- Anorexia nervosa: the
relentless pursuit of thinness
- Person refuses to maintain
normal body weight for age and height.
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- Weighs 85% or less than what is
expected for age and height.
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- In women, menstrual periods
stop. In men levels of sex hormones fall.
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- Young girls do not begin to
menstruate at the appropriate age
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- Person denies the dangers of
low weight.
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- Is terrified of becoming
fat.
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- Is terrified of gaining
weight even though s/he is markedly underweight.
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- Reports feeling fat even when
very thin.
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- In addition, anorexia nervosa
often includes depression, irritability, withdrawal, and peculiar
behaviors such as compulsive rituals, strange eating habits, and
division of foods into "good/safe" and "bad/dangerous" categories.
Person may have low tolerance for change and new situations; may
fear growing up and assuming adult responsibilities and an adult
lifestyle. May be overly engaged with or dependent on parents or
family. Dieting may represent avoidance of, or ineffective attempts
to cope with, the demands of a new life stage such as
adolescence.
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- Bulimia nervosa: the
diet-binge-purge disorder
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- Feels out of control while
eating.
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- Vomits, misuses laxatives,
exercises, or fasts to get rid of the calories.
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- Diets when not bingeing.
Becomes hungry and binges again.
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- Believes self-worth requires
being thin. (It does not.)
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- May shoplift, be promiscuous,
and abuse alcohol, drugs, and credit cards.
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- Weight may be normal or near
normal unless anorexia is also present.
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- Like anorexia, bulimia can
kill. Even though bulimics put up a brave front, they are often
depressed, lonely, ashamed, and empty inside. Friends may describe
them as competent and fun to be with, but underneath, where they
hide their guilty secrets, they are hurting. Feeling unworthy, they
have great difficulty talking about their feelings, which almost
always include anxiety, depression, self-doubt, and deeply buried
anger. Impulse control may be a problem; e.g., shoplifting, sexual
adventurousness, alcohol and drug abuse, and other kinds of
risk-taking behavior. Person acts with little consideration of
consequences.
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- The person binge eats
frequently and repeatedly.
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- Feels out of control and unable
to stop eating during binges.
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- May eat rapidly and secretly,
or may snack and nibble all day long.
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- Feels guilty and ashamed of
binge eating.
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- Has a history of diet
failures
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- Tends to be depressed and
obese.
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- People who have binge eating
disorder do not regularly vomit, overexercise, or abuse laxatives like bulimics do.
They may be genetically predisposed to weigh more than the cultural
ideal (which at present is exceedingly unrealistic), so they diet,
make themselves hungry, and then binge in response to that hunger.
Or they may eat for emotional reasons: to comfort themselves, avoid threatening situations, and numb
emotional pain. Regardless of the reason, diet programs are not the
answer. In fact, diets almost always make matters worse.
Information reported in the March 2002 New England Journal of
Medicine suggests that for some, but not all, people a genetic flaw
in combination with lifestyle factors can predispose to binge
eating and subsequent obesity.
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