Anorexia 101

Conventional wisdom dictates that you should write about what you know. Unfortunately, I know a lot about anorexia. My daughter was diagnosed with anorexia over five years ago and has been in various treatments since then. I can’t say that I am writing this blog with her blessing, but I am certainly writing it with her permission.

Education about eating disorders is severely lacking in this country, and parents whose kids have been diagnosed have very few resources to turn to. Doctors as a whole are undereducated about eating disorders, and what they do know is often outdated and not specific enough. The same goes for guidance counselors and other school staff members. Since eating disorders bear a stigma, parents are reluctant to divulge that their child is sick and therefore there are very few parents out there who are willing to offer help and support to others. There is a void out there that I would like to start filling.

Anorexia is a bizarre illness. It’s probably one of the most misunderstood illnesses that exist. People think of it as a lightweight disease since often you hear about it in the news in connection with models and celebrities. Most people associate anorexia with body image; a thin person thinks that they are fat. But that is just the tip of the iceberg. In many ways, anorexia is like cancer. The earlier you catch it, the easier it is to treat. The later you catch it and the more entrenched it gets, the chances of making a full recovery become slimmer. But unlike cancer, with anorexia, the person suffering from the illness many times does not see the illness as having any negative impact and doesn’t want treatment. They actually embrace the illness and will militantly combat anyone who tries to take the illness away. So in addition to fighting the battle against the illness, as a parent, you are effectively fighting against your own child while you are simultaneously fighting for your own child. Trust me, it’s as complicated and as ugly as it sounds.

Anorexia is classified as a mental illness. It has the dubious distinction of carrying the highest mortality rate of any other mental illness; statistics indicate about 5%. From what I have read, Israel has one of the highest rates of eating disorders among adolescents worldwide. While the majority of people with eating disorders are female, there are plenty of teenaged boys/men with eating disorders as well. Anorexia is an equal opportunity illness and affects pretty much every population in this country. Some people develop the eating disorder as young as age 10, though most develop the eating disorder between the ages of 12-25. Eating disorders are often comorbid with other psychiatric conditions, meaning that they are accompanied by an additional disorder; so it’s possible that a person with anorexia will also suffer from depression, anxiety, OCD, etc.

Anorexics are often perfectionists; they tend to be self motivated overachievers who have to be the absolute best at everything they do. They put tremendous amounts of pressure on themselves; they are generally anxious and do not deal well with stress. They are often the classic “good kid”; the kid in the family who never causes any trouble, who always brings home great grades and is highly accomplished, and who constantly does things for other people. I think that this “good kid” profile contributes to anorexia going undiagnosed and undetected until it has progressed way too far. Your dream child who has always been completely truthful and reliable will lie in your face about whether they have been eating or whether they are losing weight. Given that until now you have never had reason to doubt their word, it takes a while for us parents to catch on to the situation. Not to mention that anorexics are incredibly clever about hiding their illness.

What causes anorexia? There is no proven cause. Most experts believe that it is a combination of psychological, environmental, biological, and possibly genetic factors. It is thought that there are certain triggers which seem to bring on the illness such as puberty, extreme stress, sexual abuse, dieting, and weight related comments. However, logically, it stands to reason that a person has to be “pre-wired” for anorexia since all girls go through puberty, many are exposed to stress, many diet, and we live in a weight obsessed culture; yet only a percentage of the population develops an eating disorder. Why are some people affected and not others? That is the million dollar question that has yet to be answered.

Like cancer, eating disorders will not go away without treatment and can be life threatening in many ways. They need to be treated immediately and competently. How are eating disorders treated and where do you go for treatment? Another post for another day….