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Eating Disorders

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Approximately 8 million Americans suffer from some sort of eating disorder. In a culture obsessed with weight, it’s easy to see how the media feeds unrealistic images and ideals about body size and shape. This is significantly affecting how teenage girls and young women are defining their selfworth in terms of their appearance. Their body’s size and shape has come to define who they are. Even though eating disorders are more common with young women, recent studies show an increase of eating disorders (such as anorexia and bulimia) among women in their forties – often as an effort to remain young, attractive, competitive and to retain control. Experts say between one and three million middle aged women in this country have anorexia or bulimia, and one out of every 10 eating disorder patients is over forty. Often, “midlife” events that cause grief or loss, the changing roles of parenting and feeling out of control are the triggers. There are also more and more young men becoming consumed with obsessive exercising and food restriction to attain that impossible physique. According to the Boston College Eating Awareness Team, “One to five percent of all men have seriously unhealthy eating behaviors that would qualify as eating disorders. Ten to 15 percent of people with eating disorders are male.” Eating disorders are extreme expressions of a range of weight and food issues experienced by both men and women.  Two of the most common eating disorders are anorexia nervosa and bulimia nervosa.

Signs and Symptoms

Anorexia Nervosa is characterized by self-starvation and excessive weight loss.

Symptoms include:

  • Refusal to maintain body weight at or above a minimally normal weight for height, body type, age and activity level.
  • Intense fear of weight gain or being “fat”.
  • Feeling “fat” or overweight despite dramatic weight loss.
  • Loss of menstrual periods.
  • Extreme concern with body weight and shape.

Bulimia Nervosa is characterized by a secretive cycle of binge eating followed by purging. Bulimia includes eating large amounts of food in short periods of time, then getting rid of the food and calories through vomiting, laxative abuse or over-exercising.

Symptoms include:

  • Repeated episodes of bingeing and purging.
  • Feeling out of control during a binge and eating beyond the point of comfortable fullness.
  • Purging after a binge.
  • Frequent dieting.
  • Extreme concern with body weight and shape.

Causes of Eating Disorders

Cultural and psychological issues, personality traits and learned behavior all contribute to eating disorders. In addition, some people may have biochemical imbalances that make them prone to these disorders.

The following are some general issues that can contribute to the development of eating disorders:

  • Low self-esteem or feelings of inadequacy.
  • Depression, anxiety, anger, or loneliness.
  • Troubled family and personal relationships.
  • History of being teased or ridiculed based on size or weight.
  • Cultural pressures that glorify “thinness” and place value on obtaining the “perfect body”.

Health Consequences of Eating Disorders

Anorexia Nervosa

  • Reduction of bone density which results in dry, brittle bones.
  • General weakness, constipation and digestive problems, insomnia and amenorrhea.
  • Dry skin and hair, cold hands and feet.
  • Severe dehydration, which can result in kidney failure.
  • Weakness of the heart muscle that may lead to death.

Bulimia Nervosa

  • Electrolyte imbalance that can lead to irregular heartbeats and possibly heart failure and death.
  • Inflammation and possible rupture of the esophagus from frequent vomiting.
  • Tooth decay and staining from stomach acids released during frequent vomiting.
  • Chronic irregular bowel movements and constipation as a result of laxative abuse.
  • Gastric rupture.

Treatment of Eating Disorders

The most effective and long-lasting treatment for an eating disorder is some form of psychotherapy or counseling, coupled with careful attention to medical and nutritional needs. Ideally, this treatment should be tailored to the individual and may vary according to both the severity of the disorder and the patient’s individual problems, needs and strengths. Hospitalization may be necessary for people whose symptoms are particularly severe, and drug therapy may be useful for any underlying longterm depression and anxiety. In addition, many people with eating disorders benefit from education about their basic nutritional needs in conjunction with other forms of help.

Further information may be found at:

Anorexia Nervosa and Related Eating Disorders Inc. –

American Dietetic Association –

National Association of Anorexia Nervosa and Associated Disorders –

Healthy Body Image at any Weight –

Eating Disorder Online Community –

Written by:  Niki Finnila, Physician Assistant, Intern from Central Michigan University. Edited by:  Sue Malone


Finnila, N. (January 2006). Eating Disorders. Mental Health Matters. 3(3).

Gratiot Medical Center: An Affiliate of MidMichigan Health.

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