Mason Counseling and Psychological Services

Eating disorders are treatable conditions. Symptoms include a troubled relationship with food characterized by fasting, purging, and/or bingeing behaviors and recurring inappropriate compensatory behavior to reduce or control weight through excessive exercise, laxative misuse, and self-induced vomiting.

Beyond food-related behaviors, people with eating disorders may display a wide range of cognitive and emotional problems, including an intense fear of gaining weight, distress over body size and shape, depression, moodiness, dichotomous thinking, low self- esteem, and perfectionism.

Eating disorders include anorexia nervosa, bulimia nervosa, and many other unspecified types. It is important to see professionals, such as physicians, psychiatrists, psychologists, counselors, and registered nutritionists for accurate diagnosis.

Our society, with its obsession with thinness and obtaining the perfect body, has cultivated the development of eating disorders. Research studies found that 52% of adolescents begin dieting before age 14. Among college females, 78% reported bingeing experiences and 8.2% used self-induced vomiting to control weight.

The following myths about eating disorders add to the problem and prevent individuals from getting treatment for this potentially life-threatening

Myth #1: SINCE WOMEN COLLEGE STUDENTS ARE USUALLY INTELLIGENT AND WELL- EDUCATED, THEY ARE A LOW-RISK GROUP FOR EATING DISORDERS.

On the contrary, college women are a high-risk group. Reportedly, 5% to 20% of college females have eating disorders (See Johnson & Connors, The Etiology and Treatment of Bulimia Nervosa, 1987). "Middle-class adolescents and women in their twenties with a strong orientation toward academic achievement and a traditional lifestyle, including marriage, are most vulnerable. Many are highly intelligent, attractive in appearance, and capable of handling successful careers. Yet traditionally they have abnormally low self-esteem, a desire for perfection, and a sense of loneliness and isolation, and an obsession with food as it relates to body weight" (Boskind-White & White, 1983).

While many women college students are expected to be competitive and successful, they also feel the demand to remain feminine and "desirable." Such demands may create conflicts and overwhelmed feelings. This may be a factor in why they develop problematic relationships with food: sometimes, restricting food intake to attain desirable slimness and femininity and sometimes, indulging in food to comfort emotional distress.

Myth #2: ONLY FEMALES HAVE EATING DISORDERS.

Among the college student population, a reported 1% to 7% of male students suffer from eating disorders; among the general population, the estimate is 5%. Some research findings suggested that males and females with an eating disorder have similar clinical characteristics, such as an obsession with thinness, distorted body image, and emotional problems. They also share similar etiological factors, such as socioeconomic status, family dynamics, and a history of weight disturbance. Although men are considered a low-risk group for eating disorders, partly because they are not under as much social pressure to be slim and thin, we should be aware of the "Pursuit of Fitness" among many men. This may lead to obsessive-compulsive thinking and behaviors, low self- esteem, and distorted body image -- characteristics of eating disorders.

Myth #3: "FATTISM" IS NONEXISTENT. FAT PEOPLE HAVE NO ONE TO BLAME BUT THEMSELVES.

Unfortunately, "fattism" is predominant in our society without our being aware of its existence. Like racism and sexism, fattism is a prejudice based on physical characteristics. Many of us consider fatness equivalent to laziness, dumbness, ugliness, self- indulgence, and lack of will power. Comments such as "Look at that disgusting fat slob with incredibly hugh thighs!" or "If you could lose a few more pounds, you will look great!" are judgmental and unfair. "Fattism" implies narrow-mindedness and an inability to appreciate the variety of body shapes and sizes that are largely predetermined by biological factors such as age, gender, race, and heredity.

Myth #4: REPEATED WEIGHT-LOSS DIETING ENSURES PERMANENT WEIGHT CONTROL.

The fact is repeated weight-loss dieting leads to higher and higher weight gains. Here are three reasons:

1) When the body is faced with constant deprivation, it automatically tries to conserve energy by slowing down the metabolism, instead of continuing to burn body fat. The longer people stay on low calorie diets, the longer it takes for their metabolism to return to normal. Thus, dieting predisposes people to rapid weight gains immediately following the loosening of food restriction.

2) Evidence indicates that when people lose weight, they lose fat and protein, but when they regain, they regain mostly fat.

3) When weight is lost, the fat cells shrink, but when weight is regained, fat cells multiply. These "fattening" effects of weight loss are referred to as "overcompensation" that may mean he intention and effort to lose weight become a "never-win"distress (See Kano's Making Peace with Food, 1989).

Based on the statistics provided by the ANRED, Inc., after 2 years, 95% of dieters regain all their lost weight plus about 10 extra pounds; and after 5 years, 98% of dieters regain all their lost weight plus about 10 extra pounds.

Myth #5: WITH A SENSIBLE DIET AND A STRONG COMMITMENT, EVERYONE (OR, EVERY WOMAN) CAN BECOME AND REMAIN THIN.

This statement implies a couple of faulty assumptions as discussed in Kano's Making Peace with Food (1989). The first faulty assumption is that fatness is caused by lifestyle. The fact is that fatness most often is due to heredity and metabolism and not everyone can be as thin as they want to be, no matter how strong their commitment is. The second faulty assumption is that a sensible diet (i.e., a low calorie diet) can control weight gains. The fact is that such a diet may lead to more weight gain, as mentioned in Myth #4. Through a healthy diet and regular exercise, some weight loss may be expected; however, for most women, no matter how hard they try, they will always be heavier than "model thin." The truism here is that thinness is a prevailing unhealthy obsession in our society and we tend to mislabel thinness as "happy ever after."

Myth #6: EATING DISORDERS CANNOT BE FATAL.

Many of you have heard about people, such as the singer, Karen Carpenter, who have died of anorexia nervosa, an eating disorder characterized by self-starvation and weakened immunity and heart function due to undernutrition. Based on the information provided by the American Anorexia/Bulimia Association, an estimated 1% of U.S. teenagers suffer from anorexia and up to 10% of these will die. Fatal dangers for both anorexics and bulimics include gastric ruptures; cardiac arrhythmias, and heart failure. Many other medical complications are not necessarily fatal, but can lead to permanent physical and neurological damages. For example, in an effort to reduce weight and maintain energy without eating, many individuals with eating disorders turn to laxatives and dieting pills. Side effects of inappropriate use of laxatives are dry skin due to dehydration, abdominal cramping, muscle cramps, and electrolyte imbalances which affect neurological functioning. Daily use of dieting pills may lead to rebound fatigue and hyperphagia, insomnia, mood changes, irritability, and when in extremely large doses, psychosis (Johnson & Connors, 1987).

MYTH #7: ONLY THOSE WHO ARE APPARENTLY UNDERWEIGHT OR OVERWEIGHT MAY HAVE OR WILL HAVE EATING DISORDERS.

Among women who have bulimia nervosa, about 70% of them are normal weight, 15% are underweight, and the other 15% are overweight (Johnson & Connors,1987). This is to say, it is often inaccurate to judge if someone is okay simply by their appearance and weight. What is important to remember is that eating disorders are often characterized by a set of psychological symptoms: distorted body image, obsession with losing weight, distress over body size and shape, perfectionism, and emotional difficulties. These psychological symptoms are usually not reflected by weight status.

MYTH #8: ONLY THE MENTALLY ILL WILL DEVELOP EATING DISORDERS.

The cause of eating disorders is believed to be a combination of biological, psychological, and socio-cultural factors. To date, we know women are much more likely to have eating disorders than men. Women of color may be as vulnerable as Caucasian women to developing eating disorders. Adolescents and young adults are a high-risk group, especially if they are achievement-oriented. Sports or artistic activities -- such as wrestling, gymnastics, and dancing -- that require careful maintenance of body weight often make people prone to eating disorders. Generally speaking, eating disorders can develop in any "ordinary" person. The good news is that eating disorders can be prevented and successfully treated.

Myth #9: BECAUSE PEOPLE WITH EATING DISORDERS TEND TO REMAIN SECRETIVE ABOUT THEIR EATING BEHAVIORS, IT IS EXTREMELY DIFFICULT TO DETECT AND HELP THIS POPULATION.

It is not uncommon for people to engage in bingeing and/or purging behaviors for years before their family or friends notice a problem. Learning about eating disorders may help to detect early warning signs including frequent use of bathrooms right after meals, vigorous exercise, preoccupation with body weight and constant weighing. Knowledge about medical complications, such as hair loss, complaints of sore throat and bloating stomach, fatigue and muscle weakness, tooth decay, and edema, can help to identify this disorder. The most challenging task is to confront the person who denies having an eating disorder. Because so much shame and guilt is involved, acknowledging the problem can be very terrifying. Direct and supportive communications as well as consultation and help from professionals (such as physicians, psychiatrists, psychologists, counselors, and nutritionists) often leads to the successful initiation of the treatment and recovery process.

February, 1995

Campus Resources

For general information, educational brochures, programming, consultation, treatment & referrals please contact:

* Counseling and Psychological Services, Joan Mizrahi Ph.D., Psychologist, SUBI, Suite 364, 703-993-2380

* Health Education Center, SUBI, Suite 255A, 703-993-2829

* Student Health Center, Wagida Abdalla, M.D., Medical Director, SUBI, Suite 299C, 703-993-2830

On-Line Resources

Eating/Body Image Concerns

Mason's Response Team Guide to Eating Disorders and Body Image Concerns

Eating and Body Image Quick Assessment About Face
Renfrew Center Foundation
Eating Disorder Referral and Information Center
National Eating Disorders Association
Anorexia Nervosa and Related Eating Disorders, Inc.
Eating Disorder Resources
Eight traits of Emotional Hunger- University of Texas