MEDA-College-Guide (PDF)

& EATING DISORDERS COLLEGE STUDENTS   Factors That May Contribute to an Eating Disorder 2 Eating Disorder Myths 4 College Students & Eating Disorders 6 About Eating Disorders 8 Do’s and Don’ts of Helping a Friend 12 Eating Disorder Statistics 14 Do You Have a Healthy Relationship with Food and Your Body? 16 Contact Information 18 MEDA’s Programs & Services 19 MEDA’s Support Groups 20 MEDA’s Partners 21 TABLE OF CONTENTS BETTER STARTS HERE WWW.MEDAINC.ORG 1  Eating disorders are complex conditions that arise from a combination of long-standing behavioral, biological, emotional, psychological, interpersonal, and social factors. Scientists and researchers are still learning about the under lying causes of these conditions.We do know, however, about some of the general issues that can contribute to the development of eating disorders. While eating disorders may first appear to be solely about food and weight preoccupations, those suffering from them often try to use food and the control of food to cope with feelings and emotions that may otherwise seem overwhelming. For some, dieting, bingeing and purging may begin as a way to cope with painful emotions and to feel in control of one’s life. These behaviors can damage a person’s physical and emotional health, self-esteem and sense of competence and control. FACTORS THAT MAY CONTRIBUTE TO AN EATING DISORDER 2  BETTER STARTS HERE 617.558.1881 BIOLOGICAL FACTORS: • Scientists are still researching possible biochemical or biological causes of eating disorders. In some individuals with eating disorders, certain chemicals in the brain that control hunger, appetite, and digestion have been found to be unbalanced • Eating disorders often run in families. Current research indicates that there are significant genetic contributions to eating disorders PSYCHOLOGICAL FACTORS: • Low self-esteem • Feelings of inadequacy or lack of control in life • Depression, anxiety, anger, stress or loneliness INTERPERSONAL FACTORS: • Troubled personal relationships • Difficulty expressing emotions and feelings • History of being teased or ridiculed based on size or weight • History of physical or sexual abuse SOCIAL FACTORS: • Cultural pressures that glorify thinness or muscularity and place value on obtaining the “perfect body” • Narrow definitions of beauty that include only specific body weights and shapes • Cultural norms that value people on the basis of physical appearance and not inner qualities and strengths • Stress related to discrimination or prejudice 3  MYTH: EATING DISORDERS ARE NOT AN ILLNESS TRUTH: Eating disorders are a complex medical/ psychiatric illness. Eating disorders are classified as a mental illness in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Health (DSM-V). They are considered to often have a biologic basis and co-occur with other mental illnesses such as major depression, anxiety or obsessive- compulsive disorder. MYTH: EATING DISORDERS ARE UNCOMMON TRUTH: Among U.S. females in their teens and 20s, the prevalence of clinical and subclinical Anorexia may be as high as 15%. Anorexia ranks as the 3rd most common chronic illness among adolescent U.S. females. Recent studies suggest that up to 7% of U.S. females have had Bulimia at some time in their lives. At any given time an estimated 5% of the U.S. population has undiagnosed Bulimia. Current findings suggest that Binge Eating Disorder affects 0.7% to 4% of the general population. EATING DISORDER MYTHS 4  BETTER STARTS HERE WWW.MEDAINC.ORG MYTH: EATING DISORDERS ARE A CHOICE TRUTH: People do not choose to have eating disorders. Eating disorders develop over time and require appropriate treatment to address the complex medical/psychiatric symptoms and underlying issues. MYTH: EATING DISORDERS OCCUR ONLY IN FEMALES TRUTH: An estimated 25% of Anorexia diagnoses in children are in males. For Binge Eating Disorder, preliminary research suggests equal prevalence among males and females. Incidence in males may be underreported because research shows that females are more likely to seek help. Also, health practitioners are more likely to consider an eating disorder diagnosis in females. MYTH: YOU CAN TELL IF A PERSON HAS AN EATING DISORDER SIMPLY BY APPEARANCE TRUTH: You can’t. Anorexia may be easier to detect visually, although individuals may wear loose clothing to conceal their body. Bulimia is harder to “see” because individuals often are average weight. People with an eating disorder can become very effective at hiding the signs and symptoms. Eating disorders can go undetected for months, years or a lifetime. MYTH: A PERSON CANNOT DIE FROM BULIMIA TRUTH: While the rate of death from Bulimia is much lower than that seen with Anorexia, a person with Bulimia can be at high risk for death and sudden death because of purging and its impact on the heart and electrolyte imbalances. Various purging techniques and excessive exercise can increase risk of death in individuals who are actively bulimic. 5  WHY ARE COLLEGE STUDENTS SUSCEPTIBLE TO DEVELOPING EATING DISORDERS? • New peer groups • Difficulty forming new friendships • New found self-reliance; no longer living under parental rules • Eating in a cafeteria with an unlimited amount of food; making food choices may be difficult • Fear of the “Freshman 15” • Dorm-living • The need to fit in • Too many commitments • Academic and financial stress • Intense pressures to be thin/ “perfect” • Difficulty managing transitions COLLEGE STUDENTS & EATING DISORDERS A 2006 survey by the National Eating Disorders Association (NEDA) found that nearly 20% of the more than 1,000 college students surveyed — both male and female — said they have or previously had an eating disorder 6  BETTER STARTS HERE 617.558.1881 WHY ARE COLLEGE STUDENTS NOT SEEKING TREATMENT? • Unwilling to seek treatment • Do not know that they have an eating disorder • Lack of awareness of treatment resources • Embarrassed to seek treatment • Lack of treatment resources • Perceived lack of anonymity in treatment • Lack of knowledge by college staff about where to refer students WHAT CAN COLLEGES DO TO HELP TREAT AND PREVENT EATING DISORDERS? • Form a body image/eating disorder group that is run by students and/or faculty • Assist in education, prevention and activism on campus • Promote as many food choices as possible in the cafeteria (options may include a soup and salad bar, deli, pasta bar, fruit stand and/or frozen yogurt machine) • On- campus dietitian should be available, as well as counseling and health services staff 7  Eating disorders claim as many as 11 million lives each year. With the highest mortality rate of any mental illness, eating disorders continue to be a major part of our culture. According to the Diagnostic and Statistical Manual – Fifth Edition (DSM-V), eating disorders are classified into four major categories: Anorexia, Bulimia, Binge Eating Disorder, and Other Specified Feeding or Eating Disorders. ANOREXIA Signs & Symptoms • Intense fear of weight gain, obsession with weight and persistent behavior to prevent weight gain • Self-esteem overly related to body image • Preoccupation with weight, food, calories, fat grams, and dieting • Frequent comments about feeling “fat” or overweight despite weight loss • Development of food rituals (e.g. eating foods in certain orders, excessive chewing, rearranging food on a plate) • Consistent excuses to avoid mealtimes or situations involving food ABOUT EATING DISORDERS STATISTICS Anorexia Between 0.5–1% of American women suffer from anorexia. Between 5-20% of individuals struggling with Anorexia will die. The probabilities of death increase within that range depending on the length of the condition. Bulimia Bulimia affects 1-2% of adolescent and young adult women. People struggling with Bulimia usually appear to be of average body weight. Bulimia is frequently associated with symptoms of depression and changes in social adjustment. 8  BETTER STARTS HERE WWW.MEDAINC.ORG • Excessive, rigid exercise regimen--despite weather, fatigue, illness, or injury, the need to “burn off” calories taken in • Withdrawal from usual friends and activities HEALTH CONSEQUENCES OF ANOREXIA Due to the body being denied essential nutrients it needs to function, the body is forced to slow down all of its processes to conserve energy. This results in serious medical consequences such as: • Slow heart rate or low blood pressure. There is a risk for heart failure as the heart rate and blood pressure levels decrease • Osteoporosis or osteopenia • Muscle loss and weakness • Dehydration – if severe enough, it can result in kidney failure • Fainting, fatigue, and overall weakness • Dry hair and skin, hair loss can occur • Growth of lanugo, a layer of hair all over the body, which develops in an effort to keep the body warm BULIMIA Signs & Symptoms • Frequent episodes of consuming very large amount of food (“bingeing”) followed by behaviors to prevent weight gain, such as self-induced vomiting • A feeling of being out of control during the binge eating episodes • Unusual swelling of the cheeks or jaw area • Evidence of binge eating, including disappearance of large amounts of food in short periods of time or finding wrappers and containers which can indicate the consumption of large amounts of food • Evidence of purging behaviors, including frequent trips to the bathroom after meals, signs and/or smells of vomiting, presence of wrappers or packages of laxatives or diuretics • In general, behaviors and attitudes indicating that weight loss, dieting, and control of food are becoming primary concerns 9  HEALTH CONSEQUENCES OF BULIMIA The recurrent binge-and-purge cycles of Bulimia can affect the entire digestive system and can lead to electrolyte and chemical imbalances in the body that affect the heart and other major organ functions. Some of the health consequences include: • Electrolyte imbalances, from dehydration or other factors, that can lead to irregular heartbeats and possibly heart failure and death • Inflammation as well as potential rupture of the esophagus from frequent vomiting • Tooth decay and staining due to frequent vomiting • Peptic ulcers and/or pancreatitis • Irregular bowel movements and constipation if laxatives are abused BINGE EATING DISORDER Signs & Symptoms • A feeling of being out of control during the binge eating episodes • Feelings of strong shame or guilt regarding the binge eating ABOUT EATING DISORDERS STATISTICS Binge Eating Disorder Binge Eating Disorder affects women slightly more often than men — estimates indicate that about 60% of people struggling with Binge Eating Disorder are female, 40% are male. The prevalence of Binge Eating Disorder is estimated to be approximately 1-5% of the general population. 10  BETTER STARTS HERE 617.558.1881 • Eating alone because of shame about the behavior • Attributes social and professional successes/failures to weight gain/loss • Eating large amounts of food when not physically hungry or eating uncontrollably or to the point of discomfort HEALTH CONSEQUENCES OF BINGE EATING DISORDER Binge Eating Disorder often results in many of the same health risks associated with clinical obesity. Some of the potential health risks include: • High blood pressure • High cholesterol • Heart disease as a result of high triglyceride levels • Type II diabetes mellitus • Gallbladder disease OTHER SPECIFIED FEEDING OR EATING DISORDERS People with “Other Specified Feeding or Eating Disorders” exhibit symptoms which do not meet the strict criteria for eating disorder diagnosis, although they may be very severe. Examples include: • ATYPICAL ANOREXIA: All of the criteria for Anorexia are met, except significant weight loss. The individual’s weight is within or above the normal range • BULIMIA OR BINGE EATING DISORDER (of low frequency and/or limited duration): All of the criteria are met, except that the behaviors occur, on average, less than once a week and/or for less than 3 months • PURGING DISORDER: Recurrent purging behavior to influence weight or shape in the absence of binge eating • NIGHT EATING SYNDROME: Recurrent episodes of night eating, as manifested by eating after awakening from sleep or by excessive food consumption after the evening meal 11  DO • Talk openly and honestly about concerns • Try to make yourself available when they need someone • Be honest about your own fears, struggles, and frustrations • Take time to listen, even though the talk may seem trivial or insignificant to you • Understand that they are terrified of gaining weight and being fat (regardless of how they actually look to you) • Focus on personality and positive character qualities • Encourage them to accept support and express their feelings • Avoid conflicts and battles of will • Be patient; recovery can be a long process • Know your limits and respect them DO’S AND DON’TS OF HELPING A FRIEND 12  BETTER STARTS HERE WWW.MEDAINC.ORG DON’T • Try to be their therapist; enlist professional help • Be afraid to upset them; communicate openly • Ignore them; they need support from family and friends • Offer simple solutions (“why don’t you just eat?!”) • Comment on their weight (if you say “you look too thin”, they may take it as a compliment; if you say “you look healthy” they may take it as an insult) • Blame them or make them feel ashamed or guilty for having an eating disorder • Threaten (“if you don’t eat…”) • Use “you” statements, because they sound accusatory. Instead, try starting your sentence with “I see it this way...” • Expect an instant recovery • Try to force them to eat or stop exercising • Focus on food, weight, or appearance MOST IMPORTANTLY, REMEMBER TO ACT NOW! A Ask to speak with your friend privately C Confront with concern and care T Tell your friend what you see that makes you concerned Never continue the conversation if either of you becomes N too emotional Only professionals can diagnose, so don’t play the role of a therapist or a caretaker W When you end the conversation, tell a school counselor, teacher or parent immediately Remember that by speaking to a professional about your friend’s problem you are not being a bad friend. Even though it may feel this way, you are actually helping more than you may realize. By holding in this kind of secret you are creating stress in your own life and also not helping your friend. Speak to someone, and let your friend know you are doing this because you want to see her/him get better. 13 O