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April 1999
EATING DISORDERS
By Margaret Stoll, Ph.D.

Are you preoccupied with food, focused on what you have eaten or always planning your next meal? Do you feel controlled by food, eating more than you intend, often in secret, and then feeling guilty or depressed afterward.? Do you try to "undo" overeating through vomiting, exercise or dieting. Or maybe you severely restrict your eating, fearing that eating normally will make you fat. Often such people become significantly underweight while still disliking their bodies and believing they are too heavy. People with eating disorder may have any one or a combination of these symptoms. They also often experience depression, anxiety, work or school difficulties, relationship problems and a host of medical complications. One of the hallmarks of any addictive disorder, including eating disorders, is denial. Therefore, the sufferer is often unaware of or at least defensive or minimizing of their condition. If any of this describes your behavior, you or maybe someone you know, may be among the many people who are struggling with an eating disorder.

The three major eating disorders are Anorexia Nervosa, Bulimia and Compulsive Overeating. Anorexia, developing most frequently in adolescent and young adult women, is characterized by extreme weight loss, fear and avoidance of food and distorted body image. Bulimia, also most common in females, consists of rapidly consuming large quantities of food and then "undoing" this by vomiting, exercise or dieting. Finally, compulsive overeating is the inability to contain food intake to that needed for nutrition. It is the use of food for emotional purposes, resulting in overweight and obesity.

The effects of an eating disorder are far reaching. Anorexia is one of the few emotional disorders that can be life threatening. Severe weight loss and malnutrition can compromise many major bodily systems such as digestion, circulation, reproduction and particularly the cardiovascular system. Bulimia, also potentially fatal due to electrolyte imbalance, can result in dental impairment and esophageal tearing. While the physical consequences of eating disorders seem most dramatic, there is also likely to be serious damage to one's relationships, self image and mood. The ability to function effectively in the world is greatly impaired.

While the origin of an eating disorder is complex it is believed that biological, social and familial factors are involved. Often families of eating disorder patients have difficulty with such issues as independence, recognition, management and communication of emotions, conflict, control, problem-solving and flexibility of family roles. The fact that our society promotes and idealizes thinness as an indication of beauty in women most likely contributes to the disproportionate number of eating disorders in women. Finally the large number of eating disordered patients who also have depressive or anxiety disorders and the fact that these disorders all seem to run in families, is evidence that suggests that there may be a biological predisposition toward developing an eating disorder.

While disordered eating can be extremely distressing and disabling, the good news is that effective treatment is available. This consists of a comprehensive approach including medical, nutritional and psychological help. Psychological treatment often includes individual, group and family psychotherapy with a psychotherapist who specializes in treating eating disorders.

Dr. Stoll is a psychotherapist in practice in Redondo Beach and Glendale. She is a member of the Independent Psychotherapy Network.

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