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Spokane, Washington  Est. May 19, 1883

House Call: Eating disorders can affect anyone

By Dr. Bob Riggs For The Spokesman-Review

Eating disorders can be hard to understand for people without one. You can have an eating disorder and look just as healthy as the next person. Although eating disorders more commonly affect young women, anyone can develop an eating disorder. A family history of eating disorders, other mental illness or stress and dieting can all put you at increased risk of developing an eating disorder at any time in your life.

The most common eating disorders are anorexia nervosa, bulimia and binge eating disorders. In anorexia nervosa, the individual who is underweight perceives him or herself as overweight and severely restrict their food intake to lose or control their weight. This eating disorder can lead to severe malnutrition and metabolic imbalances that can be fatal. This disorder is associated with a high risk of suicide.

In bulimia, the sufferer intermittently eats large amounts of food and follows this with efforts to compensate for it. This may be with self-induced vomiting or the use of laxatives or diuretics to try to lose weight. The person with bulimia typically feels out of control but usually maintains a normal or near normal weight.

In binge eating disorder, the sufferer regularly eats foods in large quantities but does not follow this with purging behaviors and is likely to become overweight or obese.

There are several eating patterns that can indicate the existence of an eating disorder long before any physical symptoms are perceptible. They include the following:

Skipping meals or making excuses for not eating

Adopting an overly restrictive diet

Focusing excessively on healthy eating

Withdrawing from normal social activities

Checking the mirror frequently for perceived flaws

Eating large amounts of sweets or high-fat foods repeatedly

Using dietary supplements, laxatives or herbal products for weight loss

Exercising excessively

Leaving during meals to use the toilet

Eating much more food in a meal or snack than is considered normal

Expressing disgust, shame or guilt about eating habits

Eating in secret

Acknowledging that you may have an eating disorder can be difficult. Do not be hard on yourself and remember that it’s not a character deficit but an illness. Friends or family members who try to talk with you about the possibility of an eating disorder are concerned with your health and well being and are not looking for a reason to be critical of you.

The best way to prevent onset of an eating disorder is to develop healthy eating behaviors as a child. This means it is up to parents to nurture those healthy behaviors. A wise pediatrician once told me that it is up to parents to decide when their child eats and what foods they have to choose from. The child gets to decide how much. I encourage family dinners with a balance of nutritious foods served and eaten in reasonable portions. Paying attention to what your child is viewing on the Internet and on television is important too. Ensure that they understand the risks of unhealthy eating choices. It is good to periodically discuss self-image and the many types of body shapes which are healthy and normal. Your kids are always watching you, so role model healthy eating, refrain from negative talk about your body’s appearance and avoid diet talking and behavior.

As with any illness, your primary health care professional is a good place to start if you are worried about an eating disorder in yourself or someone in your family. If an eating disorder is present, a comprehensive approach to treatment that includes a mental health professional and a dietician with interests and skill in treating eating disorders is typically needed as well.

The earlier treatment of an eating disorder begins, the better the chances of a good outcome, so don’t hesitate to seek help or talk to a loved one you are concerned about.

Bob Riggs is a family medicine physician practicing at Kaiser Permanente’s Riverfront Medical Center. His column appears biweekly in The Spokesman-Review.