Eating disorders have less to do with food and more to do with Preventing Medical Mistakes. Understanding the mind/body connection can provide healing.

Most Americans understand that being overweight is a serious health risk that may require some changes in what and how much they eat in order to peel off some pounds.

At first glance, people with eating disorders who lose significant amounts of weight may appear to have similar concerns. But, in fact, their reasons for losing weight and the methods they employ are vastly different.

“In most cases, people with eating disorders lose weight, not to improve their health, but almost as a side effect of using the control of food to compensate for feelings and emotions they find overwhelming,” explains Gina E. Rayfield, Ph.D., a psychologist in private practice in Randolph, N.J. “They also have an obsessive drive to be thin, in most cases, and as a result develop abnormal eating habits that threaten their well-being.”

Even though restrictive dieting can trigger eating disorders, they arise from a combination of behavioral, emotional, psychological, interpersonal, and social factors that are generally perceived to be beyond a person’s control.

The following answers to common questions about eating disorders can help you understand and seek help for these complex conditions.

Q: What are the most common eating disorders?
A: Anorexia nervosa, bulimia nervosa, and binge eating are the most common disorders. People with anorexia nervosa are food- and fatphobic, often refuse to eat, and may exercise compulsively in an effort to lose weight. They can become dangerously thin.

People with bulimia nervosa binge on huge amounts of food, then purge by vomiting or using laxatives. People with binge-eating disorders also experience out-of-control eating, but they don’t purge, which can result in obesity.

Q: What causes eating disorders?
A: They have multiple causes, including having family members with the disorders, perfectionist parents who demand high academic and social achievement, intense peer pressure to be thin, and a distorted body image.

“Eating disorders also often have a trigger, such as sexual abuse, rape, being teased about body image, or participation in gymnastics or other sports that demand a low weight or certain body type,” says Rayfield.

The disorders also tend to kick in during times of intense developmental change, such as puberty, leaving home for school, or having a baby.

Whether it’s heading off to college or getting married, change can be emotionally unsettling, causing people who are susceptible to eating disorders to latch on to something they can control, such as what and how much they eat.

In addition, cultural pressures in the media that idolize celebrities for being thin contribute to women’s internalization of unrealistic body images.

Q: Who needs help?
A: Eating disorders rarely go away on their own, and leaving them untreated can have serious consequences.

Successful treatment requires a team approach with a psychotherapist for individual and group counseling, a nutritionist to help the person reinstate a healthy diet, and medical supervision to monitor vital signs and prescribe medication, as needed.

“If you’re experiencing any of these problems, or if you think you could have an eating disorder, seek help,” Rayfield encourages. “The sooner these disorders are diagnosed, the easier they are to treat.”

Barbara Floria spoke with Gina E. Rayfield, Ph.D., a psychologist in private practice in Randolph, N.J. For more information, visit the American Psychiatric Association at www.apahelpcenter.org and search for “eating disorders.”

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