Anywho, here's my essay!
Eating Disorders: Dying to Be Thin
What psychiatric illness affects 10 million people in the United States alone (more than Alzheimer disease and schizophrenia combined) and has the highest premature mortality rate of any psychiatric illness (Sullivan, 1995)? No, it’s not bipolar disorder or even depression; it’s eating disorders, which includes bulimia and anorexia. Millions of adolescents, primarily girls, are affected by an eating disorder. Although many people associate their childhood with happy memories of playing with dolls and worrying about boys, for many adolescent girls their time is consumed by body image concerns and, in some cases, eating disorders.
“While the most common age of onset is between 14 and 25 years of age, eating disorders occur in a wide range of ages, and are increasingly seen in children as young as 10” (Cavanaugh & Lemberg, 1999). Among girls polled in a far-reaching survey, 50% of girls between the ages of 11 and 13 see themselves as overweight, and 80% of 13-year-olds have attempted to lose weight. (South Carolina Department of Mental Health [SCDMH], 2006). Although dieting isn’t necessarily cause for alarm, in a child as young as 11, it can often be an indicator of the beginning of a long, and often times fatal, battle with an eating disorder. With the constantly rising number of people suffering from an eating disorder, it is of the utmost importance to recognize both the symptoms and the warning signs of anorexia and bulimia.
Anorexia has four primary symptoms: a resistance to maintaining a healthy body weight, or a weight above the minimum standards; a fear of gaining weight; a denial of weight loss or changing of body shape; and loss of menstruation. Other warning signs include refusal to eat certain groups of foods, development of food rituals, denial of hunger, avoidance of meal times, and rigid exercise (National Eating Disorders Association [NEDA], 2006). Bulimia, on the other hand, has three main symptoms, which include a loss of control over eating accompanied by regular excessive consumption of food, regular use of inappropriate behavior to compensate for overeating (i.e., self-induced vomiting and use of laxatives, diuretics and ipecac), and an overwhelming concern about weight and self-image. Some of the warning signs of bulimia are calluses on the knuckle area (from self-induced vomiting), swelling of the cheeks or jaw area, discoloration of the teeth, a sudden creation of complex schedules to allow time for purging, and excessive trips to the restroom to purge. (NEDA, 2006).
Help for many girls comes too late, with the mortality rate of anorexia nervosa at 5%-20% (Sullivan). Recovery is a long, tedious and often very expensive process that can continue for the anorexic or bulimic person’s entire life. Not taking into consideration the physiologic aspect of treatment, recovery usually begins with intensive in-patient care in an eating disorders treatment facility. Although treatment in an in-patient care facility usually consists of “reprogramming” the people’s dysmorphic views of their body and the way they treat their bodies, their treatment also often includes cognitive behavior therapy (CBT), dialectic behavioral therapy (DBT), group work, pharmacologic therapy, consults with nutritionists, discussions with self-esteem experts, and sometimes art therapy. Several types of drugs are considered a staple in the treatment of eating disorders. These include selective serotonin reuptake inhibitors (SSRIs), such as sertraline (Zoloft), fluoxetine (Prozac), paroxetine (Paxil) and escitalopram (Lexapro) and antipsychotic agents, such as prochlorperazine (Compazine), quetiapine (Seroquel), risperidone (Risperdal), and olanzapine (Zyprexa) (Mickley, 2007). Most of these medications treat the anxiety and obsessive-compulsive disorder that are considered to be the primary illness, with the eating disorder being the secondary coping mechanism. Incidentally, most of the antipsychotic medicines also cause extreme weight gain. While in treatment, patients rarely have alone time, or time when they aren’t being watched, since health care professionals usually have to keep constant watch over them to make sure that the patients aren’t purging or reverting to disordered behavior. Despite the fact that in-patient treatment is absolutely necessary and is life saving, many insurance companies refuse to cover the soaring costs. On average, a month of inpatient treatment costs $30,000 (SCDMH), and treatment usually lasting three to six months. Some of the best treatment centers, such as Remuda Ranch in Wickenburg, Arizona, charge up to 1 million dollars. As the cost and numbers of people suffering from eating disorders continue to rise, many people wonder whether the media, and society in general, is to blame.
When a health crisis of the magnitude of eating disorders occurs, people often want to play the blame game and point their finger at one individual thing such as the media. It is true that the face of the media is changing and is a far cry from the media in the 1950s. Marilyn Monroe, one of the most famous icons of the 1950s, was 5’5, weighed 120 pounds and wore a size 12. Kate Moss, an icon in today’s fashion industry, on the other hand, is 5’7, weighs 101 pounds and wears a size 2. The average model in today’s industry has a minimum height of 5’8 and weighs between 108 and 125 pounds, with 125 being the absolute maximum. According to the Center for Disease Control, however, the average American woman is 5’2.7 and weighs 163 pounds (2002). Also, in the world of competitive sports, lower weight is considered a plus and, in some cases, a necessity. For instance, in ballet the prima ballerinas are often the thinnest as well as the best. So who is to blame? Maybe everyone; maybe no one.
Whether people choose to blame the media, genetics, preexisting mental illnesses or even their mothers, the one thing that everyone should agree on is that something needs to be done…not next year, next month, or even tomorrow, but now!
Cavanaugh, C. and Lemberg, R. What we know about eating disorders: facts and
statistics. In Lemberg, Raymond and Cohn, Leigh (Eds) (1999). Eating Disorders: A
reference sourcebook. Phoenix, AZ: Oryx Press.
Center for Disease Control. (2002). Body Measurement. Retrieved from
Mickley, D. (2004). Medication for anorexia nervosa and bulimia nervosa. Eating Disorders
Today, 2(4), 1 & 15
National Eating Disorder Association [NEDA]. (2006). Anorexia Nervosa & Bulimia Nervosa.
Retrieved from http://www.nationaleatingdisorders.org/index.php
South Carolina Department of Mental Health [SCDMH]. (2006). Eating Disorder Statistics.
Retrieved from http://www.state.sc.us/dmh/anorexia/statistics.htm
Sullivan, P.F. (1995). Mortality in Anorexia Nervosa. The American Journal of Psychiatry, 152,
1073-1074. Retrieved from http://ajp.psychiatryonline.org/cgi/content/abstract/152/7/1073