In this Issue: Your Love Language, Children of Alcoholics, and Eating Disorders

An eating disorder is characterized by extreme reduction or increase in food intake, or feelings of extreme distress or concern about body weight or shape. A person with an eating disorder may start out by eating smaller or larger amounts of food than normal but at some point takes it to an extreme. The two main types of eating disorders are anorexia nervosa and bulimia nervosa.

In her book, "Wasted: A Memoir of Anorexia and Bulimia," Marya Hornbacher, describes how her eating disorder started with bulimia.

"It was that simple: One minute I was your average nine-year-old, shorts and a T-shirt and long brown braids, sitting in the yellow kitchen, watching the Brady Brunch reruns, munching on a bag of Fritos, scratching the dog with my foot. The next minute I was walking, in a surreal haze I would later compare to the hum induced by speed, out of the kitchen, down the stairs, into the bathroom, shutting the door, putting the toilet seat up, pulling my braid back with one hand, sticking my two fingers down my throat, and throwing up until I spat blood. Flushing the toilet, washing my hands and face, smoothing my hair, walking back up the stairs of the sunny, empty house, sitting down in front of the television, picking up my bag of Fritos, scratching the dog with my foot."

Bulimia nervosa is characterized by recurrent and frequent patterns of eating unusually large amounts of food (binge-eating) followed by purging (e.g. vomiting, abuse of laxatives or diuretics), fasting and/or excessive exercise. People with bulimia believe that the act of purging compensates for the binge eating. Unlike those with anorexia, those with bulimia are often within the normal weight range for their age. However, they are still preoccupied by the desire to lose weight, are unhappy with their body shape and size and have an intense fear of gaining weight. Bulimic behavior is done secretly because it is usually accompanied by feelings of shame or disgust. In most cases, the binging and purging cycle is repeated several times a week. Bulimia is often comorbid with psychological disorders such as depression or anxiety and accompanied by physical health complications.

Marya Hornbacher also described how she became anorexic.

"Anorexia started slowly. It took time to work myself into the frenzy that the disease demands. There were an incredible number of painfully thin girls at Interlochen, dancers mostly. The obsession with weight seemed nearly universal. Whispers and longing stairs followed the ones who were visibly anorexic. We sat at our cafeteria tables, passionately discussed the calories of lettuce, celery, a dinner roll, rice. We moved between two worlds. When we pushed back our chairs and scattered to our departments, we transformed. I would watch girls who'd just been near tears in the door-room mirrors suddenly become rapt with life, fingers flying over a harp, a violin, bodies elastic with motion, voices strolling through Shakespeare's forest of words."

Anorexia nervosa is the inability or unwillingness to maintain a normal body weight for a person's age and height. A clinician will usually diagnose the disorder when a person fails to meet 85% of their normal or expected weight. Some symptoms include distorted body image and extreme fear of gaining weight, obsession with food and weight control, and extremely disturbed eating behavior. Girls and women may experience lack of menstruation. Some methods of weight loss used are excessive diet and exercise, self-induced vomiting and misuse of diuretics, laxatives or enemas. Other signs of anorexia include thinning of the bones, brittle hair and nails, dry and yellowish skin, and growth of fine hair all over the body. A person with anorexia may also experience mild anemia, muscle weakness and loss, severe constipation, low blood pressure, slow breathing and pulse, a drop in internal body temperature (feeling cold all the time), and feeling lethargic.