Do you know if your child is suffering from an eating disorder?
It was a typical Saturday afternoon for 15-year-old Kristen*. The moment her parents left the house for their weekly grocery shop she felt as though she was possessed. Something inside her was about to snap. She felt detached – watching her bony hands frantically opening the fridges and creaky cupboard doors. The macaroni on the stove was burning as she was loaded the toaster, chewing on Bar One chocolates and buttering the slices from the previous batch.
She would eat everything within a matter of minutes and top it off with a litre of ice cream –this made it easier to throw up. An hour later the kitchen and bathroom would have been long ventilated and cleaned, after which Kristen would collapse on her bed. Her unsuspecting parents came home with the bags of food, agitated that their “lazy” daughter never seemed to help.
Anorexia Nervosa entails a person, usually a female, who becomes underweight and refuses to maintain a normal weight. She has an intense fear of gaining weight or becoming fat, even though she is underweight. Her body image is disturbed and she denies the seriousness of her low weight. Some girls will even stop menstruating.
Anorexia kills more people than any other psychiatric illness, and sufferers still experience hunger but are terrified to give in to the impulse to eat. They also have a distorted perception of satiety. If they feel anything in their stomach, they begin to panic. Often they exercise excessively or fidget a lot. They are cold and try to keep warm by moving. The peak onset for eating disorders is between 13 and 18 years of age which is significant because we find that during these years the girl is developing into a woman; at 18 she is fully grown.
Some anorexics starve themselves because they dread having a woman’s body. Perhaps they have been molested or hurt in the past as they associate a woman’s body with losing safety. Males form part of a small percentage of anorexic patients and tend to be in specific groups such as jockeys or models.
Anorexia is mostly found among high-achieving high school pupils in upper middle class homes, but it is found virtually everywhere.
Instant death is a reality
The effect on the body includes brittle hair and nails, dry skin, lanugo (fine hair that grows in an attempt to keep the body warm) and a yellowish tinge to the skin. In addition, they have low blood pressure, damaged kidneys, osteoporosis and irregular heartbeats. The most severe effect is the electrolyte imbalance in the body as it can cause instant death.
With bulimia nervosa there are recurrent episodes of binge eating, which entail a loss of control. This would be followed by attempts to compensate for all the food eaten by vomiting or using laxatives, diuretics, enemas, fasting, or exercise.
Unlike anorexic girls, bulimics are usually within 5% of their normal weight. They’re preoccupied with food, eating and vomiting, such that it may become their treadmill of existence. Some may resort to stealing food.
They are terrified of losing control over eating and have an all-or-nothing way of thinking. A prominent characteristic of their feelings and behaviour is their sense of shame. They live double lives as they attempt to hide their illness. They are typically very good at doing so to the point where loved ones of a bulimia sufferer may be oblivious until she is admitted to hospital following a heart attack.
Tell-tale signs of bulimia
The health risks are similar to those of anorexics, with imbalances in electrolyte levels and low potassium due to purging – this can cause serious cardiac problems. A significant tell-tale sign is the calluses on the hand used for purging. They also have tears in the throat, mouth ulcers and tooth cavities. Some have puffy faces because their salivary glands are swollen.
Cut from similar cloth
In terms of personality, anorexia sufferers tend to have an obsessive personality, while those with bulimia tend to be impulsive. Anorexics are proud of their sense of will power, while bulimics are overcome by shame and guilt for giving in. Those with anorexia also binge and purge at some stage, though tend to do so less frequently. In general, anorexic women are emotionally restricted while those with bulimia are more labile.
In practice, while the Diagnostic and Statistical Manual of Mental Disorders has distinguishers, there is emerging consent among practitioners that anorexics and bulimics engage in similar behaviours. They have different personality and emotional profiles but they seem to be generally opposites on the same continuum.
While treating an eating disorder is a challenge, the sooner it is addressed, the better the prospects of recovery. Regardless of the situation, with the right help and support many young women survive these illnesses and reclaim her lives. If you think you may be at risk, I encourage you to open up to someone whom you trust and seek help from a mental health professional. If you have a loved one whom you suspect has an eating disorder, try to reach out in a manner that is empathic and allows her to feel safe.
*Name has been changed
SA Depression and Anxiety Group (national)
Who is Antonia Roos?
Antonia Gueorguieva Roos, originally from Bulgaria, is a Clinical Psychologist in Garsfontein, Pretoria. From the age of five she trained to become a classical musician and excelled in music performance and composition. Along the way she recognised her compelling interest in the human mind and decided to pursue a higher education in psychology. She completed her degrees at the University of Pretoria (BSocSci; BSocSci Hons) and University of Johannesburg (MA Clin Psych) with distinction. Antonia strives to facilitate healing by continually learning and developing as a person, sharing her knowledge and experience, and treating matters of the heart with the highest level of respect and support.