Eating Disorders is the term used for problems concerning eating and food intake. The most common problems under this diagnosis are anorexia nervosa, and bulimia nervosa. Both bulimia and anorexia are life-threatening diseases that mainly affect young women and adolescent girls. Unfortunately, these problems are also on the rise among adult men and women. Both diseases have roots in societal pressure to be thin; those affected try to achieve an "ideal" weight. The problems can also stem from chaos and emotional pain in a person's life. Anorexia brings a sense of control by not eating, and bulimia brings a sense of control by purging what was eaten. Both anorexia and bulimia can co-occur with obsessive compulsive disorder, self-mutilation, or bipolar disorder; dissociative identity disorder and substance abuse can sometimes occur in those suffering from bulimia. Poor nutritional habits, food fads, and slight overeating are all common problems among young people; however, they should not be confused with anorexia or bulimia. Both are severe psychiatric disorders that can lead to calcium loss and brittle bones, a ruptured stomach, or even death.

Anorexia Nervosa is the loss of body weight to 15% or lower than normal, the intense fear of gaining weight, distorted body image and amenorrhea (absence of at least 3 consecutive menstrual cycles when they are expected). Anorexia occurs in about ½% to 1% of females in the United States, which means it affects 1 in roughly 133 females in Kentucky alone. More than 90% of all those affected with anorexia are adolescent and young women. Characteristics commonly found in those diagnosed with anorexia are perfectionism or being a high achiever, low self-esteem, an irrational belief that they are fat, social isolation, and are usually considered good students and/or good athletes. Some warning signs of anorexia include complaining often of feeling cold (due to dropping body temperature), developing lanugo (the fine hair found on newborns) to cope with the drop in body temperature, cutting foods into tiny pieces, refusing to eat in front of others, fixing elaborate meals for others but refusing to eat it themselves, hiding food, and excessive exercise. If anorexia is not caught early on, the patient may suffer from irregular heart rhythms, calcium loss, or worse, starvation.

Bulimia Nervosa is the recurrent inappropriate behavior to control one's weight by consuming large amounts of food within a short period of time, and is marked by a destructive pattern of binge-eating. A person can only be diagnosed as bulimic when a minimum of two binge-eating episodes a week for at least three months has occurred, and when a doctor has made the diagnosis. Bulimics often eat food that is sweet and high in calories and has texture that allows for fast eating. Binging is thought of as large amounts of food, but the patient determines the amount, so it can be as small as a salad or half an apple. The weight is controlled by purging which takes the form of self-induced vomiting, abuse of laxative, diuretics, or enemas, or non-purging in the form of fasting or excercising. Bulimia usually affects adolescent girls and young women, but 15% of bulimics are males and a large number of bulimics are college aged. Many diagnosed with anorexia later become bulimic, so the same traits found in anorexics (perfectionism, low self-esteem, etc.) are also found in bulimics. Bulimia also has a higher rate than anorexia, affecting two to three percent of the population or 1 in roughly every 20 people in the state of Kentucky. Dangers of bulimia include electrolyte imbalance, which can cause tingling in hands, or feet, general weakness and depletion of abilities, or dehydration and both of which may cause cardiac complications that can lead to sudden death. Binging could cause the stomach to rupture, while purging could result in heart failure due to the loss of vital minerals such as potassium. Repeated vomiting can cause erosion of dental enamel (from the acid in the vomit), scarring on the backs of hands (from continually pushing fingers down the throat to induce vomiting), swelling of glands near cheeks, frequent sore throats, and abdominal pains. Other dangers include irregular menstrual cycles, and a depressed mood. There are no certain or definite causes of bulimia; some factors that may lead up to bulimia are obesity in adolescents or obese parents, parents' anxiety over a chubby child, and it's possible that bulimia could run in families. Studies show that there is a lack of certain neurotransmitters such as serotonin and norepinephrine which help control appetitie, mood, alertness, and sleeping patterns. Some bulimics also report feeling a sort of "high" when they vomit. The pain from vomiting also takes away from the emotional pain they may be feeling in their everyday life. Like anorexia, bulimia allows the patient to escape from their problems by focusing on food and giving them control over their food intake.

Treatment comes in different forms for dealing with eating disorders. Therapy is a must, as is support from family and friends. Sometimes hospitalization is equally necessary. Bulimics are usually treated as outpatients while in the hospital as occasionally are anorexics, but more often anorexics will have to stay longer since there is a danger that they may starve to death. Treatment for anorexics will include returning to within ten percent of their normal body weight with a safe weight gain of one to three pounds per week, individual, group and family therapy, some medication and talking with a nutritionist. Bulimics will be kept in the hospital if their disorder has gotten out of control. Group therapy is most effective for these patients, additional one on one therapy is necessary, and support groups are always a plus. Therapy will mainly consist of support and teaching the patient to monitor their own eating and purging habits. Therapy will also help to change the patients' thought process about their eating habits, and will include nutritional counseling and sometimes antidepressant medication.

Information for Families
The first thing every family should know and remember is that eating disorders are very difficult to catch early on. Binging and purging are done secretly and when no one is around; not eating can be easily hidden and can even be confused for an increase in healthy activity when combined with exercise. These actions allow the person to concentrate on their weight rather than painful feelings, and allow them to reduce tension and anxiety. What the family must also keep in mind is that bulimia and anorexia are very real and possibly devastating disorders with a six- percent mortality rate. If you should see someone not eating, trying to get him or her to eat more is not the best intervention and may backfire. Therapy may also be effective even before obvious physical symptoms occur. If a person has an ongoing preoccupation with food and weight even though they are thin, therapy may prove valuable.