Eating Disorders: Who, When, What to Do
An Interview with Rebecca Lowry, MA LPC

Although a person of any age or gender may suffer with an eating disorder, who is most commonly affected?

The prevalence is higher among females, but it is rising in males, for all types of eating disorders including anorexia, bulimia, binge eating and compulsive overeating. Anorexia afflicts girls and women 9 times more often than boys and men

The age range is widening as well. The most common age group is probably teens to early twenties. It is rampant on college campuses, but it is not uncommon in preteens and older adults. Dr. Jantz [see Book Reviews] believes that the peak time for developing an eating disorder is between 11 and 13.

Why do you believe females suffer more frequently from eating disorders than males?

In American culture women are judged on their physical appearance. Women receive positive attention, particularly from men, when they maintain small figures. There is a lot of pressure from the media and the advertising industry to dress a certain way, to look a certain way, to wear a certain type of makeup – in order to be acceptable. Many young women feel that in order to be valuable and acceptable, they must be perfect, and a part of that perfection which they can control is the way they look.

There is also some interesting research on serotonin, the brain chemical that most people associate with mood. Serotonin functions differently in the female brain and the male brain, creating a greater susceptibility in women to certain disorders, such as eating, mood and anxiety disorders.

How would you explain preadolescent/adolescent years as the most common age of onset?

The teen years are stressful (Duh!). Peer pressure is brutal. The child is struggling with becoming an adult and discovering who she/he is. In early adolescence there is much self-doubt and self-consciousness. Self-esteem and self-image issues abound. Developmentally the child is experimenting with different roles and establishing identity. She desperately wants to be accepted and to feel good about herself and believe that the only way to do that is to have the perfect appearance.

As a therapist, what emotional differences do you see between anorexia and bulimia?

Those with bulimia – tend to “take in” too much, swallow emotions be over-involved with activities, work, relationships. My experience with those who have bulimia is that the “purging” is an attempt to rid themselves of emotions that they have not been allowed to express or been unable to express in other ways.

Those with anorexia are good at putting up walls and keeping things out – emotions, relationships, etc. The eating behavior is an attempt to gain control over some part of their life, and they are quite good at it.

Briefly, how would you describe the treatment and life-long prognosis for someone diagnosed with an eating disorder?

I think the most important component is early diagnosis and treatment. As with any disease, the earlier the treatment begins, the better the outcome. There needs to be a team approach to treatment, including a medical doctor, nutritionist, and counselor. Sometimes family counseling is recommended in addition to individual therapy.
Outpatient treatment can be effective, again…if the diagnosis is made early and when there is a high level of commitment with the patient and patient’s family. Residential treatment provides in-depth focused treatment. Inpatient treatment is mandatory for those who are in a state of severe malnutrition and/or who have medical complications. Cardiovascular complications are probably the most severe, with arrhythmias, EKG alterations, loss of heart muscle mass. This is serious stuff. People die from it. Many patients recover completely, some have relapses and struggle with it for years.

What are some signs which parents or friends should look for if they are concerned for someone?

• Unusual redness and puffiness around the eyes (from purging, bingeing, and overeating)
• Irritation and swelling of salivary glands yielding a “chipmunk” facial appearance
• Poor dental hygiene, bad breath, dry, cracked lips from dehydration
• Sleep problems
• Menstrual irregularities or absence
• Sudden weight loss not due to an illness
• Obsession with body weight, including excessive, rigid exercise regimen, and excessive weighing
• Refusing to eat meals with family
• Evidence of self-induced (usually secretive) vomiting, such as bathroom messes and smells or running to the bathroom after eating
• Extreme concerns about appearance and anxious comments about being “fat”

If you, or a friend, or family member may be struggling with an eating disorder, take the steps to get some help. For more information, call ACC at 336-896-0065, ext. 203.

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