What to look for, where to find help
As a loving and concerned parent, you may notice that when your daughter enters puberty she will gain weight. Most of this gain is due to her body developing and preparing her to grow taller; the weight usually precedes the growth spurt. A healthy adolescent may gain anywhere from 20 to 50 pounds. Because there is so much focus on weight and body size in our culture, however, adolescents are not given the opportunity to go through these changes with the weight fluctuations that are necessary for normal development. This is the time that most eating disorders start. Over the years, I have heard my clients say that they started their eating disorder between the ages of 11 and 15 years old. Most started with a diet or over-exercising.
It is very hard to tell if your daughter is going through normal changes or has the beginning stages of an eating disorder. Research reports that 50 percent of girls between the ages of 12 and 14 say they are unhappy because they “feel fat,” 45 percent of elementary-school-age children report wanting to be thinner, and 40 to 60 percent of high-school girls in the United States are on a diet.
Here are some eating disorder signs to look for:
• Uses food when upset or stressed.
• Has lost a significant amount of weight in a short period of time.
• Uses laxatives, diuretics and/or appetite suppressants .
• Must exercise or goes to the bathroom during or following meals.
• Has a preoccupation with body, weight, diets and/or food.
You cannot tell if someone has an eating disorder just by looking at them. The eating disorder is used as a way of coping with the stresses of life. It is a way to avoid feelings or some traumatic event that a person does not want to face. Left untreated, the eating disorder can cause disruptions in emotional and physical development, including osteoporosis and infertility later in life.
Many people ask me, “What are the best ways to avoid an eating disorder?” One of the most important factors is role modeling and dieting. We now have generations of women brought up with dieting and not liking their body. A child sees Mom looking in a mirror and being upset about her weight. She sees her going on one diet after another. She thinks Mom is beautiful and wants to be just like her.
Research is showing that 35 percent of “normal dieters” progress to disordered eating that may last a lifetime. Alterations occur in brain chemistry from restricting food then binging. People start using food to feel better. Food uses the same reward system as mind-altering substances. This is one of the reasons for cravings and obsessive thoughts about food. Also, some foods are addictive to some people.
Currently, 11 million people in the United States have eating disorders. Disordered eating is not entirely about what we eat. Most people with disordered eating could write books about nutrition. They know the calories, fat grams and carbohydrate contents of the foods they eat. They know what they should eat and how much; they just cannot put that into practice. The real problem is that food or the compulsive thoughts are being used to avoid some part of our life. Usually they do not know what feelings they are avoiding.
In our treatment center, we see so many people who are not only disconnected from their feelings, but also from their appetite and themselves. When dieting, they may be hungry, but they tell themselves, “I am doing well, because I am sticking to my diet.” They are not listening to their body signals. Over time, they do not even know when they are hungry or full. They search for an external source (the diet) to regulate their food intake. With each failed diet, they lose a little more self-esteem, because they did not stay with their diet. Yo-yo dieting or other forms of external control only work temporarily. The real issues need to be dealt with so that there is no need to use food to shove these issues down. Only an internal shift can produce lifelong changes.
Many people have followed the steps outlined in my book, “Diets Don’t Work” (ReBu, 2009), so that they can once again eat when hungry and stop when full and make healthy choices.
Obviously, there is a continuum of eating disorder behaviors, but if disordered eating is causing a problem in your life, relationships or self-esteem, you should consult a professional who specializes in eating disorders. Eating disorders and disordered eating do not go away on their own; they require professional help. There is no simple cause of eating disorders, nor is there a simple cure.
It is usually a good idea to start treatment with a team of experienced eating disorder professionals. The collaborative approach — including a medical doctor, registered dietitian, exercise physiologist and therapist, along with group therapy — is necessary to facilitate dealing with the core issues and build a solid foundation for long-term recovery. The dialogue among these professionals is indispensable in planning the best treatment for each individual. An eating disorder treatment program will help the person deal with the underlying reasons why he or she has been using the eating disorder, and create the foundation for lasting recovery.
Rebecca Cooper is a licensed therapist, certified eating disorder specialist, the author of “Diets Don’t Work” and the founder of Rebecca’s House Eating Disorders Treatment Program in Laguna Hills.