Q: Because I constantly hover around 20 pounds over my normal weight, I always seem to be on one diet or another; do I have an eating disorder?

Q: Because I constantly hover around 20 pounds over my normal weight, I always seem to be on one diet or another; do I have an eating disorder?

A: If you've lost a good bit of weight yet still perceive yourself as "fat," despite being within or below normal weight ranges, you have a problem. If you binge by taking in thousands of calories at a time — often in secret, and perhaps followed by purging — you probably suffer from an eating disorder. If you are preoccupied with your body and caught up in destructive patterns of dieting and overeating, you probably have an eating problem, which also can affect your health and well-being, though not as dramatically as an eating disorder. You should consider talking to your health care professional about your feelings and constant need to diet. Have him or her assess the diets you are trying; if they don't offer enough nutrients or calories, they will be almost impossible to stick to.

Q: My daughter is neither overweight nor underweight, but I have found evidence of secretive eating, like dozens of candy wrappers under her bed. What's going on?

Q: My daughter is neither overweight nor underweight, but I have found evidence of secretive eating, like dozens of candy wrappers under her bed. What's going on?

A: Bulimia is often hard to recognize because bulimics don't tend to be at an extreme weight. However, if a person takes in thousands of calories at a time — a dozen candy bars, for instance — then purges by making herself vomit, taking laxatives or enemas, fasting, or exercising to the extreme, she has an eating disorder called bulimia. If asked, she will probably deny it. You should talk to your health care professional about how to approach your daughter regarding her disorder.

Q: Is a compulsion to exercise to the extreme — several hours a day — part of an eating disorder?

Q: Is a compulsion to exercise to the extreme — several hours a day — part of an eating disorder?

A: If the compulsion is driven by a desire to lose weight, despite being within a normal weight range, or if the compulsion is driven by guilt due to binging, then, yes, this compulsion to exercise is a dimension of an eating disorder.

Q: How is anorexia treated? Does it require hospitalization?

Q: How is anorexia treated? Does it require hospitalization?

A: Your health care professional may hospitalize you if your anorexia has resulted in life-threatening complications that are best treated in a hospital, or if continued starvation will lead to such complications shortly. In any case, you mostly likely will be treated with a combination of psychological counseling, nutritional education, family therapy and, perhaps, antidepressant medications. 

Q: How is binge eating treated?

Q: How is binge eating treated?

A: Binge eating is a symptom of bulimia nervosa. Psychological counseling, nutritional education and family therapy all play a role in recovery from bulimia nervosa.

Q: Who gets eating disorders?

Q: Who gets eating disorders?

A: Eating disorders are mental illnesses that cut across the socioeconomic and ethnic spectrum. However, about 90 percent of those suffering from eating disorders are women, and the illnesses develop at an average age of 17.

Q: What causes eating disorders?

Q: What causes eating disorders?

A: There is no single cause of eating disorders. Biological, social, and psychological factors all play a role. A person may even have a genetic predisposition to anorexia. In most women, an event or series of events — from a degrading comment to rape or incest, to times of transition such as divorce or starting college — triggers the eating disorder and allows it to take root and thrive. Parents or coaches who are preoccupied with eating and overly concerned or critical of a young girl's weight or body image may also encourage an eating disorder, as can societal pressures.

Q: I have a young daughter; how do I prevent her from developing an eating disorder?

Q: I have a young daughter; how do I prevent her from developing an eating disorder?

A: Starting young is the best advice. First instill in her a healthy body image and good eating patterns by modeling these yourself and having open conversations with her. Teach her about how her body will change as she enters puberty so she will expect some weight gain. Show her that women of all body types and sizes can be successful and independent. And talk to her about the unrealistic expectations formed by constant exposure to models and actresses who starve themselves to look emaciated. Don't nag her or focus on her eating habits, but set a healthy example yourself.

Copyright 2003 National Women's Health Resource Center, Inc. (NWHRC)