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Kevlar for the Mind: Eating disorders often complicated by other mental health concerns

Discussing eating disorders.

Q. I think my roommate may have an eating disorder. She always goes to the bathroom right after she eats, and a couple of times I’ve heard her vomiting while she was in there. I confronted her and she just said she was sick. Am I just being paranoid?

A. Nearly 8 million Americans suffer from an eating disorder. Of those, nearly 7 million are women between the ages of 15 to 24 — though men can develop the disorders, too. The two most common are anorexia nervosa and bulimia nervosa.

Anorexics are generally at 85 percent or less of their ideal body weight. They have an intense fear of becoming fat, even though they are underweight, and base their self-worth on a distorted image of their bodies.

They may maintain a low body weight by dieting, excessive exercise or starvation. They also may engage in binge-eating followed by vomiting or the use of laxatives and or diuretics.

Bulimia is characterized by episodes of uncontrollable binge eating that are triggered by stress, sadness or traumatic events. The bulimic also engages in compensatory behaviors similar to some anorexics, such as vomiting, caloric restriction and excessive exercise. Unlike anorexics, bulimics are generally at or slightly above their ideal weight.

No one is quite sure what causes eating disorders. There is some evidence to show that past traumatic events can play a role, although little research has been done on the relationship between eating disorders and full-blown post-traumatic stress disorder. Society’s views about beauty and images in the media also are contributing factors.

One of the most difficult aspects of identifying and treating eating disorders is that the person often times has other mental health problems. Depression, anxiety, substance abuse and even PTSD can be present.

Someone with an eating disorder is not just going through a “phase.” Thousands of people die each year from these illnesses. If you think a friend or family member has an eating disorder, showing that you are concerned is a great first step.

The next step is to help them get treatment from a trained mental health or medical provider.

Warning signs

Seven signs of eating disorders:

• Obsessed over body image

• Changes in eating patterns

• Extreme weight loss

• Making excuses not to eat at meals

• Use of the bathroom immediately following eating

• Excessive exercise

• Only eating certain types of food

For more information, visit http://www.nationaleatingdisorders.org or call 800-931-2237.

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Bret A. Moore is a board-certified clinical psychologist who served two tours in Iraq. E-mail kevlarforthemind@militarytimes.com. Names and identifying details will be kept confidential. This column is for informational purposes only and is not intended to convey specific psychological or medical guidance. Readers should see a mental health professional or physician for mental health problems.