”Dead girl walking”, the boys say in the hall
”Tell us your secret”, the girls whisper. One toilet to another
I am that girl. I am the space between my thighs, daylight shining through.
I am the bones they want, wired on a porcelain frame.
Each year, thousands of teens develop eating disorders, or problems with weight, eating, or body image. An eating disorder is more than just going on a diet to lose weight or trying to exercise every day. They’re extremes in eating behaviour – the diet that never ends and gradually gets more restrictive.
What are the different types of eating disorders?
Bulimia – is recurrent binge eating, following by self-induced vomiting.
Anorexia – is the starvation of one self by eating less or as little as possible.
Binge eating – is eating unusually large amount of food at one time.
Pica – is an unusual craving for eating, licking or chewing on food or non-food with no nutritional value, for example chalk, paper, sand, plastic.
EDNOS – is an eating disorder that do not fall in any of the above categories – a combination of the symptoms of anorexia, bingeing and bulimia.
What causes eating disorders?
Eating disorders are complex illnesses with a genetic component that can be affected by a wide variety of biological and environmental variables.
Though the exact cause of eating disorders is unknown, it is generally believed that a combination of biological, psychological,and/or environmental abnormalities contribute to the development of these illnesses.
Examples of biological factors include:
- Irregular hormone functions
- Genetics (the tie between eating disorders and one’s genes is still being heavily researched, but we know that genetics is a part of the story).
- Nutritional deficiencies
Examples of psychological factors include:
- Negative body image
- Poor self-esteem
Examples of environmental factors that would contribute to the occurrence of eating disorders are:
- Dysfunctional family dynamic
- Professions and careers that promote being thin and weight loss, such as ballet and modeling
- Aesthetically oriented sports, where an emphasis is placed on maintaining a lean body for enhanced performance. Examples include: rowing, diving, ballet, gymnastics, wrestling, long distance running.
- Family and childhood traumas: childhood sexual abuse, severe trauma
- Cultural and/or peer pressure among friends and co-workers
- Stressful transitions or life changes
What are the signs & symptoms of an eating disorder?
It is important to know the warning signs of an eating disorder. These may indicate that an eating disorder is developing or is being experienced in full.
Physical warning signs
- Sudden or rapid weight loss
- Frequent changes in weight
- Sensitivity to the cold (feeling cold most of the time, even in warm environments)
- Loss or disturbance of menstrual periods (females)
- Signs of frequent vomiting – swollen cheeks/ jawline, calluses on knuckles, or damage to teeth
- Fainting, dizziness
- Fatigue – always feeling tired, unable to perform normal activities
Psychological warning signs
- Increased preoccupation with body shape, weight and appearance
- Intense fear of gaining weight
- Constant preoccupation with food or with activities relating to food
- Extreme body dissatisfaction/ negative body image
- Distorted body image (eg. complaining of being/feeling/looking fat when actually a healthy weight or underweight)
- Heightened sensitivity to comments or criticism about body shape or weight, eating or exercise habits
- Heightened anxiety around meal times
- Depression or anxiety
- Moodiness or irritability
- Low self-esteem (eg. feeling worthless, feelings of shame, guilt or self-loathing)
- Rigid ‘black and white’ thinking (viewing everything as either ‘good’ or ‘bad’)
- Feelings of life being ‘out of control’
- Feelings of being unable to control behaviours around food
Behavioural warning signs
- Constant or repetitive dieting (e.g. counting calories/kilojoules, skipping meals, fasting, avoidance of certain food groups or types such as meat or dairy, replacing meals with fluids)
- Evidence of binge eating (e.g. disappearance of large amounts of food from the cupboard or fridge, lolly wrappers appearing in bin, hoarding of food in preparation for bingeing)
- Evidence of vomiting or laxative abuse (e.g. frequent trips to the bathroom during or shortly after meals)
- Excessive or compulsive exercise patterns (e.g. exercising even when injured, or in bad weather, refusal to interrupt exercise for any reason; insistence on performing a certain number of repetitions of exercises, exhibiting distress if unable to exercise)
- Making lists of ‘good’ and ‘bad’ foods
- Changes in food preferences (eg. refusing to eat certain foods, claiming to dislike foods previously enjoyed, sudden interest in ‘healthy eating’)
- Development of patterns or obsessive rituals around food preparation and eating (e.g. insisting meals must always be at a certain time; only using a certain knife; only drinking out of a certain cup)
- Avoidance of all social situations involving food
- Frequent avoidance of eating meals by giving excuses (e.g. claiming they have already eaten or have an intolerance/allergy to particular foods)
- Behaviours focused around food preparation and planning (e.g. shopping for food, planning, preparing and cooking meals for others but not consuming meals themselves; taking control of the family meals; reading cookbooks, recipes, nutritional guides)
- Strong focus on body shape and weight (e.g. interest in weight-loss websites, dieting tips in books and magazines, images of thin people)
- Development of repetitive or obsessive body checking behaviours (e.g. pinching waist or wrists, repeated weighing of self, excessive time spent looking in mirrors)
- Social withdrawal or isolation from friends, including avoidance of previously enjoyed activities
- Change in clothing style, such as wearing baggy clothes
- Deceptive behaviour around food, such as secretly throwing food out, eating in secret (often only noticed due to many wrappers or food containers found in the bin) or lying about amount or type of food consumed
- Eating very slowly (e.g. eating with teaspoons, cutting food into small pieces and eating one at a time, rearranging food on plate)
- Continual denial of hunger