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The following criteria are used by mental health professionals to determine if someone is suffering from an eating disorder. They are taken from the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Click the (+) next to each topic to learn more.
|+||Anorexia Nervosa: Deliberate self-starvation|
|+||Bulimia Nervosa: Binge-eating followed by purging|
People with anorexia restrict their caloric intake for long periods of time and deliberately starve themselves, resulting in loss of body weight of at least 15 percent. Weight loss is achieved by avoiding food, fasting, frenzied exercise, vomiting, laxatives and other means. An intense fear of becoming obese as well as distorted body image are significant characteristics of anorexia nervosa. Loss of hair, dehydration, cold hands and feet, bloating, fatigue, menstrual irregularities or loss of menstrual period, loss of muscle tissue, low blood pressure, dizziness, growth of body hair (languno), rigid food rules and rituals, frequent weighing of self on a scale, layering of clothing, insomnia, purging or compulsive exercise are other signs of this illness. Emotional and psychological characteristics can include depression, low sense of self-worth, difficulty thinking clearly, suicidal thoughts, self-hatred, perfectionism, obsession about thinness, loss of sexual interest, withdrawal and isolation.
A cyclic pattern of binge eating associated with some type of purging describes bulimia nervosa. The purging takes on several different forms: fasting, self-induced vomiting, excessive exercising, or use of cathartics, diuretics, laxatives, or enemas. It is characterized by an intense fear of becoming fat linked to secretive and recurring episodes of compulsively acquiring and eating large quantities of food and purging the food through self-induced vomiting or other compensatory behaviors such as excessive exercise. Fear of not being able to stop eating or control what or how much is being eaten is another significant characteristic. Weight fluctuations, heart arrhythmia and irregularities, swollen glands and face, sore throat, abdominal pain and distress, chest pain, tooth decay, loss of tooth enamel, gum erosion, dry mouth, headaches, fatigue, and constipation are other signs of this illness. Emotional and psychological evidences can include an intense preoccupation with appearance and 'image', constant ruminations and worries about body weight and size, self-loathing, self-disgust, perfectionism, unreasonable comparisons with the appearance of other women, constant feelings of being out of control, isolation, and an inability to be in touch with or express their own feelings.
Bulimia Nervosa and Anorexia Nervosa are often present together. These disorders are prevalent among women, especially between the ages of 12 and 30. One in 150 females suffer from Anorexia Nervosa, and recent studies on college campuses show that almost 20 percent of college females struggle with bulimia.
Eating disorders are complex and painful illnesses that have many underlying and contributing causes and factors in their development. In view of the growing epidemic in the number of women and men in the United States with eating disorders, it is important to explore ways to prevent this disorder from taking root in someone's life.
The prevention of an eating disorder requires a balanced approach which avoids the extremes in a person's response to life and its challenges and stresses, performance expectations, media influences, cultural and social experiences, etc. Prevention for any addictive problem requires awareness, honesty, balance and wisdom in a person's choices and coping strategies.
In clinical observations, it can be noted that the strategies and ideas helpful in preventing an eating disorder are the same strategies that someone who is in the process of recovery from an eating disorder uses to help them maintain their positive improvements and changes.
Dieting may not be the cause of eating disorders, but it is often a precursor. The National Eating Disorders Association reports that 35% of "normal dieters" progress to pathological dieting and that 20-25% of those individuals develop eating disorders. It is far too common that eating disorders start off as dieting. Dieting can be a way for individuals to exercise control - counting calories and fat grams, limiting types and amounts of food, and watching the numbers drop on the scale. Focusing on dieting and weight loss can be a "perfect" escape from true emotions and issues. Not only can the focus on dieting and weight loss be distracting, but also dieters tend to have slower reaction time and less ability to concentrate due to lack of adequate nutrition.
Our culture has brainwashed us into thinking being ultra-thin is equated with beauty. To obtain this image, Americans put so much time, energy, and money into diets, and in the end the diets don't even work. The dieting failure rate helps to explain the industry's rapid growth. When a diet fails, the search is on for a new one that "really works."
How often do you look in the mirror and say, "If I could just lose ten pounds, then I would be happy?" Unfortunately, the majority of American women and girls are dissatisfied with their bodies, and many take extreme measures in an attempt to change their bodies. For example, one study found that 63% of female participants identified weight as the key factor in determining how they felt about themselves-more important than family, school, or career. Other research suggests that 85% of all women are dissatisfied with their bodies and want to lose weight. Women and adolescent girls regard size, much like weight, as a definitive element of their identity. Some girls assume there is something wrong with their bodies when they cannot fit consistently into some "standard" size; others will reject a pair of jeans simply because they won't wear a particular size.
Although a large majority of women are displeased with their bodies, many women and girls experience extreme body image difficulties that can be part of more complicated problems. These extreme body image disturbances include body dysmorphic disorder, eating disorders and severe depression.
When you realize that someone you love may be struggling with anorexia nervosa or bulimia nervosa, naturally you want to know more about it. And because you care, you also want to understand what they are experiencing so that you can be as supportive as you can throughout their recovery.
You may already know that anorexia and bulimia are complex and confusing illnesses. Now that you are past the initial shock of discovery, you may be experiencing feelings of anxiety, guilt, anger, fear, and frustration-all understandable reactions. Seeing a family member of a friend suffer from an eating disorder is very frightening and difficult. We know it's not easy.
You can play a critically important role in the recovery process. Knowledge-based appropriate actions and support can be a tremendous source of strength and comfort to your loved one.
Those suffering from eating disorders most often have two things which are the common denominators of eating disorders. The first common denominator is poor self-esteem, the belief that they are not good enough, that they do not have much to offer the world, and the "felt need" to do something to "make up for that," which is partially acted out in the eating disorder. Secondly, the eating disorder truly is a disorder of avoidance. It becomes a way for those so addicted and so trapped in its grip to avoid painful emotions, painful beliefs about self, pain that comes from a lost sense of one's identity, and further, a way to avoid rejection and other painful experiences in life.
Poor self-esteem is the thread of the deep woven fabric of an eating disorder. Eating disorder patients most often become trapped in a belief about self which is: 'I am nothing more than my appearance, my achievements, and what others think of me.' It is these beliefs about themselves that keep the eating disorder alive and well. Therefore, a step to recovery, and then ultimately one of the blessings of recovery, is to once again learn that esteem and worth are much more than appearance, so much more than achievements, and everything more than what others might think and feel.
Self-esteem has more to do with what one believes in, what one thinks, feels and desires, the intentions of one's heart, one's sensibility, intuition, capabilities, and more. It has to do with passion and how one lives their life. Self-esteem has more to do with the internal than the external. For the religious, it has to do with deity and divinity, the meaning of being a creation of God. For others, it may include ideas of connection with others, self-respect, good intention, talents, whether developed or not, a sense of being rather than doing. It is about who we are, and the intentions of the heart.
According to Bednar Wells and Peterson (1989), self-esteem is: "An enduring and affective sense of personal value based on accurate self-perceptions."
At their core eating disorders are a spiritual problem. Almost all women with eating disorders have distorted and lost touch with their sense of identity and worth. This identity loss is pervasive to the extent that they lose touch with virtually every healthy aspect of their identity until their identity is their eating disorder. They no longer are capable of seeing themselves as women, daughters, mothers, artists, creations of God, and so on but see themselves exclusively as an eating disorder, or as the expression of an eating disorder. Their whole sense of identity revolves around their body and their eating disorder. A 19-year-old former patient who participated in a survey we conducted about the role of faith and spirituality in recovery wrote,
An eating disorder doesn't want just a part of your life, it wants it all-it demands it all. This was the case for me. Before I knew it, I was consumed by my eating disorder and spent 110% of my time thinking about food, weight, etc.
A 22-year-old former patient wrote,
Having an eating disorder hurt my spirituality and relationship with God just as it hurt everything else. There was nothing else-only an eating disorder to occupy my time and energy.
For many patients, the loss of their spiritual sense of identity is an extremely painful part of their experience. Many patients feel that they have lost God or that God has left them. They no longer feel worthy or deserving of God's love. A 25-year-old former patient wrote,
My eating disorder destroyed my relationship with God. It blocked me from God and I lost all faith and trust in God. I became very angry with God because I felt like God had abandoned me. Eventually, I just stopped thinking about God. My eating disorder became my God and my body became the Devil.
A 23-year-old former patient wrote,
My eating disorder robbed me of my relationship with God. I was in a personal anguish that shred my soul and threatened my spiritual and mortal life. I felt no love and saw no mercy. Anger consumed me. I felt abandoned and worthless. My heart turned bitter and hard. I cut God out of my life completely. My eating disorder robbed me of my self-worth. I felt like nothing. I could not feel love, for I was unlovable. I could not give love, for I was incapable. I lost my self-respect and went against all I believed to be true. It was a downward spiral that almost led to my death.
These statements help illustrate the damage an eating disorder can do to a woman's sense of spiritual identity and worth and to her relationship with God. One of the sad consequences for women who suffer with eating disorders is that through the course and development of the eating disorder, they often lose touch with what is most powerful within themselves. They become numb or lose contact with the feelings of their heart or spiritual identity and worth.
National Eating Disorder Association (NEDA) http://www.nationaleatingdisorders.org/
International Association of Eating Disorder Professionals (IAEDP) http://www.iaedp.com/
Gurze 2008 Eating Disorders Resource Catalogue - Gurze Books (specializing in eating disorder publications, education and treatment directory) Catalogue is available at BYU-Idaho Counseling Center. http://www.bulimia.com/
National Institute of Mental health http://www.nimh.nih.gov/
Eating Disorder Awareness Week http://www.edaw.org/
American Dietetic Association http://www.eatright.org/
Eating Disorder Hope http://www.eatingdisorderhope.com/How to Avoid a Thinness Obsession in Today's World (upload the Powerpoint)