Robin Boudette, Ph.D.

Articles by
Robin
Boudette, Ph.D.

Transform Unhealthful Eating Habits

Mindful Eating

Stress, the
Silent Epidemic

Eating Disorders are a Peril for Vulnerable Young People

Eating Disorders are a
Peril for Vulnerable Young People

Reprinted from Princeton Packet, August 2001

Our society attaches great importance to a person’s weight and looks. This skewed sense of priorities is taking its toll on the young.

The American Dietetic Association estimates that more than five million Americans suffer from eating disorders, namely anorexia nervosa and bulimia. The majority of sufferers are young girls and women, though adolescent boys as well as adults have them. Recent reports indicate that children as young as eight are developing eating disorders.

"When a person can admit that “it’s not about the food,” he or she will soon be able to make connections and translate the language of food and fat into the language of feelings." - Robin Boudette, Ph.D., psychologist, Women's Wellness Program the Medical Center
at Princeton

When eating disorders spiral out of control, the conditions can become life-threatening. It is important for families to be pro-active about identifying warning signs. The first step is to gain knowledge about the disorders.

Anorexia nervosa begins when a person starts to diet and then the dieting gets out of control, resulting in self-starvation. Bulimia also typically begins with dieting behavior but eventually results in binge eating, followed by purging. Many people may start out anorexic and eventually become bulimic.

When the dieter reaches a low, unhealthy weight, the body rebels by supplying appetite stimulants. This triggers binge eating. Often a dieter in danger will restrict her food intake all day and then overeat at night. This bingeing leaves the person feeling guilty and ashamed, so she may begin to try to make up for the bingeing but using self-induced vomiting, laxatives or excessive exercise.

This cycle repeats itself. Once the behaviors have started, it is very difficult to stop without help. In time, this cycle becomes a way for the person to cope with life and its many stresses.

• Preoccupation with food, weight and appearance;
• Bingeing at least two times a week;
• Eating large amounts of food and then engaging in laxative abuse, self-induced vomiting or excessive exercise;
• Making excuses to go to the bathroom;
• Having dental problems (in late stage)

• Feeling fat despite extremely low weight or distorted body image;
• Dieting down to a body weight less than 85 percent below what is healthy;
• Expressing an intense fear of being fat;
• Frequent weighing;
• Denying hunger;
• Developing routine eating habits such as cutting food up into pieces, lingering over meals and eating alone;
• Having a preoccupation with food;
• Refusing to admit that eating habits are abnormal;
• Experiencing social isolation;
• Ceasing to have menstrual periods.
  

Those most susceptible are adolescents around the ages of 13-14 who are experiencing separation from the family as they develop peer relationships, and young adults around 18 who are striving for independence and often heading off to college. These young people tend to be high achievers who get good grades, are good at a variety of activities and sports, and have a perfectionistic attitude, yet have difficulty being assertive and often suffer from low self-esteem.

Their inability to identify and express feelings (“alexthymia”) plays an important role in fostering the disease as sufferers become cut off from their own needs and lose track of internal cues as basic as hunger. Therapy can help them regain the ability to identify what is needed and ask for it.

There are things that families can do to help prevent eating disorders from taking root. For example, avoiding conflict makes problems disappear, only to fester beneath the surface. It is much healthier for families to confront conflicts, discuss them, and work toward a resolution.

Encourage adolescents to spend less time in front of a mirror and to enjoy their bodies for what they can do, not for what they look like. Extinguish prejudice against fat within the family and point out that beauty comes in all shapes and sizes. Be good role models and think about the messages you are giving your kids.

It is also important to examine what messages coaches and instructors are sending. Dance, wrestling, crew and track are activities where weight and body sculpting are often issues. Emphasize enjoyment over competition and help boost self-esteem at every opportunity.

Adolescents with eating disorders are often superficially compliant, making it imperative that families be aware of warning signs. As a family member, if you have concerns, start reading up on eating disorders, talk to your loved one openly, and continue to watch for signs. If it appears to be a growing problem see a specialist in the field for an assessment. It can be tough to combat society’s messages, but it can be done.

Dr. Robin Boudette, a licensed psychologist, is the program director of the Eating Disorder Program at the Medical Center at Princeton. This article was prepared in collaboration with Lorraine Seabrook.