It was not so long ago that eating disorders, such as bolimia and anorexia, were thought to be purely the result of mental conditions. More recently, though, some physical factors have been attributed to these conditions. It is now thought that eating disorders can be triggered by a multitude of factors, in combination, including those of a psychological, behavioural, social, or biological nature.
How Can Yoga Help With Eating Disorders
As with many conditions, eating orders can better be dealt with through a calm and focused mind. Depression and low self esteem are problems often associated with eating disorders, and Yoga can help with both.
It has been proven that Yoga can reduce depression, restoring a state of balance and well being in the individual. Also, there are different yoga practices which encourage heightened levels of self esteem, and promote a positive view of your own body. These are crucial factors with eating disorders, and it has been shown that the application of yoga can significantly increase recuperation and healing. Through the elimination of self judgment, yoga establishes a strong connection between mind and body. This, of course, is the natural state of wellness. By re-establishing this strong connection, mind and body will work in harmony to repair the damage.
Regular yoga practice will increase the overall fitness level of the human body, improving the immune system and giving it a good chance of fighting illnesses. This is helpful with Anorexia, for example, because the sufferer's body will experience lower energy levels, and the condition reduces bone density.
In dealing with eating disorders, the yogic system identifies them as a problem related to the first chakra. There are different yoga poses that can be used to balance it: eg. staff, crab, full wind, and pigeon. By using grounding postures (eg mountain, goddess, standing squat and prayer squat) strength and courage can be increased. What these postures do is to re-establish the strong mind-body connections, and through that connection help overcome many physical obstacles. For anorexia sufferers, most of the yoga back bending poses help reduce depression, while forward bends can calm the spirit and reduce anorexia's effects.
Because the mental state has an important role in eating disorders, meditation can be used successfully to reduce negative and harmful thoughts and feelings. An active, well targeted, meditation practice should prove to be very effective. The yoga poses work best when external factors are shut out, and concentration is allowed to focus on your inner self. Giving special attention to breathing, and also to inner sensations, will transport you to a state of greater awareness and calmness. This new state will allow you to go on further to explore new concepts, and hopefully pursue new goals that may have been impossible before.
As with many medical conditions, being aware of the bulimia or anorexia problem, and showing a constant and strong desire to defeat it, is a great method to reduce their effect. It is likely that an early adoption of yoga practices would make the patient more aware of the problem, thus making a positive contribution to an early cure. However, these yoga techniques are more usually used in the recuperative stages of the illness. That is a pity because, as with all illnesses in which it can be beneficial, yoga works best in the prevention stage, when the negative effects are still low and easier to over come.
Roy Thomsitt is the owner and part author of http://www.routes-to-self-improvement.com
Eating Disorders and the Use of Yoga in Prevention and Treatment
Eating Disorders and Personality Disorders
Some patients develop eating disorders as the convergence and confluence of two pathological behaviours self-mutilation and an impulsive (rather, obsessive-compulsive or ritualistic) behaviour.
Patients suffering from eating disorders either binge on food or refrain from eating and sometimes are both anorectic and bulimic. This is an impulsive behaviour as defined by the DSM and is sometimes comorbid with Cluster B personality disorder, particularly with the Borderline Personality Disorder.
Some patients develop eating disorders as the convergence and confluence of two pathological behaviours: self-mutilation and an impulsive (rather, obsessive-compulsive or ritualistic) behaviour.
The key to improving the mental state of patients who have been diagnosed with both a personality disorder and an eating disorder lies in focusing at first upon their eating and sleeping disorders.
By controlling his eating disorder, the patient reasserts control over his life. This newfound power is bound to reduce depression, or even eliminate it altogether as a constant feature of his mental life. It is also likely to ameliorate other facets of his personality disorder.
It is a chain reaction: controlling one''s eating disorders leads to a better regulation of one''s sense of self-worth, self-confidence, and self-esteem. Successfully coping with one challenge - the eating disorder - generates a feeling of inner strength and results in better social functioning and an enhanced sense of well-being.
When a patient has a personality disorder and an eating disorder, the therapist would do well to first tackle the eating disorder. Personality disorders are intricate and intractable. They are rarely curable (though certain aspects, like obsessive-compulsive behaviours, or depression can be ameliorated with medication or modified). The treatment of personality disorders requires enormous, persistent and continuous investment of resources of every kind by everyone involved.
From the patient''s point of view, the treatment of her personality disorder is not an efficient allocation of scarce mental resources. Neither are personality disorders the real threat. If one''s personality disorder is cured but one''s eating disorders are left untouched, one might die (though mentally healthy)...
An eating disorder is both a signal of distress ("I wish to die, I feel so bad, somebody help me") and a message: "I think I lost control. I am very afraid of losing control. I will control my food intake and discharge. This way I can control at least ONE aspect of my life."
This is where we can and should begin to help the patient - by letting her regain control of her life. The family or other supporting figures must think what they can do to make the patient feel that she is in control, that she is managing things her own way, that she is contributing, has her own schedules, her own agenda, and that she, her needs, preferences, and choices matter.
Eating disorders indicate the strong combined activity of an underlying sense of lack of personal autonomy and an underlying sense of lack of self-control. The patient feels inordinately, paralyzingly helpless and ineffective. His eating disorders are an effort to exert and reassert mastery over his own life.
At this early stage, the patient is unable to differentiate his own feelings and needs from those of others. His cognitive and perceptual distortions and deficits (for instance, regarding his body image ? known as a somatoform disorder) only increase his feeling of personal ineffectualness and his need to exercise even more self-control (by way of his diet).
The patient does not trust himself in the slightest. He rightly considers himself to be his worst enemy, a mortal adversary. Therefore, any effort to collaborate with the patient against his own disorder is perceived by the patient as self-destructive. The patient is emotionally invested in his disorder - his vestigial mode of self-control.
The patient views the world in terms of black and white, of absolutes ("splitting"). Thus, he cannot let go even to a very small degree. He is constantly anxious. This is why he finds it impossible to form relationships: he mistrusts (himself and by extension others), he does not want to become an adult, he does not enjoy sex or love (which both entail a modicum of loss of control).
All this leads to a chronic absence of self-esteem. These patients like their disorder. Their eating disorder is their only achievement. Otherwise they are ashamed of themselves and disgusted by their shortcomings (expressed through the distaste with which they hold their body).
Eating disorders are amenable to treatment, though comorbidity with a personality disorder presages a poorer prognosis. The patient should be referred to talk therapy, medication, and enrol in online and offline support groups (such as Overeaters Anonymous).
Recovery prognosis is good after 2 years of treatment and support. The family must be heavily involved in the therapeutic process. Family dynamics usually contribute to the development of such disorders.
In short: medication, cognitive or behavioural therapy, psychodynamic therapy and family therapy ought to do it.
The change in the patient following a successful course of treatment is VERY MARKED. His major depression disappears together with his sleeping disorders. He becomes socially active again and gets a life. His personality disorder might make it difficult for him ? but, in isolation, without the exacerbating circumstances of his other disorders, he finds it much easier to cope with.
Patients with eating disorders may be in mortal danger. Their behaviour is ruining their bodies relentlessly and inexorably. They might attempt suicide. They might do drugs. It is only a question of time. The therapist''s goal is to buy them that time. The older they get, the more experienced they become, the more their body chemistry changes with age ? the better their chances to survive and thrive.
Sam Vaknin ( http://samvak.tripod.com ) is the author of Malignant Self Love - Narcissism Revisited and After the Rain - How the West Lost the East.
He served as a columnist for Central Europe Review, Global Politician, PopMatters, eBookWeb , and Bellaonline, and as a United Press International (UPI) Senior Business Correspondent. He was the editor of mental health and Central East Europe categories in The Open Directory and Suite101.
Eating Disorders - Hope for Those with Eating Disorders
Eating disorders that are increasing among teens and kids, especially among young women. Read on to understand more about how an eating disorder can affect.
Eating disorders are often described as an outward expression of internal emotional pain and confusion. Eating disorders afflict millions of people, thousands of which will die from them yearly.
There is good news though, eating disorders can be beaten. An eating disorder involves a distorted pattern of thinking about food and size/weight there is a preoccupation and obsession with food, as well as an issue of control or lack of control around food and its consumption.
Eating is controlled by many factors, including appetite, food availability, family, peer, and cultural practices, and attempts at voluntary control.
Dieting to a body weight leaner than needed for health is highly promoted by current fashion trends, sales campaigns for special foods, and in some activities and professions. Eating disorders involve serious disturbances in eating behavior, such as extreme and unhealthy reduction of food intake or severe overeating, as well as feelings of distress or extreme concern about body shape or weight.
These are also the three most common eating disorders. Eating disorders can cause heart and kidney problems and even death.
Eating disorders frequently co-occur with other psychiatric disorders such as depression, substance abuse, and anxiety disorders. The main types of eating disorders are anorexia nervosa and bulimia nervosa. A third type, binge-eating disorder.
Eating disorders are not due to a failure of will or behavior; rather, they are real, treatable medical illnesses in which certain maladaptive patterns of eating take on a life of their own. Eating disorders frequently develop during adolescence or early adulthood, but some reports indicate their onset can occur during childhood or later in adulthood.
In addition, people who suffer from eating disorders can experience a wide range of physical health complications, including serious heart conditions and kidney failure which may lead to death.
Eating Disorders are about being convinced that your whole self-esteem is hinged on. Eating Disorders are about attempting to control your life and emotions through food/lack of food. A person with anorexia nervosa typically starves himself or herself to be thin and experiences excessive weight loss, typically 15% below the weight that doctors consider ideal for his or her height and age.
A child with anorexia or bulimia may experience dehydration as well as other medical complications. Anorexia may affect a child''s growth, bone mass, cause puberty delays, an irregular heartbeat and blood pressure problems, and gastrointestinal problems.
Treatment of anorexia calls for a specific program that involves three main phases
- restoring weight lost to severe dieting and purging;
- treating psychological disturbances such as distortion of body image, low self-esteem, and interpersonal conflicts; and
- achieving long-term remission and rehabilitation, or full recovery.
- Treatment can include medical supervision, nutritional counseling, and therapy.
- Supportive group therapy may follow, and self-help groups within communities may provide ongoing support.
- Behavioral therapy has proven effective in achieving this goal.
- Psychotherapy has proven effective in helping to prevent the eating disorder from recurring and in addressing issues that led to the disorder.
- Family members or other trusted individuals can be helpful in ensuring.
- Certain selective serotonin reuptake inhibitors (SSRIs) have been shown to be helpful for weight maintenance.
Difference between People with Eating Disorders and Other People; Comfort by Eating (or by Starving)
Written by: Gunborg Palme, certified psychologist and certified psychotherapist, teacher and tutor in psychotherapy.
In what way are people with eating disorders different from other people? Are these differences the causes of eating disorders? Do they get comfort by eating, even when they do not need more nutrition?
Answer:
People with eating disorders experience that they are not in control of their needs and impulses. Rather they feel controlled by forces outside themselves. If you look at the story of their lives, certain phenomena recur. When they were children, the surrounding people have not responded in an adequate way to the signals which expresses needs or feelings. If the surrounding environment does not understand the child's true needs and take proper action, the child is inhibited in learning to be more conscious of its needs.
Either people with eating disorders don't feel the body signals for hunger and satisfaction, or they don't listen to these signals. They eat for reasons other than physical hunger, for example, they are tired, stressed or feel melancholy. Their relation to food makes them unhappy and they are not being able to cope with food in a proper way.
People without eating disorders are in contact with their physical feelings of hunger and satisfaction, and use those feelings when they decide when and how much to eat. They generally eat for no other reasons than hunger, and need food to be satisfied. Eating is satisfying and works smoothly like breathing and sleeping.
| | Disturbed Eating | Normal Eating |
| What controls eating? | Eating is separated from its normal control by hunger, appetite and satisfaction. It can be controlled by the will, planned diet, counting of calories, feelings, appearance and food odour. | Eating is controlled by hunger, appetite and satisfaction. A person eats when in need of nutrition and stops when satisfied; is usually hungry at mealtimes. |
| Why a person eats: | Often for other reasons than nutritional needs: to alter the figure, to reduce pain, stress, anguish, anger, loneliness and melancholy. There are unpleasant physical feelings after excessive eating together with regret, guilt and shame. | For nutrition, health and energy. Also for pleasure and as a part of social company. Normal eating gives a feeling of satisfaction. |
| When a person eats: | Eating is irregular and chaotic - often too much or too little. | Regular habits. Usually three meals a day and small snacks between them if needed. |
What controls eating?
For a healthy person, eating is controlled by feelings of true hunger, appetite and satisfaction. You eat when you need nourishment and stop eating when you are satisfied.
A person with eating disorders lacks the normal connection between the nutritional need of the body and the hunger signals. Eating is determined by will, planned diet, counting calories and if you are tempted by delicious food.
Why a person eats.
A healthy person eats for nourishment, health and energy, but sometimes also for pleasure or as an part of a social event. You feel content when you eat.
For people with eating disorders, eating is governed by the will to change the appearance of the body, or to reduce pain, stress, anxiety, loneliness, monotony, etc. After completing the meal, they feel discomfort and remorse, guilt and shame.
When a person eats.
The healthy person eats regularly, for example, three main courses and snacks according to what the body craves.
A person with an eating disorder eats irregularly and chaotic - sometimes too much, sometimes too little. Sometimes you skip a meal, sometimes you fast, sometimes you overeat and sometimes you diet. It's common to either eat too much or too little.
Normal eating: You have contact with your body's physical sensations of hunger and satisfaction, and use it to decide when and how much to eat. You normally do not eat for other reasons than that you are hungry and need nourishment. You get satisfied with eating and eating works by itself like breathing and sleeping.
Disturbed eating: Either you cannot feel your body's signals for hunger and satisfaction, or you can feel them, but you disregard them. In both cases, you eat for other reasons than need of nourishment, such as stress or sadness. You are unhappy with your relation to food and cannot resolve it in a sensible way.
Eating Disorder Predisposing Factors
Written by: Fabio Piccini, doctor and Jungian psychotherapist, in charge of the "Centre for Eating Disorders Therapy" at "Malatesta Novello" nursing home in Cesena. Works privately in Rimini and Chiavari. E-mail: piccini@anoressia-bulimia.it
First version: 26 Nov 2006. Latest revision: 26 Nov 2006.
Question(s):
Which factors make it more likely that a person will get an eating disorder?
Answer:
Research on eating disorders has shown that it is not possible to attribute only one cause to an eating disorder development.
Eating disorder development has been described as a three-phase process where the presence of certain risk factors creates a predisposition to fall ill; for this reason some people become more vulnerable to eating disorder development.
When these more vulnerable people have to face up to very stressful events, there is a high probability that they will develop an eating disorder rather than psychological, psychosomatic or other kinds of pathology.
When the eating disorder is stable, it is prone to self-maintenance.
There are different factors that predispose people to develop an eating disorder. Some predisposing factors are:
* Being a woman. It is undeniable that a woman is more subject to the slimness cult than a man.
* Being between the ages of 15 and 35. Eating disorders reach their peak in this age bracket.
* Suffering from depressive disorders and having particular personality traits.
* Being overweight. It has been noticed that many eating disorders begin with a strict diet in overweight people.
* Having a family where weight and body fitness are considered important problems.
* Having been victims of sexual abuse during childhood and adolescence. An incidence of abuse victims is of statistical importance in eating disorder patients.
* Growing up in a family that had not transmitted enough self-esteem, trust in oneself and the capacity to recognize and elaborate emotions.
The presence of two or more factors will create in people a predisposition to suffer from eating disorders that will be stronger as the factors increase.
Diabetes and Eating Disorders
The combination of diabetes and an eating disorder can have severe consequences. Diabetes does not cause an eating disorder, but often proceeds or contributes to the creation and maintenance of an eating disorder. However, this is a dangerous and potentially fatal combination. Some clinicians and researchers believe that those with diabetes may be a greater risk of developing an eating disorder than those in the general population. In addition, diabetics with an eating disorder may not be identified for many years due to symptoms of diabetes management and bodily symptoms that can mirror those of an eating disorder. Therefore, it is important to be aware of the risks that combining the two can have.
Specific medical risks can include:
- Diabetic Retinopathy, which is a condition in which blood vessels break in the eye
- Blindness (a progression for many that develop diabetic retinopathy)
- Kidney disease
- Liver failure
- Circulation and breathing issues
- Heart disease
- Ulcers
- Malnutrition
- Electrolyte and fluid imbalances
- Extreme fluctuations in blood sugar
- Low or high blood pressure depending on the type of eating disorder
- Iron deficiencies
- Amenorrhea and infertility
- Easily bruising skin
- Dental issues
- Depression
- Amputation of limbs
- Death
With children or teenagers with both diabetes and an eating disorder, there can be additional acting out or rebellious behavior because of what the child/teen may perceive as over-controlling or over-protective behavior by their parents that are constantly watching and commenting about eating behaviors and sugar levels.
Development of the Eating Disorder
For a diabetic person, their focus and that of their medical team, is on weight management, monitoring the level of insulin, and tight control over eating habits. A person can very easily take these areas and go overboard with them, which can lead to strictly controlling the amount of calories consumed or the use of compensatory behaviors, such as binging, purging, excessive exercise or laxative use to control weight gain that are seen in an eating disorder. The person with diabetes may also be feeling out of control and like his/her body has failed him/her, which can lead to obsessive control and monitoring, as well as emotional feelings of guilt, shame and anxiety that can contribute to the beginnings of an eating disorder.
Diabetics that are taking insulin can use it to reduce weight gain by taking less insulin than the doctor prescribed, which causes their blood sugar to increase and spill over into the urine. Once the urine is released from the body, the person will see weight reduction and may even see improvement in their diabetic symptoms, but is also destroying tissues in the body through this dangerous practice and can lead to organ failure that can be life-threatening or cause death.
Both those with an eating disorder and diabetes are asked to pay close attention to the state of their body at different points throughout the day, and to control the types and amounts of food that they eat. With diabetes, certain foods are considered "bad," such as those with a great deal of sugar and diabetics are often asked to maintain food diaries or use exchange programs that track the amount and type of food eaten each day. They are also told that weight gain in bad for their health. This is very similar in many ways to a person with an eating disorder that is watching and evaluating everything that they eat and labeling certain foods as "good" or "bad" and that any weight gain is dangerous for them. When you combine diabetes with an eating disorder in the same person, you often find a person that is focused on controlling their body and closely monitoring and trying to change their blood sugar level and their weight.
For the person that is suffering from diabetes and an eating disorder, it is important to seek out and begin treatment as early as possible. The sooner treatment begins, the better the chance there is to reduce the long-term effects on the body and to create healthy eating and diabetic management behaviors that the person can utilize throughout their lifetime.
Please visit Avalon Hills Eating Disorder Treatment Center for more information about eating disorders and how it can affect diabetes.
A Parent's Guide to Understanding Anorexia Part 2/2b
What treatment options are available for Anorexia?
Anorexia is a serious illness which, if ignored, can be fatal. Fortunately there is a good chance for full recovery if the illness is diagnosed and treated early. The longer the detrimental behaviors are left untreated, the less likely full recovery without long-term consequences will be. Treatment for Anorexia involves a multi-faceted approach which involves psychotherapists, nutritionists, doctors, counselors, and other medical professionals. There are options for out-patient treatment, however treatment at a clinic which specializes in recovery from eating disorders is often the most successful option. Treatment usually involves cognitive behavioral therapy with a psychotherapist. This is to help replace negative body image and damaging attitudes and thought processes with positive, more realistic ideals. Along with this, dance therapy, animal therapy and other ''hands on'' types of approaches may be used. The patient will receive a medical evaluation to assess the extent of damage which has been done by the malnourishment. A nutritionist will be consulted to provide a well rounded nutritional plan and to teach proper eating habits. A healthier relationship with food will be taught. The patient may be asked to keep a food diary or journal detailing not only what is eaten and when, but her emotional state at the time. Family therapy is often incorporated in the treatment process to help loved ones understand the intricacies of eating disorders in general and Anorexia in particular. They will be told what they can do to help facilitate recovery. Finally, pharmacological intervention with antidepressants and/or anti-anxiety medications may be incorporated to help stabilize the emotional upheaval surrounding an eating disorder and recovery.
Group therapy and support groups are generally encouraged during treatment for Anorexia. It can be very helpful for the anorexic patient to realize that they are not alone in their struggles. It is also a good way to draw the patient out and discourage a lot of the secrecy that usually surrounds Anorexia. It is very important, when choosing a treatment facility, that you ask about the methodology used in their group therapy. Sitting with a group of patient''s who struggle with Anorexia and discussing methods of purging or ways that they hide their illness is counter-productive to healing.
Where can I find organizations with more information regarding Anorexia?
There are many organizations geared toward helping those with eating disorders. Some organizations specialize in information about specific eating disorders, however generally they are geared to help those suffering from all eating disorders. Caution should be used, when searching for help, to make sure that the organizations and web sites are providing up to date, accurate information. Some organizations you may utilize are:
? National Eating Disorders Association
? www.nationaleatingdisorders.org
? Eating Disorder Referral and Information Center
? www.edreferral.com
? Pale Reflections Eating Disorders Community Treatment Finder
? www.pale-reflections.com
? Something Fishy Website on Eating Disorders
? www.something-fishy.org
What can I do if I feel my child is struggling with Anorexia?
The first thing to remember is that you cannot force your child to change her behavior. Trying to persuade, force, or ''guilt'' her into changing will not work! Generally individuals suffering from eating disorders already feel guilty for their behavior. Adding to that guilt is not beneficial. If your child is over 18, there is nothing you can do to make them stop their destructive behavior. Your best option is to be a good listener. Provide them with a list of resources should they choose to seek help. Remember that eating disorders are generally not about the food. The underlying emotional issues are what need to be addressed. Express love and concern for your child and a desire to help if you are able. Provide them with support if and when they decide to seek professional help.
If your child is under the age of 18, you have more options. This leaves you with a difficult choice. Denial and anger are common reactions when confronting a child about an eating disorder. Your child may beg, plead, promise to change, etc. to avoid being put in in-patient treatment. Keep in mind that the ultimate goal is full recovery and that the sooner the eating disorder is addressed, the greater the chance of a full recovery. It is rare for an individual to be able to quit these self-destructive behaviors on her own. It is not uncommon for a child to promise to change and then just work harder to hide the habits while continuing the behaviors. Some people with Anorexia claim that they try to hide their illness, while secretly hoping that someone will care enough to notice and intervene. There are many options for recovery and help. Research these and decide which option is best for your situation. Remember that recovery is the goal and that with consistent love, caring and intervention that this is goal is very attainable.
A Parent's Guide to Understanding Anorexia Part 2/2
What are the health consequences of Anorexia?
Dehydration. Dehydration causes strong smelling, dark urine. Mucous membranes become dry and tacky. Crying produces few tears. Skin and hair become dry. Irritability and anxiety become more apparent. Electrolytes become poorly balanced. Loss of coordination and confusion.
Kidney stones. A result of dehydration and lack of adequate fluids to process minerals in the body. Kidney stones are very painful. Smaller kidney stones generally pass on their own within a few days, however larger stones may need to be taken care of by a doctor.
Kidney failure. Again, a result of dehydration. Ultimately the kidneys will fail without adequate fluids and nutrients.
Extreme weight loss. This is an obvious result of starvation. In extreme Anorexia an individual will literally be skin and bones. In this emaciated state, they will often believe they are still fat and will look at their bloated bellies, a result of gas production due to malnourishment, as an indication that they still need to lose weight.
Lanugo, a fine, white hair all over the body. This develops as a response to excessive fat loss and is the body''s way of keeping itself warm.
Irregular bowel habits. Without adequate fluids and fiber, the gastrointestinal system is unable to function properly. Constipation and diarrhea can result. The diarrhea leeches out even more fluids and electrolytes from an already lacking system.
Low blood pressure and risk of heart failure.
Muscle atrophy. Without adequate protein the muscles are unable to rebuild and maintain themselves.
Hair loss and thinning, brittle, dry hair and fingernails. Hair and fingernails are often the first places that will show outward signs of malnourishment. The body, when it kicks in to ''starvation mode'' will see nourishing these as less important than other organs and will divert nutrients to more vital areas of the body for survival.
Fainting.
Inability to concentrate and memory problems. Extreme hunger, malnourishment, electrolyte imbalances and resultant change in brain chemistry cause an inability to concentrate.
Abdominal pain.
Osteoporosis. The combined effect of minimal nutrients, particularly calcium and vitamin D, and amenorrhea cause osteoporosis. The brittle bones can result in fractures. Long term effects can result in poor posture as well as broken bones.
Cold sensitivity. Lack of body fat leads to poor insulation.
Fluid retention.
Loss of menstruation which could lead to problems conceiving and infertility problems.
Iron deficiency anemia.
Easy bruising.
Yellow skin and nails.
Death. Without treatment, Anorexia can result in premature death. Even with treatment the damage done to the heart muscle is often permanent.
A Parent's Guide to Understanding Anorexia Part 1/2
What is Anorexia?
Anorexia Nervosa, often just called Anorexia, is an eating disorder wherein an individual has a distorted body image. This misperception leads to an avoidance of food and severely restricted caloric consumption. Low body weight and an intense fear of gaining weight are characteristic traits. Anorexia is a psychophysiological disorder which, if left untreated, can eventually lead to death.
Who might be at risk of developing Anorexia?
Anyone can develop an eating disorder, however there are certain individuals who seem to have an increased risk. Women are, of course, more likely to develop an eating disorder than are men. That said, the rates of Anorexia Nervosa in men is increasing somewhat. More research is needed to determine the cause of eating disorders, however those at risk may include high strung individuals with a stringent set of ideals. People who exhibit perfectionism in their pursuits both academically and extracurricular. Someone with a family history of obesity. An individual prone to dieting on a regular basis. A history of physical or sexual abuse. Someone who has been subject to bullying and/or teasing. Elite athletes who believe their success depends on maintaining and achieving a certain ideal weight. Aspiring to a profession which focuses on weight and appearance (dancers, models, actresses, etc.) Someone who struggles with depression or anxiety. A tendency toward addictive behaviors, perhaps manifest in alcohol or substance abuse.
What are the signs and symptoms of Anorexia?
The symptoms of Anorexia can be easy to hide, initially, but to a concerned and watchful parent they should become relatively easy to spot, particularly as the disorder progresses. Keep in mind, however, that generally the person suffering from the eating disorder will feel guilt and shame and will try to prevent anyone from noticing their struggles. Warning signs may include;
- A refusal to eat certain foods. This may be in the form of cutting out an entire food group, i.e. carbohydrates, sugar, fat. It may also be just individual foods like no longer eating beef or refusing to eat bread.
- Always being ''on a diet''. This can become a common excuse for avoiding food and social situations where food may be served. It is so common for young women, in particular, to be on a diet that until the weight loss becomes excessive this may not be considered a problem.
- Strange eating patterns. Cutting up food into tiny pieces, chewing each bite a certain number of times, eating only one food at a time, refusing to let foods touch, pushing food around the plate.
- Excessive exercise. Anything more than an hour per day of high intensity exercise would be considered excessive. Many elite athletes do exercise more than this, but for the average young woman this could be cause for concern. Current recommendations are 2-3 days per week of weight bearing exercise with 8-12 repetitions of the exercise per body part. 3-5 days of cardiorespiratory training for 20-60 minutes per session. 2-3 days per week of flexibility training.
- Wearing baggy clothes to hide her figure. This could be because the individual feels fat and wants to hide her supposed horrible figure. It could also be an attempt to hide the excessive weight loss from not eating. Additionally, sometimes there is a desire to avoid growing up and baggy clothing can hide the fact that a womanly figure is emerging.
- Preoccupation with food. Wanting specific information on nutritional values of foods, knowing the exact fat and calorie content of foods, talking about and thinking about food all of the time.
- Weight loss. This is a relatively obvious sign, however initially the weight loss may be seen as a good thing. If the young woman was somewhat overweight, the initial weight loss may be complimented. This acknowledgment and attention may feed the desire to lose even more weight. Anorexics typically can get down to less than 85% of normal height and weight for age.
- Sensitivity to cold. Loss of body fat leaves the body sensitive to temperature and feeling cold when everyone around is comfortable.
- Labeling foods ''good'' ''bad'' etc. Giving a moral connotation to the foods available and feeling guilty for eating ''bad'' foods. Eventually even healthy foods can be designated as ''bad'' because of a high calorie content. Good examples of this would be nuts and avocado.? Dizziness or lightheadedness. Drop in blood pressure, dehydration, iron deficiency anemia. All can lead to dizziness and lightheadedness. This may be particularly sensitive to change in position.
- Frequent headaches.
- Avoidance of social situations which may involve food. As mentioned above, the excuse that she is "on a diet" may be used to avoid social situations. People who have Anorexia don''t necessarily want people watching them eat. This may be because they don''t want people analyzing what, if anything, they are eating. Additionally, it could just be a way of avoiding the temptation of food. It is a common misperception that Anorexics don''t get hungry. This is not the case. They do feel hunger, but their fear of weight gain and desire to be ''in control'' of their appetite is stronger than their hunger.
- Absence of menstrual periods (amenorrhea). Strict dieting and excessive exercise can lead to a disruption in the flow of hormones. Consequently, the body doesn''t produce enough estrogen and progesterone. Ovulation is suppressed and menstruation stops.
- Anxiety and/or depression. This is a vicious cycle in regards to eating disorders. Feelings of anxiety, depression, and low self worth can lead to Anorexia. The physical and mental effects of the Anorexia can lead to even more depression and anxiety. The eating disorder and depression continue to feed off of each other, each aggravating the other.
- Eating rituals such as only using a certain cup to drink out of or always insisting on a certain fork. These are small methods of exerting control over the environment where food is involved.
- Increased interest in food, cooking, collecting cook books etc. Although someone with Anorexia will avoid eating, the hunger causes a huge interest in food. Being around food and providing food for others become almost an obsession as the body fights for the nutrients it needs but is being deprived of.
Avalon Hills Eating Disorder Treatment Center is located in Utah and has two eating disorder clinics for anorexia and bulimia. Learn more about anorexia symptoms
Singing and Eating Disorders
Eating disorders are now epidemic. Singers and others in the entertainment business with its requisite media exposure are, I believe, especially vulnerable to these debilitating secret illnesses.
No one can approach their full vocal potential while chained to an eating disorder. Why? Because the voice will have problems in these areas:
- Breathing (Power)
- Tone (Path through an open throat)
- Communication (Performance)
That''s right --- with an eating disorder --- everything I teach in Power, Path & Performance vocal training ... everything necessary to the workings of your voice ... is compromised and plagued with problems; some very pesky to diagnose and correct.
From denial to her long-term recovery from anorexia/bulimia, I''ve been Jenni Schaefer''s voice teacher and friend. Jenni recovered using a unique therapeutic approach that involved treating her eating disorder as a relationship, rather than an illness or condition. Jenni actually named her anorexia/bulimia, "Ed," an acronym for "eating disorder." She and I co-wrote the song "Life Without Ed" which is also the title of her McGraw-Hill book endorsed by Dr. Phil and many others.
Testimonials tell us her story is powerful, so here it is from both our points of reference:
What I noticed the first time I met Jenni was her strange numbness. She couldn''t move out of the ''guarded stance:'' slumped shoulders, head hung forward, eyebrows frozen, jaw clenched, spine and hips frozen, arms limp and legs locked. She was like a stick figure. Her voice was thin, colorless. She complained that her throat hurt when she sang. Her range was limited, and she had several ''breaks'' in her voice. I tried to help her loosen up, but I could barely get her to lift her arms from her sides to allow ribcage expansion. She inhaled from the upper chest in short gasps.
Jenni speaks... "With Ed, I was disconnected from my body... felt like a floating head. I was rigid and had difficulty moving. In therapy sessions, I was encouraged to ''just move'' --- anything."
I also had a lot of trouble helping Jenni connect to her songs. When I asked her to visualize singing "Valentines Day" to someone she loved, she couldn''t think of anyone! Finally she began to connect by imagining singing to children in a cancer ward where she had worked. An odd thing... She didn''t want me to look at her when she sang.
Jenni... "I was disconnected from feelings. I lived in my head. A big purpose of my eating disorder was to starve and stuff feelings --- to keep me out of my emotions. So when I was supposed to connect with feelings in a song, it was not only completely foreign to me, it was also terrifying."
Jenni was easily deflated and crushed. I had to be very careful not to push her too far with exercises. She somehow needed to sing, but music didn''t seem to move her. Because she didn''t have the energy to keep her posture erect and flexible, she usually just stood still and lifeless. Or walked like a zombie.
Jenni..."I had no energy --- restricting, bingeing and purging requires a lot of energy (physical and emotional) and leaves little left for anything else."
Jenni couldn''t understand why she didn''t feel something. She would watch me express feelings she couldn''t experience, and I think that was a big part of why she reached out for help. She asked me to pray for her. She thought since she didn''t feel something, she couldn''t pray herself.
Jenni... "Singing is spiritual. An eating disorder kills all spiritual connection. This was a huge hurdle."
Little by little, as Jenni got help, she got stronger. However, voice lessons became even harder. She developed a diaphragmatic spasm of some kind and a kind of fatalism took hold, making her expect the strange uncontrolled vibrato weirdness to happen at a certain place in her range. I sent her to Vanderbilt Voice Clinic. Only when they couldn''t find anything organically wrong did Jenni start to believe she could beat this strange vocal problem. Soon after, I was able to coach her into the flexible rib stretch necessary to allow the issue to completely disappear.
Jenni... "Anorexia is characterized by intense perfectionism. While singing, I would concentrate more on being perfect than on getting a greater message across."
Jenni kept improving, but it was two-steps forward, one-step back. It was hard for her to picture singing to someone. She was stuck in self-consciousness. She began to experience feelings, but with the feelings came anger at being critiqued, which made her feel judged. At one point, I suggested she practice differently and she flew into a rage. I didn''t see it coming. I didn''t read the signs that said I was pushing too far, and the lesson ended in disaster.
Jenni... "All eating disorders are characterized by constant self-criticism. It is difficult to sing when a negative voice is constantly screaming in your ear."
The trust and friendship Jenni and I had developed made the misunderstanding short-lived. We got back to the business of vocal training and then another challenge set in. It was a long season of intense sadness. I was afraid for her; she would cry, literally for days, and then go numb. She pushed people away, saying she had no friends. For a while, she stopped singing and cancelled voice lessons.
Jenni... "Depression is often an underlying symptom of an eating disorder. When lost in despair and hopelessness, singing can seem too vulnerable because emotions might leak out. So Ed would often build yet another ''protective'' wall."
Jenni and I began working together again, and this time every lesson seemed to break new ground. Her recovery was solid, her physical and emotional health much more stable. I watched her persevere with great courage through those monumental battles of recovery. And I listened to her find her voice at last.
One of the last pieces in the puzzle was put in place by the brilliant performance coach Diane Kimbrough. Diane told Jenni to stop worrying about ''going there'' every time she sang. She said this is way too much pressure for an artist to have to re-experience the emotional scene during every performance. Instead, Diane suggested, forget yourself and make THEM (the audience) feel something! It was a miracle.
Jenni stopped focusing inward and made the connection, through the song, to someone else. Her voice is now strong, controlled, confident and beautiful. She FEELS joy, frustration, anger, and love. All of this is giving her a voice with which to rock the world. She speaks and sings all over the country to entertain, teach and prove that recovery from an eating disorder is indeed possible. And oh, I so love to hear her laugh!
For those struggling with an eating disorder, we hope you read in our story that it''s never too late to reach out for help, start healing- and start singing your heart out!
Judy Rodman - singer/songwriter/producer/vocal instructor, developer of... Power, Path & Performance? vocal training - Website, Newsletter and Blog: http://www.judyrodman.com Jenni Schaefer - singer, songwriter, speaker, author of "Life Without Ed" Website: http://www.jennischaefer.com
Eating Disorder Predisposing Factors
Written by: Fabio Piccini, doctor and Jungian psychotherapist, in charge of the "Centre for Eating Disorders Therapy" at "Malatesta Novello" nursing home in Cesena. Works privately in Rimini and Chiavari. E-mail: piccini@anoressia-bulimia.it
First version: 26 Nov 2006. Latest revision: 26 Nov 2006.
Question(s):
Which factors make it more likely that a person will get an eating disorder?
Answer:
Research on eating disorders has shown that it is not possible to attribute only one cause to an eating disorder development.
Eating disorder development has been described as a three-phase process where the presence of certain risk factors creates a predisposition to fall ill; for this reason some people become more vulnerable to eating disorder development.
When these more vulnerable people have to face up to very stressful events, there is a high probability that they will develop an eating disorder rather than psychological, psychosomatic or other kinds of pathology.
When the eating disorder is stable, it is prone to self-maintenance.
There are different factors that predispose people to develop an eating disorder. Some predisposing factors are:
* Being a woman. It is undeniable that a woman is more subject to the slimness cult than a man.
* Being between the ages of 15 and 35. Eating disorders reach their peak in this age bracket.
* Suffering from depressive disorders and having particular personality traits.
* Being overweight. It has been noticed that many eating disorders begin with a strict diet in overweight people.
* Having a family where weight and body fitness are considered important problems.
* Having been victims of sexual abuse during childhood and adolescence. An incidence of abuse victims is of statistical importance in eating disorder patients.
* Growing up in a family that had not transmitted enough self-esteem, trust in oneself and the capacity to recognize and elaborate emotions.
The presence of two or more factors will create in people a predisposition to suffer from eating disorders that will be stronger as the factors increase.
Causes of Eating Disorders and Obesity in Children and Adults
Written by: Gunborg Palme, certified psychologist and certified psychotherapist, teacher and tutor in psychotherapy.
First version: 26 Nov 2006. Latest revision: 04 Jul 2007.
Question(s):
What are the causes of eating disorders and obesity in Children and Adults?
Answer:
There are various contributory causes of eating disorders and often several of these may act in combination.
* The ability to distinguish between hunger, satisfaction and other feelings is learned when one is very young. Faulty upbringing can interfere with this. The effect is often not noticed until later in life.
* Eating disorders often arise when a person tries to reduce to an abnormally low weight. The unnatural slim ideal may be therefore a contributory cause of eating disorders.
* Many people with eating disorders are not aware of their physical feelings of hunger and satisfaction. Thus, they lack a natural control of their eating. Such people will easier be pulled into eating disorders, where they use eating to conceal feelings and escape from constructive problem solutions.
* Both overeating and fasting can stimulate the reward centre in the brain. Eating disorders therefore function in the same way as alcoholism and drug addiction. The same personality traits which increase the risk of alcoholism and drug addiction also increase the risk of eating disorders.
* The personality traits which increase the risk of eating disorders are partly hereditary. Addictive problems or affective disorders (depression, etc.) are more common among relatives.
* Some of the personality traits involved are: a tendency to please others and a low ability to assert one's own needs; a need to reduce unsettling feelings of anxiety, depression and low self-confidence; perfectionism and problems with impulse control. More about personality.
* Eating disorders are more common among women and those who are affected by social attitudes and body ideals and who also lack the ability of following their own feelings and needs.
* Children of overweight parents, and parents with an exaggerated interest in body shape, more often get eating disorders. Also, demands from the family and insecure family circumstances increase the risk.
Overweight occurs if you eat more fat than your body can consume. Both biological (somatic) and life-style factors can cause overweight. Eating disorders (see above) can also cause overweight. There are also some illnesses and drugs which can make a person more susceptible to overweight.
Causes of Addiction and Eating Disorders
Written by: Gunborg Palme First version: 26 Nov 2006. Latest revision: 14 Sep 2007.
Question(s):
Is there any connection between eating disorders, alcoholism, smoking and drug addiction? Are the causes of anorexia, bulimia and binge eating the same as the causes for alcoholism, smoking and other addictions?
Answer:
Research on eating disorders has shown that there are similarities between many cases of eating disorders and addictive conditions such as alcoholism and drug addiction. The human brain has special reward centres and these are normally activated when a person feels well, takes care of the body, behaves sensibly, is praised, is in love, exercises, etc. More.
It is also possible to stimulate these reward centers by artificial means. Drugs of all kinds forbidden and permitted, produce chemical stimulation which is an important part of the cause of addiction. Stimulation also blocks unpleasant feelings and therefore those with eating disorders, as well as those with other addictive disorders, may use them to block unbearable feelings.
Normal people get their stimulation of the reward center by doing good things. They are stimulated by exercise because it is good for the body to get exercise. They are stimulated by eating, because it is good for the body to get nourishment. They are stimulated by being in love, because it is good for the survival of the human race that people mate. They are stimulated when they have achieved something or when they get appraisal because it is good that people do constructive things.
However, if the reward centre is stimulated by drugs, alcohol or abuse of food, they cease to function in the way they should. Abuse is a short cut to false happiness, a happiness which doesn't come from doing something good.
Incorrect usage of the reward centres is especially common with people who have a personality requiring a lot of reward effects in order for them to feel well, and also have worry and stress which can be reduced by drugs.
There is accordingly a common factor with many types of addiction:
- Alcoholism and drug disorders
- Eating disorders
- Compulsive sex dependence
- Compulsive gambling
- Compulsive exercising
- Self-injury and anorexia nervosa (even body injury can stimulate the reward centre in order to protect the body from pain).
This means that much of what is known about the treatment of alcoholism and drug addiction can be used for eating disorders. The patient's own ego must be strengthened and taught to refuse the kind of eating pattern which tempts with quick artificial solutions.
A similarity between eating disorders and drug addiction is that the addiction is compulsively developed into an even stronger form regardless of the effect on the patient's health. Despite serious medical complications, it is difficult for addicts to give up their addiction. Starvation in anorexia reduces the activity of the hormone Serotonin and this in turn reduces anxiety in a patient with an overactive nervous system. Patients with anorexia are, less often than others, drug addicts and alcoholics while those with other eating disorders more often are so. Those anorectics who alternate between eating attacks and starvation are more like bulimics.
Research shows, for example, that personality types that more often feel stress and anxiety, need more stimulation in order to feel well.
Research also shows that those with eating disorders often have excessively low values for dopamine and CSF-5-HIAA as well as Serotonin which causes them to feel more stressed than others and that many drug addicts began with compulsive eating before going over to drugs and furthermore that certain hereditary characteristics increase the risk of eating disorders and drug addiction.
However, everybody with these hereditary characteristics does not become an addict as there are other ways of managing the problem, e.g., medicine which stabilises the concentration of Serotonin in the brain may help (in combination with other treatment) those who have eating disorders.
Anorexia Can Give You a Feeling of Satisfaction
Written by: Gunborg Palme, certified psychologist and certified psychotherapist, teacher and tutor in psychotherapy.
First version: 27 Nov 2006. Latest revision: 25 Jul 2007.
Question(s):
Is anorexia similar to drug addiction?
Answer:
People who fast can get high from starvation. Many anorectics describe how starvation reduces psychic anguish and how the anxiety returns when they begin to eat again. It seems as if anorexia stimulates those substances in the brain which affect the pleasure and reward centre, and thereby enables them to control and avoid psychic anguish in the same way as alcoholics and drug addicts do.
