Signs that a loved one may struggle with an eating disorder:

1. Skips meals or under-portions in comparison to others.

2. Boasts about eating healthy foods.

3. Holds rigid rituals and rules about eating (i.e. eats certain food groups in order or by color, won’t eat past a certain time, cuts foods into small pieces, counts bites, etc).

4. Verbalization of dissatisfaction with body image.

5. Calorie counts.

Did you know…?

• 1% of teenage girls and 5% of college-age women become anorexic or bulimic.
• Anorexia nervosa has the highest premature fatality rate of any mental illness (Sullivan, 1995).

6. Volunteers to cook for the family in order to have more control over the condiments that go into the food.

7. Cooks for others but does not eat what is prepared.

8. Chews food and spits before swallowing.

9. Exercises rigorously and consistently, often compensating the amount of time working out based on the type of foods or amount of foods consumed. The exercise is excessive (typically more than one hour daily) and the commitment to exercise is honored even when ill, injured or in the presence of bad weather.

10. Avoids eating in front of other people and often gives excuses such as not feeling well, not being hungry or eating earlier in the day.

Did you know…?

• 50% of 9-year-old girls and 80% of 10-year-old-girls have dieted.
• 90% of high school junior and senior girls diet regularly, even though only 10% to 15% are over the weight recommended by standard height weight charts.

11. Wears baggy clothing to hide disliked body parts or hide body shape.

12. Meals seem repetitive and hold very little variation.

13. Categorizes food as safe, good or healthy versus unsafe, bad and unhealthy.

14. Secretly hoards food.

15. Reads labels and sticks primarily to low-calorie and low-fat food items.

Because of the secretiveness and shame associated with eating disorders, many cases are probably not reported. In addition, many individuals struggle with body dissatisfaction and sub-clinical disordered eating attitudes and behaviors. For example, it has been shown that 80% of American women are dissatisfied with their appearance (Smolak, 1996).

16. Uses credit cards to buy large amounts of food items he/she considers to be forbidden or “bad” (i.e. fast food, starches, desserts and other sweets).

17. Binges (eating large amounts of food at one time).

18. Uses the bathroom immediately after meals and you notice signs of vomiting (i.e. runs the shower or hair dryer to cover vomiting sounds, excessive use of mouthwash, clogged toilets, foul smell, vomit stains, etc).

19. Consistent use of laxatives, diuretics, diet pills or weight loss products.

20. Obsesses over the media’s standards of thinness and beauty – often competing and comparing self to others.

In March 2005, NEDA contracted with Global Market Insite, Inc. (GMI), a leader in global market research, to conduct a 1,500 nationwide sample of adults in the U.S. Their findings concluded from those surveyed that four out of ten Americans either suffered or have known someone who has suffered from an eating disorder.

42% of 1st-3rd grade girls want to be thinner (Collins, 1991).

If you or someone you know struggles with an eating disorder or shows some of these signs, it is advisable that you seek help by a licensed mental health professional as soon as possible.

Copyright © 2009 Cesar G. Gamez, MA., All Rights Reserved Worldwide.

References

Collins, M.E. (1991). Body figure perceptions and preferences among pre-adolescent children. International Journal of Eating Disorders, 199-208.

Smolak, L. (1996). National Eating Disorders Association/Next Door Neighbors Puppet Guide Book.

Sullivan, P. (1995). American Journal of Psychiatry, 152 (7), 1073-1074.

Credits

Thumbnail image: Untitled (4036269240) by shannooners / © All rights reserved

http://www.flickr.com/photos/shannooners

http://shannonjeanphoto.blogspot.com

Facts and Figures provided by NEDA.  For more information, please contact the National Eating Disorders Association’s Information and Referral Helpline at 1-800-931-2237 or visit the website.

Professional Resource

Remuda Ranch provides inpatient and residential programs for women, girls and boys suffering from Anorexia, Bulimia, other Eating Disorders, and related issues. For additional information on Remuda programs, please contact them at 1-800-445-1900 or on the web at http://www.remudaranch.com

In his 2004 American documentary film, Super Size Me, Morgan Spurlock embarked on the journey of taking an honest look at the obesity problem in America, pointing its finger at the unmoderated consumption of fast food as the culprit.

The saying, “you are what you eat,” reminds us of the importance of being mindful about what we put in our mouths within the context of balance, variety and moderation.  Considering the myriad of diet products and advertisements that we are constantly inundated with (promising big results if we can only stop “being bad” with food), being health conscious and vigilant about healthy eating patterns is unlikely to raise concern from our loved ones. However, in recent years, increased attention has been given to a new term to describe a fixation on healthy food and the obsessive pursuit of the perfect diet: Orthorexia.

Steven Bratman, MD, coined the term orthorexia nervosa to describe a fixation on pure or righteous eating.  Orthorexics, unlike anorexics or bulimics, are not enticed into restrictive behaviors in order to lose weight; instead, the goal is to achieve a feeling of perfection and purity.  This obsession with organic or biologically pure foods prompts rigid and restrictive eating patterns.  Foods that get categorized as unsafe, bad, or wrong, are both avoided and removed from meal plans.  If these foods are ever consumed, the person experiences guilt, shame and anger towards self. He/she is likely to self-punish for breaking their food rule and become stricter with their dietary plans.  Because these obsessions are real and hold meaning, individuals struggling with orthorexia have a difficult time enjoying social activities or family gatherings where a variety of food (unsafe food) is present.

Such people are sometimes affectionately called “healthfood junkies.” However, in some cases, orthorexia goes beyond a mere lifestyle choice. Obsession with healthy food can progress to the point where it crowds out other activities and interests, impairs relationships, and even becomes physically dangerous. When this happens, orthorexia takes on the dimensions of a true eating disorder, like anorexia nervosa or bulimia.

Source: http://orthorexia.com/Index.php?page=katef

According to Bratman’s research, orthorexia sometimes holds a spiritual component that drives this extreme healthy eating commitment.  These inner rules are often rooted in the belief that consuming organic foods will make a person cleaner, or in some ways, more righteous.  Some individuals admit feeling a sense of superiority over others and/or perceiving themselves as able to live by higher standards in obedience to God’s calling to pursue purity and perfection.  The obsessions and rigid food rules are often rationalized through overspiritualized statements such as, “I’m just a good steward of the body God gave me,” or “my body is the temple of God, so I need to take care of His temple.”  Therefore, the idea of consuming food that has been scientifically altered is experienced as an unwise and deliberate choice to mar what God created to be enjoyed in its original state.

Some of the following Biblical verses are often quoted to defend health-food obsessions:

Do you not know that your body is a temple of the Holy Spirit, who is in you, whom you have received from God? You are not your own; you were bought at a price. Therefore honor God with your body.

I Corinthians 6:19-20 NIV

So whether you eat or drink or whatever you do, do it all for the glory of God.

I Corinthians 10:31 NIV

We always carry around in our body the death of Jesus, so that the life of Jesus may also be revealed in our body.

II Corinthians 4:10 NIV

For it is written: “Be holy, because I am holy.”

I Peter 1:16 NIV

The children of Israel were given a set of strict dietary laws at Mount Sinai.  These were recorded by Moses in Leviticus chapter 11 and Deuteronomy chapter 14.  As you read through these laws, you will noticed some food items categorized as “clean” and “unclean.”  The food laws were ritualistic, and most theologians believe that one reason for giving the laws of clean and unclean meats was “holiness” (See I Peter 1:16).

It is important to note that orthorexia is not a part of the current edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM IV-TR) and that much controversy and debate surrounds the idea of giving it its own designation in the manual.  While those of us who specialize in the treatment of eating disorders can attest this fixation is real in some of the people we treat, there is a recognition that due to the insufficient research data that currently exists, orthorexia may not have its own diagnostic category any time soon.  What is concerning is that orthorexic symptoms appear to be increasingly common.

If you or someone you know struggles with orthorexia, an assessment by a professional mental health clinician would be highly recommended.  Whether or not orthorexia is seen as an eating disorder type, the emotional distress, obsessions and compulsions surrounding orthorexia may be an indicator of anxiety or OCD issues.

Copyright © 2009 Cesar G. Gamez, MA., All Rights Reserved Worldwide.

Imagine that every morning as you wake up, you are given one red balloon in the palm of your hand. Your job is to manage, regulate and control your balloon. The purpose of this balloon is to hold your emotions throughout the day. And so as you go about your day and experience a myriad of emotions – you blow into the balloon.

When you sense you’re running late, when your hair isn’t cooperating with your curling iron, as you get in the car and get stuck in traffic, as you get to school or the office and are confronted with tasks, deadlines and upcoming projects that demand more of your time and efforts; these are all examples of experiences that are likely to evoke an emotional reaction causing you to blow air into the balloon. By the time you drive home from school or work at the end of the day, your emotional tank (red balloon) is ready to blow up. And so you may do just that.

A loved one might say something small, and your reaction might be to either explode or implode. If you have a limited set of positive coping skills that would ensure your air pressure is being regulated and deflated appropriately, then chances are very high that either your balloon will blow up, or you’ll do something to rid yourself from it all.

You unclasp your fingers and watch the balloon fly around the room in a loud, chaotic, uncomfortable and unpredictable manner. You numb out. You distract. You sweep your emotions under the rug.

The reasons why so many people do not like feeling their feelings is because they have not developed the proper skills to handle their red balloon.

• “If I let myself feel angry, I’ll lose it and blow up.”
• “If I let myself grieve, I’m afraid that I’ll never stop crying.”
• “If I let myself feel, I will feel vulnerable and out of control.”

Subconsciously, sometimes we create rules for ourselves such as:
• “I will cry but never around others. They can’t see my tears.”
• “I will cry but apologize for doing so. I wouldn’t want them judging me.”
• “I will not get angry or frustrated, but if I do, I’ll talk back to the devil and tell him to leave me alone!”
• “I will be happy, positive, cheerful and wear a permanent smile. I wouldn’t want to bum other people with my troubles.”

But these rules seldom, if ever, really work for us. In the end, living by those rules is like unclasping our fingers, watching the balloon dance in mid-air and then making an attempt to catch it before it completely deflates.

That is no easy task!
In fact, it’s an embarrassing task.
It’s no wonder those of us who have tried it were left feeling weak and awkward around our own emotions.

Partners S.H.O.W. U.P. in relationships not only by engaging their heads but also by engaging their hearts. Healthy relationships cannot be done from a distance or void of feelings because emotions are the music to your attachment bond. The more openly and honestly you share your feelings within the context of a safe and secure relationship, the more oneness and intimacy you both will experience.

Have you ever met couples who have logical reasons for staying together but yet one of them chooses to walk away? I’ve seen married couples with a partner who deliberately walks from their children, financial commitments and marital vows, giving reasons such as, “she makes me feel alive,” or “I’ve fallen out of love.” You see, affairs are not about sexual excitement, newness or compatibility. Affairs are often about meeting emotional needs that have gone unmet, unnoticed and unaddressed in the existing relationship.

Step #6 of the SHOW UP strategy is to Put Words to Your Feelings.  If you are functioning from an internal places that tells yourself, “crying makes you weak” or “emotions are just for chicks,” I say break the rules and risk being vulnerable within the context of relationships that matter most to you!

Some of the most powerful emotional phrases you can say to someone today are…

• “I love you.”
• “I forgive you.”
• “I’m sorry.”
• “I’m proud of you.”
• “I believe in you.”
• “I’m committed.”

In my experience, emotional silence can ruin relationships.  Statistics show that a larger percentage of women initiate marital counseling over men.  Why is that?  Typically speaking, men seem to have a hard time expressing and experiencing a wide array of emotions without feeling like they have to turn in their man card in the process.  But it’s not just men who struggle with emotional silence, many women also struggle sharing their genuine feelings often times masking them with their mother role, busyness, complete submissiveness, inner/outward stubbornness, passive-aggressiveness, addictions, perfectionism, eating disorders, becoming the peacemaker in the home or the “Mary Kay” syndrome (looking good on the outside but feeling terrible on the inside).

Communication Exercise For Couples

On a scale 1 (lowest) to 10 (highest), how connected do we each feel towards each other?

What’s happened in our life and our relationship that has brought us to this level of emotional connectedness?

What is one thing we each can do to raise this number?

What is my biggest emotional need right now? Are you willing to meet that need?

Copyright © 2009. Cesar G. Gamez, MA., All Rights Reserved Worldwide.

S.H.O.W. U.P. highlights six communication principles that are present in healthy relationships.  Mutual respect and overall partner responsiveness are the goal of this technique.  Because I want to give each point the emphasis it deserves, I will be posting each of them in separate blog posts in the next few days.  By the way, if you have not subscribed to my blog, be sure to do it today either via e-mail or rss feed.

State the Problem

H – coming soon

O – coming soon

W – coming soon

U- coming soon

Put Words to Your Feelings

Fat Talk Free® Week (Oct 19 – 23, 2009) is an international,
5-day body activism campaign that draws attention to body image issues and the damaging impact of the thin ideal on women in society.

For more information on how you can get involved,
go to www.endfattalk.org

81% of 10 year olds are afraid of being fat. 51% of 9 and 10 year old girls feel better about themselves if they are on a diet. (Mellin LM, Irwin CE & Scully S, 1992)

More than 2/3 of women ages 18-25 would rather be mean or stupid than be fat and over 50% would rather be hit by a truck. (Martin, 2007)

As many as 10 million females are suffering from anorexia or bulimia. That’s more than are suffering from breast cancer. (National Eating Disorder Association)

Spread the word this week!

www.endfattalk.org

Related posts

When I grow up, I want to be a pole dancer!

Is the media making you fat?

A battle ship was on exercise at sea in bad weather. The captain was on the bridge. It was foggy. Just after dark the look out spotted a light on the starboard side. The captain asked if it was steady or moving. The look out replied the light was steady meaning they were on direct collision course with that ship! The captain ordered the lookout signal to the other ship

‘Change course 20 degrees. We are on collision course.’

The signal came back ‘Advisable for you to change course.’

The captain signalled ‘I am a captain. Change course 20 degrees.’

‘I am a seaman second class. You had better change course 20 degrees’ came the reply.

The captain was furious. He sent back ‘ I am a battleship. Change course!’

Back came the signal ‘I am a lighthouse!‘

The captain changed course.

Like the ship captain, I find that many people in relationships do speak up when facing a problem.  But depending on the circusmtances and the person we’re addressing, we may do a lot of speaking accompanied by intense emotions like anger, fear, and anxiety.  We may use intimidation tactics to force people to either draw close to us or to stay away from us.  We are constantly speaking through verbal and non-verbal messages, and when something is wrong, you can be sure that in one way or another, we are sending a message to the world around us that something is amiss.

While we do a lot of speaking, I don’t know if we do a lot of communicating. I grew up in a household where my step-father used a lot of anger, force and intimidation to get his point across.  It wasn’t until I became an adult that I began to realize that his anger was a secondary emotion.  By that I mean that his violent reactions were like the tip of an iceberg.  Once I began to look below the surface of his anger, I discovered the real emotions he masked through his rage.  Deep down he was a lonely man, disappointed with life and emotionally bankrupt.  Hurting people, like my step-father, not only hurt themselves – they end up also hurting others.  In his case, the real issue wasn’t anger.  It was the hurt and frustration he felt on the inside that, for whatever reason, caused him to have difficulty articulating how we as a family could come along side of him and begin the process of meeting his needs.

A lot of times, couples use similar ineffective tactics.  In their efforts to communicate with each other, rather than stating the problem, they project, deflect, minimize or rationalize relationship problems.  In fact, I believe that one of the greatest culprits behind many dysfunctional relationships is that at least one of the two partners has not taken the time to identify problematic cycles or behavioral patterns in their own life.  Therefore, by not giving the problem a voice (whether it be fear of intimacy, dysfunctional codependent attachments, possessiveness or jealousy) and addressing the issue, a person ends up replicating those dysfunctional patterns in future relationships.  What I’m saying is that in some cases, for some people, the answer for a better, healthier, happier relationship may not necessarily be starting fresh with a new face, but rather facing the truth about the problematic baggage in their existing relationship.

An article published by Psychology Today stated the following:

An astonishing 75% of the broken-hearted get married all over again. And if you count among the remarried those who merge lives and households without legal ratification, the de facto remarriage rate is even higher… Yet a whopping 60% of remarriages fail. And they do so even more quickly; after an average of 10 years, 37% of remarriages have dissolved versus 30% of first marriages… If divorce and remarriage rates prove one thing, it is that conventional wisdom is wrong: When it comes to remarriage, experience doesn’t count. A prior marriage actually decreases the odds of a second marriage working. (1)

The Barna group also published an interesting article, “Born Again Adults Less Likely to Co-Habit, Just as Likely to Divorce.”

I created the S.H.O.W. U.P. communication method because I believe that thriving relationships require adults to step up and show up to the plate in order to attend to the relationship and to each other.  Healthy relationships are never established on autopilot.  Although stating the problem may sound like an obvious step in interpersonal communication, if we were to make an honest assessment of our current and past relationships, we may discover that this is a step we may have been overlooking.

What If I Speak Up and SHOW UP But He/She Doesn’t Reciprocate?

Like the story about the ship, many couples find themselves in an ongoing cycle of what I call a “verbal tug of war,” where points are tallied and kept to signal a temporary power differential in the relationship.  Like the captain, we end up making demands that our needs be met, that our problem is addressed or that the issues that matter most to us be taken seriously and with concern from our girlfriend or husband.  Once we muster up the courage to do something about our situation and initiate the process of communicating, we may discover that the other person may be either unwilling or incapable of giving us what we want.

A perfectionistic father may never acknowledge your growth and accomplishments or accept them as good enough.  You may never get his stamp of approval or his blessing.

A controlling mother may still send you messages like: Jump higher. Run faster. Don’t be lazy – be productive. Do something with your hair!”

An spouse may continue to be physically present for dinner or family gatherings but emotionally absent from the conversations or even in bed.

A boyfriend may never express or display faithfulness, respect and value of who you are as a woman.

Now, in some cases stating the problem may be as simple as making a request like, “Can you please put the toilet seat down after you’re done?” or “Can you please remember to squeeze the toothpate from the bottom of the tube rather than from the middle?“  Unless the couple is already in high conflict with each other, these types of requests are not likely to escalate into a dsyfucntional dance; however, there are other requests that are even more important because they have to do with our values, our worldview and our worth.

The invitation to state the problem is to consider what your relationships would look like if you began talking about the real issues that are getting in the way of your happiness and intimacy.  At the end fo the day, your partner will either S.H.O.W. U.P. by respecting your feelings and responding to your requests for change or will H.I.D.E. O.U.T. (more on that later), walking away from the truthfulness of your moment.

If that were to happen, you’ll be left with grief.  You’ll be left with hurt and pain, but you will no longer walk in the illusion that you have a relationship that cares about the core issues of your soul.  Instead, you will step into the reality of the condition of your existing relationship.  This is what it means to SHOW UP and taking the first step towards reclaiming the life you want and securing the quality relationships you choose to invite into your life.  Should he/she reciprocate, tune-in and validate your words, then you have the opportunity to take the next step in this process.  The next step is the content of  my next blog post.

Copyright © 2009 Cesar G. Gamez, MA., All Rights Reserved.

This post is part one of the S.H.O.W. U.P. blog series.  Related articles include…

• How To Talk To Your Husband (or wife).

References

(1) http://www.psychologytoday.com/articles/200003/divorced