- Starving to Death
She's not exaggerating. Of all psychiatric illnesses, eating disorders have the highest fatality rate. Nearly 45,000 people die from them in America each year, and that number is growing. Even after patients have sought treatment, eating healthfully becomes a lifelong struggle. Angela Blier, a clinical counsellor who treats patients with eating disorders in Portland, Maine, explains this by comparing it to someone with a drug addiction. "When you give up drugs and get clean, you never do them again. With an eating disorder, you have to eat to survive, so there's always the chance to backslide."
The two most common eating disorders are Anorexia Nervosa--where the person has a distorted body image and severely restricts their intake of food, sometimes to the point of starvation--and Bulimia Nervosa, where the key symptoms are binge eating followed by purging, either by vomiting or using laxatives. Many factors play into the weight loss obsession, including genetic predisposition to the disease, family attitudes about food, the friends a teen chooses to hang out with, the presence of depression or anxiety, biological make-up, and a perfectionistic or obsessive personality. In addition, images from the media of painfully thin models and actresses bombard kids daily, teaching them a distorted definition of what is normal, and encouraging them to aspire to a goal that is unattainable for most. Often, like in Michelle's case, a traumatic event may trigger the onset of a disorder--a death, their parents' divorce, sexual abuse. The statistics about where we're headed as a nation are disturbing: 40% of fourth graders report that they diet either "very often" or "sometimes." According to a Mayo Clinic study, three out of every one hundred girls will develop an eating disorder as they mature. Though it's less talked about, boys are not immune to the illness--one out of every 10 people with an eating disorder is male, and that number is growing as well, according to Dr. Roberto Olivardia of Harvard Medical School, a clinical psychologist who primarily treats men and boys with the disease.
If you suspect your child might have an Eating Disorder, take them to your family physician or pediatrician right away.
It's important to trust your instincts when it comes to your child, says Dr. Patrice Lockhart, Medical Director of the New England Eating Disorders Program. The youngest children now being seen there are seven years of age. "You can't hurt your child by bringing up concerns, but you can hurt your child by avoiding them," says Dr. Lockhart. "So many parents come in here and say, 'Oh, I wish we'd called 6 months ago.' You've known your child since birth. The minute you have any concerns, trust your gut."
Experts advise that you approach your child in a loving way, directly expressing your concerns for their health and the fact that you are worried about them. Don't be surprised if your child denies the problem. "The danger with eating disorders is denial--denial with a capital D," says Blier. "It's easy to defend not eating a lot and exercising. If your child denies the problem, the next step is the doctor."
Early Warning Signs The earlier you address your child's eating disorder and get them to the doctor, the better chances are for recovery. Early warning signs may include a child's obsession with dieting and weighing themselves, and sudden dietary changes. In the case of bulimics, you may see your child running to the bathroom immediately after every meal. If you notice a pattern, follow them and listen by the door to see if they are purging. Another danger sign is if "they start on an exercise program that they can't imagine stopping," according to Dr. Lockhart. "Anything they can't imagine stopping has the potential for being dangerous. In addition, another sign is that "they may suddenly decide to become a vegetarian but not have the education to support a healthy vegetarian diet."
Boys are even more secretive about their eating disorders, and therefore their presence is often harder to detect than with girls. "With boys on the anorexic range, they're more likely to disguise through exercise," says Dr. Olivardia, who is also the co-author of The Adonis Complex. "They'll spend a lot of time at the gym, and parents might dismiss it until their son starts losing lots and lots of weight and becomes hyper-conscious of everything he eats." Boy who have a predisposition to eating disorders might gravitate toward wrestling, for example. "There are some who become bulimic as a function of joining the sport, but many others who had body issues before they joined," says Dr. Olivardia. "People don't suspect boys in the first place. They rarely use the language of 'I don't want to get fat,' they'll say 'I want to get into good shape, I want to get cut.' Words like 'Cut,' and 'lean,'"--accompanied with drastic weight loss and obsessive eating habits-- should be as triggering as a girl saying, 'I don't want to get fat.'"
What should parents avoid doing? If you suspect your child has an eating disorder, don't try to force feed them. "Don't try to put them into situations where they'll eat--don't try to take the treatment on yourself," says Blier. "By trying to make the food they want, it will just result in them not eating it. Don't schedule a family activity during their exercise time. Don't you try to control what they're doing. You're not a treatment provider, you're their parent." Statistically speaking, the most important thing is to address the problem as soon as you sense there might be one, and that you get your child some good medical help as soon as possible.
Seeking Counselling After consulting with your physician, if it's determined that your child has an eating disorder, the next step is to find a counsellor or accredited eating disorder program. Many use cognitive behavioural therapy to address poor eating habits and give patients a healthier approach to food. If the situation is more critical, children may have to enter an inpatient program. If it's severe enough, they may be put on IV fluids and admitted for a longer period of time. Family counselling may also be recommended.
- Author: Elisabeth Wilkins. Her work has appeared in national and international publications, including Mothering, Motherhood, and The Japan Times.