Posted by: cindy | July 7, 2008

Who is at risk for eating disorders?

These disorders usually appear in bright, attractive young women between the ages of twelve and twenty-five, although there are both older and younger exceptions. At least ten percent (10%) of the people with eating disorders are male, possibly more. Researchers are just now beginning to determine how widespread these problems are in men and boys.

Who is at risk for developing anorexia nervosa?

People who become anorexic often are or were good children — eager to please, conscientious, hard working, and good students. Typically they are people-pleasers who seek approval and avoid conflict. They may take care of other people and strive for perfection, but underneath they feel defective and inadequate. They want to be special, to stand out from the mediocre masses. They try to achieve that goal by losing weight and being thin.

Some clinicians believe that the symptoms of anorexia are a kind of symbolic language used by people who don’t know how to, or are afraid to, express powerful emotions directly, with words. For example, making one’s body tiny and thin may substitute for, “I’m not ready to grow up yet,” or “I’m starving for attention.” Refusing to eat may translate to “I won’t let you control me!”

People who develop anorexia often feel stressed and anxious when faced with new situations. Many are perfectionists who have low tolerance for change (including the normal physical changes their bodies experience at puberty), feeling that it represents chaos and loss of control. Some set rigid, unrealistic standards for themselves and feel they have failed totally when they cannot achieve and maintain the degree of excellence they demand of themselves.

In addition to restricting food, classic anorexics also restrict other areas of their lives. They are risk-averse individuals, preferring to live closely circumscribed lives, with few changes in established routines, to which they tightly cling. They need to become more adventurous and learn how to cope with expanded horizons.

Although people who have anorexia nervosa don’t want to admit it, many fear growing up, taking on adult responsibilities, and meeting the demands of independence. Many are overly engaged with parents to the exclusion of peer relationships. They use dieting and weight preoccupations to avoid, or ineffectively cope with, the demands of a new life stage such as adolescence, living away from home, or adult sexuality.


Who is at risk for developing bulimia?

People who become bulimic often have problems with anxiety, depression, and impulse control. For example, they may shoplift, engage in casual sexual activity, indulge in shopping binges, abuse alcohol and other drugs, cut their flesh and engage in other self-harm behaviors. They do not handle stress gracefully. They may be dependent on their families even though they fiercely profess independence. Many have problems trusting other people. They have few or no truly satisfying friendships or romantic relationships.

They may diet, thinking to improve their lives and feel better about themselves. The deprivation leads to hunger, which leads to powerful cravings, which lead to binge eating. Feeling guilty, and afraid of weight gain, they try to remove calories from their bodies by vomiting, abusing laxatives, fasting, or other methods of purging.

Bulimics binge not only on food but also in other areas of their lives, often taking on more than they can handle: relationships, jobs, responsibilities, family duties, and sometimes possessions and alcohol and other drugs. They need to learn to set limits and boundaries, to slow down and step back a bit so they don’t feel so overwhelmed. When they can set appropriate limits, they will have less need to turn to the binge/purge behaviors that serve as a defense against the stress and intensity of being over-involved.


 Are some people at special risk?

Because of intense demands for thinness, some people are at high risk for eating disorders — wrestlers, jockeys, cheerleaders, sorority members, socialites, dancers, gymnasts, runners, models, actresses, entertainers, and male homosexuals.


Eating disorders and abuse

Some clinicians find that a high percentage of their clients with eating disorders also have histories of physical, emotional or sexual abuse. Research, however, suggests that people who have been abused have about the same incidence of eating disorders as those who have not been mistreated. Nevertheless, the subject arises often enough to warrant discussion here.

People who have survived abuse often do not know what to do with the painful feelings and overwhelming memories that remain, sometimes even many years later. Some try to escape those feelings and memories by numbing themselves with binge food or through starvation. Some try to symbolically cleanse themselves by vomiting or abusing laxatives. Some starve themselves because they believe they are “bad” and do not deserve the comfort of food and the nurture it represents.

As with all eating disorders, the starving and stuffing that follow abuse are coping behaviors. The key to recovery is finding out what the person is trying to achieve, or avoid, with the behaviors. S/he then needs to find, and use, healthier and more effective behaviors to feel better and make life happier. Almost always professional counseling is necessary to complete the process.


Age and brain maturation/impairment play a role too

When an eating disorder begins in childhood or adolescence, it may be especially hard to deal with. Magnetic resonance imaging provides evidence that the brain continues to develop and become increasingly complex until people are in their mid-20s. The parts of the brain that effectively plan ahead, predict consequences, and manage emotional impulses are just not fully operational in children and teens. Teens may insist they are mature, but the research shows there’s a lot more brain wiring that needs to be done before the he or she is truly an adult. (David Walsh, Why Do They Act That Way? Free Press, Simon & Schuster, 2004.)

And if that were not enough, even when the person is well past 20, starvation, chronic dieting, binge eating and purging can interfer with brain wiring and chemistry, impairing the very centers needed to make healthy choices.


Western culture — an incubator for eating disorders

People with eating disorders seek external solutions for internal problems. They feel empty, depressed, anxious, fearful, sorrowful, guilty, frustrated, insecure and depressed. They want to feel better, which is good, but they choose woefully ineffective ways of doing that. In fact, starving and stuffing have the opposite effect: they cause MORE emotional pain and distress.

Nonetheless, manipulating food and body weight is encouraged by Western culture, which exhorts all of us, and especially women, to improve ourselves by “fixing” the external package, the body. Make-over reality shows on TV are a prime example. The message is, “Change your hair color and style, buy new clothes, paint your face, shove your feet into shoes that hurt, tone your muscles, enlarge your breasts AND LOSE WEIGHT. Then you will be happy, admired, and loved — an instant new identity, a new you.

The problem is, of course, that sprucing up the outside (or starving it to death) does not fix what’s wrong on the inside. True happiness and deep contentment are achieved through psychological and spiritual growth and ultimate realization of one’s worth and place in the world, not by abusing the body. It takes a lot of wisdom and maturity to realize and accept this hard truth, and the young people most vulnerable to eating disorders are those who most lack those characteristics.



  1. Very insightful and informative post. Thanks.

    Beth Fehlbaum, author
    Courage in Patience, a story of hope for those who have endured abuse
    Chapter 1 is online!

  2. Hello this is Brianna visiting first time to this site and find it very interesting. I really like to join it.and really want to continue the discussion with this site..

    kansas drug rehab

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