Eating Disorder Talk

Today the BBC reported that Scotland is now ranked second for obesity amongst developed nations - being the runner up the the States, of course.

Some handy facts:

• One in five Scottish seventh graders were estimated to be obese in 2004/2005.
• In 2005/2006, 643 cases were treated in UK NHS hospitals of either anorexia or bulimia - surprisingly, 620 of the cases were for anorexia, with bulimia being the less presented disorder.
• Of a total UK population of about 60.8 million people, it’s estimated that 1.1 million are affected by an eating disorder - that’s almost two percent.
• Scotland makes up about eight percent of the total UK population.
• Twenty percent of the UK population is under the age of 16; about 17 percent are over the age of 65.

I found most of those statistics on Disordered Eating UK, you should look and see what you find, there, too.

It’s a long-standing theory - women who were abused, especially sexually, prior to puberty are at an increased risk for development of eating disorders. Stereotypically, it was thought that bulimics were all rape survivors since the purging addiction was a form of cleansing; anorexics were resultant of molestation, attempting to rid themselves of anything pleasant to touch. I’ve never heard a stereotype about overeaters, though one could go far enough to say that it’s a form of escapism - requisite by so many different types of sexual abuse.

Well known for developing an eating disorder after her rape at 12 years of age, Fiona Apple feeds the myth of eating disorders decreasing sexual aggression.

She had strange eating habits. “It was colors,” she explains. “I couldn’t eat things that looked a certain way, that were a certain color. I mean, there was a time when I couldn’t eat things that I felt clashed with what I was wearing. I don’t mean ‘clash’ like ‘fashionably clash’ - there was just something in my head that if it didn’t balance, I couldn’t eat it, and I was so afraid of doing the wrong thing. If I ate something, I felt like I was doing it because I don’t want to be crazy.’ ‘I’m going to eat that fucking apple right now, even though I’m wearing a yellow dress.’ This would go on in my head all the time. And it’s exhausting. I would tell my sister, ‘I’m just so tired I can’t manage myself anymore.’ I felt like I was the mother of some retarded child that was throwing fits all the time, and I couldn’t help it. It would take me half an hour to pick an apple out of the drawer. I couldn’t pick the right one.”

So why were you like that?

“Because I felt like I had no control over my life.”

“For me, it wasn’t about getting thin, it was about getting rid of the bait that was attached to my body. A lot of it came from the self-loathing that came from being raped at the point of developing my voluptuousness,” she explains. “I just thought that if you had a body and if you had anything on you that could be grabbed, it would be grabbed. So I did purposely get rid of it.”

In 2005, the BBC produced an article with the University of Bristol’s study findings - stating that girls who has faced abuse before the age of 16 were twice as likely as their counterparts to develop an eating disorder in later life. This was based on any physical abuse, but of the study’s participants who’d been sexually abused, 15% showed symptoms of an eating disorder. That’s 5% more than the assessed prevalence in North America.

A spokesman for the Eating Disorders Association said the findings were not surprising and should be viewed in context.

“We have known for some time that sexual abuse can lead to eating disorders.”

…

“What is interesting about people who develop disorders after abuse is that it is a defense mechanism; they do it so they don’t draw attention to themselves.”

Something Fishy had something to say, as well. If food has been used as a lure into the sexual abuse, sufferers may develop a food phobia or even, in the case of oral sexually-based abuse, an automatic gagging, choking or frightened feeling upon eating.

Survivors may feel a loss of immense control over their bodies and their lives. Because of self-blame they may carry a tremendous burden of guilt. They may feel a need to push others away, or a hurried sense to grow-up, in order to protect themselves.

The backlash of Sexual Abuse is that survivors may turn to food (or alcoholism or drug addiction) as a means to cope. Binging may offer a sense of comfort and a way to stuff down emotions of pain and anger. Purging may serve as a release of emotion or as a means to self-punish. In a desperate attempt to gain control over their bodies some victims will turn to food and restriction. They may feel dirty and violated, unable to get clean and purging may serve as a temporary fix to those feelings. They may attempt to control their body-shape, becoming overweight or under weight, in order to push people away to prevent further abuse, or so that the abuse will stop (if it is still occurring). Food, binging and purging and restriction/starvation may all provide a sense of safety, certainty and security that they feel they cannot find anywhere else.

About.com has an article detailing why anorectics may have problems with sexual relationships - in fact being sexually anorexic. Lack of development, the lack of “need” for sex, pleasure avoidance and intimacy issues are discussed briefly. I’d like to challenge this article and it’s supporting research with a survey of my own, but that will have to wait for another day, another post.

Since quite a few of the studies of prevalence, epidemiology and outcomes of anorexia has involved cases documented or diagnosed by the medical system, Anna Keski-Rahkonen, M.D., Ph.D., of the University of Helsinki and Columbia University, and colleagues reported their findings in a new, unbiased study, created to look at the general population. Lifetime prevalence, incident rates and 5-year recovery were examined in the 2,881 women from the 1975-79 cohorts of Finnish twins.

Lifetime prevalence of severe anorexia was 2.2% or 63 women, of which half hadn’t been detected by the medical system. When removing some of the symptoms of severe anorexia, such as amenorrhea, about 5% of subjects were considered anorexic. It’s been suggested that half of the population suffering with the eating disorder go undiagnosed and only about a third receive mental health care.

Onset usually occurred between 10 and 25 years of age, with the peak ages being between 15 and 19. Interesting was the finding that women in the starvation phase were less likely to date, live in long term relationships and marry than their healthy twins. However, once recovered, they were just as likely to engage in these behaviours, have sexual relations and even have children.

The five year recovery rate was 66.8%, or 42 women, regardless medically detection or not. By this five year mark, most recovered women were almost or entirely clear of the effects if the disorder. In fact, the average duration of the disorder was about three years. About a third of the affected women still had symptoms after the five year mark and only 8.4% surpassed 10 years.

Resources: American Journal of Psychiatry, Medpage Today, Science Daily.

Finnish, anorexia, twin studies, recovery, mental help, eating disorders, Finland

Diet Blog posted an article on a study’s findings published recently in the New England Journal of Medicine that shows a direct relationship between obesity in ourselves and our close familial and social ties. In the same article, it’s mentioned that girls who talk about their problems at length with friends may be more likely to suffer from depression and anxiety symptoms.

Playing devil’s advocate and being argumentative are my passions - yes, there is a difference as many a frustrated debater has said to me.

So I’d like to know, of those people who suffer from eating disorders, at what rates are their close social ties and family also dealing with their own symptoms?

The relationship between family members and eating disorders has been speculated and researched in the past few years extensively. In one article, an expert sums it up nicely:

But relatives of individuals with eating disorders are at seven to 12 times higher risk than relatives of individuals without eating disorders. The familiality of anorexia nervosa is the highest; they tend to have the densest family history[.]

So ask yourself, if you’re currently an eating disorder sufferer or are recovered, how many people do you know closely, be it in your family or friends, that have their own histories? Is this an example of modeling the behaviours or enabling them?

In past years, Body Mass Index (BMI) has gained and lost favour multiple times. Since my last post mentioned BMI’s role in Madrid’s last Fashion Week, I thought I’d do a little calculating and see how the top models “measure up.” You can figure out your own BMI here. Using it, I found out that mine’s 17 - no catwalk strutting for me!

According to Forbes, the following supermodels were the top income earners in 2005.

1. Gisele Bundchen: (5′10″, 127 lbs., 34-24-34) BMI of 18.2.
2. Heidi Klum*: (5′9″, 119 lbs., 35-24-31) BMI of 17.6.
3. Tyra Banks**:(5′10″, 131 lbs., 36-34-36) BMI of 18.8.
4. Kate Moss: (5′7″, 105 lbs., 33-23-35) BMI of 16.4.
5. Adriana Lima: (5′10″, 112 lbs., 34-23-33) BMI of 16.1.

As you can see by plugging in the height and weight of nearly everyone you know (you know you’re curious), model sizes just aren’t realistic. I mean, look at me - I’m nearing Kate Moss’ stats, but my body looks nothing like hers. And it took 20 years of self-deprecating and destruction to do it - get as close, numerically, as I have. She probably couldn’t even maintain it, naturally, either.

* I’m assuming this was before getting pregnant and getting into television nearly full-time.

** It was truly hard to find mention of Tyra’s pre-retirement weight, so I resorted to this.

A new over the counter (OTC) weight loss product has hit the shelves in the US. alli is a fat-blocker reputed to block absorption of about 25% of the fat you take in. The major drawback, besides the embarassing and uncomfortable side effects, is that alli will be most effective and least invasive when used with the low-calorie, low-fat diet plan and exercise regime marketed with the product’s starter pack.

Side effects of not following the low-fat plan include diarrhea, unplanned bowel movements and gas with an oily discharge. The product’s website actually suggests wearing dark pants and carrying an extra pair around, in case of accidents. This hasn’t stopped consumers from purchasing the product, as reported here. Sales of the moderately stocked but massively hyped product have surprised vendors, who are being questioned about whether the drug works, not how or at what physical cost.

The problem as I see it, is that while marketing of the drug states that it is most effective when used in conjuction with lifestyle changes, such as fitness and following a low-fat, low-calorie diet, perusal of the alli message board left question marks as whether this prescribed diet is realistic for a typical user. And whether the lifestyle changes will indeed be heathier. In one location of the product’s webpage, “treatment effects” can be minimized by eating meals with less than 15 grams of fat - more and you risk the leakage and painful digestion issues. But on the message board, consumers of the product are concerned as to whether they should eat less than the recommended 19 grams of fat per meal or risk the drug not working to help them lose weight…this specific number of fat grams was based on their own “alli diet plan”.

One user went so far as to explain the diet plans available in the product’s diet plan book and this is where the red flags were raised. She describes having a choice between a 1200, 1500 and 1800 calorie plan, each with specific fat intake recommendations. But let’s examine this, based on the calorie recommendations, alone…

The average Canadian woman weighs 153 pounds and is 5 feet, 3.4 inches tall; American women are 10 pounds heavier, while being 0.4 pounds taller. This means, using this caloric calculator, an average 35 year old Canadian woman needs 2,063 calories daily and her American counterpart, 2,170. Using alli’s suggested 1,200 calorie per day diet plan means a deficit of over 900 calories for some women. Add three thirty-minute sessions of jogging per week, she could burn an extra 750 calories weekly, totalling a loss of 2 pounds per week.

So, without even introducing fat-blockers - non-digestion of a quarter of the fat you eat (not to mention what else you won’t be absorbing: fat-soluble vitamins, for one) - you can expect to lose 2 pounds a week if you’re an average woman living in the US, eating 1,200 calories a day and jogging for a total of an hour and a half a week. So, what’s the point of the fat blockers, again? Why deal with anal leakage? Sounds great, right? Sounds like a plan?!

It sounds fishy to me.

In my personal experience, the very devoted anorexics I’ve known adhere to a diet of between 100 and 1,200 calories daily. So, yes, I question how many women are setting themselves up for the fall, here - in an effort to lose 10 to 20 pounds. I know that it would send me into a spiral of starvation. Would it be worth it for you - the mess, the lack of food, the lack of control?

alli, anal leakage, calories, diet pills, low-fat