Eating disorders are not just about food. Food is just a tool: a coping mechanism. Anorexia Nervosa, as defined by the Great Ormond Street Criteria for Rating Disorders, combines elements of distorted body image, with a morbid preoccupation with weight and/or shape, food and/or eating. Those who have anorexia are determined to loose weight and maintain an unhealthy, unrealistic body mass through food avoidance, self induced vomiting, excessive exercise or abuse of laxatives.
The authors of Medicinenet.com state the 95% of those affected are female, usually teenage girls. Approximately 1 in 100 adolescent girls has the disorder. Statistically, it is more common in white, urban, upwardly mobile families. Feeding problems in infancy, maternal depression may play a part. Abuse in childhood is common among those diagnosed. For many, the destructive cycle starts with a poor self image and wanting to be thin to be attractive.
Angelina Jolie and Maria Shriver, when seen on the Academy Award broadcast, appear to have crossed the fine line between fashionably thin, sculpted by exercise and skeletal. This distinction is often lost on impressionable young women. They see the glamour, luxurious lifestyle, public admiration and idealized romance with leading men. Being thin, rather than accomplished, seems more attainable. Controlling food consumption is not easy but it does have fairly quick, measurable results. Pursuing an education, honing a talent yields long term benefits but isn’t enough to help someone who needs emotional reassurance and illusion of control NOW.
What can be done? Someone who has anorexia is in denial. By focusing on food and keeping thin, they attempt to “solve” more complicated issues, gain approval, avoid deeper family conflicts. Family and friends may be too preoccupied to notice, unsure what to do, unwilling to start an emotional scene. The best “intervention” may be none at all. Health class in high school, brochures in the principal’s office, freshman orientation, mandatory team meetings; a simple presentation of symptoms and short term consequences in a non judgmental forum without singling out one individual will be beneficial to most. Schools already discuss drug and alcohol abuse; body image issues should be added to the discussion for both boys and girls. Pediatricians need to initiate the conversation. The State of Illinois requires all 6th graders to see a health care provider. What an opportunity to discuss potential preteen issues with parents and kids! Teens in denial don’t seek help.
For those whose illness has progressed to skipped menstrual periods, a more serious 12 step style program may be necessary. Insight Psychological Centers have an informative website (insightforeating.com) as well as downtown Chicago and suburban offices.