Eating Disorders: Causes and Treatment of a Growing Medical Problem

February 2001

Contact: Robyn Alie
MMS Department of Public Health and Education
ralie@mms.org
781-434-7371

The stories have become too common: Teenage girls dieting to the point of emaciation and college-aged women inducing vomiting after periods of binge eating.

Whatever the manifestation, an estimated five million Americans, predominantly women, suffer from some form of eating disorder, most commonly anorexia nervosa or bulimia nervosa. One out of 10 of these sufferers will die as a result of their eating disorder, according to the National Institute of Mental Health. 

"A true eating disorder is a serious problem," says Brenda E. Richardson, M.D., who chairs the Massachusetts Medical Society's Committee on Nutrition. "The physical side effects can include an imbalance of the electrolytes in a person's body. This can lead to serious cardiac problems and possibly death."

What differentiates the desire to lose a few pounds with potentially life-threatening eating disorders? The issue is complex, but medical researchers generally agree that anorexia (preoccupation with dieting and thinness leading to excessive weight loss) and bulimia (ridding the body of food usually following rapid food consumption) are often linked to psychiatric disorders related to identity and self-concept.

Psychologist Margaret Marino, Ph.D., the director of child and adolescent eating disorders and obesity at the New England Medical Center, also cites genetic, environmental and cultural issues as factors that frequently cause eating disorders. "Family dynamics play an important role in establishing patterns that lead to eating disorders," says Dr. Marino. "An over-emphasis on physical appearance and negative experiences resolving conflicts within the family can result in their onset, usually coinciding with the start of adolescence."

Diagnosis

Drs. Richardson and Marino agree that early diagnosis is key to successful treatment of eating disorders. "Some people think that eating disorders in young people are just a phase and if you leave the person alone the kids will grow out of it," warns Dr. Richardson. "That is sadly not the case."

Dr. Marino recommends that family and friends use generally accepted checklists if they're concerned that someone they know may be suffering from an eating disorder.

Specific signs of anorexia may include:

• Significant weight loss in the absence of illness.
• Significant reduction in eating coupled with a denial of hunger.
• Dieting when not overweight.

Sufferers of bulimia may exhibit different signs, including:

• Evidence of binge eating. (Including actual observation and verbal reports, large amounts of food missing, or the stealing of money or food.)
• Frequent weight fluctuations.
• Evidence of purging, including vomiting, laxative or diuretic abuse, frequent fasting and excessive exercise.

There are instances when an individual displays a combination of both sets of symptoms and when binge eating is not followed by the purging found among bulimics. This is commonly referred to as Binge Eating Disorder or BED.

Treatment

Medical professionals agree that curing these disorders can take months or years and that the most important factor is early detection. "Clearly these patients have many psychological problems," says Dr. Richardson. "However, the physical damage is significant if the problem is not attended to. Many disciplines contribute to the whole picture including the physician, nurses, dieticians and therapists," she adds.

More Information

There are a number of excellent resources available to learn more about eating disorders, their diagnosis and treatment. They include the following Internet sites:

www.anad.org - The National Association of Anorexia Nervosa and Associated Disorders is the oldest national, non-profit organization dedicated to helping people with eating disorders. The site contains a number of interesting articles and helpful information.

www.aedweb.org - The Academy for Eating Disorders is an eight year-old professional organization promoting the cooperation of various disciplines to treat eating disorders.

This article is provided as a public service by the Massachusetts Medical Society to offer information about ways to attain good health. For more information, contact: Robyn Alie, MMS Department of Public Health and Education, ralie@mms.org, 781-434-7371.