Anorexia and Bulimia—The Facts, the Dangers
“Food carries an emotional weight far heavier than anything that can be measured in calories or grams.”—Janet Greeson, author.
ANOREXIA and bulimia are the two most common eating disorders. Each has its unique characteristics. Yet, as we shall see, both can be dangerous—even deadly.
Anorexia sufferers, anorexics, either refuse to eat or eat in such small amounts that they become malnourished. Consider 17-year-old Antoinette, who says that at one point her weight may have dropped to 82 pounds [37 kg]—very low for a teenager five feet seven inches [170 cm] tall. “I ate no more than 250 calories a day and kept a notebook about what I ate,” she says.
Anorexics are obsessed with food, and they will go to extreme lengths to avoid gaining weight. “I started to spit my food out in a napkin pretending I was wiping my mouth,” says Heather. Susan strenuously exercised to keep her weight down. “Virtually every day,” she says, “I ran eight miles [12 km], or swam for an hour, or felt terribly anxious and guilty. And every morning I got my greatest pleasure, usually my only real pleasure, by getting on the scale to confirm that my weight was well under 100 pounds [45 kg].”
Ironically, some anorexics become excellent cooks and will serve exquisite dinners that they themselves refuse to touch. “When I was at my very worst,” says Antoinette, “I prepared every single dinner at home and made all the brown-bag lunches for my little brother and sister. I wouldn’t let them near the refrigerator. I felt like the kitchen was all mine.”
According to the book A Parent’s Guide to Anorexia and Bulimia, some anorexics “become obsessively neat and may demand that the entire family meet their unrealistically fastidious standards. No magazine or pair of slippers or coffee cup may be left out of place for a moment. They may become equally, or even more, obsessed with personal hygiene and appearance, spending hours in the bathroom with the door locked and refusing to allow others to come in to get ready for school or work.”
How does this unusual disorder called anorexia develop? Typically, a teenager or young adult—most often a female—sets out to lose a certain number of pounds. When she reaches her goal, however, she is not satisfied. Looking in the mirror, she still sees herself as fat, and so she decides that shedding a few more pounds would be even better. This cycle continues until the dieter’s weight falls to 15 percent or more below what is normal for her height.
At this point friends and family members begin to express their concern that the dieter looks extremely thin, even emaciated. But the anorexic sees things differently. “I didn’t think I looked skinny,” says Alan, a five-foot-nine-inch [175 cm] male anorexic whose weight at one point dwindled to 72 pounds [33 kg]. “The more weight you lose,” he says, “the more your mind becomes distorted and you can’t see yourself clearly.”a
Over time, anorexia can lead to serious health problems, including osteoporosis and kidney damage. It can even be fatal. “My doctor told me that I had deprived my body of so many nutrients that two more months of my eating habits, and I would have died of malnutrition,” says Heather. The Harvard Mental Health Letter reports that over a ten-year period, about 5 percent of women diagnosed as anorexic die.
Bulimia—Bingeing and Purging
The eating disorder known as bulimia nervosa is characterized by bingeing (rapidly consuming large amounts of food, perhaps up to 5,000 calories or more) and then purging (emptying the stomach, often by vomiting or using laxatives).b
In contrast with anorexia, bulimia is not easily recognized. The sufferer may not be unusually thin, and her eating habits may seem quite normal—at least to others. But for the bulimic, life is anything but normal. Indeed, she is so obsessed with food that everything else is unimportant. “The more I binged and threw up, the less I cared about other things or people,” says 16-year-old Melinda. “I actually forgot how to have fun with friends.”
Geneen Roth, a writer and teacher in the field of eating disorders, describes a binge as “a thirty-minute frenzy, a dive into hell.” She says that during a binge “nothing matters—not friends, not family . . . Nothing matters but food.” A 17-year-old sufferer named Lydia describes her condition with a vivid analogy. “I feel like a trash compactor,” she says. “Shovel it in, smash it, throw it out. Over and over, the same thing.”
The bulimic is desperate to prevent the weight gain that would normally result from her uncontrolled eating. Immediately after the binge, therefore, she either induces vomiting or takes laxatives to eliminate the food before it can be turned into body fat.c While the very idea of this might seem repulsive, the experienced bulimic does not view it that way. “The more you binge and purge, the easier it becomes for you,” explains social worker Nancy Kolodny. “Your early feelings of revulsion or even fear are quickly replaced by the compulsion to repeat these bulimic patterns.”
Bulimia is extremely dangerous. For example, repeated purging by vomiting exposes the mouth to corrosive stomach acids, which can wear away the enamel of the bulimic’s teeth. The practice can also damage the sufferer’s esophagus, liver, lungs, and heart. In extreme cases, vomiting can cause stomach rupture and even death. Excessive laxative use can also be hazardous. It can destroy bowel function and can also lead to ongoing diarrhea and rectal bleeding. As with repeated vomiting, abuse of laxatives can, in extreme instances, lead to death.
According to the National Institute of Mental Health, the incidence of eating disorders is consistently rising. What moves one young woman to flirt with death by starving herself? Why does another become so obsessed with food that she binges and then becomes so obsessed with her weight that she feels compelled to purge what she has eaten? These questions will be explored in the following article.
a Some experts claim that a 20- to 25-percent loss of a person’s total weight can induce chemical changes in the brain that may alter his perception, causing him to see fat where there is none.
b Compulsive overeating without purging is also considered by some to be an eating disorder.
c To keep from gaining weight, many bulimics exercise strenuously every day. Some of these are so successful with weight loss that in time they become anorexic, and thereafter they might alternate between anorexic and bulimic behavior.