HealthyLife® Students' Self-Care Guide	Table of Contents
Section I–Common Health Problems

Eating Disorders

“One night, I sat and watched my roommate enjoy eating a bagel with cream cheese and drinking hot chocolate. I wish I could enjoy food that much. I take hours contemplating calories before I can put anything in my mouth.”

Angelina R., University of Texas

Five to 10 million adolescent girls and women have an eating disorder. About 1 million males do. The 3 most common eating disorders are anorexia nervosa, bulimia nervosa, and binge eating disorder. These eating disorders are a coping mechanism. They result in an obsession with food and/or weight; anxiety around eating; guilt; and severe and adverse effects on psychological and physical health. Eating disorders should be taken very seriously.

Causes & Risk Factors

No specific cause has been found for these eating disorders. They affect persons from all socio-economic classes, ages, genders, and ethnic cultures. Risk factors include:

	Possible biological and genetic links, including a family history of eating disorders
	Pressure from society to be thin
	Personal and family pressures
	A history of sexual, physical, or alcohol abuse
	Fear of entering puberty or of sexual relations
	Pressure for athletes to lose weight (sometimes quickly to qualify for an event) or to be thin for competitive sports
	Chronic dieting

Signs & Symptoms

For Anorexia Nervosa:

	Loss of a significant amount of weight in a short period of time
	Intense, irrational fear of weight gain and/or of looking fat. Obsession with fat, calories, and weight.
	Distorted body image. The person feels and sees himself or herself as fat when below normal weight for his or her height and age.
	A need to be perfect or in control in one area of life
	Marked physical effects, including loss of hair, slowed heart rate, low blood pressure, feeling cold due to decrease in body temperature, and absence of menstrual periods in females

For Bulimia Nervosa:

	Repeated acts of binge eating and purging. Purging can be through vomiting; taking laxatives, water pills, and/or diet pills; fasting; and exercising excessively to “undo” the binge.
	Excessive concern about body weight
	Being overweight, underweight, or normal weight
	Frequent dieting
	Dental problems, mouth sores, and chronic sore throat
	Frequent time spent in bathrooms
	Because of binge-purge cycles, severe health problems, such as stomach damage, an irregular heartbeat, and kidney and bone damage can occur.

For Binge Eating Disorder:

	Periods of continuous and sporadic eating that are unrelated to hunger
	Impulsive binging on food without purging
	Repeated use of diets or sporadic fasts
	Weight can range from normal weight to mild, moderate, or severe obesity.

Treatment

Treatment for eating disorders varies with the disorder and its severity. The earlier the condition is diagnosed and treated, the better the outcome. Treatment includes:

	Counseling. This can be in individual, family, group, and/or behavioral therapy.
	Support groups
	Antidepressant medication
	Nutrition therapy
	Outpatient treatment programs or hospitalization, if the condition is severe enough

Questions to Ask

Have you lost more than 10 pounds by binging and purging, fasting, dieting, and/or exercising on purpose, with any of these problems? An intense fear of gaining weight or of getting fat You see yourself as fat even though you are at normal weight or are underweight. You continue to diet and exercise excessively even though you have reached your goal weight.

Do you have recurrent episodes of eating a large amount of food within 2 hours, are not able to control the amount of food you eat, and do you do at least 3 of the following? Eat very fast Eat until you feel uncomfortably full Eat when you are not hungry Eat alone due to embarrassment Feel depressed, disgusted, and/or guilty after you overeat

Do you hoard food, induce vomiting and/or take laxatives and/or water pills right after meals?

Do you have a combination of the following problems with abnormal eating behaviors? An irregular heartbeat A slow pulse and/or low blood pressure Rapid tooth decay Low body temperature; cold hands and feet Thin hair (or hair loss) on the head; baby-like hair growth on the body Dry skin or fingernails that split, peel, or crack Problems with bloating, digestion, or constipation Three or more missed periods in a row or delayed onset of menstruation Periods of depression, lethargy, euphoria, and/or hyperactivity Tiredness, weakness, muscle cramps, tremors Lack of concentration

Self-Care/Prevention

Eating disorders are too complex and physically harmful to be treated with self-care alone. Get professional care. See “For Information, Contact” below. Along with professional care, do the following:

	Eat at regular times during the day. Don’t skip meals; if you do, you are more likely to binge.
	Remember that all foods are okay to eat. Having a balance of foods is the goal.
	Get regular, but moderate exercise 3 to 4 times a week. If you exercise more than your health care provider advises, make an effort to do non-exercise activities with friends and family.
	If you participate in competitive or other sports, consult your coach, trainer, or sports nutritionist for sound advice to be at a healthy weight for your sport. Don’t fast, use laxatives, etc., to “make weight.” The health consequences could be devastating and definitely impair your performance.
	Find success in your work, hobbies, and volunteer activities.
	Learn as much as you can about eating disorders from books and related organizations. (See “For Information, Contact” below.)

Strive for Body Acceptance:

	Accept that bodies come in a variety of shapes and sizes.
	Don’t let your body define who you are. You are much more than just a body.
	You can be your worst critic. Most likely, others find you more attractive than you see yourself.
	Don’t judge others on the basis of their appearance, body size, or shape.
	Accept weekly and monthly changes in weight and shape.
	Explore all the things you have to offer others: recognize your positive qualities.
	Enjoy the people and positive things in your life instead of spending a lot of energy pursuing the perfect image.
	Be aware of your weight prejudice. Explore how those feelings may affect your self-esteem.
	Don’t forget that you are not alone in your pursuit of self-acceptance. It is a life-long process that many people struggle with.

If You Have an Eating Disorder:

	Follow your health care provider’s treatment plan.
	Attend counseling sessions and/or support group meetings as scheduled.
	Identify feelings before, during, and after you overeat, binge, purge, or restrict food intake. What is it that you are hoping the food will do?
	Set small goals that you can accomplish easily and congratulate yourself for every success. This is a process. Accept set backs and learn from them.
	Talk to someone instead of turning to food.
	Work toward the point where weight is no longer something by which you rate your success. Think about your accomplishments, positive personal qualities, and valued relationships.
	Learn to recognize your personal rights and to state how you feel. You have the right to say no, the right to express your feelings and your opinions, and the right to ask to have your needs met.
	Keep a journal of your experiences, feelings, thoughts, and insights, but not about what you eat. The journal is or your eyes only, not for others to read or judge. This is a safe place to be honest with yourself. The journal can also help you identify your “triggers” so that you may prepare yourself to choose alternative strategies.
	Don’t let the scale run your life. Better yet, throw out the scale!

Support groups can be
very helpful for persons
with an eating disorder.

For Information, Contact:

Your school’s Student Health Service, Student Counseling or Mental Health Service

National Eating Disorders Association
206.382.3587
www.nationaleatingdisorders.org

Something Fishy Website on Eating Disorders
www.something-fishy.org

October 11, 2004

Last Updated On: 11/8/05