Expert: Ryan Hale - 2/9/2010

Question
i am writting a research paper on anorexia im just wondering if it possible to be over wieght yet still anorexic. if so how common is this? is it usually thin people who become anorexic?

Answer
Natasha- sorry it has taken a while to get back to you... hopefully your paper hasn't already been turned in.  Anyway, there is a diagnostic criteria for someone to be labeled with anorexia.  These include: refusal to maintain a body weight at or near a minimally normal weight for age and height.  There must also be the intense fear of gaining weight or becomming fat (even when underweight).  There is also a disturbance in the way someone experiences their body such as an undue influence on one's body shape or size or denial of the seriousness of the problem.  And, in females, 3 consecutive missed periods.  There are subcategories such as "restricting type" and "binge-eating/purging type."  The binge eating type is different than true bulimia, often bulimics are near normal weight, while anorexics who use binge/purge behaviors are underweight.

There are many, many cases that are considered "sub-clinical" meaning that they don't meet the criteria for a diagnosis or for admission to a medical facility, however, their eating behaviors are problematic and serious.

The problem is serious though because it has the highest rate of death of ANY mental problem (including depression).  Up to 20% may die as a result of their condition with 5% dying within 10 years.  Half of the deaths are suicides, indicating a 50x more common in people with eating disorders than in the general population.  Eating disorders are culturally specific and are not found in developing countries but have seen increases in areas of the world that have received more media capability such as access to television, Internet, and print media.  90% of the cases occur in females who come from white, middle or upper middle class, who live in a socially competitive environment (often coming from families that have very high expectations or who are perfectionistic).  

There are disorders that are common with anorexia such as anxiety and/or depression, and a third of bulimics abuse drugs and alcohol.  Most of the worlds top models are below an 18 for body mass index (16 is considered starvation and one model from Brazil was measured at 13.4!  

There is about 1/3 of the cases who get better, and 1/3 who get better but relapse.  About 6-8% of women on college campuses meet diagnostic criteria, although the problem is being seen more and more in both straight and gay men.  The African-American population used to be largely unaffected by the disorder, but there are more and more cases among black women recently.

Hopefully this info helps, let me know if you have any other questions.

Ryan

references:  Abnormal Psychology 5th ed  Barlow and Durand