Anorexia and Bulimia: Signs and Symptoms
By Pat Roles, MSW, RSW, BCATR
Eating Disorders are a Coping Mechanism:
Eating disorders develop for a reason. They do not appear out of the blue. The reason may not be apparent initially though as many youth keep their concerns to themselves and don't share their self-doubt, fears and worries.
Eating disorders develop as an attempt to feel better about something. They may be a way to try to feel more confident, decrease anxiety or worry, feel more in control, or be more socially popular with peers.They may be a way to try to feel more in control when there is a lot of change going on in life or may be triggered by upsetting situations. Many individuals with eating disorders are not very flexible or adaptable and lack self-esteem. They then may find it hard to cope with difficult situations such as: transitions or losses (change to high school, loss in the family through separation, death or moving) or teasing and bullying. Many youth facing eating disorders appear to be successful as childrenwith high academic achievement, excelling in sports or other pursuits on the outside. However, on the inside, they may have a lot of self-doubt, may please others rather than know what their own real needs are, and may not have developed the skills to find a voice to speak up about these inner needs.
Eating Disorders: General Signs to Watch For:
- Preoccupations with food, weight, shape and possibly exercise
- Weighing self a lot
- Obsessed with body shape and size
- Focused on food, recipes, calories, preparing food, food shopping (cooking for others but not eating food themselves)
- Critical of appearance and feeling overweight when not
- Changes in mood with increases irritability or depression
- Social withdraw around food and from friends
- Irregular periods in girls or loss of menstruation
- Guilt around eating
- Spending a long time in the bathroom after meals, evidence of vomiting, use of laxatives, diuretics or diet pills
Signs and Symptoms of Anorexia:
- Drastic weight loss or staying significantly below a healthy weight range for a long period of time
- Significant food restriction, changes in food patterns, such as eliminating food groups such as fat choices or desserts
- Intense fear of gaining weight
- Over-exercise may be an accompanying behavior
- Feeling of being fat when underweight
- Loss of menstruation for females
Signs and Symptoms of Bulimia:
- Binge eating where the individual loses a sense of control
- Purging of food following a binge such as vomiting, use of laxatives, diuretics or excessive exercise
- Secrecy around eating and purging
- Extreme guilt around eating
- Dental and mouth problems from the acidity of vomiting; possibly excessive tooth brushing
- Excessive amounts of food eaten without weight gain
Some people can suffer with a combination of anorexia and bulimia, or anorexia can develop into bulimia. Dieting and food restriction can be triggers for bulimia because the body is starving and this can lead to binge behavior. Binges are then followed by extreme guilt and vomiting provides relief. This release of food can provide not only physical relief but emotional release with a discharge of emotions that are held in.
Treatment for Eating Disorders:
It is important to understand the way these eating practices help each person as it differs between individuals. Because the problem does help in the short run, it leaves people feeling ambivalent about getting totally rid of this problem. In the long run the habit of either food restriction or binging and purging creates another problem requiring attention and is not effective as a coping strategy in the long run with the initial triggers. This means that treatment must include help that addresses the food and physical health but also the emotional health and coping strategies to replace the food habit as a way of coping with distress. Some people suffer with additional problems such as depression that pre-dates the eating disorder, anxiety problems or addiction issues. These all need to be addressed together as they interconnect.
Treatmentinitially involves an assessment with a team who specialize in Eating Disorders. Family Based Therapy is the evidence based practice that is highly recommended with children and youth who are facing an eating disorder. Parents are in a position to assist their son or daughter to deal with the problem. Parents also need help themselves to cope as eating disorders profoundly affect all family members. Parent support groups can also be a great help for parents.
About the Author: Pat Roles, MSW, RSW, BCATR
Pat Roles is a social worker, art therapist and family therapist. She worked with children, youth and families coping with eating disordersfor over 30 years at BC Children's Hospital's Provincial Specialized Eating Disorders Program in Vancouver, BC, Canada. She is experienced with Family Based Treatment (FBT). She has authored articles in this field and has a private practice where she provides individual, couple and family therapy as well as e-counseling.
If you are going through a tough time, e-mail counseling can help you cope. Online counseling is available on this site via e-mail with Patricia Roles who is a registered social worker with over 30 years counseling experience as an individual and family therapist. This is an alternate way to get professional help and support over the internet without leaving your own home. It is less expensive than face-to-face counseling.
Face-to-face counseling available for individuals. couples and families living locally in the Vancouver area.
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