Dr. Linda Mintle

Tag: eating disorders

  • Bulimia: Shame the Silencer

    When you are bulimic you can also suffer from depression, anxiety, substance abuse and other psychological problems. You might be an episodic drinker–not drink for periods of time and then go on drinking binges. Psychologically, drinking binges are similar to food binges. Alcohol and drug binges are more ways to numb the body from feeling loss or pain.

    Dieting can start the course of bulimia. If you are overweight or have overweight family members, you may be teased about weight. Losing weight, you think, is a way to stop this teasing. Or you may be anorexic and need to gain weight. Once you allow yourself to eat, you may feel out of control and start to binge.

    But issues around dieting are not the single cause of bulimia. Like anorexia, food is the abused substance. There is an internal struggle with self-image and external relationship problems.

    Bulimia usually begins later in adolescence than anorexia. It’s also not uncommon to see women in their 20s and 30s fight the disorder. The reason for this is that bulimia typically develops when identity is firming up and independence increases. These are tough development transitions for some people.  It’s not easy to figure out who you are or what you want to do with your life. In addition, the culture gives confusing messages when it comes to feminine and masculine roles.

    Furthermore, family problems may complicate the emotional process of leaving home. And certain personal characteristics such as perfectionism, low self-esteem and mood swings can complicate development.

    There is no one “bulimic” personality. But if you have bulimia you tend to feel inadequate, lonely, helpless, impulsive and moody. Low self-esteem is coupled with very high self-expectations that you or others place on yourself. You may have trouble saying no to demands and want to please others. Saying “no” to rigid demands might mean a loss of acceptance or even love.

    The worse thing you can do is hide your pain.  It takes courage to walk into a counselor’s office and say, “I need help. This disorder is running my life and I want to stop this constant bingeing and purging.” Be honest about your symptoms. Let someone help you. You don’t have to live your life thinking about the next binge or where you will vomit after the next meal.

  • Male Eating Disorders

    Not much media attention is given to men and eating disorders. One in ten males suffer.

    Not much media attention is given to men and eating disorders. One reason may be that these disorders are disproportionately female. In recent years, however, the number of males afflicted has risen from one in twenty, to about one in ten. Approximately one-third of adolescent boys report bingeing with food.

    Men, like women, are affected by cultural media stereotypes that promote a fit and buffed body as signs of attractiveness and success. But men are more concerned about their shape than weight. Men also are affected by other sociocultural factors such as the pressure of a demanding job market and the changing view of masculinity and gender roles.

    Exercise appears to be a common entrée into symptom development. Dieting plays a role related to playing sports, past obesity, gender identity conflicts, and avoidance of feared medical illness. Boys may begin to diet to lose a few pounds, exercise to lose more weight, and then refuse to eat normally. Exercise is usually the chosen route for weight loss.

    Like women, certain subgroups of men are more at risk. For example, male wrestles have a high proportion of eating disorders. In addition, men who develop eating disorders are more likely than women to have been obese.Clinical symptoms are similar with the obvious exception of amenorrhea.

    Onset of a male eating disorder can begin at preadolescence, adolescence and young adulthood, or adulthood. Men benefit greatly from treatment and are often happy to find someone who appreciates their concerns. They typically have more alcohol related problems and obsessional thinking than female eating disorders. Female eating disorders are more afflicted with mood disorders in addition to eating problems.

    Why are these disorders more typically female? One thought is that males don’t diet as often to control weight. In addition, males increase muscle during puberty and are less concerned about fat than girls. Males want to be bigger and taller. It also may be that eating disorders in males are under diagnosed and underreported since they are known as female disorders.

    Whatever the reasons, it is important to know that males do use food to cope with emotional difficulties. For more information about eating disorders in general, refer to other articles in this section.

  • Risk Factors for Eating Disorders

    What causes eating disorders? This simple question has a complex answer. Families are mystified as to what makes a 16 year-old jeopardize her health. Friends are disgusted by the vomiting sounds heard in college dorm room bathrooms. Husbands are baffled by their wives seeming inability to love themselves. Why do women and men abuse their bodies with food?

    An estimated 11 million people in Western society are afflicted. So, what are the risk factors for developing eating disorders? Researchers search for answers.

    There is no one thing that predicts whether someone will submit to the bondage of these disorders. What we do know is that the causes are multiple, interactive and complex. No one factor stands alone. Keeping that in mind and knowing we don’t have definitive answers, here are some of the risk factors thought to lead to the predisposition and development of an eating disorder:

    ·History of a mood disorder (increased risk for bulimia) or family history of mood disorder

    ·Traumatic life events

    ·Genetics:  Eating disorders do tend to run in families. Usually females are most affected. This may suggest that some people are predisposed to these disorders, but it certainly doesn’t eliminate the role other factors play. Research is currently being conducted looking carefully at the role of genetics. Heritable factors may be involved in the development of an eating disorder. However causation is difficult to determine given other contributing factors.

    ·Family history of substance abuse may increase the risk for bulimia

    ·Odd family eating habits and strong concern about appearance and weight may translate to family members

    ·Dissatisfaction with body and desire to be thin

    ·Dieting appears to be an entrée to an eating disorder.

    ·Normal development events such as the onset of puberty, leaving home, the beginning of a new relationship, particularly with the opposite sex.

    ·Repeated negative comments on appearance

    ·Emphasis on thinness among upper and middle class women and female adolescents

    ·Positive family history of eating disorders coupled with dieting

    ·Personality traits: For anorexia the risks include affective over control and intolerance, lack of self-direction and personal effectiveness, and difficulty adapting to developmental tasks. There is some evidence for the contribution of affective instability and poor impulse control in developing bulimia.

  • Is Beauty the Beast?

    “I never thought about how magazines influence my feelings about my body. I look at the models and sometimes read the articles. I’m interested in fashion and want to stay in style. But lately I’ve been obsessing on different body parts. It seems no matter what I do, I don’t look like the models I see. I’ve been feeling depressed. My mom is worried because I started dieting. She says I’m not fat.”

    Many teens I see in therapy struggle with body image disturbance. Their bodies become their enemies—not good enough to win them acceptance or popularity. They falsely believe that a “killer” body is the key to love.

    Adolescence is a time girls reorganize internally while trying to conform externally. Their style has to be uniquely their own while conforming to a certain look. Girls are acutely aware of the physical appearance of other girls. Comparisons abound and are not limited to peers. The glamorized icons of pop culture set the standard. It is easy to feel less than perfect.

    Despite all the efforts of the women’s movement, girls still give others tremendous power over feelings of self-worth. Those who don’t have good self-esteem and lack self-worth are particularly susceptible to negative pressure from peers and media.

    While parents still constitute the single most important influence in the life of a teen, media influence. For many teens, media fill in the gap. For teens who don’t have strong parent connections, media become the teaching parent. Teens try to imitate attractive models whose photos have been airbrushed and computer altered. When they don’t match the glamorous photos they regularly stare at, dissatisfaction with the body results.

    Early on, girls learn the lesson that appearance matters. This message reinforced by magazines and other media is internalized and often leads to preoccupation with beauty and the perfect body. Salmons et al, (1988) conducted a school survey of children ages 11 to 13 years. Most girls worried about the shape of their stomachs and thighs. Other studies have documented the preoccupation of young girls with dieting despite the fact that they aren’t fat.

    Our culture says perfect bodies are to be worshipped. The American body has been glamorized to idol proportion. But parents can influence daughters to accept their imperfect bodies. Try these suggestions to help correct those distortions:

    · Educate your daughter about the use of computer altering, make-up, hairstylists and airbrushed photos in magazines. Teens need to know most people don’t look like those photos without a lot of extra help.

    · Compliment your daughters for things unrelated to beauty and looks.

    · Moms, don’t criticize your own body for its imperfections in front of your daughters and stop your endless dieting.

    · Help your daughter find her true identity in Christ by filling her with the Word so she finds her identity in Christ.

    · Work on the internal parts of her character development. Inner beauty goes a long way in life and doesn’t fade with age.

    · Limit exposure to unhealthy media images as much as possible.

    · Show your daughter how to maximize her physical appearance without becoming obsessive and spending hours on make-up and hair. Good grooming differs from obsessing.

    · Talk to daughters about the dangers of body image disturbance as a precursor to eating disorders.