February is National Eating Disorders Awareness Month. Eating disorders effect 1 or 2 out of every 100 children and are becoming more common, but many children and adults are able to hide eating disorders from their families for months or even years because they wear loose fitting clothes and appear to eat a healthy diet. Several of the causes for this increase in eating disorders include constant pressure from sports, movies, television and magazines to be abnormally slender. Many sports such as wrestling and gymnastics dance and acting also make weight and body image a huge issue. If you don’t weigh what the coach or director wants, you don’t compete in the big meet or get the best part in the play. Magazines at the grocery checkout, where I get my up-to-date medical information, always have articles featuring the thinnest people.

The two most common eating disorders are anorexia nervosa and bulimia nervosa. Anorexia and bulimia are very similar, but people with anorexia are usually very thin and underweight and people with bulimia may be a normal weight or even overweight. People with anorexia or bulimia frequently have an intense fear of being fat or think that they are fat even if their weight is normal. People with eating disorders also can have serious physical health problems, such as heart conditions or kidney failure and in severe cases suffer from severe malnutrition and may even die. The best-known example of a tragic outcome from an eating disorder is that of Karen Carpenter, the great singer, who died of heart problems after struggling for years with anorexia nervosa.

People with anorexia have an extreme fear of weight gain and a distorted view of their body size and shape and try to maintain a very low body weight. Some restrict their food intake by dieting or exercising for hours. The small amount of food they do eat becomes an obsession. People with anorexia become very thin; weigh themselves at least once a day; count calories and portion the food they eat very carefully; only eat certain foods; withdraw from social activities; and may door poorly in school because they get lightheaded and are unable to concentrate because they are starving.

Compared to people with anorexia who eat almost nothing, people with bulimia usually eat a huge amount of food, such as pizza, cakes, cookies or ice cream that almost dissolve in your mouth without chewing. They only stop eating when they are too full to eat any more or run out of food. Then they try to get rid of the calories they ate by vomiting, exercise for hours or use laxatives to not gain weight. People with bulimia also have health problems because constant vomiting can damage your stomach and kidneys; cause tooth decay from the stomach acids you throw up; and the loss of minerals such as potassium which can lead to heart problems and death.

I treat children and adults who have eating disorders by helping them to establish new patterns of thinking about food and to deal with their disordered eating patterns. I help children to think about their body size, shape, eating, and food. I also use nutritional counseling, and individual and family therapy because parents and other family members are vital to help children see their normal body shape is fine and that being excessively thin can be dangerous.

As a mother, your own eating habits and how your deal with your own body image is a great influence on how your children think about food and how they look. Create a healthy lifestyle for your family by involving your kids shopping for and cooking healthy, nutritious meals. In addition to the nutritious meals, make exercise a fun, rewarding, and regular family activity.

BRIEF SENTENCE ON THE AUTHOR

Dr. Grubb is Board Certified in Adult and Child and Adolescent Psychiatry and is a member of the Behavioral Health Team at the National Naval Medical Center at Bethesda, MD specializing in pediatric and family issues with weight. Dr. Grubb is a staff psychiatrist at the Columbia Counseling Center and can be reached by contacting the Center.

Men and Women in the Military. Studies also show a higher-than-average risk for eating disorders in men and women in the military. A study of eating behavior on one Army base reported that 8% of the women had an eating disorder, compared to 1 – 3% in the civilian female population.