Monday, January 26, 1998
Body and soul
EATING With society’s emphasis on appearance,
weight and diet, eating disorders are more than physical
diseases, but threaten mental health
By Jean Liu
Daily Bruin Contributor
An apple a day does not keep the doctor away, if it is all you
are eating each day.
In high school, Lily, who is now a fourth-year art student, used
to limit her food intake to one apple a day for several weeks. Lily
suffered from bulimia and anorexia in high school and part of
college. Within a month, her weight dropped from 135 pounds to 88
pounds. And several physiological problems came along.
"My hair was falling out, I was always sleepy or tired in class,
and I would get bruises on my knees the next morning from my legs
pressing together," she explained.
Among college students, about one in 10 women have an eating
disorder although some believe the numbers are higher, according to
Dr. Elizabeth Gong-Guy, a clinical psychologist at UCLA Student
Psychological Services.
Eating disorders such as anorexia nervosa and bulimia are
psychiatric illnesses that afflict over five million American men
and women, according to the National Institute of Mental Health
(NIMH). More than 90 percent of those with eating disorders are
adolescent and young adult women.
People with anorexia starve themselves with the persistent hope
of losing weight, even when their weight has fallen to 15 percent
below normal body weight and they look emaciated.
Those with bulimia binge, eat and then purge by self-induced
vomiting, abusing laxatives and diuretics, strict dieting or
exercising vigorously.
Serious medical complications can arise from anorexic and
bulimic behavior.
One in 10 cases of anorexia leads to death from starvation,
cardiac arrest, other medical complications or suicide, according
to NIMH. Starvation can damage vital organs such as the heart and
the brain. Women typically stop menstruating, and men with anorexia
often become impotent.
With bulimia, the acid from vomiting wears down outer layers of
the teeth. Purging may lead to heart failure due to loss of vital
minerals, such as potassium.
There may be many misconceptions about these disorders. For
instance, eating disorders are not merely physical problems. They
indicate a deeper emotional disorder.
According to UCLA Student Psychological Services, eating
disorders are the struggle for life-control and anxiety
reduction.
"Often, people with eating disorders are demanding of
themselves," Dr. Gong-Guy said. "Attaining some ‘perfection’ is
something they strive towards."
There is also usually an underlying depression, although the
psychological factors vary depending on the individual. For Lily,
there were problems in her relationships with family and boyfriends
as well as a lack of self-confidence.
"When things were going badly in my life, I thought it was
because I wasn’t pretty enough, or I wanted to blame it on being
ugly," she said. "My weight was what I could control."
People who have eating disorders rely on them as a coping
strategy. "The women focus on appearance and weight, an area where
they feel as if they have some kind of control, and develop an
obsessive and compulsive set of beliefs about their body," Dr.
Gong-Guy said. "For women and men, focusing on body and
calorie-counting distracts them from issues that are more
important. Eating disorders serve as a distraction, a numbing
mechanism."
But eating disorders are anything but anesthetic. "It is a
psychologically-painful, physically-destructive set of diseases,"
Dr. Gong-Guy said.
Treatment programs for eating disorders vary. At UCLA Student
Psychological Services, the treatment model depends on what the
individual needs.
Students may get individual and/or group therapy. "What’s good
about group therapy is that it’s great to see other people
progressing – that you’re not alone," Dr. Gong-Guy said.
Students may also see a psychiatrist, depending on what other
symptoms accompany the eating disorder.
"The great thing is that (Student Health) is a free service,"
Dr. Gong-Guy said. "We know a lot of issues that are alive for
college students. And there are many people treating you."
For students who feel they might be developing one of these
conditions, Dr. Gong-Guy advises that they should come in
immediately to avoid developing an eating disorder. They would not
be placed in group therapy but would learn to understand the
underlying issues and how focusing on these issues serves the
student.
Dr. Gong-Guy attributes the inability to develop one’s self,
seek support, or manage stress in a healthy manner to the reasons
people may find themselves indulging in addictive disorders. "One
of the most important tasks of college is to develop
self-regulation."
"In the culture, there’s a real focus on appearance, body weight
and diet. It is easy to slip over the edge from a healthy concern
for your body to an unhealthy over-concern and obsessive focus on
body and food," she added.
Some people may wonder whether they should see a nutritionist or
dietitian instead. For Lily, the choice seemed pretty clear. To
overcome her eating disorder, she went to psychiatric counseling on
and off for about four years.
"It’s a mental problem," Lily said. "Going to a dietitian is
like using cough drops for a cold, but you still have a cold.
Forcing someone to eat if they are anorexic or keeping an eye on
them if they are bulimic is only treating the symptoms, not the
cause."
At the same time, some nutritionists are very knowledgeable
about this issue. "I wouldn’t say, ‘Don’t go to a nutritionist,’
but it’s not really a nutritional disorder. It’s an emotional
disorder," Dr. Gong-Guy said. "Most women (who have eating
disorders) know a lot about nutrition compared to the average
person. It is not nutritional knowledge that’s lacking."
And what should you do if someone you care about has an eating
disorder? Often, the person is in denial that the disorder needs
treatment and attention.
"People should not condescend – say they know exactly what
you’re going through and how you feel," Lily said. "The best way is
to encourage them to seek help from someone knowledgeable to help
out."
It is important to let the person with the eating disorder know
that you care. Although, "you don’t want to become part of the
food-police," Dr. Gong-Guy said.
She also warns against isolating the person by ostracizing
them.
"What you do want to do is indicate you know something is going
on that is destructive," Dr. Gong-Guy said. "Try to get the person
to talk about why they feel they need to do that and then encourage
them to talk about what is driving this disorder. Encourage a
friend to try to get help if it isn’t getting better on their
own."
For Lily, talking to a friend was very important, as her eating
disorder was also a cry for help. "Sometimes I just wanted somebody
to listen to me, and they’d be able to listen to my problems," she
said. "I really wanted someone to know I was really in pain."