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When Dieting Becomes Dangerous

When Dieting Becomes Dangerous: A Guide to Understanding and Treating Anorexia and Bulimia

Deborah Marcontell Michel
Susan G. Willard
With a Foreword by Arthur Crisp
Copyright Date: 2003
Published by: Yale University Press
Pages: 176
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  • Book Info
    When Dieting Becomes Dangerous
    Book Description:

    This primer on anorexia and bulimia is aimed directly at patients and the people who care about them. Written in simple, straightforward language by two experts in the field, it describes the symptoms and warning signs of eating disorders, explains their presumed causes and complexities, and suggests effective treatments.The book includes:• guidance about what to expect and look for in the assessment and treatment process;• emphasis on the critical role of psychotherapy and family therapy in recovery;• explanation of how anorexia and bulimia differ in their origins and manifestations;• information on males with eating disorders and how they are similar to and different from female patients;• a separate chapter for health care professionals who are not specialists in the diagnosis and treatment of individuals with eating disorders;• up-to-date readings, Internet sites, and professional organizations in the United States and in Europe.

    eISBN: 978-0-300-13011-9
    Subjects: Health Sciences

Table of Contents

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  1. Front Matter
    (pp. i-vi)
  2. Table of Contents
    (pp. vii-viii)
  3. foreword
    (pp. ix-x)
    Arthur Crisp

    Severe eating disorders, as defined here, are common. The phobic fear of fat that underwrites them is widespread in the female population of the Western world. Many women live with it as a powerful factor within their makeup and social life without developing major or overt eating disorders. Others are not so fortunate. Bulimia nervosa can erupt and become a source, often secret, of longstanding social handicap and misery. Anorexia nervosa is among the most serious of the mental illnesses in terms of its crippling physical, social, and psychological effects and potentially fatal outcome. At the least, it reflects a...

  4. preface
    (pp. xi-xii)
    D.M.M. and S.G.W.
  5. acknowledgments
    (pp. xiii-xvi)
  6. one Introduction
    (pp. 1-4)

    Historically, anorexia nervosa and bulimia nervosa may have existed in some form since the days of “starving saints” and Roman vomitoriums. Yet not until 1973, when Hilde Bruch published her classic text entitledEating Disorders: Obesity, Anorexia Nervosa, and the Person Within,did anorexia become widely recognized as a psychological disorder. Bulimia did not receive much attention until the late 1970s, and in fact was not even given a distinct name until Gerald Russell coined the termbulimia nervosain 1979.

    Today eating disorders constitute a major health concern. According to the National Eating Disorders Organization, between 5 million and...

  7. two What Is an Eating Disorder?
    (pp. 5-22)

    Features of the DisorderThe formal psychiatric name for this illness is anorexia nervosa, but it is often shortened to simply “anorexia.” Anorexia nervosa should not be confused with general anorexia, which means loss of appetite. People who have anorexia nervosa do not lose their appetites; rather, they refuse to maintain a normal body weight. They lose at least 15 percent of normal weight for height and have an intense fear of gaining it back or becoming obese. They often weigh themselves several times a day for fear of gaining weight and/or to see if they are continuing to lose....

  8. three Who Is Likely to Develop an Eating Disorder?
    (pp. 23-29)

    More than 90 percent of individuals with eating disorders are female. The prevalence ofdiagnosableeating disorders in males is estimated to be at a ratio of one male case for every ten female cases. Some researchers believe that the numbers are closer to one male for every six females. In cases of anorexia occurring before puberty, boys constitute approximately 20–25 percent of diagnosed cases. Thus, the gender gap in terms of prevalence is not as large among boys and girls as it is later in adolescence and young adulthood.

    Eating disorders tend to strike during the adolescent years,...

  9. four Why Does Someone Develop an Eating Disorder?
    (pp. 30-49)

    No one knows exactly how or why an eating disorder occurs. We do know that there is no single reason for someone to develop one of these illnesses, and we know that eating disorders are not about food. The thoughts and behaviors having to do with eating, weight, and body image are symptoms of deeper psychological conflicts and issues that drive the eating disordered behavior. Just as fever signals some sort of infection that a person’s body is trying to fight, an eating disorder is indicative of other underlying problems. The fact that the principal concerns of eating disorders are...

  10. five How Is an Eating Disorder Treated?
    (pp. 50-79)

    The anorexic patient rarely chooses to go for evaluation or treatment. It is usually the parents, spouse, or friends who insist on seeking help. The afflicted individual is typically gratified by her symptoms and they become intrinsically reinforcing. She does not therefore understand why her family and friends are so concerned. She generally feels quite successful, in fact, in her quest to be thin above all else. She often denies any problems and rejects intervention; her resistance makes treatment difficult initially. For those close to the sufferer of anorexia, the disease presents itself as a bottomless pit from which there...

  11. six What Can Family, Friends, and Others Do to Help?
    (pp. 80-90)

    As mentioned throughout this book, convincing someone with an eating disorder to admit that she has a problem and persuading her to seek help can be a daunting task. The person’s life, however, can depend on someone’s stepping in to take necessary action when she cannot, or will not, help herself.

    For family members, it is often imperative to use whatever resources are at your disposal to escort the individual to an evaluation. Keep in mind that intervention with someone who is in the throes of an eating disorder is usually more of a process than a one-time event. Family...

  12. seven Are Eating Disorders Different in Males?
    (pp. 91-100)

    The largest discrepancy between males and females in the diagnosis of psychiatric illnesses occurs among eating disorders, where males are in the vast minority. The males who are affected, however, suffer no less than females and, perhaps, in some ways more. Although many signs, symptoms, and features of eating disorders are shared, important differences result from gender. In this chapter, we will first describe the prevalence and onset of eating disorders in males, then highlight the similarities and differences between males and females with regard to development and treatment. It must be noted that relatively little research has been conducted...

  13. eight How Does a Nonspecialist Assess, Treat, and Refer Someone with an Eating Disorder?
    (pp. 101-127)

    Assessment and treatment of people with eating disorders can be challenging for even the most seasoned eating disorders specialists. When professionals whose expertise is in a different area are confronted with these difficult cases, they can become frustrated, overwhelmed, and even frightened. Over years of practice we have compiled a set of guidelines for physicians, mental health professionals, and nutritionists who do not specialize in the treatment of eating disorders but who want to know what to do if they suspect that an individual presenting for evaluation and/or treatment has an eating disorder. These guidelines are meant to serve only...

  14. afterword
    (pp. 128-130)

    We hope that after reading this book the reader has gleaned a deeper understanding of how dieting can become dangerous—even deadly. As Arthur Crisp stated in the Foreword, anorexia and bulimia represent “attempted biological solutions to existential problems.” In other words, our stressed and confused young people often look to their bodies to compensate for feelings of gross inadequacy. In doing so, they find perceived solutions to problems, masks to cover fears, and a physical identity to substitute for any real feeling of self. As has been amply illustrated, the ramifications can be crippling both psychologically and physically.


  15. appendix a Professional Resources and Organizations with Information on Eating Disorders
    (pp. 131-137)
  16. appendix b Supplemental Readings
    (pp. 138-144)
  17. index
    (pp. 145-154)