E ATING D ISORDERS EXAMINING ANOREXIA, BULIMIA, AND BINGE EATING DISEASES, DISORDERS, SYMPTOMS Marylou Ambrose and Veronica Deisler Copyright © 2015 by Enslow Publishers, Inc. Jasmine Health, an imprint of Enslow Publishers, Inc. Originally published as Investigating Eating Disorders (Anorexia, Bulimia, and Binge Eating): Real Facts for Real Lives in 2011. All rights reserved. No part of this book may be reproduced by any means without the written permission of the publisher. Library of Congress Cataloging-in-Publication Data Ambrose, Marylou, author. Eating disorders : examining anorexia, bulimia, and binge eating / Marylou Ambrose and Veronica Deisler. — [New edition]. pages cm. — (Diseases, disorders, symptoms) Summary: "Discusses eating disorders, including risk factors, causes, symptoms, history, prevention, diagnosis, treatment, and coping."— Provided by publisher. Audience: Grades 7 to 8. Includes bibliographical references and index. ISBN 978-1-62293-070-8 1. Eating disorders—Juvenile literature. 2. Eating disorders in adolescence—Juvenile literature. I. Deisler, Veronica, author. II. Title. RC552.E18A438 2015 616.85'26--dc23 2014019138 Future editions: Paperback ISBN: 978-1-62293-071-5 EPUB ISBN: 978-1-62293-072-2 Single-User PDF ISBN: 978-1-62293-073-9 Multi-User PDF ISBN: 978-1-62293-074-6 This is the PDF version 1.0. To Our Readers: We have done our best to make sure all Internet addresses in this book were active and appropriate when we went to press. However, the author and the publisher have no control over and assume no liability for the material available on those Internet sites or on other Web sites they may link to. Any comments or suggestions can be sent by e-mail to [email protected] or to the following address: Jasmine Health Box 398, 40 Industrial Road Berkeley Heights, NJ 07922 USA www.jasminehealth.com Illustration Credits: Shutterstock.com (Alexander Dashewsky, p. 1; Olivier Le Moal, p. 4). Cover Illustration: Alexander Dashewsky/Shutterstock.com; Stefanina Hill/Shutterstock. com (Rod of Asclepius on spine). C ONTENTS What Are Eating Disorders? ..................... 5 Introduction ........................................................ 7 1 Straight Talk About Eating Disorders .............................................. 8 2 The Science of Eating Disorders ............18 3 History of Eating Disorders .....................27 4 Risk Factors and Preventing Eating Disorders ...............................................................35 5 Diagnosis and Treatment ............................48 6 Outlook for the Future ...............................61 7 Living With Eating Disorders ................70 Chapter Notes ...........................................................79 Glossary .....................................................................89 For More Information .............................................92 Index ..........................................................................94 Some people who suffer from anorexia never feel as if they have lost enough weight, even if they are already at an unhealthy low number. W A E HAT RE ATING D ? ISORDERS A n eating disorder is a psychological illness characterized by a severe disturbance in eating behavior. The most common are anorexia nervosa, bulimia nervosa, and binge-eating disorder. WHAT ARE THE SYMPTOMS? Symptoms of anorexia are extreme thinness, fear of weight gain, fast- ing, unrealistic body image, loss of menstruation, and purging techniques, such as self-induced vomiting and misuse of laxatives. Symptoms of bulimia are binge eating, unrealistic body image, self- induced vomiting, misuse of laxatives, and excessive exercise. One symptom of binge-eating disorder is eating large amounts of food rapidly until feeling uncomfortably full. Binge-eating disorder does not include purging, f asting, or e xcessive exercise. WHAT CAUSES EATING DISORDERS? The causes of eating disorders are complex. It is believed they result from a combination of biology (genes and brain chemicals), psychol- • 5 • EATING DISORDERS ogy (depression and anxiety), emotions (low self-esteem and perfectionism), and culture (pressure from society to be thin). HOW MANY PEOPLE HAVE EATING DISORDERS? An estimated 10 million women and 1 million men in the United States have anorexia or bulimia. Millions more suffer from binge- eating disorder, the most common eating disorder in the United States today. WHO GETS EATING DISORDERS? Anybody can get an eating disorder, but they are most often found among young women ages twelve to twenty-five. Dieting is the most common risk factor for developing an eating disorder. ARE THEY TREATABLE? Although people with eating disorders can never be fully cured, if treated by professionals, they can live full and rewarding lives. ARE THEY PREVENTABLE? There is no simple way to prevent eating disorders. Learning more about them is a good place to start. Building a positive self-image, expressing feelings, and living a healthy lifestyle also help. • 6 • I NTRODUCTION E veryone has heard of eating disorders. Television, magazines, tabloids, and the Internet keep readers and viewers up to date on which celebrities look too thin on the red carpet or too fat on the beach. But how much do people really understand about these illnesses? The answer is: not enough. Eating disorders are not just about eating too little or too much. They are serious psychological illnesses. They affect as many as 24 million American males and females of all ages, races, and ethnic groups. Unfortunately, most people who starve themselves, gorge them- selves, or vomit after eating never go for treatment because they are too scared and ashamed. This keeps eating disorders veiled in secre- cy. Researchers are still unlocking the mysteries of these complex diseases, but much more work needs to be done. People with eating disorders need months or years of profes- sional treatment to get better. They almost never recover on their own. Those who do not get help can end up with permanent medical problems. They can even die. Going for treatment early is critical. This book covers the three major eating disorders, anorexia ner- vosa, bulimia nervosa, and binge-eating disorder, as well as some less common eating disorders. It describes causes and symptoms, diag- nosis and treatment, risk factors and prevention, and promising research. You will also read inspiring stories of real people who have overcome their eating disorders and gone on to lead healthy, produc- tive lives. • 7 • 1 Chapter S T TRAIGHT ALK A E BOUT ATING D ISORDERS J amie-Lynn Sigler had everything going for her. At age sixteen, the Long Island, New York, high school junior got a starring role as Meadow, the head mobster's daughter, on the HBO television series The Sopranos. But between filming the pilot in 1997 and film- ing the show's first season a year later, something happened that almost cost Jamie-Lynn her acting career—and her life. It all started when her boyfriend broke up with her. Devastated, she began to wonder if there was something wrong with the way she looked. Was she too fat at 120 pounds? She decided to use diet and exercise to improve her appearance. Jamie-Lynn started skipping desserts and walking on a treadmill for twenty minutes before school. She lost a few pounds and was happy, so she took her diet and exercise program to the next level— and the next, and the next. Pretty soon she was getting up at 3 a.m. and exercising for four hours before school, taking seven dance classes a week, and eating only about 400 calories a day. “I would constantly make excuses that I ate already, or I wasn't hungry, or I was rushing here or there,” she remembered.1 In four months, Jamie-Lynn lost forty pounds. • 8 • Straight Talk About Eating Disorders “I was wearing basically children's clothes. It was hard to find clothes that would fit,” she said. “Every week. . .I would see more bones coming out, more ribs, and more hip bones. It was awful.”2 Although Jamie-Lynn wanted to go out for pizza with her friends, have sleepovers, and do the things other teenagers do, she couldn't. Counting calories and exercising had taken over her life. “I truly lost [the] will to live,” she said. “I seriously contemplated suicide because I felt that no one in this world would ever under- stand the constant battle I had in my head every day.”3 At her lowest weight, Jamie-Lynn weighed eighty pounds. Her parents begged her to eat more and exercise less, but she ignored them. Then one day, riding in the car during a family trip, Jamie- Lynn fell apart. Her rigid diet and exercise regimen had been disrupted and she couldn't handle it. She began crying and shaking and finally confessed: “I have an eating disorder. I want help.”4 The next day, her parents took her to a nutritionist, who coun- seled her on proper nutrition, and to a therapist who helped her understand the reasons for her eating disorder. The therapist also put her on Prozac, a drug that is often prescribed to control the depressed feelings that occur in people with eating disorders. Jamie-Lynn had anorexia nervosa and she was also a compulsive exerciser. People with anorexia virtually stop eating. Those who exer- cise compulsively try to get rid of any calories they do eat by working out for hours every day. In a month, Jamie-Lynn had gained back five pounds and was on her way to recovery. But when she arrived on the set to film the first season of The Sopranos, the other actors were shocked. She did not look like the girl they had met a year before—she was thirty-five pounds thinner. “I remember [actor] Jim Gandolfini took my arm and wrapped his whole hand around it,” Jamie-Lynn said. “And he was like, ‘Are you eating?’ ”5 • 9 •