Anorexia Nervosa: A fear of being fat

By Shannnon Seymour
MA, of the Wellness
Centre, who has been a
therapist for over ten
years, and enjoys
working with children
and families

Friday,  July 29, 2005

The second article in a series of three looking at Eating Disorders: Binge Eating, Anorexia Nervosa and Bulimia Nervosa.

I wrote last week about a lesser known eating disorder called Binge Eating Disorder. The response to that article was alarming in a good way. People seemed to soak it up like sponges, indicating to me that awareness and education about eating disorders are needed. It is estimated that 1 percent of American teens have an eating disorder. It may seem like a small percentage, but in a high school of 500 kids, that’s 5 kids, and that’s 5 kids at a risk of dying if not treated.

The two most common types of eating disorders are anorexia nervosa and bulimia nervosa, more commonly referred to as anorexia and bulimia. Both disorders have similar characteristics and it can often be difficult to distinguish the two apart. The common factor in both is a distorted body image and an obsession with what one eats.

Both disorders can affect boys or girls, although it is estimated that about 90% of young people with an eating disorder are female. Unfortunately boys are often not diagnosed until the disorder has advanced because we have a tendency to see this as a girl’s problem, and don’t pay attention to warning signs in boys.

I want to focus today on anorexia. With the recent obsession with teen age movie stars and their pencil thin bodies, it is no wonder there has been an increase in anorexia amongst teenagers in North America. All you have to do is turn on the TV or open a magazine and you are flooded with images of skinny bodies and a clear message that thin is what is beautiful.

People with anorexia have an intense fear of being fat, they restrict their eating to minimal amounts because of this fear. They may count calories, weigh food and exercise obsessively, not out of a desire to be healthy, but out of a fear of gaining weight. Their belief that they are fat has very little to do with the reality of the scale, and although most people with anorexia may have started off on a legitimate diet to drop 5 pounds, the emotional rush that comes from losing weight, and not giving in to feelings of hunger, quickly traps them in a viscious cycle.

Lets face it, we all want to look good and we like for others to notice. For many young people getting noticed is important. The attention that the anorexic young person receives is often a big part of the hook that traps them.

The flip side of this hook, is that once they lose too much weight and people begin to become alarmed, they are generally no longer in control of their eating and are now dealing with a disorder similar to an addiction. I once had a young woman in recovery from anorexia tell me that she was addicted to the feeling she would get in her stomach after not eating all day. It hurt, she would say, but felt good at the same time.

So what can we look for in our young girls and boys:

• Dropping to below 20% normal body weight.

• Losing weight very quickly and without the supervision of a doctor or nutrition specialist.

• Obsessive exercise, several times a day, for prolonged periods of time.
• Anyone who may get extremely irritated if not able to exercise

• Denying feelings of hunger, picking at food, but not really eating.

• Weighing themselves constantly.

• Withdrawing from social activities. Kids will often not want to face their friend’s concerns about their weight loss, so simply stop hanging out with them.

• Anyone who may complain of headaches or dizziness, or feel week & lethargic on a regular basis.

A teenager on a diet is not a sign they will develop anorexia, but a teenager who despite being a normal body weight who is becoming more and more obsessed with being fat and loosing weight may be someone you need to keep an eye on. Because we don’t really fully understand what causes eating disorders we have to be attentive to a host of warning signs which may or may not indicate a problem.

What we do know is that adolescence is a period of life with lots of changes. Emotional changes may lead some young people to feel overwhelmed and out of control. The physiological changes that take place during puberty can also leave young people feeling like they are no longer in charge of their bodies.

Peer pressure and dating also leave a lot of young people feeling unsure of themselves and lacking confidence. It is not uncommon for adolescent girls to gain some weight as their bodies adjust to big changes, and many teens find this frightening.

Control becomes the main factor, as young people attempt to control their bodies and emotions by controlling what they eat and how they exercise.
Anorexia becomes difficult to treat when we think of a few factors. Food is good, and unlike the cocaine addict who can learn to stay away from something socially viewed as bad for them, the person with anorexia can’t stay away from food. Fearful parents also don’t get very far when they try to force their child to eat.

This is a disorder of control, and if you try to force someone to do something they will usually buckle down and try even harder to maintain control.

Recovery from anorexia requires a joint treatment plan that involves nutrition education, counseling and family support. Young people with anorexia need to change the way they think first of all about themselves, as well as their bodies and food.

Shannnon Seymour MA, of the Wellness Centre, has been a therapist for over ten years, and enjoys working with children and families.

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