From the NYU Child Study Center: Ask the Expert
When Is Thin Too Thin?
By Glenn S. Hirsch, M.D.
In a culture that measures good health and good looks by celebrities and fashion magazines, there is a real danger of moving from a healthy weight to a mindset that says ‘I am still overweight,’ no matter what the scale says.
Eating disorders affect women in disproportionate numbers. Yet while 90 percent of all patients with an eating disorder are women between the ages of 12 and 25, at least one million men in this country are affected as well. In addition to the emotional and psychological distress, these disorders can cause severe chronic health problems. More than 10 percent of women with anorexia eventually die from the disorder.
Rooted in genetic, psychological and biological factors, there are three main types of eating disorders, though patients may have symptoms of more than one disorder. In all types, a major component is body image distortion and making food a central feature of one’s life.
Anorexia Nervosa is characterized by an intense fear of gaining weight or becoming fat even when underweight. Anorexics often have unusual eating habits and develop compulsive behaviors around food including repeatedly checking their weight and excessive exercise. They may vomit or abuse laxatives as a way of trying to reduce the calories they utilize. Between 0.5-3.7 percent of females will develop anorexia at some point in their life.
Bulimia Nervosa’s symptoms include recurrent periods of binge or excessive eating in a short period of time often followed by purging behaviors and/or periods of fasting or excessive exercise. Bulimia affects up to 4 percent of woman.
Binge-Eating Disorder is characterized by recurring episodes of binge eating, followed by periods of guilt and disgust. It differs from anorexia and bulimia in that there is no purging, fasting or excessive exercising. This disorder appears to affect men and women equally and may be the most common of the eating disorders—as many as 5 percent of Americans suffer from it. Most with this disorder are overweight or obese.
Eating disorders are treatable. The major components of treatment include: intervening early in the course of the illness before symptoms become chronic; restoring normal weight in patients with anorexia; therapy, often cognitive behavioral therapy; and nutritional counseling. Some patients benefit from medication.
Unfortunately, we cannot easily change our culture that celebrates thinness. However, there are some things that parents can do to change the culture of their own home to reduce the risk of a child developing an eating disorder. Start by helping your child develop healthy eating habits, including eating breakfast and having a daily meal together as a family. Help your child develop a positive attitude toward his or her body. It is important to demonstrate this by example. Discourage the idea that a particular weight or body size will lead to happiness or improve self-esteem.#
This monthly column provides educators, parents and families with important information about child and adolescent mental health issues. Please submit questions for ASK THE EXPERT to Glenn S. Hirsch, M.D., Medical Director at the NYU Child Study Center at glenn.hirsch@med.nyu.edu. To subscribe to the ASK THE EXPERT Newsletter or for more information about the NYU Child Study Center, visit www.AboutOurKids.org or call 212-263-6622.
