What are Eating Disorders?
Anorexia nervosa and bulimia nervosa are two psychiatric eating disorders characterizedby a preoccupation with food. Those affected with anorexia have a negative self image and a perception of being overweight. While actually often being extremely underweight, they see themselves as fat and have an overwhelming fear of gaining more weight. They develop an aversion to food and refuse to eat. People with bulimia engage in recurrent episodes of binge eating and then purging what they have just eaten, fasting, or exercising to excess. They will eat huge amounts of high-caloric food, often in secret. Both of these disorders are most common in teenage girls and young women. Both disorders have serious medical consequences.

What to look for:

• Usually not obese before the onset of the illness, people with anorexia are often high achievers, but suffer from low self-esteem and often become socially withdrawn.
  
• Saying "no" to food provides a sense of control in their lives and they will actually starvethemselves, causing serious damage to their bodies . . . or even death.
  
• Those with bulimia use self-induced vomiting or laxatives, or may try severe diets which cause extreme weight fluctuations. They may fast or engage in excessive exercise to counteract their overeating. These actions are a serious threat to health and can result in dehydration, hormonal imbalance, mineral depletion and damage to vital organs.
  
• Those suffering from these disorders are extremely successful in hiding them.

What can you do?

Family members of friends may need to intervene in seeking help for these potentially life-threatening disorders since those with the disorders often deny the seriousness of the problem, cannot be objective, and often resist treatment. To gain cooperation in treatment, it is imperative to build trust and a supportive relationship. A complete medical exam is necessary. For the anorexic, it is critical to meet basic nutritional needswhile focusing on positive re-enforcement for weight gain. In both cases, psychotherapy must focus on the body-image obsession. Individual therapy primarily targets self-image and self-evaluation. Often a negative self-image has been created by specific traumatic events during childhood development. Family therapy often can uncover the reinforcers of the anorexic or bulimic behaviors that have been received from significant others. Some medications are helpful and constant monitoring is often necessary.