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Feb 22,2008
Women’s Health: Identifying eating disorders
by Kenneth L. Noller, MD

Eating disorders are complex, serious health problems that affect 7 million women and girls in the US. They can occur in women—and men—of all ages and backgrounds, but most often develop in young women between ages 11 and 20.

Anorexia, bulimia, and binge eating are the three main types of eating disorders. People with these conditions are obsessed with food and body weight. They often have a distorted view of their body shape, have low self esteem, are depressed, and feel ashamed or guilty about their eating problems.

Women with anorexia have an intense fear of being fat. They think of themselves as fat when they are not and want to be thin so badly that they will exercise to extremes or starve themselves—sometimes to death. Anorexics may be withdrawn and irritable, deny that they are underweight, and refuse to eat even small portions or insist on eating alone. 

Because the body is being starved, anorexia can lead to severe and long-term health problems, such as an irregular heartbeat, bone loss and osteoporosis, low body temperature, low blood pressure, kidney problems, a slow metabolism, slow reflexes, absence of menstrual periods, and a delay in reaching puberty. Five percent to 10 percent of women with anorexia die from it.

People with bulimia eat unusually large amounts of food in a short amount of time, then purge—by vomiting or taking laxatives, diuretics, or pills that cause vomiting—to get rid of the excess calories. Bulimics can be hard to spot because, unlike anorexics, their weight is usually normal or just above normal. They know that their eating is out of control and fear that they won’t be able to stop eating.

Purging can be life-threatening. Bulimia can cause dehydration; bowel, liver, and kidney damage; damage to the throat, esophagus, and stomach (from self-induced vomiting); problems with teeth and gums; and heart complications. 

As many as two out of every 100 Americans, and up to 40% of obese people, have binge eating disorder.  Binge eaters consume large amounts of food, but they do not purge after over-eating.  As a result, they are usually overweight or obese. 

Binge eaters may experience medical problems often connected to binge-related weight gain, such as high blood pressure, high cholesterol, gall bladder disease, diabetes, and certain types of cancers.

Eating disorders can be treated with medication, counseling, and in extreme cases, hospitalization. For those struggling with an eating disorder, admitting that there is a problem is the first step toward recovery. If you or someone you know has some of the symptoms listed here, seek help. Your doctor can diagnose an eating disorder and arrange treatment.

For more information, the ACOG Patient Education Pamphlet “Eating Disorders” is available in English and Spanish at www.acog.org/publications/patient_education.
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