Nada Stotland, M.D., M.P.H., is a psychiatrist in Chicago who specializes in the mental health problems of women. She has published 6 books and over 50 articles on related topics, is often quoted in the media, and has appeared on "Larry King Live" and "Oprah". Dr. Stotland is married and the mother of four adult daughters. Her newest book is called Psychological Aspects of Women's Health Care: The Interface Between Psychiatry and Obstetrics and Gynecology, edited by Nada L. Stotland and Donna Stewart, 2nd. Edition. (American Psychiatric Press, Washington DC; 2001). It can be ordered by calling 1-800-368-5777.

Girls and women spend a lot of time worrying about what they eat and how they look.  They often feel judged on the basis of how thin they are. When does eating become a real problem, a psychological disorder? Eating disorders include anorexia nervosa and bulimia nervosa; compulsive overeating is a problem as well.  Eating disorders are serious; they can rob women of their happiness, their health, and even their lives. The good news is that, once they are diagnosed, they can often be treated successfully. 

'Anorexia' means loss of appetite, but people with anorexia nervosa don't lose their appetites; they are terrified that, if they eat normally, they will become fat; in fact, even when they have wasted away to skin and bones, they think they are fat.  In addition to limiting their food intake to less than they need, they often exercise compulsively.  They lose their menstrual periods, and have difficulty becoming pregnant.  Their families may be pleased with their weight loss at first.  Once a significant amount of weight loss has occurred, however, no matter how worried they get, they can't convince or force them to eat. Bulimia nervosa patients alternately binge on huge amounts of food and purge themselves of the food by vomiting or taking laxatives.  They are not necessarily skinny. 

Both anorexia and bulimia upset the normal chemistry of the body, affecting the heart as well as other organs.  Vomiting wears away the enamel of the teeth and the lining of the throat.  Over 10% of patients with anorexia will die without treatment.  When family and friends see someone they care about drastically cutting her diet, losing too much weight, or bingeing and purging, they must urge them to see a doctor.  Treatment includes psychotherapy, medication, and behavior modification-learning how to eat sensibly.  About two out of three patients improve with treatment, but many have lingering problems and need continuing attention, support, and treatment.

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Created: 10/26/2000  -  Nada Stotland, M.D., M.P.H.