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The Diet Dilemma: Anorexia and Bulimia
Copyright American Osteopathic Association

We live in a weight-conscious society where thin is in and anything other than skinny is just not pretty. If you don't believe this, flip on the television or head to the movies, where you will see actress upon actress wearing the perfect size 3. Or, pick up any fashion magazine and read the feature article about the latest ultra-thin modeling sensation.

Society's attitude toward thinness is having a dramatic and negative effect upon young women in the United States. According to the American Anorexia Bulimia Association, Inc. (AABA), 50 percent of 9-year-old girls and 80 percent of 10-year-old girls have dieted. In addition, it is estimated that more than five million Americans suffer from anorexia nervosa, bulimia nervosa, and binge eating. Of these five million, more than 1,000 will die yearly as a result of their eating disorders.

Anorexia Nervosa
Anorexia nervosa is an eating condition that commonly attacks young women in their teens. However, women as young as 5 and as old as 60 have been clinically diagnosed. People with anorexia, (anorectics) are obsessed with the fear of being fat or becoming fat. Because of this fear, they intentionally lose a great deal of body weight in a short period of time. Often, they suffer from depression and poor body image, and they tend to feel a loss of control in their lives.

"Many anorectics feel drawn to this behavior due to a very traumatic emotional event in their lives," states Carol Henwood, D.O., an osteopathic family practitioner who practices in Pennsylvania. "The hidden cause, however, is that these patients are actually battling poor self-esteem and are seeking to improve their feelings and take control of their lives."
To shed pounds, anorectics may exercise excessively, simply stop eating, or do both. As the pounds begin to fall away, most people feel elated. However, anorectics do not know when to stop. They continue to slim down despite health risks, always thinking that they are too fat-no matter how thin they become. And unlike people who lose weight in healthy ways, people with anorexia suffer from constant physical pain associated with not eating.

According to Dr. Henwood, some of the signs and symptoms of anorexia nervosa include:

* Depression or anxiety

* Distorted body image

* Lack of a menstrual cycle

* Hyperactivity

* Constipation

* Growth of fine body hair

* Dry hair and brittle nails

* Joint swelling

* Loss of muscle and body fat

According to Dr. Henwood, some the effects of starvation are:

* Low body temperature

* Low blood pressure

* Slowed metabolism and sluggish reflexes

* Irregular heartbeat (which can lead to heart failure)

In addition, after the loss of the body's normal fat padding, anorectics may find it difficult and painful to sit or lie down, thereby making sleep difficult. This only worsens their depression and feelings of physical weakness.

Bulimia Nervosa
Bulimia nervosa is an eating disorder in which an individual binges on food and then purges that food after eating. The "binge" part involves a rapid consumption of large amounts of food. Following a binge, the individual will "purge." Such people purge their recently eaten food through a variety of means, including vomiting, abusing laxatives, compulsive exercising, or fasting. Some people with bulimia nervosa (bulimics) may binge and purge more than 20 times a day.

While a young woman suffering from anorexia may be easily identified because of her rapid weight loss, the signs and symptoms of bulimia are often difficult to recognize. The reason for this is that bulimics often maintain a normal body weight. Bulimics appear to be healthy, happy, and striving for perfection-even though their bulimia is causing unseen damage to their bodies.

Behind the mask, bulimics often suffer from the same mentally crippling problems as anorectics. This can include low self-esteem, poor body image, depression, and an obsessive need to take control over their lives.

In addition, many people with bulimia suffer from other compulsive disorders, such as shoplifting, smoking, drinking, and drug abuse.
For most healthy young women, the average caloric intake falls between 2,000 and 3,000 calories a day. People with bulimia often average an intake of 3,400 calories in just 1 1/4 hours. Some people with bulimia have been known to consume nearly 20,000 calories in an eight-hour period and spend as much as $50 a day on food.

The symptoms of bulimia nervosa can include:

* Mood swings, depression, or feeling out of control

* Vomiting blood

* Loss of tooth enamel

* Swollen glands in the neck and face

* Broken blood vessels

* Stomach pain

* Weakness

* Sore throat

Medical consequences of bulimia can include:

* Dehydration

* Damage to bowels, liver, and kidneys

* Electrolyte imbalance which can lead to irregular heartbeat or heart failure

"The most important thing to keep in mind when it comes to anorexia and bulimia is that the effects of these diseases can be life-threatening," stresses Dr. Henwood. "An individual battling either one of these disorders must seek immediate help."

Getting Help
When treating patients who are suffering from eating disorders, Dr. Henwood incorporates the osteopathic philosophy into treating the patient.
"I treat the whole patient," she explains. "I look at helping these patients to improve all aspects of their lives. This includes school, family, and broken relationships."
The love and support of family and friends is crucial in the battle to overcome an eating disorder. In addition, professional assistance in psychotherapy, nutrition counseling and behavior modification, may be incorporated in a patients' wellness plan. Also, self-help groups may be beneficial for many patients.

Currently there is not a specific medication that can be prescribed to cure eating disorders, however, many physicians are finding success with anti-depressants.
"Anti-depressants are effective in helping to treat eating disorders," Dr. Henwood explains. "With the use of these medications, patients find they are less depressed and that their self-image improves."

Although anti-depressants can help, Dr. Henwood stresses that recovery cannot happen until the individual is ready to make a change.
"The patient must be willing to get to the root of the eating problem," said Dr. Henwood. "For some people, this can be a lifelong struggle."

As physicians who emphasize prevention and wellness, D.O.s strongly support the U.S. Department of Health and Human Services Healthy People 2010 initiative in the quest to improve quality of life and increase the number of years of a healthy life.
The American Osteopathic Association (AOA) reminds you that November 12-18 is National Osteopathic Medicine Week. This year's target group is young women from the ages of 12 to 24. During this time, osteopathic physicians (D.O.s) will work to raise awareness among young women regarding the many issues they face as they strive to maintain healthy lifestyles. In addition, D.O.s plan to educate them on how preventive care can help maintain good health throughout their lives. D.O.s are fully licensed physicians who have additional training that focuses on the body's structure and function as well as its ability to heal itself.

For more information on osteopathic medicine, or to locate a D.O. in your area, call the AOA at 1.800.621.1773, ext. 8252 or visit the AOA's Web site at

Did You know...?

* More than five million Americans suffer from eating disorders.

* 15 percent of young women have unhealthy eating attitudes and behaviors.

* Anorexia nervosa has the highest mortality rate of any psychiatric condition.

* Up to 5 percent of U.S. college women are bulimic.

* Approximately 1,000 women die of anorexia each year.

Sources: American Osteopathic Association, American Anorexia/Bulimia Association, Inc., and the National Association of Anorexia Nervosa and Associated Disorders.

You can contact these organizations for additional information:

American Anorexia/Bulimia Association, Inc.
239 Central Park West
Suite 1 R
New York, NY 10024

National Association of Anorexia Nervosa and Associated Disorders
P.O. Box 7
Highland Park, IL 60035

Craig M. Wax, DO, LLC of Mullica Hill, NJ provides information on health, nutrition, family medicine, preventive medicine, wellness, natural treatments, alternative medicine, integrative medicine, osteopathic medicine and just plain common sense.
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