Expert: Ryan Hale - 5/16/2010

Question
Hi Ryan, I'm Claudette. I'm 13 and in the 7th grade. I'm doing a research essay on anorexia and I've got to ask an expert questions, so if you don't mind, I'd like to ask you some questions.
Why do people become anorexic?
Who does anorexia mainly affect?
How do anorexics lose the weight?
Is there a cure for anorexia?
Do you know the youngest and oldest age for anorexia?

If you could get back to me by this Friday, that'd be great. Thanks!

Answer
Claudette-  I'll do my best to answer your questions

1. anorexia is the kind of problem in which the right person is sort of under the right conditions.  In other words, it's a combination of genetic predisposition (about 25% responsible for the problem), but there are also society's messages about being good enough and slim enough and attractive enough.  There are also factors such as family and relationship pressures and stresses for outside like school or work or abuse.  So, someone might come from a background that includes abuse or have a stressful life.  That won't cause it, but in the right person, having been abused, having stress on you to perform at school or work or being in a family or relationship that is very controlling may cause someone to start looking for ways to control their lives... one way is through eating behaviors.  So there is no cause, but sort of the right combination of problems in one's life that can help lead someone to it.  Like how some people can go through a terrible experience like war or trauma and come out stronger, while others may need therapy and support or resort to drugs or alcohol to cope.

2. Anorexia effects mainly young, white, middle and upper middle class women between 16-24 yrs old.  We are seeing more cases of younger women as young as 12 and older women as well.  Latinas and African-American women have  not been effected as much in the past and tend to have better body images than white women, but that is beginning to change as well.  More men are also experiencing it... the more we see Jacob and Edward on magazine covers with their shirts off, the  more pressure men are starting to feel to be thinner.  The message for men is still big and muscular for the most part, but there is a trend to lean and skinny these days.

3.  Anorexics attempt weight loss in several ways, the main way is starvation or food restricting.  I get tons of emails from people who will tell me their body mass index score and whether they know it or not, many times they are in "starvation" catagory.  Many of the top models these days would also fall into the body mass index catagory of starvation.  That means they are reaching levels close to those who were in consentration camps back ion World War II.  

Anorexics may also chew food but spit it out or practice purging techniques like vomitting.  This is a special cataogory though.  There is anorexia nervosa and anorexia nervosa/ purging type.  Often anorexics will still participate in food related activities such as party planning or cooking for others and will be very involved with the purchase and preparation of food, giving the impression that they are not withholding food, but they don't eat what they prepare or plan.  

4. There are mixed results for treatment.  Roughly 1/3 will die, 1/3 will get better and 1/3 will bounce back and forth between doing ok and having the full blown disease.   If drug use or alcohol use is involved, the chance for recovery is not very good.  Eating disorders have the highest rate of death of any mental disorder, even depression.  Anti-depressants have been used to treat anorexia but are not effective unless the person has underlying depression that needs to be treated.  On the other hand, antidepressants seem to work better for bulemics for some reason.  Treatment involves many aspects: the eating behavior (dietician or nutritionist), medical problems related to starvation ( medical physician), and the behaviors and emotional side (counselor or psychologist).  The person suffering from an eating disorder needs the whole team to treat each aspect.  If mental needs are not getting help, the other treatments will not be effective.  If the diet and mental side are helped, but the person has severe medical problems, they patient could die while being treated.  In other words, the aspects that feed into creating a disorder need to be identified and treated, or they will continue to drive the disorder.  Most people who die from the disease will die from heart problems related to not having enough nutrients for the heart's electrical conducivity to work properly.

5. very young girls are already reporting putting themselves on a diet ( 8 and 9 years olds), also older women who are influenced by print media, advertising messages TV show like The Real Housewives and such are trying harder to fit the expectation of sexiness at older ages (the whole "cougar" idea) and are trying to fit the "look."  So, we're seeing it in 30, 40 and 50 year olds too.  For a long time, women from other nationalities were insulated from the problem (especially those where "womanly curves" and traditional gender roles were prevalent such as Latin America and the Pacific Islands).  Today, it is in most developed nations.  Ironically, in nations struggling with health and nutrition problems where people starve or have a much harder time scraping enough food or money together to live on do not have this problem.  It would seem either being very over weight or very under weight is a problem of affluence.

hope this helps sorry for the mispelled words I can't get my spell checker to work for some reason.