Weight problems: questions about eating disorders


        WEIGHT PROBLEMS: QUESTIONS ABOUT EATING DISORDERS

Are eating disorders all in the mind?
No. There may be a physical malfunction in the way the body regulates hunger. And the longer a disorder persists, the greater the damage it does to the body. The impact of starvation on the brain can lead to worsening mental and emotional problems.

Is an eating disorder a sign that some other psychiatric illness exists, such as a personality disorder?
Eating disorders are illnesses in and of themselves. They are not necessarily the product of some other illness. Of course, an eating disorder arising in a young person can affect the way her personality develops.

Do eating disorders cause depression?
Depression is a separate problem. A woman can be depressed and have an eating disorder; the former doesn't necessarily cause the latter. Some patients feel depressed because they are struggling with a chronic illness. However, there does seem to be a connection between a family history of mood disorder and the risk that a member may develop an eating disorder.

Will a teenage girl who worries about her figure develop an eating disorder?
Unfortunately, over-concern about one's body is normal in our culture. But when other emotional pressures bear down on a vulnerable person, the risk rises that she'll develop an eating disorder.

Does dieting lead to eating disorders?
Many patients did diet before their disorder arose, but others who diet never develop an eating abnormality.

Do food allergies, vitamin deficiencies, or improper diet cause eating disorders?
We need more research before we can answer this conclusively. Improper diet is destructive to a person's health, as are vitamin deficiencies and untreated food allergies, but there's not enough evidence to show that these in themselves can cause an eating disorder. However, there is evidence that imbalances in some vitamins or minerals may cause certain problems. Too much vitamin A, for example, can cause menstrual problems, while too little zinc can affect one's mood, appetite, and sense of taste.

Is it true that anorexics have no appetite?
No. Anorexics do experience hunger much of the time and need considerable willpower to conquer these feelings. The more they starve, the more their bodies crave food.

Do anorexics hate sex?
Better to say that most anorexics would rather avoid sex. Starving uses up all the patient's energy, leaving her none for any other activity, including but not limited to sex.

Are anorexics lying when they say they are fat but are obviously starving?
No-they mean it very sincerely, because the disorder has warped their ability to think and see accurately. The longer the illness persists, the more the patient misjudges her appearance and the more she feels compelled to keep starving herself.

Do an anorexic's psychological problems have to be cured before she can gain weight?
Absolutely not. This would be like trying to fix a broken leg by analyzing the hidden motivations behind someone's decision to go skiing. It won't work and it only delays therapy that might do some good. An anorexic is in danger of dying. Job One is to restore weight so that her body-and her ability to think clearly- can return to normal. Only at that point will psychotherapy have some chance of succeeding.

Do anorexics starve themselves so they can look good?
Looking "good" has a different meaning for anorexics than for normal people. Many anorexics know they look skeletal and emaciated. For them, starvation is a compulsion they can't control, not a plan to become more attractive.

Do laxatives and diuretics help control weight?
Not really. By the time food passes in a bowel movement, the body has absorbed most of its calories anyway. Any weight lost is probably just temporary "water weight" loss.

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