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Eating Disorders

Our society encourages overindulgence in just about anything that can be consumed, including food. At the same time, we place an emphasis on being thin and fit. This double message causes many of us to have conflicts about food and body image.

Many of us set very high standards for ourselves which we can’t always achieve. For some people, abusive eating patterns begin in response to feelings of anxiety, frustration or disappointment. Although these eating patterns seem to offer a temporary solution, they lead to more pressures in the long run.

Not everyone who goes on a diet or eats too much pizza on Friday night has an eating disorder. Some experts describe a continuum of eating behaviors with normal eating patterns at one end and severe eating disorders on the other end. People frequently move back and forth along this continuum.

The commonly recognized eating disorders are:
• anorexia nervosa;
• bulimia;
• chronic dieting; and
• compulsive overeating.

Assess your eating behavior.

Anorexia nervosa
Someone with this condition may be intensely afraid of being overweight and claim to feel fat even if they are severely underweight. They might reject food entirely, vomit to be rid of the food, and exercise to extreme to achieve thinness.

Bulimia
Someone with bulimia may vomit intentionally, or use laxatives to rid the body of food. Often bulimics will ingest huge amounts of food (binge) before vomiting or they may alternate bingeing with severe dieting. A bulimic is not necessarily overweight or underweight.

Compulsive overeating
Someone is said to be a compulsive overeater if they eat excessive amounts of food for reasons other than physical hunger. Compulsive eaters may feel a lack of control about food, and continue to eat even when they feel extremely uncomfortable.

Chronic dieting
Someone who continually tries to lose weight by dieting is a chronic dieter. This person will go from one diet to another and is particularly vulnerable to quick weight loss gimmicks. Because dieting lowers body metabolism, a return to normal eating causes weight to be regained, leading to a sense of failure and the start of another diet.

Why do eating disorders happen?

Problem eating patterns develop for a variety of reasons, including fear of weight gain, family problems, anxieties about sexuality, pressure to succeed and fear of failure.

At first, the eating behavior might provide a feeling of comfort, solace, or control. Bingeing numbs distressing feelings. Purging might begin as a way to relieve physical discomfort after a binge or as a way to avoid weight gain. Eventually it provides a sense of control. In time, the eating behavior can become addictive, with the accompanying feelings of loss of control, shame, isolation, and low self-esteem.

Recognizing eating disorders

Some possible signs of eating disorders are:

  • frequent changes in, and constant talking about, weight;
  • preoccupation with food, nutrition or dieting;
  • severe weight loss or dramatic weight fluctuations;
  • unhealthy appearance, with pale face and limp hair;
  • wearing layers of clothing or baggy, loose-fitting clothes;
  • complaining frequently of the cold;
  • fainting, blacking out, dizzy spells or difficulty concentrating;
  • seeming sad, angry or irritable;
  • isolating from others;
  • frequent trips to the restroom;
  • taking long, frequent showers;
  • skippping meals, cutting food into small pieces, or eating large quantities of food; or
  • stealing food or money.

If an eating disorder continues

Eating disorders can have serious medical and psychological consequences, including constipation; loss of menstruation; thinning head hair; growth of fine body hair; swollen or infected salivary glands; burst blood vessels in the eyes; damaged teeth and gums; dehydration; kidney failture; electrolyte imbalances leading to heart problems; insomnia; low self-esteem, guilt; depression and loneliness; and death.

How to help

Be direct: Clearly stated, honest concern is the best approach. If the person's behavior directly affects you (you hear them vomiting, they’ve stolen food or money, etc.), tell them about it in an objective, nonjudgmental way. Use “I” messages. For example, “I care about the fact that you…” Stay focused on what you’ve observed and how you feel about it. Don’t attack or tell the person what’s ‘wrong’ with them.

Listen carefully: You want to encourage discussion of what they are feeling and doing. Careful listening involves asking questions, using attentive body language and paraphrasing the speaker’s words to show you understand them.

Keep an open mind: You want to explore the possibility that the person has an eating problem in a way that minimizes defensiveness. Think about your own attitudes towards food, body image and eating disorders. Be careful not to blame, label or judge. Learning about eating disorders is another way to keep an open mind.

Assist with referral: The person with an eating disorder might feel isolated, hopeless or trapped. Help give them hope. Encourage them to get professional help. If necessary, gather information about local resources and help make an appointment.

Be prepared for denial: The person may not be ready to hear your concern or to admit they have a problem. Presenting them with specific examples of their problem eating behavior sometimes helps to break through denial, but not always. Accept the fact that you may not see immediate results of your intervention. Consult with a professional if you have any concerns about the person’s physical safety.


Dos and Don'ts for Friends and Family

Do:

  • accept a person’s right to choose their food.
  • be willing to negotiate duties involving food.
  • allow each family member to make their own food decisions.
  • treat siblings equitably.
  • learn about eating disorders.
  • make the person with the eating disorder responsible for their actions, including replacing food that was binged on, or cleaning messes in the bathroom or kitchen.
  • be a model for good eating habits and positive self-image.
  • discuss with the person why you’re concerned about their eating behavior. Be caring, gentle and non-judgmental.
  • be supportive. Let the person know you care about them, and that there’s more to care about than just weight and appearance.

Don’t:

  • decide for the person what should or shouldn’t be eaten.
  • count points.
  • force the person to eat.
  • restrict food choices or amounts.
  • watch the person eating or make comments about food.
  • apologize for or make excuses for the person’s eating habits.
  • make mealtime a battle of wills.
  • give food- or nutrition-related advice.
  • read the person’s food or personal journal.
  • purchase or prepare food for the person only.
  • comment on people’s weight or appearance.
  • blame yourself or others.

From the National Eating Disorders Association – www.edap.org.