Eating Disorders: Treating the Body but Not the Mind

by Jennifer Wider, MD

(Washington DC 1/22/03): Despite the startling numbers of women suffering from eating disorders, a new study from the International Journal of Eating Disorders suggests that these women are not receiving proper treatment.

Researchers from the Parnassia Psychiatric Institute in the Netherlands reviewed data from international studies in order to determine the incidence and prevalence of eating disorders. They discovered that only a small minority of eating disorder sufferers ever receives proper mental health care.

"It isn't surprising," says Marlene B. Schwartz, Ph.D., clinical psychologist and co-director of the Yale Center for Eating and Weight Disorders in New Haven, Conn. "There is a stigma attached to seeking mental health, so many people don't seek care. Also, some of the symptoms of eating disorders: trying to restrain food intake, dissatisfaction with body shape and weight, are so normal among women in our culture that many people may not feel that they have a disorder."

Five to ten million girls and women in the United States battle eating disorders including anorexia nervosa, bulimia nervosa, binge eating disorder or other related illnesses, according to data from the National Eating Disorder Association. Studies also show that approximately 80 percent of American women are dissatisfied with their appearance at one time or another.

Adolescent girls tend to have lower self-esteem and more negative feelings about their bodies and intellect when compared with adolescent boys. One study from the Cincinnati Psychotherapy Institute suggests that finding methods to promote self-esteem in adolescent girls may help lower the rates of eating disorders in this population.

There are several types of eating disorders and all involve serious disturbances in eating behavior. Women with anorexia often see themselves as overweight even though they are drastically underweight. Anorexia may also involve a refusal to maintain normal body weight by avoiding food, fear of gaining weight and compulsive exercising.

Women with bulimia often engage in episodes of binge eating, followed by attempts to prevent weight gain including self-induced vomiting and laxative abuse. Bulimics often feel that they can't control their eating behavior, use food as a comfort and feel relief when they purge. Bulimics also have an unhealthy view of their body. People with binge-eating disorder engage in similar patterns of behavior to bulimics without the purging component.

The numbers of eating disorder patients seeking treatment is quite low, but recent studies have shown that women are more likely than men to seek treatment. According to the National Eating Disorder Association, the most effective treatment for an eating disorder is combining psychotherapy or psychological counseling with special attention to medical and nutritional needs.

Accumulating research suggests that the best treatment for anorexia includes individual therapy. If a patient lives at home, family therapy is usually recommended. Appropriate treatment for bulimia involves, "cognitive-behavioral therapy, which is structured treatment that helps the individual change the behaviors and negative thoughts that are maintaining the eating disorder," Schwartz said.

Eating disorders are often linked to other psychological conditions. "Depression, anxiety, and substance abuse are not uncommon among people with eating disorders," Schwartz said. Studies have shown that higher rates of depression among women and girls may be associated with a tendency to become more dissatisfied with physical appearance than their male counterparts.

Everyone suffers from poor body image from time to time, but it is important to recognize when behavior crosses the line from normal discontent to an eating disorder. Here are a few behavioral warning signs according to Schwartz: "restricting food intake by skipping meals, cutting out entire food groups, binge eating (eating large amounts of food and feeling out of control while eating), any type of purging (vomiting, laxative abuse, fasting and excessive exercise), weighing yourself more than once a day and frequent body checks in the mirror."

Disturbing feelings often go hand-in-hand with an eating disorder. Other signs to be aware of according to Schwartz include: "feeling like your self worth depends on your size, feeling like a failure if you break a rule you have set about eating and feeling distracted while doing other things because you are thinking about food, body shape or weight."

Because so many women with eating disorders are not getting proper treatment, it is essential to recognize the warning signs and seek physical and mental health care. Treating the body and the mind is vital to the recovery process from an eating disorder.

The Society for Women's Health Research is the nation's only not-for-profit organization whose sole mission is to improve the health of women through research. Founded in 1990, the Society brought to national attention the need for the appropriate inclusion of women in major medical research studies and the resulting need for more information about conditions affecting women. The Society advocates increased funding for research on women's health, encourages the study of sex differences that may affect the prevention, diagnosis and treatment of disease, and promotes the inclusion of women in medical research studies. Dr. Donnica Moore has been a member of the Society since 1990 and is a past member of its Board of Directors.

Created: 1/24/2004  -  Donnica Moore, M.D.