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"...starvation fills a void inside when it's approval from you I crave. The desire for food is gone and you are there again... yelling... so negative. Times like this filled with the pounding urge to run far away and disappear..."

The person suffering with Anorexia may be abnormally sensitive about being perceived as fat, or have a massive fear of becoming fat, though not all people living with Anorexia have this fear. They may be afraid of losing control over the amount of food they eat, accompanied by the desire to control their emotions and reactions to their emotions. With a low self-esteem and need for acceptance they will turn to obsessive dieting and starvation as a way to control not only their weight, but their feelings and actions regarding the emotions attached. Some also feel that they do not deserve pleasure out of life, and will deprive themselves of situations offering pleasure (including eating).

Some of the behavioural signs can be: obsessive exercise, calorie and fat gram counting, starvation and restriction of food, self-induced vomiting, the use of diet pills, laxatives or diuretics to attempt controlling weight, and a persistent concern with body image.

It is not uncommon for people suffering with Anorexia to waver through periods of Bulimia (bingeing and purging) as well.

It is important to point out that there can be a number of ways a person suffering from Anorexia can portray their disorder. The inherent trait of a person suffering Anorexia is to attempt to maintain strict control over food intake. In a number of cases a man or woman suffering will seem to eat normal meals with only periods of restriction. Anorexics are sometimes known to eat junk food, particularly candy, to drink a lot of coffee or tea, and/or to smoke. They may deny hunger, make excuses to avoid eating, will often hide food they claim to have eaten, use diet pills to control appetite, or attempt to purge the food away with self-induced vomiting, or by taking laxatives.

"...Emotions control me... make me hide in a safe place of silence.... my mind stays distant from what my heart feels. If I say it... it's real... so I say nothing. I can't touch it... if I did I would curl up or crumble. I may seem to be made by heart of stone.... but really just chalk... and I'm afraid to face the possibility that I could easily turn to dust..."

Anorexia Nervosa - Diagnostic Criteria

The following is considered the "text book" definition of Anorexia Nervosa to assist doctors in making a clinical diagnosis... it is in no way representative of what a victim feels or experiences in living with the illness. It is important to note that you can still suffer from Anorexia even if one of the below signs is not present. In other words, if you think you have Anorexia, it's dangerous to read the diagnostic criteria and think "I don't have one of the symptoms, so I must not be Anorexic".

  1. Refusal to maintain body weight at or above a minimally normal weight for age and height (e.g., weight loss leading to maintenance of body weight less than 85% of that expected; or failure to make expected weight gain during period of growth, leading to body weight less than 85% of that expected).
  2. Intense fear of gaining weight or becoming fat, even though underweight.
  3. Disturbance in the way in which one's body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight.
  4. In postmenarcheal females (women who have not yet gone through menopause), amenorrhoea (the absence of at least three consecutive menstrual cycles).

Physical Problems Associated with Anorexia Nervosa

Bulimia Nervosa

Men and women who live with Bulimia seek out binge and purge episodes, they will eat a large quantity of food in a relatively short period of time and then use behaviours such as taking laxatives or self-induced vomiting, in order to punish themselves for something they feel they should unrealistically blame themselves for. This can be in direct relation to how they feel about themselves, or how they feel over a particular event or series of events in their lives. The Bulimic will also seek episodes of bingeing and purging to avoid and let out feelings of anger, depression, stress or anxiety.

 "... my need to do this... it is almost instinctually protective.... a mechanism shielding out the real me in my mind... and I don't think I even know who the real me is... "

Men and women suffering Bulimia are usually aware they have an eating disorder. Fascinated by food they sometimes buy magazines and cookbooks to read recipes, and enjoy discussing dieting issues.

Some of the behavioural signs can be: Recurring episodes of rapid food consumption followed by tremendous guilt and purging (laxatives or self-induced vomiting), a feeling of lacking control over his or her eating behaviours, regularly engaging in stringent diet plans and exercise, the misuse of laxatives, diuretics, and/or diet pills and a persistent concern with body image can all be warning signs someone is suffering with Bulimia.

It is important to realize that what makes a person Bulimic, as opposed to Anorexic, is not the purging, but the cycle of bingeing and purging. Purging may be using laxatives or self-induced vomiting, but there are Bulimics who use other inappropriate compensatory behaviours such as compulsive exercise (i.e., excessive jogging or aerobics), to attempt to burn off the calories of a binge, or fasting the day following a binge. It is not uncommon for a man or woman suffering with Bulimia to take diet pills in an attempt to keep from bingeing, or to use diuretics to try to lose weight. A victim will often hide or "store" food for later binges, will often eat secretly and can have large fluctuations in their weight.

Bulimia Nervosa - Diagnostic Criteria

The following is considered the "text book" definition of Bulimia Nervosa to assist doctors in making a clinical diagnosis... it is in no way representative of what a victim feels or experiences in living with the illness. It is important to note that you can still suffer from Bulimia even if one of the below signs is not present. In other words, if you think you have Bulimia, it's dangerous to read the diagnostic criteria and think "I don't have one of the symptoms, so I must not be Bulimic".

1. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:

2. Recurrent inappropriate compensatory behaviour in order to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, enemas, or other medications; fasting; or excessive exercise.

3.The binge eating and inappropriate compensatory behaviours both occur, on average, at least twice a week for 3 months.

4.Self-evaluation is unduly influenced by body shape and weight.

5.The disturbance does not occur exclusively during episodes of Anorexia Nervosa.

Physical Problems Associated with Bulimia Nervosa

Both Anorexia and Bulimia...

There are many similarities in both illnesses, the most common being the cause. There seems to be a common occurrence of sexual and/or physical and emotional abuse in direct relation to eating disorders (though not all people living with Eating Disorders are survivors of abuse). There also seems to be a direct connection in some people to clinical Depression. The eating disorder sometimes causes the depression or the depression can lead to the eating disorder. All in all, eating disorders are very complex emotional issues. Though they may seem to be nothing more than a dangerously obsessive weight concern on the surface, for most men and women suffering with an eating disorder there are deeper emotional conflicts to be resolved.

Binge Eating Disorder (Sometimes Called Compulsive Eating)

The person binge eats frequently and repeatedly.

Feels out of control and unable to stop eating during binges.

May eat rapidly and secretly, or may snack and nibble all day long.

Feels guilty and ashamed of binge eating.

Has a history of diet failures

Tends to be depressed and obese.

People who have binge eating disorder do not regularly vomit, over exercise, 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.

Physical Problems Associated with Compulsive Eating

Anorexia Athletica (Sometimes Called Compulsive Exercising or Activity Anorexia)

The person repeatedly exercises beyond the requirements for good health.

May be a fanatic about weight and diet.

Steals time to exercise from work, school, and relationships.

Focuses on challenge. Forgets that physical activity can be fun.

Defines self-worth in terms of performance.

Is rarely or never satisfied with athletic achievements.

Does not savour victory. Pushes on to the next challenge immediately.

Justifies excessive behaviour by defining self as a "special" elite athlete.

Compulsive exercising is not a recognized diagnosis as are anorexia, bulimia, and binge eating disorder. We include it here because many people who are preoccupied with food and weight exercise compulsively in attempts to control weight. The real issues are not weight and performance excellence but rather power, control, and self-respect

Other Issues Associated with Eating Disorders

Abuse and Eating Disorders

Studies have shown that there are a high number of people suffering with eating disorders who have been subjected to some form of emotional, physical, or sexual abuse. I do not believe studies can give an accurate percentage since many victims of abuse repress the memories or have disassociated themselves from the abuse. Many of these people have found that their eating disorders help to protect them, repress or block out the memories, and numbed their feelings. Facing issues of abuse can be very painful, so most people feel they need to forget about it or make the memories disappear.

Many people blame themselves for the abuse and keep it a secret for years. Since it is so hard to understand why someone would do such horrible things to another human being, the victims usually assume they must have done something wrong to deserve it. They usually keep it a secret because of the shame and guilt they feel. They may also fear that no one will believe them it they talk about it or they may have been threatened by their abuser not to tell. For these victims, sometimes their eating disorders become their only means of coping and expressing their emotions. Many bulimics and compulsive eaters reveal that bingeing is their way of stuffing down the emotions they feel. Food becomes their only source of comfort and it can help to numb their feelings, even though it is only temporary. Many will tell you that food is the one thing that is always there for them. Food does not yell at them, hurt them and will never leave them. It becomes the one thing in their life that brings them comfort and security. Some victims of abuse believe that if they are too thin or too obese, it will make them unattractive and the abuse will stop. Others may believe that by not eating they can just fade away and die, then the abuse will have to end. Other victims have expressed a need to be in control in the areas of food. They feel the need to control the food that goes in and out of their bodies, since they felt they had no control over what was happening to their bodies during the abuse. Purging is another way for abuse victims to release their emotions. If they believe they cannot tell anyone about the abuse and express the emotions they are experiencing, purging may be the only way they know how to get those feelings out. Many feel relieved and calm after purging, but it is only temporary and that is why the cycle continues.

When people who have repressed or blocked out the abuse start having memories, it is a terrifying experience for them. They many find themselves experiencing some of the following emotions and feelings:

For many, the eating disorder has been their only means of survival for many years and it is difficult to recover because of the fear to give it up. They are not sure if they can survive without their eating disorder.


Abuse survivor’s need to be treated in a safe environment with a therapist who they like and trust. A therapist should never push them to talk about the abuse. They need to be allowed to recall the abuse at a pace that feels safest for them. Dealing with issues of abuse can cause some very intense feelings, which can cause the eating disorder to go out of control. It is during these times that the person will probably need more emotional support to get through it. If their health is at risk, there may be a need for hospitalisation. It is important that the person is reassured that it is okay to talk about the abuse. If the person finds it too difficult to express themselves verbally, writing is a good way for them to express what happened and how they are feeling.

Dealing with memories of abuse can be very painful and difficult. At times you may feel like you are reliving the abuse. If your memories are flooding back and you feel like you are re-experiencing the abuse, you may feel like you are going crazy and want to die. You will probably want to isolate yourself and not talk to anyone. It is during this time that you need to reach out to someone, especially if you have thoughts of harming yourself or if you are suicidal. It could be a family member, friend, therapist, clergyman, or anyone that you trust. It is better to have someone to talk to and help your through it, rather than having to experience the feelings, emotions and pain all alone. Having someone to turn to and support you will help you feel less alone and make the difficult times a little easier to get through.

Your eating disorder may have helped you block out the feelings for a while, but it is a very destructive way of coping. It will never make the memories disappear permanently. Working with a qualified professional can help you come to terms with the abuse and can help you to heal the child inside of you who has been hurting for far too long. There are two things I would like all survivors’ of abuse to remember. First, it was not your fault, you did nothing wrong and you did not deserve it. Second, you do not have to keep secrets anymore because it really is okay to talk about it.

Emotional Abuse

Physical Abuse


Sexual Abuse


See also the other pages on this web site:

Sexual Abuse   Physical and Emotional Abuse   Panic Attacks   Low Self-esteem


Eating Disorders and Addictions

It is estimated that approximately 30-50% of bulimics also abuse alcohol or drugs. The number is much lower among anorexics. Some individuals developed an eating disorder after they became sober. They substituted one for the other. Individuals will go to great lengths to keep these problems hidden from people. They are very secretive about their behaviours, usually because they are very ashamed and feel guilty.

Alcohol and drugs are abused for much of the same reasons as food. Individuals use these substances to try and block out feelings and emotions. They abuse substances to numb themselves because they never learned how to cope with life's problems in a healthy way. Many bulimics are left with feelings of guilt and shame about their eating disorder behaviours, and some will turn to alcohol or drugs to help relieve these feelings. They try to self-medicate by abusing substances.

It is possible to become totally abstinent from alcohol and drugs, but it is not possible to abstain from food. The individuals will need a great deal of support when dealing with these problems together. Treatment may be started within a drug and alcohol rehabilitation centre, but if the person's eating disorder is considered life threatening, then treatment should begin in an eating disorder program. If there is treatment program near you that treats both problems together, it would be best to go there for treatment. It is usually best to try and treat these problems simultaneously. It is usually beneficial for these individuals to attend a 12 step program and still continue with regular therapy. It's important that the individual deal with the underlying issues causing the behaviours, so that they can work to overcome them. Then they can begin to learn new ways of coping with difficult emotions and daily life problems.

Both eating disorders and substance abuse have high relapse rates and the individuals should be educated on how to avoid a relapse. They must also be assured that if they do relapse, that they don't have to hide it and they can ask for help. Most feel very guilty and ashamed after a relapse and try to keep it a secret, which usually leads to the continued abuse of the substance or a reoccurrence of the eating disorder.

Most individuals benefit more when they have a strong support system which should include family, friends, therapy, physicians and support groups such as Alcoholics Anonymous (AA), and Narcotics and Anonymous (NA).

Eating Disorders and Self Injury

Many people with eating disorders also engage in the act of self-injury. Just like the eating disorders are used to help the individual cope, the act of injuring oneself is also used to help cope with, block out, and release built up feelings and emotions. Self-injury is probably the most widely misunderstood forms of self harm and there are many myths associated with it, which can make it difficult for people to reach out and ask for help.

Self-injury (self-harm, self-mutilation) can be defined as the attempt to deliberately cause harm to one's own body and the injury is usually severe enough to cause tissue damage. This is not a conscious attempt at suicide, though some people may see it that way.

It has been reported that many people who self-injure have a history of sexual or physical abuse, but that is not always the case. Some may come from broken homes, alcoholic homes, have emotionally absent parents, etc. There are many factors that could cause someone to self-injure as a way to cope.

There are three types of self-injury. The rarest and most extreme form is Major self-mutilation. This form usually results in permanent disfigurement, i.e. castration or limb amputation. Another form is Stereo typic self-mutilation which usually consists of head banging, eyeball pressing and biting. The third and most common form is Superficial self-mutilation which usually involves cutting, burning, hair-pulling, bone breaking, hitting, interference with wound healing and basically any method used to harm oneself.

Most people who self-injure tend to be perfectionists, are unable to handle intense feelings, are unable to express their emotions verbally, have dislike for themselves and their bodies, and can experience severe mood swings. They may turn to self-injury as a way to express their feelings and emotions, or as a way to punish themselves.

You may be wondering why someone would intentionally harm themselves. Self-injury can help someone relieve intense feelings such as anger, sadness, loneliness, shame, guilt and emotional pain. Many people who cut themselves, do this in an attempt to try and release all the emotions they are feeling internally. Others may feel so numb, that seeing their own blood when they cut themselves, helps them to feel alive because they usually feel so dead inside. Some people find that dealing with physical pain is easier than dealing with emotional pain. Self-injury is also used as a way to punish oneself. If they were abused, they may feel ashamed, guilty and blame themselves for the abuse, which in turn causes them to feel the need to punish themselves by inflicting pain to their bodies. Some people have such hatred for themselves and their bodies that they will carve demeaning names on their bodies as a way to remind themselves of how terrible they are. Whatever form of self-injury is used, the person is usually left with a peaceful and calm feeling afterwards. Since those feelings are only temporary, the person will probably continue to self-injure until they deal with the underlying issues and finds healthier ways to cope.

If you feel the urge to injure yourself, below is a list of suggestions that might help you to overcome that urge:

It is very difficult for people to admit to someone that they harm themselves because there is usually so much shame and guilt that goes along with it. It's important to try and remind yourself that there is no shame in what you are doing and that it's okay to reach out and ask for help. In order to help yourself overcome this, you need to want to stop the behaviour and you need to find a therapist that you like and trust to help you deal with the underlying issues causing you to do this to yourself. Sometimes treatment may also involve the use of medications such as Xanax and Klonopin. Hypnosis and relaxation techniques can also be helpful, and in extreme cases, hospitalisation might be required for a short period of time. If there are support groups in your area, you may want to think about joining them for extra support.

Many people who self-injure keep it a secret because they feel like they are crazy, insane and evil. They fear if they tell anyone, they might be locked away forever. The truth is, people who intentionally harm themselves are in fact very normal and sane people, who are in a lot of emotional pain. They self-injure as a way to cope, because they were probably never taught how to deal with intense feelings and emotions in healthy ways. Unfortunately, when people hear about this form of self-harm, they do tend to place labels on these people as being psychotic and crazy, which is why so many people do not come forward and ask for help. Until society dispels all the myths surrounding self-injury and start to educate themselves on this subject, sufferers will continue to keep quiet and this form of abuse will continue to be a secret for a long time to come.

Treatment and Recovery

Is recovery possible?

Eating disorders are treatable, and people do recover from them. Recovery is a difficult process that can take several months or even years. Some people do better than others. The folks who do best, work with physicians and counsellors who help them resolve medical and psychological issues that contribute to, or result from, disordered eating.

What is recovery?

Recovery is much more than the abandonment of starving and stuffing. At minimum it includes the following:    

Maintenance of normal or near-normal weight

In women, regular menstrual periods (not triggered by medication)

A varied diet of normal foods (not just low-cal, non-fat, non-sugar items)

Elimination or major reduction of irrational food fears

Age appropriate relationships with family members

Awareness of unreasonable cultural demands for thinness

One or more mutually satisfying friendships with appropriate people

Age-appropriate interest/participation in romantic relationships

Strong repertoire of problem-solving skills

Fun activities that have nothing to do with food, weight, or appearance

Understanding of the process of choices and consequences

Person has a sense of self and goals and a realistic plan for achieving them.

What Is the Best Treatment for an Eating Disorder?

Because many factors contribute to the development of an eating disorder, and since every person's situation is different, the "best treatment" must be custom tailored for each individual. The process begins with evaluation by a physician or counsellor. Recommendations include any or all of the following. In general, the more components included in the treatment plan, the faster the person makes progress.

Hospitalisation to prevent death, suicide, and medical crisis

Medication to relieve depression and anxiety

Dental work to repair damage and minimize future problems

Individual counselling to develop healthy ways of taking control

Group counselling to learn how to manage relationships effectively

Family counselling to change old patterns and create healthier new ones

Nutrition counselling to debunk food myths and design healthy meals

Support groups to break down isolation and alienation

Please note: Support groups by themselves are not sufficient treatment for an eating disorder. To be effective, they must be integrated into a comprehensive treatment plan.

Where to Find Help

If you are in crisis, go to a hospital emergency room or call a crisis hotline.

If you are not in crisis, telephone a counsellor for an assessment session. See First Appointment Don't let embarrassment stop you from telling the counsellor all the details. Doctors, nurses, and counsellors have heard the eating disorder story many times before.

You can also ask people you trust, and who have been in your situation, for the names of physicians and counsellors they found helpful.

If you are a student, check with the school or college counselling centre. Services may be low cost or free.

Binge Prevention Tips


Telling Someone

One of the hardest steps to take when you have an eating disorder is to admit to yourself that you have one. Once you can do that and decide you want help, you are faced with another step of having to reveal this to another person. Since most people with eating disorders feel embarrassed and ashamed, the thought of telling someone can be terrifying. We fear how they will react when we tell them. We constantly ask ourselves, "Will they believe me?", "Will they be angry with me?", Will they leave me?", "Will I be locked up somewhere?" or "Will they think that I am crazy?" Those are only a few of the many questions that will probably go through your mind when you are getting ready to tell someone.

When taking this step, be sure that you chose to tell someone whom you trust and feel comfortable talking with. Many people start by telling a close friend or their family doctor. If you can open up to your family, you may chose to tell your spouse, a parent, a sibling, an aunt, etc. first. If you have a hard time opening up to your family but want to tell them, you can always have a friend or therapist with you when you tell them.

Before we tell someone, many of us spend hours trying to predict how that person will react. It is important to remind yourself that it is impossible for you to predict how anyone will react. Many people put off telling anyone because they usually have convinced themselves that anyone they tell will get upset, yell at them or abandon them. The thought of telling someone can be so terrifying that our minds will predict the worst case scenario of how people will react and try to convince you never to tell anyone. Once again, it is impossible to predict how anyone will react. The only way you can find out is by taking the risk and revealing your eating disorders to someone.

When you first tell someone, there is usually an initial reaction. The person may be surprised, shocked, upset, worried or they may cry. Some may have already seen the signs and know that you do have an eating disorder. The person you tell may not be sure how to respond to you. They many not say anything or they may ask you a lot of questions. No matter what the reaction is, remember that this person may need a few days to process the information you just gave them. When telling someone, I feel it is important to bring information about eating disorders to give to that person. That way they can have the chance to read and educate themselves about what eating disorders are and how to be helpful to you. After a few days of them reading and thinking about what you said, they are usually better able to sit down and talk about it and they can begin to be part of your support system.

Unfortunately, we are not always faced with people who are understanding and can accept we have an eating disorder. When someone is not educated about eating disorders and has no understanding, they can sometimes be cruel and say hurtful things. It can be difficult to have that happen, but try to remind yourself that this person is just ignorant and is wrong if they treat you improperly. You can still give that person information to read and hope they learn something from it. Parents sometimes have a hard time accepting the fact that their child has an eating disorders. They many not want to accept it because they fear that it would be their fault and that they did something wrong. It can sometimes take family members a while before they can accept the eating disorder and be helpful and supportive. There are also people that will become scared and will not know what to do and they may try to avoid you. This is not your fault and you have done nothing wrong. They usually do this because they are not educated about eating disorders and do not know how to react or respond. When someone does not have an eating disorder, it is impossible for them to know what we go through and to understand. Sometimes if people do not understand, they tend to not want to accept it. If this is the case, tell the person that you do not expect them to understand, but you do want them to accept it so that they can be a support for you.

Telling someone takes a lot of courage and you should be proud of yourself each time you do it. Most people will also tell you that once they have told someone, they do feel an inner relief because they are no longer keeping the secret to themselves. Telling someone is also another step in recovery and it is a way to help break away from the shame that many people feel. It is always easier when someone reacts in a positive way and wants to help, but that is not always the case. If someone cannot accept you have an eating disorder and gets angry or just totally avoids the subject, remember that is not your fault or your responsibility. If they cannot accept it, that is something that they will have to deal with. We are only responsible for ourselves and we cannot control other people's reactions, thoughts and feelings.

There is not any one way to tell someone about your eating disorder. Sometimes just sitting down with someone and saying, "I have an eating disorder and I want to get help", is one way of getting it right out in the open. If you find it too difficult to say it verbally, you can always chose to write a letter to the person you want to tell and let them know that way. If you have decided to first tell a therapist, you can always chose to have the therapist present with you when you decide to talk to family members and friends. That way, the therapist could be there to answer questions, explain what eating disorders are, how they can be helpful to you and you may also feel more safe and comfortable having the therapist with you to support you in this step.

It is during this step that people usually find out which people are going to be part of their support system. By people's reactions and how they feel, you can decide for yourself which people you want to help and which people you do not want to help. It is always great when family members are supportive, but that does not always happen at first. It can be painful if you do not have their support, but remember that there are other people available to help you. Some people have no choice but to go outside the family to receive the help and support that they need during the recovery process. It is important that you do what is best for you and your recovery. Some people believe they can overcome this on their own, but I personally feel it is best to have as much support as you can, especially during the very difficult times. Friends, doctors and therapists can be a great support for you. If there is a support group in your town, be sure to check it out and see if it is something that you want to be involved in. Being with others that know and understand how you feel can be very helpful and provide you with wonderful support.

I know that revealing your eating disorder is very scary, but it is a step you need to take. Who you tell is your decision. Never allow anyone to try and force you to reveal this to someone you might not be ready to tell or who you do not want to know about it. Also remember that there is no shame in having an eating disorder. The longer you are in recovery, the more you will see that you have nothing to be ashamed of and you will reach a point when it will not matter to you who knows. Instead of feeling ashamed, you will start to feel proud of yourself for not only admitting to the problem, but for seeking help and fighting this. Eating disorders can be overcome. If you want to recover, you can and will recover. Try not to rush your recovery. Recovery takes time and it can be a long road, but it is a road worth taking.

Frequently Asked Questions - Eating Disorders

Q. ANTACIDS. Are they safe to use?

A. Antacids neutralize and reduce stomach acid relieving heartburn and indigestion. They are used to treat upset stomach, ulcers, hiatus hernia, oesophageal reflux, and other digestive disorders. These medications are generally well-tolerated, but long-term use should be only under a physician's direction. Side effects can be constipation or diarrhoea. They should be used with caution during pregnancy. Antacids can interfere with the absorption of other drugs. Check with your pharmacist if you are taking any other over-the-counter or prescription medications.

Q. ASSISTANCE. Can I help someone?

A. Eating disorders are very often difficult to treat and have an enormous effect on people's lives. Friends and family members have a hard time knowing how to help their loved one. There are some things that you can do and some things not to do.

The Do's-

The Don'ts:

If the situation is scary, i.e. the person is bingeing/vomiting a few times a day, is having chest pains, is dizzy or passing out, is vomiting blood, is suicidal, tell a medical professional  immediately.

Q. ATHLETES. Are athletes more at risk for Eating Disorders?

A. Any sport that requires stringent weight control places an athlete at risk. Male athletes are especially at risk in body building and wrestling. Athletes may be asked or encouraged to lose weight quickly. They then turn to unhealthy weight control techniques. A study of athletes found that binge eating occurs more often in males than females, that females are more likely to vomit than males, and that an equal percentage use steroids to improve athletic performance. Men are more likely to use steam rooms or saunas to control their weight. More and more attention is being focused on high school wrestling and weight cutting. It is not uncommon for wrestlers to put their bodies through cycles of fasting, bingeing, and purging to make their weight. Studies have shown that weight cutting can alter hormonal status, impede normal growth and development, affect psychological state, impair academic performance and can cause more severe cardiac, pulmonary, and endocrine imbalances.

Q. BODY IMAGE DISTORTION. How does this relate to Eating Disorders?

A. Body image is the representation that you make of your body to yourself and the feelings and judgments that you have about this representation. This includes how you perceive the actual size and shape of your body. If you over, or under estimate the size or shape of your body, this is called body image distortion. When a person doesn't like his or her body or feels badly about it, this is called body image dissatisfaction. In our society, it is difficult for women (and increasingly men) to feel good about their bodies, because it is almost impossible to achieve the ideal look that our culture says is attractive. For some people, body image dissatisfaction is only dissatisfaction about their size and/or shape. For others, it translates into a total dissatisfaction of their selves. We are told, by the media, that in order to be happy or satisfied, we need to be thin. When we find out that losing a little weight doesn't make us happy, we continue to lose more weight in the hopes of finding this elusive happiness. Obviously, this doesn't work. People need to find ways other than weight and appearance to bring happiness to their lives. One of the goals of psychotherapy is to help people to examine the underlying issues that contribute to the eating disorder in order to move on to resolution.


A. Chromium is an essential mineral that is found naturally in the body and in some foods, such as brewers yeast, whole wheat, rye, broccoli, mushrooms, potatoes, green peppers, and apples. It is an essential part of the Glucose Tolerance Factor, a molecule that is critical in enhancing insulin function and the use of glucose by the body. Chromium's primary roles are to facilitate proper carbohydrate metabolism and to help insulin as it makes sugar available to the cells. Proponents of chromium picolinate supplementation claim it can help people lose weight by boosting their metabolic rate. Unfortunately, there are no rigorous scientific studies to support that. A Consumer Reports article in November 1995 states that much of the research conducted has been done by the patent holder, while most studies conducted by independent researchers have failed to support the weight loss claims. In the USA, the FDA has expressed concern over reports of adverse effects, including gastric irritation and irregular heartbeat. While reports have not shown any more serious side effects, studies have not supported weight loss effects obtained from this supplement. There is no "magic bullet". The way to achieve your natural body weight (or set-point) is by eating three balanced meals plus a snack from the food groups. This should be accompanied by a moderate amount of exercise that you enjoy.

Q. DEATH. What are the causes and percentages in Eating Disorders?

A. The death rate for eating disorders is high- the highest mortality rate of any psychiatric disorder. After 5 years, 8% of patients die; after 15 years 13% of patients die; and after 30 years, 20% of patients die. This means that one in five patients with an eating disorder has a premature death. The leading cause of death is cardiac related. Cardiac abnormalities occur in 87% of people with anorexia. They can include bradycardia (less than 60 beats/minute), tachycardia(over 120 beats per minute), low blood pressure, arrhythmias, and cardiac failure. Starvation seriously compromises cardiac functioning, especially when compounded by electrolyte abnormalities. Severe abnormalities have been observed during exercise and these have been associated with sudden death.

Q. DIABETES. Can Eating Disorders affect diabetes?

A. Diabetes mellitus is a group of metabolic disorders characterized by glucose intolerance. The most common of these disorders is insulin-dependent diabetes mellitus (IDDM). It can begin at any age, but it usually starts in early childhood or adolescence. People with IDDM who also have eating disorders are likely to have more short and long-term complications than non-eating- disordered diabetics. Insulin misuse and binge eating both contribute to poor diabetic control. Insulin misuse is usually characterized by omission or lowering of the dose of insulin. Patients who binge may take large amounts of insulin to compensate and gain weight as a result. Patients with anorexia nervosa who restrict their diets or who abuse exercise may not reduce their insulin dose appropriately and become hypoglycaemic. Studies have shown that IDDM usually precedes the eating disorder. The weight gain experienced by the initiation of insulin therapy is thought to be a precipitant. This may trigger the onset of the eating disorder with the omission of insulin. The chronic dietary restraint and preoccupation with carbohydrate restriction may foster the development of the eating disorder. Treatment should begin with a complete physical and psychological examination by an physician specializing in the treatment of eating disorders. Treatment should include weight restoration, normalization of eating, individual and family therapy and nutritional counselling. The patient sometimes needs inpatient hospitalisation for both medical and psychological management of the two illnesses.

Q. DIETS. Why diets don't work.

A. Dieting is not an effective means of weight loss. In fact, dieting causes weight gain. Approximately 95%-98% of people who lose weight by dieting regain the lost weight. About 33%-50% of these people gain to a higher weight. When you diet, your metabolic rate decreases since you are not meeting your body's energy needs (not enough calories). You become intensely hungry, and as a result you will most likely overeat at some point. This is not only because you are not taking in enough foods, but because you are probably avoiding certain foods such as foods from the "others" group and high fat foods from the dairy and meat groups. This causes you to crave these foods and overeat them. Even if you return to normal eating after dieting, you are likely to gain to a higher weight, especially if you have dieted frequently. This is because the body feels that it needs to prepare for the next diet or "famine" by storing more energy. To accomplish this, the body may lower the metabolic rate or increase the number of fat cells. In other words, the body may reset its set-point weight to a higher weight. If you are above your natural weight, it is probably because you are eating when you are not hungry or eating past the point of satiety. Or it might be because your diet is particularly high in fat. Dieting will only make these problems worse. The solution is not to diet, but to eat 3 balanced meals plus one snack from the 5 food groups and the "others" group. This should be accompanied by a moderate amount of exercise. When you eat healthily, your weight will stabilize within a small range.

Q. DIETS & CHILDREN. Is it OK for children to be put on diets?

A. When children are put on diets, they often feel deprived (much like adults). They worry that they won't get enough food to satisfy their hunger. They can resort to overeating (or bingeing), stealing food, and hiding food. They can't learn to trust their bodies telling them when they are hungry or full. All of this can lead to disordered eating. Instead, it is important that children and teenagers learn to eat a variety of foods from the 5 food groups. This should be accompanied by moderate exercise that they ENJOY.

Q. DIET PILLS. Are they safe to use?

A. Appetite suppressants, such as Phentermine, Accutrim, and Dietrim may appear to "work" in the short-term. Initially, there is a weight loss effect, but as the body becomes addicted, more and more drug is needed to achieve the desired effect. This is where people run into trouble. Without a change in lifestyle, most people gain back the weight that they had originally lost. Some go on to gain even more weight. Appetite suppressants have a number of very serious side-effects. There can be increased blood pressure, chest pain, fainting, swelling of feet or lower legs, trouble breathing, unusual bleeding or bruising, mental confusion, hallucinations and depression. There can also be constipation or diarrhoea, painful urination, dizziness, dryness of mouth, feeling of heart pounding, nervousness or insomnia. I do not recommend appetite suppressants for anybody, adult or child. Rather, I recommend eating 3 healthy meals plus one snack taken from the five food groups along with moderate exercise to help you reach your set point (the point at which your body works best).

Q. ELECTROLYTES. How does purging affect body chemistry?

A. Potassium deficiency, along with chloride and sodium depletion, is one of the most dangerous complications of vomiting and laxative abuse. Potassium, chloride, and sodium are called electrolytes. They carry electrical charges when dissolved in a solution. They are essential to the body for metabolism and normal nerve and cell functioning. Deficiencies in these electrolytes can cause weakness, tiredness, constipation and depression. They can result in cardiac arrhythmia's and SUDDEN DEATH. Palpitations and bradycardia (slow pulse) are warning signs of serious medical consequences. Do not ignore them. Seek medical help IMMEDIATELY.

Q. EXERCISE. Isn't it beneficial?

A. A Many people with eating disorders exercise excessively in response to media pressures that link self-worth and happiness to physical activity and fitness. There can also be pressure from parents and coaches. Comments concerning appearance, weight, or laziness can greatly affect children, and may trigger harmful dieting and uncontrolled, excessive exercising. In some cases the increased physical activity helps hide the disordered eating.. Friends and family are more likely to condone over exercising as a means of becoming fit, than if it was an intense drive to lose excessive amounts of weight. A level of activity that is reasonable for a healthy person, who is eating normally is not appropriate for someone who is malnourished and /or severely restricting their intake. When an activity, whether its exercise or something else, stops being enjoyable and becomes something that you have to do, its time to question the significance that it plays in your life. This strong need to exercise, coupled with some of your other behaviours, sends up a warning signal that there are issues that might need to be addressed.

Q. IPECAC ABUSE. Is it really harmful?

A. Ipecac Syrup is an over the counter drug intended for emergency use to induce vomiting if there has been a drug overdose or accidental poisoning. Ipecac syrup is made from a plant extract. Its active ingredient is a compound called emetine. Emetine is effective in inducing vomiting by two mechanisms: 1) It acts as an irritant to the stomach lining and 2) it stimulates the area of the brain that triggers vomiting. Unfortunately, some people with eating disorders use Ipecac Syrup to self induce vomiting in an attempt to prevent weight gain after eating. Studies have shown that between 7.6% to as high as 28% of people with bulimia experiment with Ipecac during the course of their illness. Approximately 1% to 4% are regular users. The toxic effect of emetine is cumulative. The more the drug is taken, the greater the medical risk. Side effects of repeated use include diarrhoea, prolonged nausea, stomach cramps, troubled breathing, unusual tiredness, and irregular heartbeat. Emetine is eliminated by the body through the kidneys. This can be a slow process and can take as long as 60 days. It is stored in the body in muscle tissue and may be predisposed to heart muscle. As a result, regular users may experience weakness, aching, and stiffness of muscles, especially those of the neck, arms and legs. They may experience difficulty walking. Cardiac toxicity resulting in an enlarged heart can be fatal. While many of the side effects of Ipecac abuse are reversible over a long time of not taking the drug, the damage to the heart is irreversible. Several deaths have been reported in association with Ipecac abuse. If you are abusing Ipecac, you should have an evaluation for your eating disorder and a physical examination including an EKG as soon as possible.

Q. LAXATIVE ABUSE. How harmful is it?

A. Laxatives act through various mechanisms to induce the passage of stool through the intestinal tract and cause a bowel movement. Laxatives can be divided into groups based on their action. The most common laxatives used by patients with eating disorders are stimulant laxatives. These laxatives stimulate the smooth muscle of the bowel in order to promote evacuation. These laxatives are most often associated with side effects, dependency, and abuse. It is estimated that approximately 15% of the population have used a laxative at some time in their life. People with eating disorders may use laxatives in an attempt to not gain weight. It is estimated that as high as 75% of patients with bulimia have experimented with laxatives and 28% have regularly abused laxatives. A significant number of these patients abuse up to 20 times the recommended dosage. Use of laxatives to lose weight is ineffective. Calories and nutrients are absorbed from food in the small intestine. Waste is passed into the large intestine. The large intestine is the area of the bowel that laxatives work on. Laxatives give a false sense of weight loss because they promote rapid loss of water from the body. This water loss gives patients a sense of feeling lighter that can be addictive. Water weight loss is short lived. Studies have shown that people that abuse laxatives do not achieve real weight loss. Use of laxatives can result in many medical complications. Minor side effects include increased thirst, belching, cramping, and nausea. More serious side effects can include dehydration, electrolyte imbalance, irregular heartbeat, urinary tract infections, kidney failure, passing out and confusion. The colon can become dependent on laxatives to function normally. This is usually reversible when laxatives are no longer taken, but in some cases the colon may be permanently impaired. Chronic use of some laxatives has been associated with colon cancer. The recommendation for someone who is abusing laxatives is to immediately discontinue their use. Tapering off the laxatives slowly has never proven effective. Stopping the laxatives can be extremely uncomfortable. Patients may gain between 5 to 15 pounds in what is known as rebound fluid retention. This is water weight that usually resolves in 7 to 10 days. There has been some cases in which it took weeks for there to be complete resolution of this extra water weight. When discontinuing laxatives patients should increase fiber intake in their diet and limit fluid intake. Individuals that abuse laxatives should seek treatment for their eating disorder. Studies have shown that these individuals experience a higher frequency of depression, self-injurious behaviors, and suicide attempts.

Q. MALES. Can males have Eating Disorders?

A. Eating disorders (bulimia nervosa , anorexia nervosa, and binge-eating disorder) certainly affect both males and females. Despite reports of anorexia nervosa in males in the 17th century, little attention was paid to males with the disorder until recently . It is thought that 10% of people suffering from anorexia are males, 10-15% of those suffering from bulimia are males, and that men make up 25% of the population with binge-eating disorders. The signs, symptoms, and treatment for males and females with eating disorders can be similar, However, there are some factors that apply to males that don't necessarily apply to females. They are: the presence of obesity before the disorder and a history of being picked on or teased about their weight, weight loss related to success in sports, wanting to change a body part (muscle definition) to be attractive to women . Men are more likely to purge (getting rid of food or weight) by compulsive exercise rather than by vomiting or laxative abuse.

Q. MENSTRUAL CYCLE. Can Eating Disorders affect my cycle?

A. In order to be diagnosed with anorexia nervosa, a female needs to have lost her menstrual period. Irregularities and loss of menses occur in about 50% of people with bulimia nervosa. Menstrual dysfunction and infertility can exist in people for months even after normalization of weight.

Q. PREGNANCY. Can an Eating Disorders affect my pregnancy?

A. Pregnancy is a period of great developmental change for women. Some of the issues that arise during pregnancy, such as changes in body shape and size, changes in roles, and concerns about mothering, are also issues that are found in the psychology of eating disorders. Therefore, pregnancy is a time of great stress for people with eating disorders. Little is known about the effects of eating disorders on pregnancy, but the information that is available suggests that there are very dangerous consequences for the mother and the unborn child. Studies suggest that in patients with anorexia nervosa, there is a higher incidence of premature delivery, low birth weight, delayed development and inadequate weight gain for the child. The complications for the mother can be miscarriage, vaginal bleeding, decreased uterine size and increased nausea. Birth complications for babies with actively bulimic mothers can be still birth, low birth weight, breech delivery, cleft palate, and low Apgar scores. The complications for the bulimic mother can be increased bulimic symptoms, low and high weight gain, miscarriage and hypertension. Although these are limited studies, the results are certainly enough to warrant concern. You need to be completely honest with your obstetrician about your illness. You also need to access psychological treatment immediately so as to minimize any possible complications.

Q. PROZAC. How is it used to treat Eating Disorders?

A. Prozac is a medication in the class of serum serotonin reuptake inhibitors or SSRIs. They increase the serotonin level in the brain which is thought to be related to hunger and satiety cues. They can assist in decreasing the obsessive thoughts and the impulses to binge and purge. SSRIs are very effective in treating the depression that sometimes accompanies the disorders. They are also very effective in the treatment of eating disorders with or without an accompanying depression. See SSRIs.

Q. PURGING DAMAGE. What are the dangers of purging.

A. Most individuals with eating disorders do not intend to maintain the symptom for a lifetime. It is frequently started as a short term means of weight loss. However, the process can and does easily escalate and years later people feel trapped in an endless cycle. It is best never to start. There are many medical hazards of self inducing vomiting and using laxatives. The oesophagus is not meant to be exposed to acid. When a person self induces vomiting the stomach's acid burns the oesophagus. This results in irritation and inflammation called oesophagitis. The oesophagus can also tear and in some cases rupture which can be fatal. The amount of time that food remains in the stomach is longer. For most people food passes from the stomach to the intestine after one hour of eating. For people with bulimia nervosa this can takes several hours. Consequently, people end up feeling uncomfortable and full long after a normal sized meal. The stomach also can develop ulcers and the lining become irritated (gastritis). By self inducing vomiting water and electrolytes are lost. This causes the person to become dehydrated. Individuals will feel lightheaded and may pass out. Loss of potassium can result in cardiac arrhythmia that can be fatal. Self inducing vomiting is a dangerous behaviour. Individuals that do self induce vomiting should seek medical treatment and an evaluation for their eating disorder.

Q. TEETH & GUMS. What are the affects of malnutrition and chronic vomiting?

A. Self inducing vomiting results in acid from the stomach passing over the teeth. Repeated vomiting over a two year period results in significant erosion of dental enamel. One third of patients with bulimia nervosa have significant dental erosion. Gum disease is equally as common. If the erosion progresses untreated, patients develop marked sensitivity to temperature. There is a higher incidence of caries in these patients. Teeth will change in appearance so that they are rounded and brown or gray. Patients with anorexia nervosa even without inducing vomiting are subject to a similar decay. The incidence is not as great as it is in bulimia nervosa and the mechanism for the decay is not completely understood.

Q. THYROID MEDICATIONS. Can they help with weight loss?

A. Levothyroxine, a thyroid hormone, is used to treat hypothyroidism, a condition whereby, either naturally or because of past treatment with iodine, the thyroid gland does not produce enough thyroid hormone. Without this hormone, the body cannot function properly, resulting in poor growth, slow speech, lack of energy, weight gain, hair loss, dry thick skin, and increased sensitivity to cold. When taken CORRECTLY, levothyroxine can re verse all of these symptoms. When taken INCORRECTLY, serious side effects can occur. They can be: rapid heartbeat, weight loss, chest pain, tremor, headache, diarrhoea, nervousness, insomnia, sweating, increased appetite, stomach cramps, fever, changes in menstrual cycle, and sensitivity to heat. It is DANGEROUS to fiddle with or manage your thyroid medication without a physician's supervision. Playing around with your thyroid medication is NOT a viable method for weight loss.


Q. VOMITING. Does it eliminate calories?

A. Vomiting is not an effective way to lose weight. Initially, it appears to solve the short-term problem of getting rid of food. It gives the person "permission" to binge more frequently, thereby increasing the binge-purge cycle. However, it fails to remove all calories from the stomach, so that the person often ends up gaining weight. Another factor at work is the slowing of the metabolism that is the body's response to inadequate intake. It "holds on" to the calories so that it can accomplish what it needs in order to survive.

Q. WEIGHT SET POINT. What is it?

A. Your set point is the weight at which your body functions best. Studies show that there is stability in body weight over time. According to this theory, body weight is regulated by physiological means that oppose the displacement of body weight caused by either over or under feeding. Think of a furnace with a set thermostat that regulates itself up or down according to the outside temperature. If the temperature drops, the furnace fires up to increase the temperature and if it gets too hot, the furnace temporarily shuts off to maintain the temperature at which it is set. The human body responds in much the same way. It responds to deviations in body weight, by turning up or down the metabolic furnace. Genetic and environmental factors influence the "normal" weight at which a body is regulated. In fact, the body will "fight" to maintain its set point over time. Regardless of socio-cultural pressures to lose weight, there is a biological resistance to permanent weight change. People with eating disorders and people who diet show the ability to suppress this natural mechanism in the short term, but their bodies constantly pressure them to return to the natural weight that it prefers.

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Eating Disorders


On this page:

Anorexia Nervosa   Bulimia Nervosa   Compulsive Eating   Anorexia Athletica   Abuse and Eating Disorders       Eating Disorders and Addictions   

Eating Disorders and Self Harm      Treatment and Recovery   

Where To Find Help      Binge Prevention Tips      Telling Someone   

Frequently Asked Questions About Eating Disorders

Society and Eating Disorders

It is not surprising that eating disorders are on the increase because of the value society places on being thin. In the western world, women are given the message at a very young age that in order to be happy and successful, they must be thin. Every time you walk into a store you are surrounded by the images of emaciated models that appear on the front cover of all fashion magazines. Thousands of teenage girls are starving themselves this very minute trying to attain what the fashion industry considers to be the "ideal" figure. The average model weighs 23% less than the average woman. Maintaining a weight that is 15% below your expected body weight fits the criteria for anorexia, so most models, according to medical standards, fit into the category of being anorexic. Teenagers need to realize that society's ideal body image is not achievable. The photos we see in magazines are not real either. Many people don't realize that those photos have gone through many touch ups and have been airbrushed to make the models look perfect. Teenagers striving to attain society's unattainable ideal image will just end up increasing their feelings of inadequacy.

Teenagers are under a lot of pressure to be thin. They are lead to believe that the only way they can be accepted and fit in, is if they are thin. They resort to starving, vomiting and eating only diet foods to try and be thin. Television is a big influence on them. Many actresses we see on TV have endured hours of exercise and have deprived themselves of the proper nutrition in order to maintain a thin figure. Some even resort to plastic surgery, liposuction and breast implants. You just have to watch an episode of  “Bay watch” to know that statement is true. Society is brainwashing young people into believing that being thin is important and necessary.

Diet commercials are constantly appearing on our television screens telling us that once we lose the weight, we will be happy. While your standing in the check out line at the supermarket you are surrounded by magazines claiming to have the newest and best diet. Each month another new diet appears claiming to be the diet to end all diets. Whatever happened to last month's diets that claimed the same thing? Dieting has become an obsession in the western world. We spend billions of pounds and dollars each year trying to look the way society tells us we need to look. If diets really worked, then why are there so many of them? The reason a new diet pops up each month, is because last's month's diets did not work. You know, the ones that claimed to really work. The truth of the matter is that DIETS DON'T WORK. As soon as you start to diet, you automatically set yourself up for failure.

It's unfortunate, but in today's society, people have forgotten that it's what's inside a person that counts, not what's on the outside. We need to start loving and accepting each other for who we are, not what we look like. Next time you decide that you are going to start another diet because you feel you are too fat, stop, sign up for a self-esteem class instead. That would be money well spent. If we learn to love and accept ourselves, we will also begin to love our bodies, no matter what size we are.

We also need to teach our children to be proud of who they are. We need to remind them that people come in all shapes and sizes, and we need to teach them to accept everyone for who they are. Parents need to also teach their children the value of healthy eating and not send the message that being thin is important. Many children, under the age of 10, are becoming obsessed with dieting and their bodies. They are afraid of becoming fat. They don't just learn this from the media, they also learn this from their parents. If their mothers are constantly dieting and expressing their desire to be thin, these young children will start to believe they also need to be thin. We need to encourage and support our children, especially teenagers. They need to feel good about themselves and their accomplishments, they need your approval and they need to know that you are proud of them. If a child is raised to love and accept who they are and what they look like, they will be less likely to strive to fit into society's unattainable standards.

Eating Disorders

Anorexia Nervosa

It is not easy to understand a person suffering Anorexia. People living with the illness often have a low self-esteem and a tremendous need to control their surroundings and emotions. Quite often the Eating Disorder is a unique reaction  to an array of external and internal conflicts, such as stress, anxiety, and unhappiness. Anorexia is a negative way to cope with these emotions.

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