In the United States today more than eight million people, ninety percent of them women, suffer from eating disorders. Anorexia and bulimia nervosa are psychological illnesses characterized by an intense preoccupation with food and weight, a distorted body image, and a morbid fear of becoming obese. Bulimic behavior is practiced by fifty percent of anorexics whose main symptom is refusal to eat. The main symptoms of bulimia are repeated episodes of binge eating and purging. Women suffering from bulimia are typically intelligent, middle to upper class Caucasians. Their main goal is to "eat and not gain weight" The binge and purge cycle is a hard to stop, almost addictive method of control. Bulimia is a coping mechanism for many problems.

The peak onset age of bulimia is seventeen to twenty. Bulimics are very secretive about their habit, thus making it hard for others to notice and diagnose the eating disorder. Victims of eating disorders often suffer from dehydration as a result of a significant loss of potassium and sodium. Fatigue, fainting spells, skin rashes, hair loss, chest pains, palpitations, and inability to think clearly are common side effects of bulimia.

A common contributing factor to the onset of bulimia is societal influences. From an early age, children are taught that looks matter. Television advertisements give advice on how to lose weight and become beautiful in order to gain acceptance. Overweight characters are often perceived as lazy and unpopular whereas the thin characters are successful, popular, and sexy. What many young girls do no know is that the average model weighs up to twenty-five percent less than normal. Most if not all photos of models in magazines are air-brushed, no-one looks like that in real life.

Many magazine advertisements and television commercials are of diet sodas and bathing suits, sending the message that if one eats, one will get fat. By filling magazines with skinny models and weight loss methods, the media sends the message to females that they are fat, as most people do not look like the underweight models.

Eighty percent of eating disorders begin with diet, thus proving that diets can lead to anorexia or bulimia. The diets set up an unhealthy relationship with food. When a woman decides to diet, she is usually successful at first. This success can turn into an obsession with body shape and weight, which leads to more stringent periods of dieting. The control over food will eventually weaken, resulting in a binge. Purging provides the perfect solution. One can eat whatever she wants, and as much as she wants, without having to worry about calories or gaining weight. Obviously all diets do not result in eating disorders, but they are often a contributing factor, especially to eating disorders among teenagers. Teenagers are more influenced by the media and advertisements than adults, and they are at a time in their lives when their bodies are undergoing major changes. Dieting and or purging are tempting methods of weight control.

Social pressure is not the only factor leading to bulimia. Many eating disorders stem from more personal issues. Abuse is a common problem among girls. The pain of being abused can lead to severe emotional problems. The eating disorder is a way of burying the painful feelings and easing the emotional pain. Children who are sexually abused grow up with little sense of control over their own bodies. Victims of abuse often think they are abused because they are bad or did something wrong. Bulimia may be a way for victims to punish themselves because they do not feel they deserve to be happy.

Physical and verbal abuse can also lead to fear and feelings of powerlessness. The people who are supposed to love and protect these young girls turn on them in fits of rage, hurting them the most. Some children are verbally abused as well, being told they are stupid and worthless. They may be neglected or abandoned by their parents. Such abuse leaves the victims with a nagging sense of self-hate and the idea that they do not deserve to be loved. They may push away people who make attempts at closeness because of a lack of self-esteem, a distrust of others, and a lack of control. Losing weight is often used as an attempt to gain back control. Girls who have been abused think that if they are thinner the abuser will be happy with them and will stop hurting them. Anorexics will deprive themselves of food they do not think they deserve. For bulimics, purging is a way to release emotions or to punish themselves for enjoying something they don't feel they deserve to enjoy.

Family and relationship problems can trigger eating disorders. A comment about weight from a parent, friend, or coach is often enough to change a girl's eating pattern. The parent child relationship is very important during a girl's teenage years. If parents do not praise their daughter for her accomplishments, she may feel disapproval, contributing to low self-esteem. Workaholic parents make their children feel less important, as though no one is there for them. Extreme traumas such as the death of a parent can result in severe depression and a need for a coping mechanism. "Food provides an outlet for all of these feelings and conflicts that cannot be exposed" ( Brisman 26). A child has an increased risk of developing a negative coping mechanism, such as an eating disorder, when the parent has an eating disorder or suffers from alcoholism or a drug addiction. Perfectionist parents can set an example for their children to be perfectionists also, usually placing high expectations on their children to achieve certain levels of success which the children might not be able to fulfill. A girl whose mother has disordered eating patterns, is continuously on diets, or has an obsession with appearance, has a high chance of developing an eating disorder.

Just as family relationships can play large roles in the development of an eating disorder, so can peer relationships. A child who is of above average intelligence, expresses tremendous individuality, or has a unique gift of talent, may have feelings of unacceptance among peers. A strong need or desire for acceptance and increased external pressure to achieve is common in this type of situation. The child might become a perfectionist, one who strives to be perfect in everything, including weight. If a child does indeed have weight problems, she might be continuously picked on by her peers, leading to lack of self worth, weight concerns, and body image issues. A sense of loneliness often occurs in girls who are shy or have problems making friends.

An eating disorder does not stem from one thing, but rather from a combination of social, environmental, biological attributes, and family dysfunction that leads to bulimia or anorexia. One thing that is apparent in all eating disorder victims, however, is low self-esteem.

Just as there are many causes of eating disorders, many different types of treatment exist. Treatment involves concentrating primarily on the patient's psychological problems. Individual therapy is a common first step along the road to recovery. The patient will develop a one-to-one relationship with her therapist. As a trust begins to develop, the patient will start to release all of the feelings that were kept inside for so long. Together, the patient and therapist will focus on why the patient is using the eating disorder as a coping mechanism. The patient will learn other, healthy ways to deal with her feelings.

Group therapy is another treatment option. Being surrounded by others who know and understand exactly how it feels to have and struggle with an eating disorder can be very comforting. Members can help one another find ways to change their eating patterns and develop healthier coping mechanisms. Often group therapy is a way to stop feeling lonely. Victims can learn from others and feel supported.Group therapy is also a place to deal with feeling associated with abuse. As physical or sexual abuse is common among eating disorder victims, members will learn that they are not to blame. Meeting other abuse victims is one of the best ways to realize that they did nothing to deserve the abuse. To stop blaming one's self is a large step toward recovery.

For victims with a history of family problems that contributed to the eating disorder, family therapy is recommended. In order to solve problems, the whole family must be willing to participate in therapy and make changes in their own behaviours. Parents can work on being more supportive and understanding. If the parents themselves are suffering from issues, family therapy can help the parents to deal with their problems as well. Family therapy sessions can also help to deal with sibling tensions.

In some cases medical treatment is necessary. A physician who is aware of the eating disorder must monitor the patientís health. She needs to be open and honest about eating behaviours and symptoms in order to receive the best medical treatment possible. Hospitalisation is necessary if the victim's weight is extremely low or if bingeing and purging occurs several times a day. Being in the hospital provides a safe environment and helps patients control their eating habits. Antidepressants may also be needed in cases involving depression.

The road to recovery is long and hard. It is not an easy road to travel. Treatment has to be individualized and is aimed to help the particular individual correct her own eating disorder. The recovery process may be geared towards changing the patient's eating habits or towards helping her cope with a specific problem. There is no one answer. Patients must be warned that they may revert back to their eating disorder habits if a stressful event occurs in life. If setbacks occur, they must use these incidents to learn more about their eating disorder and continue on their path to recovery. Some people never recover. But if the treatment is aimed toward treating the causes, it is frequently successful and the victim will be freed from her pain.
Bulimia Research
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