Anorexia (an-o-REK-see-a) is an eating disorder * involving excessive dieting, preoccupation with food, distorted body image, fear of getting fat, and rapid, significant weight loss. The disorder primarily affects young women.
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Food and nuftilon
Wendy has been taking ballet since she was 5. For as long as she can remember, her dream has been to dance professionally after she graduates from high school. This spring, the young dancer's company will perform the ballet Swan Lake, and Wendy hopes to be chosen for the lead part.
But since she turned 13 last summer, Wendy has noticed that her figure has started to round out. Constantly in front of the mirror in the dance studio, Wendy cannot help seeing every new curve of her body, and she feels self-conscious about how her growing breasts look in her skintight dancewear. She is worried about gaining weight. What if she becomes too heavy for her dance partner to lift? With try-outs for the spring ballet coming up soon, Wendy fears a tinier dancer will be chosen for the lead instead of her. Lately, she has been wishing for the body she had at 11: tiny and light, like the "perfect" ballerina she dreams of being.
* eating disorder is a condition in which a person's eating behaviors and food habits are so unbalanced that they cause physical and emotional problems.
For the past month, Wendy has been on a crash diet, keeping a strict record of everything she eats. She weighs herself morning and night. When there is time, she jogs after dance class. She is relieved to have lost some weight and wants to keep going. She has been allowing herself only the tiniest portions of food and has started to skip lunch altogether. Pleased with her weight loss so far, she decides to cut back to just a small salad for dinner and maybe just a yogurt for breakfast.
Fear of Fat
No one sets out to have anorexia. It takes hold siowiy and might start with a simple desire to lose a few pounds. However, in fully developed cases, people with anorexia are malnourished, often depressed, obsessed with food or exercise, and still are convinced that they are fat.
People with anorexia refuse to eat enough food to maintain normal healthy body weight. Because they fear getting fat, people with anorexia use extreme dieting to lose a lot of weight rapidly. They also may exercise excessively to burn off calories. People with anorexia lose at least 15 to 20 percent of their normal body weight. For example, a girl who starts out at 130 pounds might drop to 100 pounds. Anorexia involves a distorted awareness of the body. People with this condition become preoccupied with thinness and may continue to believe that they are fat even though others around them may see them as unnaturally thin. Over time, the weight that people with anorexia want so desperately to control can become frighteningly out of control for them.
Anorexia is much more common among girls (90 to 95 percent of cases), but boys can have it too. At least 1 in 100 young women in the United States have anorexia, and the disorder usually begins during adolescence. Girls who participate in activities that value thinness, such as dancing, gymnastics, or figure skating, are at higher risk than others for developing anorexia.
What Causes Anorexia?
No single factor causes anorexia. Emotional problems, family difficulties, social pressure, and biological variability all play a role. Contemporary society's glamorization of thinness influences many girls to diet excessively. Once started, some extreme dieting practices can be hard to stop. Girls who have a high need for perfection and control may see dieting as a way to be the prettiest, thinnest, and most perfect of their peers, or to live up their parents' expectations for perfection, or to look as perfect as models or stars they admire. Girls with anorexia tend to come from loving, highly controlled families. A girl who feels that she does not have enough independence may use control of eating as a way to assert herself. In other cases, anorexia may develop because of pressure to be extra-thin when certain sports or activities demand it.
* period , or menstruation (menstroo-AY-shun), refers to the monthly flow, or discharge, of the blood-enriched lining of the uterus that normally occurs in women who are physically mature enough to bear children. Most girls have their first period between the ages of 9 and 16. Because it usually occurs at four-week intervals, it is often called the "monthly period."
Athletes and Anorexia
Girs and young women involved in sports that place a high value on thinness are three times more likely than others to develop anorexia or bulimia (bu-LEE-me-a; binge eating followed by vomiting or other methods of emptying the stomach). A 1992 study conducted by the American College of Sports Medicine estimated that as many as 62 percent of females involved in sports like gymnastics and figure skating struggled with eating disorders. Many well-known athletes have spoken out about their battles with eating disorders, including gymnasts and Olympic gold medal winners Nadia Comaneci and Kathy Rigby. Christy Henrich, who in 1989 was ranked the #2 gymnast in the United States, died from complications of anorexia in 1994 at the age of 22. The pressure to be thin does not appear to be easing up. The average gymnast in 1976 was 5′3″ tall and weighed 105 pounds; the average gymnast in 1992 was 4′9″ tall and weighed 88 pounds.
What Can Happen When Someone Has Anorexia?
Anorexia can cause a number of serious medical problems, such as disturbed heart rhythms and vitamin and mineral deficiencies that can harm vital organs. With anorexia, the body is literally starving. Bone and muscle begin to waste away. Blood pressure and body temperature drop because the body cannot maintain them properly. Hair, nails, and skin become dry and brittle. Girls with anorexia often stop getting their periods * , and overall body growth and development can begin to slow down. Without treatment, anorexia can cause irreversible damage to the body. It can lead to heart failure * and sometimes death. In the United States, about 1,000 young women die each year from complications of anorexia.
What Can Be Done About Anorexia?
There is help for people with anorexia, but it sometimes takes others to convince people with this problem that they need help. Family members or friends may ask about the weight loss. A girl with anorexia may be ashamed or self-conscious and may say she does not have a problem. Many girls with anorexia resist getting help because they do not want to gain weight. Seeking help sooner, rather than later, can be life-saving, but the distorted body image that is part of anorexia can make it hard for people with the condition to realize how dangerously thin they are.
Treatment for anorexia typically includes several parts and a few different health professionals. Treatment may begin with a medical visit to evaluate nutritional status and overall health. The doctor may ask about weight loss, order blood tests, and ask about the patient's eating habits and feelings about her body. Nutritional counseling helps with planning and following a healthy diet. Individual psychotherapy allows the person to talk about feelings and problems that led up to the anorexia, come up with new solutions, and work on body image. Group therapy brings together people with similar concerns to share their experiences and receive support. Medications are sometimes used to reduce anxiety * and depression * . If a person with anorexia is in a severe health crisis, she may have to be hospitalized to stabilize her medical condition and become better nourished before other aspects of treatment can begin.
* heart failure is a medical term used to describe a condition in which a damaged heart can-not pump enough blood to meet the oxygen and nutrient demands of the body. People with heart failure may find it hard to exercise due to the in-sufficient blood flow, but many people live a long time with heart failure.
* anxiety can be experienced as a troubled feeling, a sense of dread, fear of the future, or distress over a possible threat to a person's physical or mental well-being.
* depression (de-PRESH-un) is a mental state characterized by feelings of sadness, despair, and discouragement.
Berg, Frances M. Afraid to Eat: Children and Teens in Weight Crisis. Hettinger, ND: Healthy Weight Journal, 1997.
Brumberg, Joan Jacobs. Fasting Girls: The History of Anorexia Nervosa. New York: Vintage Books, 2000.
Levenkron, Steven. Anatomy of Anorexia. New York: W. W. Norton and Company, 2001.
American Anorexia Bulimia Association, Inc., 165 West 46th Street, Suite
1108, New York, NY 10036.
Eating Disorders Awareness and Prevention, Inc. (EDAP), 603 Stewart
Street, Suite 803, Seattle, WA 98101.
Telephone: (800) 931-2237 for toll-free information and referral hotline http://www.edap.org
National Association of Anorexia Nervosa and Associated Disorders
(ANAD), P.O. Box 7, Highland Park, IL 60035.
, a website sponsored by the Nemours Foundation and the Alfred I. duPont
Hospital for Children, Wilmington, DE, contains information about
anorexia and other eating disorders.