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Nearly 24 million Americans suffer from an eating disorder, according to the National Association of Anorexia Nervosa and Associated Disorders (ANAD). Anorexia, bulimia, and binge eating cause serious health complications; the ANAD reports that nearly 20 percent of people with anorexia, in particular, will die prematurely from complications stemming from their disorder. Though anorexia is prevalent in people of all ages and genders, Sheridan Road decided to take a closer look at how the eating disorder affects girls and women on the North Shore. We sat down with Wilmette-based therapist Suzanne Gazzolo, Ph.D., LCPC, who works extensively with patients suffering from anorexia, to learn more about this life-threatening illness.
Sheridan Road: The incidence of anorexia nervosa has been associated with higher income levels. Any ideas what the numbers are like here on the North Shore?
Dr. Suzanne Gazzolo: It is difficult to find accurate statistics in general, and I don’t know of anyone who is tracking the North Shore specifically. Doctors are not required to report eating disorders. In the general population, the estimate is that 1 percent of adolescent girls and 0.5 to 3.7 percent of women suffer from anorexia in their lifetime. Historically, anorexia has been associated with white, affluent, adolescent, and college-age women, but that is not the actual current picture of who is affected, especially globally. One of the reasons affluence has been associated with anorexia is probably because these are the families who have the best access to quality health care and mental health care, and they have had the problem identified. Though the statistics may vary, what most professionals in the field agree on is that there is a complex web of psychological, biological, and sociocultural factors that factor into someone’s vulnerability to anorexia.
SR: How do you tell if a teen is anorexic versus merely thin?
SG: When teens are under the influence of anorexia, they tend to be very preoccupied with their bodies and with food, and feel driven to continue being thinner. Many of their thoughts paradoxically focus on food and losing weight; they also worry about their size and shape, and have a distorted view of their body. Warning signs might be if you notice a teen stops eating foods they used to enjoy, cuts out entire categories like fats or carbs, and becomes more and more restrictive about what they are willing to eat. A teen who is merely thin will probably not be consumed with ideas about food and weight, and will have a fairly accurate sense of their own body size.
SR: What are some preemptive things parents can do to build healthy attitudes about food and bodies?
SG: Be aware of your own assumptions and attitudes. Do you criticize or compare your own body or that of others in front of your children? Fostering a body image founded on strength and ability rather than size and shape can innoculate teens to some of the cultural messages they get bombarded with. Your body serves important functions; it is not merely an object to conform to a very narrow and exclusive ideal of beauty. We need to understand how our bodies make sense on their own terms, and what health feels like, not just looks like. Listening to our own body’s signals of hunger, satiety, fatigue, and energy is a skill that often needs to be relearned. Parents who can do that for themselves and stand up against the culture of “thin is better for all” or fat phobia offer their children alternatives. And parents who show respect for others—regardless of size, shape, or appearance—take a powerful stand against the weapons of eating disorders. Teaching children to focus on what matters in their lives—their important relationships, interests, skills, and curiosities—crowds out focusing on size and shape as a measure of self-worth.
SR: With Demi Moore’s stick-thin figure in the news lately, how common is it for adult women to suddenly develop anorexia?
SG: It is not common for an adult woman to develop anorexia if she has not already experienced some of the influences of eating disorders, like recurrent dieting, negative body image, and over-exercising. It can also be exacerbated if drugs and alcohol are involved.
SR: How does anorexia affect other family members? Is there a greater chance of a family member developing an eating disorder?
SG: There is some evidence that tells us there is a genetic piece to the puzzle that makes some people more vulnerable to the influence of eating disorders—specifically anorexia. If you were to speak with any family who has had a member struggle against anorexia, I think they would say anorexia had affected the entire family. It is enormously distressful to see a loved one in the grips of what can seem like a tyrannical force. Some families have described it as feeling like a terrorist has taken over their loved one.
SR: Are there any promising new treatments out there?
SG: There is so much new work being done in the field, and frankly the field is still young. In our own backyard, the University of Chicago has been doing world-renowned work in their family-based treatment model. Traditionally, parents (particularly mothers) were seen as the problem and cause of eating disorders. Thankfully, more and more practitioners are stepping away from these notions and understanding the importance of parents’ roles in combating the eating disorder. U of C’s family-based treatment model reflects this shift. In Stockholm, there is a hospital that has developed biofeedback treatment that they say is showing 90 percent effectiveness in treating anorexia; this kind of success is unheard of in the field.
SR: Do patients ever really recover from anorexia or is it a lifelong struggle?
SG: Yes, people do recover. And, with anorexia, recovery is really important because the alternative is starving to death. Research says that the mortality rate of anorexic people is about 20 percent in untreated cases and about 2 to 3 percent of patients in treatment. It is not unusual for the recovery process to take some detours into other disordered eating influences like bulimia or bingeing. But, with perseverance and treatment, it is possible to recover.
If you suspect a friend or loved one may be suffering from anorexia, it’s important to know what symptoms he or she may display. Here are a few telltale indicators that a problem likely exists:
° Significant weight loss with a preoccupation to continue to lose or to remain significantly underweight
° Preoccupation with body size and shape
° Constant comparisons to others and a voiced desire to be thinner
° Amenorrhea (an abnormal absence of menstrual periods)
° Forgoing activities or social opportunities because of eating concerns
° Skipping meals
° Avoiding foods that used to be enjoyable
° Frantic or excessive exercise, especially after eating