Eating Disorders

What are Eating Disorders?

Simply put, an eating disorder is a disease that anyone can get, regardless of their age, gender or ethnicity. Eating disorders are not just about food, shape or weight. In fact, anorexia nervosa, bulimia nervosa and compulsive eating are thought to be expressions of a persons complex problems with identity and self-concept (how they see themselves). These feelings are often caused by traumatic experiences and are influenced by society's* ideals of what beauty is and what a person should look like.
A person who develops an eating disorder may also be responding to biological factors, family issues and their psychological* make-up.

Warning Signs

If any of these problems affect you or someone you know, an eating disorder might be the reason.

· refusal to eat
· excessive exercise
· preoccupation with food, weight and dieting
· distorted body image (this means you don't like what you see and you may not be seeing what is really there, for instance you think you're fat when you really are the ideal weight for someone of your body type)
· irregular or absent menstruation
· frequent use of laxitives, diuretics, diet pills or Ipecac*
· avoidance of friends and family
· uncontrolled or binge eating
· guilt and shame about eating
· responding to emotion by eating or not eating
· denial of hunger
· unusual eating habits
· frequent weight fluctuations (this means your weight changes alot)
· self-induced vomiting
· frequent dental problems
· low self-esteem
· depression and moodiness
· perfectionism
· "all or nothing" thinking

Eating disorders can be treated. If you think you or a friend has an eating disorder, please use one of the resources below for help.

Eating Disorders

Anorexia Nervosa

is characterized by extreme weight loss from a self-imposed and severe restriction of foods and fluids, a distorted body image, an intense fear of becoming fat, and low self-esteem. People with anorexia diet to extremes and will commonly overexercise in an effort to lose weight. Most sufferers don't realize how underweight and undernourished they are, despite comments from others. Even after reducing to dangerously low weights, individuals suffering from anorexia will temporarily feel better after losing weight, continue to "feel fat," and be convinced they need to lose even more weight. This denial of the problem makes it very hard to convince individuals to seek help.

Signs and Symptoms
· excessive concern about weight and shape
· significantly reduced food intake
· obsession with food and recipes
· increased selectivity of diet
· unusual eating habits, eg. cuts food into tiny pieces
· noticeable weight loss
· feeling fat in spite of weight loss and increasing thinness
· excessive exercising
· always feels cold
· irritable denial that anything is wrong
· depression
Physical Problems Related to Weight Loss
· dry, pasty skin
· stringy lusreless hair
· brittle nails
· constipation
· menstruation ceases
· lowered heart rate
· lowered body temperature
· hair loss
· swelling or puffiness in face, fingers and ankles
· growth of fine downy hair on face and back
· sleeping problems
· overall lowering of body metabolism

Bulimia Nervosa
is distinguished by regular periods of uncontrolled binge eating (consuming large amounts of food) followed by some form of purging in an attempt to prevent weight gain: self-induced vomiting, abuse of laxatives or diuretics, strict dieting, fasting, or excessive exercising. Individuals suffering from bulimia often experience a persistent and driving concern with their weight and shape, although they may be of average weight, "over" weight or underweight. An episode of bingeing and purging is usually followed by dieting. Dieting often results in feelings of deprivation and hunger which may trigger another binge. Individuals with bulimia may initially lose weight but will most likely regain it because of the ineffectiveness of purging methods.

Signs and Symptoms

· eats large amounts of food with little weight gain
· food disappears from fridge and cupboard
· excessive concern about weight and shape
· goes to the bathroom after meals for secretive vomiting
· excessively sensitive, secretive and irritable about food and eating
· chronic sore throat and hoarse voice
· evidence of vomiting or laxative abuse
Physical Problems Related to Binge Eating, Vomiting and Purging
· erosion of dental enamel
· swollen glands in neck
· dermatitis around mouth
· Castro-intestinal problems, eg. abdominal pain, bloating, constipation
· dehydration
· electrolyte desturbance (sodium and potassium imbalances which can cause headaches and irregular heartbeat)
· kidney damage
· irregular menstrual period

Compulsive Eating

can be identified by periodic episodes of uncontrolled eating or bingeing. Compulsive eaters, like people struggling with anorexia and bulimia, use food to cope with low self-esteem, stress, emotional conflict and powerlessness. This pattern is often triggered by chronic dieting, then maintained by an inablility to deal directly with uncomfortable feelings and daily problems. Compulsive eating is frequently followed by renewed pledges to diet or overexercise, thus perpetuating the compulsive cycle. Compulsive eaters are not necessarily "over" weight; they can be any shape or size.

Signs and Symptoms
Compulsive overeating is a seperate eating disorder, but it is really very similar to bulimia. The only difference is that compulsive overeaters do not purge. Often, they too eat to combat stress, binging on large amounts of food.

Physical Problems Related to Compulsive Eating

· can be overweight to an extent which limits physical activity
· may have weakened heart
· high blood pressure
· diabetes
· heart disease
· possible nutritional shortcomings, eg. if they're eating too much junk food & not enough nutrients

Coping With an Anorexic or Bulimic Person

This is written using a female for an example because most often they are the victims of eating disorders. Increasingly however, more males are developing eating disorders. We recognize the damaging affects these disorders have on everyone involved and in no way wish to minimalize the impact on males.

· let her know you are concerned d and there to help
· encourage her to seek professional help. If she resists seeking help, you may want to take the first step and find a good therapist
· remind her that she is not alone. If she is unwilling to seek the help of a ofessional, help her find a support group to attend.
· you may want to help find a support group for friends and families. you may find it beneficial to talk to someone who has shared the same experience.
· read as much as possible about eating disorders. The more you know, the more you can help her understand.
· be persistent, but not pushy, in trying to get her to seek help. If she is in physical danger because of her eating disoder, be pushy!
· don't force her to eat
· don't tempt her with favourite or high calorie food
· avoid comments such as "if you eat, you'll look better," or "you look better since you have a few pounds," since most anorexics and bulimics interpret this as "to be better is to be fat"
· don't let conversations focus on food and weight

 

Treatment
Various treatments are used with people with eating disorders. Which of these is appropriate for a particular person will depend on several factors, including the type of disorder, severity, and what is available in your community. The family physician and somethimes a mental health professional should make a clinical assessment, which will result in treatment refcommendations (sometimes after referral to a medical specialist). These treatments may include:

· counselling
· consultation with a dietitian
· group and/or family therapy
· support groups
· medication
· hospitalization (not usually necessary unless weight is dangerously low)

Where to get help-for eating disorders

B.C. Children's Hospital - Youth Clinic
3644 Slocan St.
Vancouver, BC
604-434-3522
The youth clinic has increasingly focused on serving as a provincial referral centre for adolescents with eating disorder problems.

Day Programs
Hospitals with psychiatric day programs that accept patients with eating disorders:
· Kelowna General, Kelowna
· Matsqui-Sumas-Abbotsford, Abbotsford
· St. Paul's, Vancouver

Dial-A-Dietitian
604-732-9191 (Vancouver) or 1-800-667-3438 in the rest of BC

Eating Disorder Resource Centre of British Columbia
St. Paul's Hospital
1081 Burrard St.
Vancouver, BC
phone #604-651-5313 or
1-800-665-1822
This is an information, referral and educational service for both the public and professionals. The centre maintains a library, and a directory of treatment resources in BC.

InPatient
Several hospitals accept patients with the primary diagnosis of an eating disorder. Those listed below offer special skills in assessment and treatment:
· BC Children's Hospital
· Kelowna General Hospital, Kelowna
· St. Paul's, Vancouver
· Royal Jubilee - Eric Martin Pavilion, Victoria
OutPatient
Clinics with a specific interest in patients with eating disorders:
· BC Children's Hospital/Youth Clinic, Vancouver
· St. Paul's, Vancouver

Private Practitioners
Many registered professional accept private patient referrals. The following professional organizations offer lists of referral resources:
· College of Psychologists of BC - 604-877-1454
· BC Association of Social Workers - 604-876-9535
· BC College of Physicians & Surgeons - 604-733-7758
· BC Dietitians' & Nutritionists' Association - 604-736-7331
· Registered Nurses' Association of BC - 604-736-7331

Support Groups
ANAD (Canadian Association of Anorexia Nervosa & Associated Disorders)
Offers support group services and informational material. For information, call 604-684-2623 (Vancouver).
BCEDA (British Columbia Eating Disorders Association)
Offers support group services, information and referral services. For information call 250-383-2755 (Victoria).
Some other communities offer professionallly led support groups, including Surrey (604-584-5811) and Cranbrook (250-426-1400). Contact your local health unit or mental healthy centre.

University Resources
Victoria - University of Victoria Counselling Services
Individual and Group Treatment 250-721-8431
Vancouver - University of British Columbia Counselling Services
604-822-3811
Burnaby - Simon Fraser University Counselling Services
604-291-3694

The Vancouver Anti-Anorexia Anti-Bulimia League
207-1168 Hamilton Street
Vancouver, BC
V6B 2S2
They run a support group, publish a newsletter and often hold conferences. This is an excellent group to become involved in.

Vision Counselling Services
#5-38921 Progress Way
(above Squamish Upholstery)
Industrial Centre
Contact Trudie or Sandi at 892-2213 for more information.
Offers an Eating Disorder Support Group on Monday nights at 7:30 pm or individual counselling.

Whistler Disordered Eating Support Group
604-938-1006
They focus on the emotional and coping difficulties that underlie disordered eating behaviours. They have an on-going confidential support group.

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