MEDICATIONS: FREQUENTLY ASKED QUESTIONS: EATING DISORDERS (ANOREXIA AND BULIMIA)
The article is one of a series of articles about eating disorders by the
American Psychiatric Association (APA). For more information about these
conditions, please review the "Find More Information About" section at the end
of this article.
|
Q: |
Why are eating disorders so common among college
students? |
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A: |
Problems with eating, including weight gain and weight loss, are common
among college students, particularly women. Many parents are surprised to
see their college freshman return for the first Thanksgiving break having
gained or lost a lot of weight. For some students, this weight change will
persist for the rest of that year.
College students live in a world with intense social and educational
pressures. Competition is great to look good and be noticed. Many students
are away from home for the first time in their lives. Looking great and
doing well are highly valued, and the family is not there to
counterbalance this pressure.
In this setting, preoccupation with appearance is quite common. This
preoccupation can lead to dieting and/or vigorous exercise. For certain
emotionally vulnerable people, especially when these people live together,
what begins as a diet and a fitness plan turns into an eating disorder.
For these young people, getting help so they can cope with the demands of
this new stage in their lives is very important for gaining control of
their eating problems. |
Anorexia
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Q: |
Is a person's thinking affected by starvation? |
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A: |
Yes. As you might imagine from the times you have been hungry or
thirsty, starvation causes someone to think a great deal about food.
Being preoccupied with food is a normal reaction to hunger, and most
people who feel starved will eat. The opposite is true for people with
anorexia. Their preoccupation with food does not lead to eating. Instead,
it offers an ongoing challenge not to eat, which is one of the ways people
with anorexia try to gain control of their lives.
This extraordinary willfulness is characteristic of people with
anorexia and can be seen in the way they eat and exercise.
As starvation proceeds, thinking becomes compromised. People with
anorexia cannot think clearly or stay focused. They may seem dull and
slow. Their ability to understand the relationship between their eating
problem and the way they feel can become even more limited. When
starvation is severe, a person can lose the ability to make judgments
about what they need to survive, such as basic nourishment.
Regaining weight and nutritional rehabilitation are essential elements
of the initial treatment of anorexia, and they usually reverse the
thinking problems that starvation causes. However, regaining weight and
normalizing eating do not improve the emotional problems underlying the
disorder. Because these emotional problems cannot be treated successfully
when someone is mentally compromised by starvation, treating someone with
anorexia must begin with nutritional care. |
|
Q: |
How can I talk with someone who has anorexia about her weight problem
when she refuses to believe it? |
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A: |
It is hard not to focus on the weight and appearance of a person with
anorexia, especially someone you care about who looks so thin and ill.
Taking a less direct approach may be necessary, however, because a person
with anorexia cannot recognize her weight problem. She looks in the mirror
and truly believes she is fat and needs to continue dieting. Although the
weight problem may be readily apparent to you, it is not to her. For this
reason, you will not be successful if you try to convince someone she has
anorexia.
Instead, begin by talking about what matters to her, even if these
matters seem small or unimportant to you. Find a way to help the person
feel at ease talking with you. Talk about things she takes pride in. It
often is easier for someone with anorexia to share her troubles if she
doesn't feel pressured and can have some self-respect regarding other
parts of her life.
Once an open dialogue is established, you can offer your thoughts about
what you see and what you think are some of the problems that weight loss
has produced (such as difficulty concentrating and fatigue). Remember that
the person with anorexia needs to feel in control, so you don't want to
tell her what to do. It is important to convey your caring and concern and
your belief that she can take better control of her life in ways that do
not cause so much suffering. To do this, the person with anorexia needs
professional help, which she must consent to (unless involuntary treatment
is required for life-threatening weight loss or chemical imbalances caused
by vomiting).
If your encouragement does not work, remember you are not alone and you
are not responsible for the person with anorexia. You may need to contact
the person's parents, teachers, minister or other friends and share your
concerns with them.
The person suffering from anorexia needs to seek professional help. A
psychiatrist can help the person with anorexia make the connections
between how they feel and the problems they are having with eating.
Therapy also can help the person with anorexia find less destructive and
more adaptive ways to take control of her
life. |
Bulimia
|
Q: |
Why do antidepressants sometimes help improve bulimic
behavior? |
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A: |
Researchers do not know why antidepressants help people with bulimia,
but studies show that sometimes these medications are effective. Some
researchers speculate that depression may play a role in bulimic behavior.
Others have suggested that newer types of antidepressants help control the
impulsive behavior that characterizes bulimia. Fortunately, we can take
advantage of an effective treatment, even if we don't know exactly how it
works.
Antidepressants are used to treat many illnesses besides depression –
including headaches, anxiety conditions and fibromyalgia. They can be
prescribed by psychiatrists and by family and primary care physicians.
Antidepressant medications alone are not sufficient treatment for
bulimia. Psychotherapy, often combined with nutritional counseling and
group training in various interpersonal and emotional skills, is essential
for a person to recover from bulimia. Psychotherapy is a series of private
talks with a psychiatrist where a person discusses the feelings, thoughts
and behavior that cause difficulty. The goal of psychotherapy is to help
people understand and master their problems so they can function
better. |
Find More Information About…
Eating disorders:
· See "A Basic Guide to Eating Disorders" in Medem's
Medical Library under "Mental Health - Eating Disorders"
· See "A Closer Look at Eating Disorders" in Medem's
Medical Library under "Mental Health - Eating Disorders"
Psychiatrists:
· See "Let's Talk Facts About Choosing a Psychiatrist" in
Medem's Medical Library under "Mental Health - Introduction to Mental
Health"
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