Overview of Anorexia & Bulimia
The United States is a fat-phobic society, and from an early age, girls are taught to believe that thin is better. The famous writer and theater critic Dorothy Parker once said "no woman can be too rich or too thin," a catchphrase that is still referred to today. Many people associate fat with ugliness and failure. Advertisements feature thinner-than-normal models that are often more than 15% below the expected weight for their height and age, a criterion for anorexia nervosa according to the American Psychiatric Association's DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th edition).
Social pressure to stay unhealthfully thin is a primary cause of anorexia and bulimia. The clinical course of these disorders usually begins with self-dissatisfaction.
Many healthy children of normal weight are concerned about their weight and are afraid becoming too fat. An increasing number of girls who have not reached puberty are showing signs of anorexia. In one study, 45 percent of third through sixth graders said they wanted to be thinner, 40 percent of them had tried to lose weight, and 7 percent of them scored in the high risk range on an "eating attitude" test that detects or predicts eating disorders.
Eating disorders usually begin before the age of 20. In a 10-year study conducted by the National Association of Anorexia Nervosa and Associated Disorders, 10% of participants reported that anorexia or bulimia started before they were 10 years old, 33 percent reported an onset between the ages of 11 and 15, and 43 percent reported an onset between the ages of 16 and 20.
Parents, teachers, coaches, and health care practitioners should watch for signs and symptoms of anorexia nervosa and bulimia in young men and women.
Anorexia nervosa and bulimia cause serious physical and psychological problems, which, if left untreated, can be fatal. They can affect the cardiovascular, hematological (blood), gastrointestinal, renal (kidneys), neurological (nervous system), endocrine (hormones), and skeletal systems.
About 6% of severe anorexia nervosa and bulimia cases result in death from suicide, starvation, gastric hemorrhaging, or multiple organ failure. Treatment usually includes a combination of medical management, nutrition education, and psychotherapy.