" or hollow look; feeling cold all the time; irregular, delayed or stopped menstruation; dry or brittle hair and nails, or hair loss; dry and rough skin; constant abdominal pain, constipation or bloating; and, stunted growth.Bulimia Nervosa ... Bulimia nervosa is a disorder in which, rather than starving themselves, a person eats large amounts of food at one time and then gets rid of it before it can be digested ... a process called "bingeing and purging." Unlike anorexia, bulimia usually develops between the ages of 15 and 24 years of age, again striking mostly females. Also unlike anorexics, bulimics tend to stay within a normal weight range. Bulimics have a distorted relationship with food. While anxious about their weight, they have a hard time dealing with stress, anxiety and impulse control without turning to food. Although they may spend a great deal of time dieting, stress forces them to give into their food cravings by bingeing. The bulimic may eat from 3,000 to 7,000 calories of food, often within a few hours. Often a binge may take on a frenzied aspect in that they will stuff themselves, hardly chewing or tasting the food, and only stop when the food is gone or they experience pain rather than simply when they get full. Once the binge is over, their sense of shame over their loss of control and  their fear of gaining weight leads the bulimic to purge. Purging can be accomplished by self-induced vomiting or using laxatives to cause diarrhea. They may also abuse diuretics (water pills) to lose weight quickly. Intense periods of exercise and dieting may follow until the next binge occurs, beginning the cycle once more. Behaviors to recognize in the bulimic may include: becoming secretive about or hoarding food; over-spending on food; avoiding eating in front of others; and, spending a lot of time planning for times to binge. They may appear to be very out-going but secretly find themselves quite imperfect and suffer from a poor body image. Unlike anorexics, bulimics are aware they have an eating disorder, making them somewhat easier to treat. Body or health changes may include: tooth decay from stomach acids; slight but rapid weight fluctuations; swelling or puffiness around the lower face and throat; dehydration; irregular menstruation; dizziness and black-outs; constant stomach upset, constipation and sore throats; organ damage; kidney, liver and heart failure; and, death. How can eating disorders be treated? Treatment for eating disorders requires a multidisciplinary approach. It begins with an examination and diagnosis by a physician. If the child is acutely underweight and suffering from related physical problems, they may need immediate hospitalization.  Counseling can help the eating disordered child better understand their relationship with food and how they use it to handle their feelings. It can help uncover the underlying reasons for the child's distorted self-image and need for control. These issues may include depression, anxiety, and childhood physical and/or sexual abuse. Individual and family therapy may be used since an eating disorder in one member, usually effects the whole family ... and vice versa. If you suspect your child has an eating disorder, check with his or her pediatrician or family doctor first. If you're not satisfied, seek specialized help. The resources below may help. National Assoc. of Anorexia Nervosa  and Associated Disorders Box 7 Highland Park, IL 60035 847-831-3438 American Anorexia/Bulimia Assoc. 418 E. 76th Street New York, NY 10021 212-734-1114   Anorexia Nervosa and  Related Eating Disorders Box 5102 Eugene, OR 97405 503-344-1144 (Partially excerpted from Eating Disorders: What you should know about anorexia and bulimia by the American Academy of Pediatrics.)