Eating Disorders

By Lauren Muhlheim, Psy.D.

Dr. Lauren Muhlheim is an American Psychologist who has been working with clients with eating disorders since 1991.  She sees clients at Parkway Health and the Community Center and is President of the Shanghai International Mental Health Association.

Appeared in That’s/Urbanatomy, April 2009

Eating disorders are serious mental disorders affecting Western adolescent girls and young women at increasing rates over the last 30 to 40 years.  The two main eating disorders are Anorexia Nervosa and Bulimia Nervosa.

Anorexia Nervosa is characterized by failure to maintain a healthy body weight, intense fear of gaining weight, and distorted body image.  According to the Academy for Eating Disorders approximately 0.5 percent to 1.0 percent of late adolescent or adult women meet criteria for the diagnosis of Anorexia Nervosa.

Bulimia Nervosa is characterized by recurrent and frequent episodes of eating unusually large amounts of food (e.g., binge-eating), and feeling a lack of control over the eating. This binge-eating is followed by a type of behavior that compensates for the binge, such as purging (e.g., vomiting, excessive use of laxatives or diuretics), fasting and/or excessive exercise. Unlike people with anorexia, people with bulimia can have weight within the normal range for their height and age.  Approximately 1.0 percent to 2.0 percent of late adolescent and adult women meet criteria for the diagnosis of Bulimia Nervosa.

If not identified or treated in their early stages, eating disorders can cause chronic, debilitating, even life-threatening medical problems.  Anorexia Nervosa in particular has the highest death rate of any mental illness:  between 5% and 20% of people who develop the disease eventually die from it.

Although there are many factors that are believed to contribute to the development of an eating disorder, parents and educators can do much to reduce the risk of occurrence in teens and children.  Some of the most powerful risk factors for the development of an eating disorder are a mother, sister, or friends who diet.  Accordingly, some prevention strategies include modeling healthy body image, emphasizing fitness over thinness, encouraging healthy but flexible eating, and discouraging dieting.  It is also helpful to talk to children about the unrealistic images they see in media.  Parents should also promote self-esteem and communicate to children that they are loved unconditionally.

If an eating disorder develops, early diagnosis and intervention can significantly enhance recovery.  According to the National Eating Disorder Association (NEDA), "The most effective and long-lasting treatment for an eating disorder is some form of psychotherapy or counseling, coupled with careful attention to medical and nutritional needs.  Ideally, this treatment should be tailored to the individual and will vary according to both the severity of the disorder and the patient's individual problems, needs, and strengths."