WOSIB Eating Disorders
Jana's room is her oasis.  It's where she listens to music, does her homework, and talks on the phone to her friends.  It's pretty messy in there- she has clothes piled on the chair, her desk is overflowing with books and papers, and the towering stack of CDs looks like it's about to topple.  For the most part, it looks like a typical teen's room - except for what's under the bed.  That's where Jana keeps her secret stash of snacks and tosses the leftover candy wrappers, chip bags and cookie crumbs.

Jana has just polished off a whole package of cookies and a large bag of chips - and she hasn't even finished her homework yet.  She's searching for more chips to eat while she does her math.  She hates that she's overweight, but she can't seem to stop bingeing on junk food.  Somehow, the food seems to ease her tension.  In the back of her mind, she knows that in an hour or she's going to feel guilty and disgusted with herself, but right now it feels like she just can't stop eating.
What Jana is doing is called binge eating and along with Anorexia Nervosa, and Bulimia they are eating disorders.  On this page you will read about all three eating disorders and along with information and links there will also be a list of places you can contact for help.
Definitions
Anorexia nervosa
Anorexia is an eating disorder characterized by
refusal to maintain a minimally accepted body
weight,
intense fear of weight gain, and distorted body
image.
Inadequate calorie intake or excessive energy
expenditure results in severe weight loss (see also
bulimia and intentional weight loss).
BULIMIA
Bulimia Nervosa is a emotional disorder in which the person has recurrent episodes of binge-eating  and then rid their bodies of the excess calories by purging (self-induce vomiting, misuse of laxatives or diuretics) or by non-purging (excessive exercise, diuretics and or fasting) behaviors. Some bulimics use a combination of purging and non-purging behaviors.
Binge Eating
Consumption of large amounts of food in a short period of time, especially as a symptom of bulimia.
Eating Disorders

Eating disorders are rampant in our society, yet few states in the nation have adequate programs or services to combat anorexia nervosa and bulimia. Only a small number of schools and colleges have programs to educate our youth about the dangers of eating disorders.

Facts

EATING DISORDERS ARE WIDESPREAD AND DESTRUCTIVE
•Eating disorders cause immeasurable suffering for victims and families.
•Eating disorders have reached epidemic levels in America: all segments of society, young and old, rich and poor, all minorities, including African American and Latino
•Seven million women
•One million men
•Victims lose the ability to function effectively -- great personal loss and loss to society

AGE AT ONSET OF ILLNESS:

•86% report onset of illness by the age of 20*
•10% report onset at 10 years or younger
•33% report onset between ages of 11-15
•43% report onset between ages of 16-20

DURATION OF ILLNESS/MORTALITY:

•77% report duration from one to fifteen years*
•30% report duration from one to five years
•31% report duration from six to ten years
•16% report duration from eleven to fifteen years
•It is estimated that six percent of serious cases die
•Only 50% report being cured

COST OF TREATMENT:

•Treatment for anorexia nervosa and/or bulimia is often extremely expensive. Large numbers of victims require extensive medical monitoring and treatment, and therapy generally extends over two years or more.
•Cost of inpatient treatment can be $30,000 or more a month. Many patients need repeated hospitalizations.
•The cost of outpatient treatment, including therapy and medical monitoring, can extend to $100,000 or more.

Better Known Disorders

There are many diseases, disorders, and problem conditions involving food, eating, and weight, but in everyday conversation, the term "eating disorders" has come to mean anorexia nervosa, bulimia, and binge eating
Anorexia Nervosa
Alternative names
Eating disorder - anorexia; Anorexia

Causes, incidence, and risk factors

The exact cause of this disorder is not known, but
social attitudes towards body appearance and family
factors are believed to play a role in its
development. The condition usually occurs in
adolescence or young adulthood. It is more common in
women, affecting 1-2% of the female population and
only 0.1-0.2% of males.

Anorexia is seen mainly in Caucasian women who are
high academic achievers and have a goal-oriented
family or personality. Some experts have suggested
that conflicts within a family may contribute to
anorexia. It is thought that anorexia is a way for a
child to draw attention away from marital problems,
for example, and bring the family back together.

Other psychologists have suggested that anorexia may
be an attempt by young women to gain control and
separate from their mothers. The causes, however,
are
still not well understood.

Prevention
In some cases, prevention may not be possible.
Encouraging healthy, realistic attitudes toward
weight
and diet may be helpful. Sometimes, counseling can
help.


Symptoms
weight loss of 15% or greater below the expected
weight
inappropriate use of laxatives, enemas, or diuretics
(water pills) in an effort to lose weight
self-imposed food intake restrictions, often hidden
absence of menstruation
skeletal muscle atrophy
loss of fatty tissue
low blood pressure
dental cavities may be present with self-induced
vomiting
blotchy or yellow skin
depression may be present in addition to the eating
disorder
most individuals with anorexia nervosa refuse to
recognize that they have an eating disorder (denial)
Signs and tests
Diagnosis is based upon ruling out other causes of
endocrine, metabolic, and central nervous system
abnormalities to explain the weight loss.
Or Just Look Like One
by Analee "Annaleigh" Maria Watts, August 15, 2000

My stomach becomes sallow
and for what, I am still disturbed

and hungry, my heart beats, beats, thuds, hollow...
aching, each beat, beat, beat, hurts more than the next

Should I give into my myself, admit distress?
No, I fight, fed up with fat, and the mutters under breath

Telling myself to stay strong, think of the weight maybe lost
Avoiding food, fat, food, fat, food, fat, failure, at any cost.
Bulimia
BULIMIA
By Victoria Parks


Some bulimics use a combination of purging and non-purging behaviors. The cycle of overeating and purging can quickly become an addictive behavior. Often, the individual will feel a loss of control during over eating and the purging/nonpurging behavior becomes a way of regaining control. During the episodes, the person eats to control overpowering emotions, and is not usually hungry. Bulimia may start out as a simple diet, escalating into a binge/purge cycle that feels very much like an addiction. After many attempts to stop, the eating disorder takes on a life of its own.

WHO SUFFERS FROM BULIMIA NERVOSA:

As with anorexia, bulimia typically begins during adolescence. Most girls who develop an eating disorder are between the ages of 11 and 14 (although they can develop even earlier in some people). At this time in their lives, many girls don't feel as though they have much control over anything; the changes that come along with puberty can make it easy for even the most confident person to feel a bit out of control. The exact cause of bulimia is unknown, but factors thought to contribute to its development are family problems, perfectionist personalities, and an overemphasis on physical appearance. Bulimia may also be associated with depression and occurs most often in adolescent females. And even though it's completely normal (and necessary) for girls to gain some additional body fat during puberty, some girls respond to this change by becoming very fearful of this weight and feel compelled to get rid of it any way they can. Some girls who develop eating disorders are depressed or have low self-esteem, and their anorexia or bulimia gives them some way to handle the stresses and anxieties of being a teen. By controlling their own bodies, people with eating disorders feel as though they can regain some control - even if it is done in an unhealthy way.

Bulemia is more common than anorexia. Bulimia nervosa has been identified primarily in men and women in their teens and 20s, with about 90% women and 10% men (the same as for anorexia) accounting for bulimic patients. Studies using rigorous diagnostic criteria suggest that about 1% to 2% of pre-college and college women are bulimic, although occasional bulimic behavior appears to be much more common.

Although the majority of patients who are currently diagnosed as bulimic are of normal weight, bulimia nervosa may be unrecognized in obese persons. Self-evaluation of one's worth as a person is unduly influenced by body shape and weight. The disordered self-evaluation does not occur exclusively during episodes of Anorexia Nervosa. Some bulemics are also anorexic. If bulimia is accompanied by anorexia, body weight may be extremely low. Because bulimia nervosa has been recognized as a clinical entity for only about 10 years - anorexia has been recognized for 100 years or longer - , more is known about its onset than about its long-term outcome. The vast majority of patients (85%) begin binge eating during a period of dieting.

The affected person is usually aware that her eating pattern is abnormal and may experience fear or guilt associated with the binge-purge episodes. Although the behavior is usually secretive, clues to this disorder include overactivity, peculiar eating habits or rituals, and frequent weighing. Body weight is usually normal, although the person may perceive themselves as overweight. Binge/purge behaviours are coping mechanisms used to control overwhelming emotions. Food and feelings are the same. Unrecognized feelings and unmet needs are stuffed down and thrown up. In the majority of cases of Bulimia, there is a history of sexual abuse. Although these behaviours are self-perpetuating, they are recognized as being abnormal. The person with Bulimia is usually outgoing, which hides the emotional pain. Food has a specialized meaning: comfort, punishment, a reward, an expression of love, anger, control, offering a private world, etc.

SIGNS

What are some of the warning signs of bulimia? The binge-purge cycle may be accompanied by self-deprecating thoughts, depression, and an awareness that the eating is abnormal and out of control. Bulimia may be present when a person frequently shows some of the following warning signs. Evidence of binge-eating, including disappearance of large amounts of food in short periods of time or the existence of wrappers and containers indicating the consumption of large amounts of food. Evidence of purging behaviors, including frequent trips to the bathroom after meals, signs and/or smells of vomiting, presence of wrappers or packages of laxatives or diuretics. The person becomes very secretive about eating. They often create complex lifestyle schedules or rituals to make time for binge-and-purge sessions. There often is a withdrawal from usual friends and activities. Their behaviors and attitudes indicate that weight loss, dieting, and control of food are their primary concerns. The binge eating and inappropriate compensatory behaviors both occur at least twice a week for 3 months. They often have a excessive, rigid exercise regimen, which they pertake in despite weather, fatigue, illness, or injury. They might have calluses on the back of the hands and knuckles from self-induced vomiting. Unusual swelling of the cheeks or jaw area. There is soreness in the mouth, gums and teeth are sensitive to cold and hot. A dental exam may show dental cavities or gum infections (such as gingivitis). The enamel of the teeth may be eroded or pitted because of excessive exposure to acid in vomitus. There may also be discoloration or staining of the teeth. Other signs included swollen glands in the neck, chronic sore throat, fainting spells, and dizziness. Weight fluctuations are only slight, despite eating large quantities of food.

MEDICAL COMPLICATIONS:

In bulimia they include and occur due to bingeing and purging behaviors. They may develop esophageal complications. Esophageal involvement is found in patients who purge through self-induced vomiting, resulting in esophagitis or esophageal ulcers, strictures, or rupture. Esophageal rupture (Boerhaave's syndrome) may develop. Tears in the esophagus are not uncommon, and if it ruptures, it can cause instant death. They can develop calluses on the back of the hand and fingers, salivary gland enlargement, and erosion of dental enamel. Fluid and electrolyte abnormalities, including dehydration , occur frequently and can lead to disturbances of cardiac (heart) conduction and rhythm. Bulimic patients who use ipecac to induce vomiting can develop a potentially lethal cardiomyopathy (heart problem). Infrequent serious complications of repeated vomiting include esophageal or gastric rupture and pneumomediastinum. Long-standing laxative abuse can lead to laxative dependence and severe constipation. Menstrual disturbances often afflict even normal-weight bulimic patients, and in other ways, despite being at a statistically normal weight, these patients may show physiological similarities to underweight anorectic patients. They many develop kidney problems as well. The incidence of affective disorders and other impulsive behavior, such as alcohol and drug abuse, is increased in patients with bulemia. Bingeing and purging causes chronic constipation, broken blood vessels in the eyes, and bags under the eyes. Depression results from intense feelings of being out of control. They may also have these other complications: pancreatitis and hemorrhoids. Bulimia can be extremely harmful to the body. The type of purging behavior used can have varied effects on different body systems.

ACCEPTED TREATMENT:

Bulimia can be successfully treated with a variety of approaches. The physical condition should be looked after first. Depression can sometimes be treated with medication. Therapy with an experienced person in treating eating disorders can replace the binge/purge cycle with more functioning expressions of emotions. Support groups are helpful to alleviate the isolation Bulimia can bring. Nutritional counselling can reaffirm the need for a balanced diet. A dentist may be needed to repair the dental effects of purging. Treatment focuses on breaking the binge-purge cycles. Outpatient treatment may include behavior modification techniques as well as individual, group, or family counseling. Antidepressant drugs may also be used in cases that are coincide with depression.

Self-help groups like Overeaters Anonymous may help some people with bulimia. The American Anorexia/Bulimia Association is a source of information about this disorder. Call for an appointment with your health care provider if you (or your child) are exhibiting behaviors of any eating disorder, including bulimia. The treatment of bulimia should address both physical and psychological needs of the person. The ultimate outcome of treatment is to restore physical health and normal eating patterns. Many times treatment is undertaken by a team of medical, nutritional, and mental health professionals to evaluate the severity and meaning of the symptoms and to both prescribe and provide care. It is essential that team members communicate regularly about the patient and clarify their roles in treatment on an ongoing basis, to the patient and the family, as well as to each other. Bulimia is a chronic illness and many people continue to have some symptoms despite treatment. People with fewer medical complications of bulimia, and who are willing and able to engage in therapy, tend to have a better chance of recovery. Less social and cultural emphasis on physical perfection may eventually help reduce the frequency of this disorder.
Binge Eating
Anorexia nervosa: the relentless pursuit of thinness

Person refuses to maintain normal body weight for age and height.

Weighs 85% or less than what is expected for age and height.

In women, menstrual periods stop. In men levels of sex hormones fall.

Young girls do not begin to menstruate at the appropriate age

Person denies the dangers of low weight.

Is terrified of becoming fat.

Is terrified of gaining weight even though s/he is markedly underweight.

Reports feeling fat even when very thin.

In addition, anorexia nervosa often includes depression, irritability, withdrawal, and peculiar behaviors such as compulsive rituals, strange eating habits, and division of foods into "good/safe" and "bad/dangerous" categories. Person may have low tolerance for change and new situations; may fear growing up and assuming adult responsibilities and an adult lifestyle. May be overly engaged with or dependent on parents or family. Dieting may represent avoidance of, or ineffective attempts to cope with, the demands of a new life stage such as adolescence.
Most of us overeat from time to time, and many people often feel they've eaten more than they should have. Eating a lot of food does not always mean that a person has binge eating disorder. Doctors generally agree that most people with serious binge eating problems often
feel their eating is out of control
eat what most people would think is an unusually large amount of food
eat much more quickly than usual during binge episodes
eat until so full they are uncomfortable
eat large amounts of food, even when they are not really hungry
eat alone because they are embarrassed about the amount of food they eat
feel disgusted, depressed, or guilty after overeating.
Binge eating also takes place in another eating disorder called bulimia nervosa. Persons with bulimia nervosa, however, usually purge, fast, or do strenuous exercise after they binge eat. Purging means vomiting or using a lot of diuretics (water pills) or laxatives to keep from gaining weight. Fasting is not eating for at least 24 hours. Strenuous exercise, in this case, means exercising for more than an hour just to keep from gaining weight after binge eating. Purging, fasting, and overexercising are dangerous ways to try to control your weight.
Binge eating disorder is probably the most common eating disorder. Most people with this problem are either overweight or obese,* but normal-weight people also can have the disorder.

About 2 percent of all adults in the United States (as many as 4 million Americans) have binge eating disorder. About 10 to 15 percent of people who are mildly obese and who try to lose weight on their own or through commercial weight-loss programs have binge eating disorder. The disorder is even more common in people who are severely obese.

Binge eating disorder is a little more common in women than in men; three women for every two men have it. The disorder affects blacks as often as whites. No one knows how often it affects people in other ethnic groups.

People who are obese and have binge eating disorder often became overweight at a younger age than those without the disorder. They might also lose and gain back weight (yo-yo diet) more often.

* The 1998 NIH Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults define overweight as a body mass index (BMI) of 25 to 29.9 and obesity as a BMI of 30 or more. BMI is calculated by dividing weight (in kilograms) by height (in meters) squared.
This is just some information about eating disorders please if any of this sounds familiar to what you are doing please visit some of these links
NaaNad
HEDC
NEDA
NIMH
You can find out more about eating disorders and other mental disorders by contacting the National Women's Health Information Center (800-994-9662)
National Institute of Mental Health
Phone: (301) 443-4513
National Eating Disorders Association.
Phone: (800) 931-2237
Harvard Eating Disorders Center (HEDC)
Phone: (617) 236-7766
National Association of Anorexia Nervosa and Associated Disorders (ANAD)
Phone: (847) 831-3438
Anorexia and Bulimia Support Group