By Dr. Georgette Savvides, Psy.D
Research shows that 3% of women who develop an eating disorder in their lifetime will die. Clinical Consultant and Business Psychologist Georgette Savvides, Psy.D, has spent the past 25 years dealing with eating disorders as a psychotherapist. She believes that the best way to understand eating disorders is to learn about them and encourage the people around us to seek treatment.
Miss D is a 24-year-old that walked into my counseling center on September 9, 2015. Greeting her at the reception, I realized immediately why she had come to therapy: Miss D was about 1.62 cm tall and weighed around 32 kilograms. She looked weak and fragile, with bones protruding from her body and dark circles under her eyes; she was dressed in baggy clothes to hide her figure. When she looked at me, her eyes seemed to say: “I am dying. Save me.”
As we started our assessment, Miss D told me that she had developed an intense fear of gaining weight at the age of 13. Raised in a household with strict, overprotective yet overcritical parents, she found herself caught between a mother who pressured her to look good and be thin, and an older sister who gained weight and went on yoyo diets. Disturbed and scared of the negative comments that constantly surrounded her about being fat, she began to diet to avoid judgment and criticism. Thus began her story with anorexia nervosa.
When Miss D began to lose the weight, she found herself receiving compliments from everyone around her, which gave her a sense of accomplishment and control, and the more control she felt, the more restrictions she put on what she ate. Eventually, cutting calories was not enough, and she soon restricted her diet to “safe food” only (no fat, organic, low calorie foods). Although she continued to lose weight, she still believed that she was fat, and added a three-hour high cardio exercise regimen to her routine; more drastically, she also began to purge the food she ate. This cycle of eat, exercise, and purge lasted for a couple of years until Miss D’s daily diet was limited to one, finger-size carrot.
Miss D developed several physical and psychological complications in the following years, one of the most severe being the loss of her menstrual cycle. She also lost her capacity to have normal bowel movements, had low potassium and calcium, and an inflamed and enlarged liver. To cope with malnutrition, she had sprouted lanugo hair (fine downy hair similar to that found on newborn babies) on her body. She also experienced constant low mood, fatigue and exhaustion, and had lost her motivation and ambition in life. She was easily angered and experienced frequent outbursts, and began to isolate herself from social interactions. For Miss D, everything had to be done perfectly according to a set of impossibly high standards that she had set for herself, and anything less was considered a sign of failure.
In a desperate attempt by her parents to help her, she was taken to visit several psychiatrists and general practitioners. She described these experiences as torturous. She felt no one was able to understand what she was going through and that they only wanted to medicate her. In turn, she never took the medications that they prescribed and refused to engage with their treatment because she felt that they “did not understand” her problem.
How many Miss D’s have we encountered in our lives and how many times has the ignorance of parents or practitioners resulted in the deterioration of a client’s condition? This is just one story of one girl, who, thankfully and after a long and tortuous journey with anorexia, sought treatment. But there are many others out there who may not realize that they have a problem before it’s too late.
What Are Eating Disorders?
Eating disorders are more than just going on a diet to lose weight or trying to make sure you exercise every day. They are extremes in eating behavior: the diet that never ends and gradually gets more restrictive, or the person who does not socialize because he or she thinks it’s more important to go running to work off a piece of cucumber.
The most common types of eating disorders are anorexia nervosa and bulimia nervosa (usually shortened to anorexia and bulimia.) But other food-related disorders, including binge eating disorders, body image disorders and food phobias are showing up more frequently than they used to.
Eating disorders are usually long-term problems and they often require long-term treatment. They frequently occur with other problems such as depression, substance abuse, and anxiety disorders. The earlier these disorders are diagnosed and treated, the better the chances are for full recovery.
Contrary to common belief, eating disorders are not limited to women. It was recently found that men experience binge eating disorder (BED) at a rate almost equal to women. Men are also experiencing muscle dysmorphia – a compulsive pursuit of increased muscle mass – sometimes referred to as reverse anorexia, at increasing rates. Many men suffer from body image dissatisfaction and distortion, with 40% of men wanting to lose weight, 40% wanting to gain weight, and all of them wanting to gain muscle.
Anorexia nervosa affects about 1% of the population. For females who have anorexia nervosa and who are between the ages of 15 -24, the chances of dying is about 12 times higher than the chance of dying from all other causes. Anorexia nervosa is the third most common chronic illness in girls aged 15 -19. Bulimia nervosa affects 14% of the population and carries with it an increased risk for multiple medical and/or psychiatric complications.
Approximately 90% of patients with anorexia nervosa (AN) and bulimia nervosa (BN) in clinics are female. Female: Male ratios for cases of AN and BN is about 6:1.
Anorexia: The Slow Death
Anorexia Nervosa is the refusal to maintain body weight at or above minimal weight for age and height (less than 85% of what is expected). Individuals with this condition have an intense fear of gaining weight or becoming fat, even if they are currently underweight. They try to control body weight through exercise, food intake, vomiting, and use of laxatives, and have a distorted perception of their body shape. Anorexic females often have no menstrual cycle for three consecutive months.
Bulimia: Eat & Purge
Bulimia nervosa is the attempt to control body weight by eating large quantities of food followed by compensatory behaviors, such as self-induced vomiting, use of laxatives or diuretics (water pills), excessive exercise and/or further restriction of calorie intake. After ingesting large quantities of food or binge eating, bulimics purge their bodies of the food, even if their body weight is normal or acceptable. The exhibit many of the same symptoms that anorexics develop, obsessing about food quantities, weight, and exercise.
Binge Eating Disorder & Obesity
Binge eating is the ingestion of large quantities of food – more food than most people would eat in a similar circumstance and time frame – without compensatory behavior, and feeling a lack of control over eating during the time span. The results of binge eating are significant emotional and /or physical distress. Binge eaters tend to eat more rapidly than normal, eat until they feel uncomfortably full, and eat large quantities of food even if they are not hungry. Binge eaters often eat alone because they are embarrassed by how much they eat; they later feel disgusted at themselves, depressed, or guilty because of their eating habits.
Dr. Georgette Savvides PSY.D
Phone: +2 012 7852 9814