Be the first line of defense against eating disorders : Friends and family can save a life
By Kimberly Dennis, M.D.
Medical Director of Timberline Knolls Residential Treatment Center
February 15, 2010
While the majority of us do not work in the emergency room, or in any sector of the healthcare field, we can still save lives.
In the United States, as many as 10 million women and one million men are fighting a life-and-death battle with anorexia or bulimia, according to the National Eating Disorders Association.
By becoming aware of certain signs and symptoms, you may be able to intervene in a disease process that may otherwise go unnoticed – and untreated. Armed with the knowledge of what to look for and a willingness to speak to what you see, you can potentially save a life.
A deadly disease spreads – faster
Eating disorders are potentially fatal, biologically-based psychiatric illnesses. Anorexia nervosa has the highest mortality rate of any psychiatric illness, nearly 12 times greater than any other cause of death among women between the ages of 15 and 24.
What's more, eating disorders among young women are increasing at an alarming rate. Nationally, the incidence of bulimia in women ages 10 to 39 tripled between 1988 and 1993, and continues to grow. It's unclear how much of this increase is due to increase in disease as such and how much is due to increased public awareness, improved access to care and better screening for eating disorders among professionals.
Anorexia typically begins at the start of puberty and is more common among adolescent girls and young adult women. It affects one to two percent of the female population, and 0.1 to 0.2 percent of men. Because more than 90 percent of all those who are affected are adolescents and young women, the disorder has been characterized as primarily a young woman's illness. Not infrequently, however, middle to late-aged women, ,males and children as young as seven years old are diagnosed with this illness.
Patients with anorexia usually have a body weight that is 85 percent or less of their normal, healthy weight. Most patients also have an obsessive preoccupation with body weight and calories, as well as an intense fear of gaining weight or becoming fat. Body image in anorexia nervosa is grossly distorted, resulting in an unwarranted psychological impact on self-esteem.
There are two types of anorexia nervosa: the restrictive eating type and the binge-eating/purging type. Binge eaters rapidly consume a large amount of high-calorie food in a very short time – perhaps 1,500 to 3,000 calories or more in less than an hour. Those who purge may do so with self-induced vomiting, excessive exercise or the use of laxatives, diuretics, stimulant medications or enemas. Approximately 70 to 80 percent of people with bulimia purge by means of self-induced vomiting, while 30 percent use laxatives. Some who purge, however, do so without actually binge-eating first.
Recognizing the danger signs
The physical complications associated with anorexia are potentially life-threatening, since dehydration and malnutrition can damage vital organs. Medical complications associated with anorexia include:
- low blood pressure
- electrolyte imbalance
- cardiac arrhythmias
- decreased heart function from loss of cardiac tissue
- poor attention and concentration due to loss of brain tissue (frontal lobes)
- thyroid gland deficiencies, which can lead to cold intolerance and constipation
- appearance of fine, baby-like body hair (lanugo)
- bloating or edema
- decrease in white blood cells, leading to increased vulnerability to infection
- osteoporosis
- loss of menses
- seizures related to fluid shifts and electrolyte imbalance
- kidney damage or failure
Signs that a person may be suffering from an eating disorder include:
- High level of concern about weight and body size or shape
- Repeated attempts to control weight by diet, refusal of food, vomiting or laxative/diet pill/stimulant abuse.
- Prolonged exercising despite fatigue and weakness.
- Rigid rules or peculiar patterns regarding the process of eating and/or handling food.
- Limited variety in food choices.
- Repeated trips to the bathroom during or after meals.
- Lying about food intake
- Hiding food or food remnants
- Exhibits abnormally fast weight loss or gain, without any other known medical condition.
- Depressed, anxious or labile moods.
- Other forms self-deprecating behavior.
The most important thing to do if you recognize these signs is to let go of the urge to remain silent. Remember, denial is a big part of eating disorders – another reason they can become fatal and a major obstacle to recovery. Seek advice from an expert, act in a caring and non-judgmental way, simply stating what you see, and asking how you can support recovery. Model recovery by getting help and support for yourself as a person who may be impacted by someone else's potentially fatal eating disorder.
Also, you can go to the Web site of the National Eating Disorders Association (www.myneda.org) or call Timberline Knolls Residential Treatment Center at 877-257-9611. We would be happy to help you find a professional or interventionist in your area. That referral just might save a life.
Kimberly Dennis, MD, is the medical director at Timberline Knolls Residential Treatment Center. Located in Lemont, Ill., TK is designed exclusively for women and adolescent girls with emotional disorders, including eating disorders, addiction, mood disorders and other co-occurring disorders. Dr. Dennis is a member of the Academy of Eating Disorders, the American Academy of Addiction Psychiatry, and the American Society of Addiction Medicine.
