Mirror, Mirror On The Wall

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What colour would you say the above square is? Did you say blue? What if I told you it was actually yellow? Would you insist that it is blue? What if I were adamant that this square was yellow- how could you convince me otherwise if I just don’t see it that way?

As we are in the middle of Canada’s Mental Health Week, I thought it would be fitting to address a mental health issue which although is portrayed over and over again in the media, is still misunderstood. Eating disorders range in symptoms depending on the specific disorder. What is found however, as with all mental health disorders, is that the eating disorder is a manifestation of a bigger problem.  The most challenging part of treating someone with an eating disorder, however, is that the disorder itself can change brain chemistry, along with the patient’s physiology, including metabolism, heat rate, and other hormone-mediated processes. This is why eating disorders have the highest rate of death among all mental illnesses.

Canadian Mental Health Association

I have been studying and educating students, child and youth workers, and other professionals on eating disorders for a number of years, and have had the opportunity to speak with at-risk youth in hopes of prevention. As an outreach volunteer for Sheena’s Place, a Toronto-based, non-clinical centre providing support for people with eating disorders, I had the opportunity to find out what messages needed to be sent to at-risk populations in order to ensure effective prevention. As there is so much to know about eating disorders, and so much to be said to encourage prevention, I would like to provide you with a modified version of my typical one-hour presentation. As each case is so individual, and each person’s needs are so individual, please feel free to contact me with further questions, or to request more resources.

What is an Eating Disorder?

An eating disorder is a mental disorder which consists of three types: Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder. For the sake of this post, I will only focus on the first two. Anorexia nervosa, is defined by the Diagnostic and Statistical Manual of Mental Disorders as a refusal to maintain a normal body weight, leading to the maintenance of a body weight of 15% lower than the lowest point of the normal range for that age and height, intense fear of gaining weight, denial of the seriousness of the low body weight, and amenorrhea (loss of menstrual period). Bulimia nervosa most often consists of a cycle of binge eating and purging through self-induced vomiting, laxatives, and diuretics, as well as a feeling of lack of control over eating behaviour. Symptoms may also consist of excessive exercise in an effort to lose weight, as well as fasting.

Eating disorders primarily affect females, but are becoming more prevalent in males, and can be found in children as young as 5 years of age.

Causes- Eating disorders are often a manifestation of other emotional, social, or physical factors, or the presence of another mental disorder. Given this, the best way to attack prevention is to strive to live a balanced and both physically and mentally healthy lifestyle. As with prevention for most other mental illnesses, this is truly the best method for prevention. I will discuss some ways to work towards this shortly. 

Complications of Eating Disorders:

Anorexia Nervosa (AN)- Those suffering from anorexia nervosa will often present a loss of hair on their head, but will also form a dark peach fuzz-like hair on their arms and face.  Due to the lack of nutrition, someone suffering from this disorder will feel extremely tired, weak, and cold, will be unable to think clearly, become easily irritable, and may present erratic behaviour. A person with anorexia nervosa will maintain a distorted image of him/herself.  It has actually been shown that the more one looks at an object in a mirror, the larger it will look.  As those with AN have a preoccupation with weight, they are constantly weighing themselves and examining their bodies in the mirror.  It is important to note that no matter how ill one may look, he/she will not see themselves that way- at this point, perception has changed at the level of the brain. Going back to the questions about the square- those suffering from AN cannot see the square (their bodies) as blue (dangerously thin) no matter how many times you tell them.

Bulimia Nervosa (BN)- Bulimia nervosa is extremely dangerous for a number of reasons, including its persona as a silent killer.  Often times people with BN lose very little weight and may even gain weight as the binge-purge cycle actually slows the metabolism. This can make it difficult for others to detect, as opposed to AN where there is evident weight loss. As those with BN go unnoticed, the severity increases. What is so fatal if there is no weight loss? Constant vomiting can lead to rotting teeth, problems with the heart and kidney, swollen glands, muscle cramps, and cuts on the knuckles.  In many cases, people with BN who have gone unnoticed die of kidney failure or even sudden heart failure.

What can I do to help?

As you become familiar with the signs and symptoms of anorexia and bulimia, you may feel concerned about someone you know or perhaps even yourself. Typically these disorders become apparent during adolescence, but can start earlier or well into adulthood.  If you suspect someone you know has an eating disorder, make sure they know you are there for them when they are ready for support. If you are comfortable, let them know you’ve been concerned about certain warning signs you’ve noticed, but be sure to be comforting rather than scolding and judgemental, as this can cause them to spiral further into these detrimental habits. Do not center your talk around food, weight, or diet. If that person is suffering from AN or BN then they are already too preoccupied with the subject, and further discussion will feed the disorder. Finally, seek help from a professional. A professional does not always have to be a doctor.  It can be any specialist in the field. As mentioned earlier, a great place to start in Toronto, is Sheena’s Place.  They are there to counsel those suffering from an eating disorder, as well as friends and family. It is important that if someone really does have an eating disorder, that the recovery process begin as soon as possible, as the further along one is with the disorder, the more difficult it is to treat.

Prevention- Living a physically and mentally healthy life:

There are many stresses younger kids are facing in today’s world, which continue to exacerbate into their youth, and then right into adulthood. We must teach our kids early on how to effective cope with the stresses they may face throughout life.  We have to teach our kids (and most often ourselves) how to stay physically and mentally strong. It is important to find a healthy balance in all that we do- including exercise, eating, sleeping, and working. Know your good qualities. We are all good at something, and we all have great aspects to our personalities.  Identify these and have your children do the same, and know that you are special.  Identify what healthy choices make you feel relaxed (again, have your children identify these for themselves as well)- playing piano, painting a picture, bird watching, watching a movie, karaoke, soccer, writing- and make sure you do these things on a regular basis.

Teach your children to find time for physical activity.  Perhaps you have had trouble finding time for this yourself? If you are a parent or a teacher, take time with your children and partake in some fun physical games that will contribute to making them and you stronger. Regular sleep helps maintain homeostasis within the body.  Homeostasis is the ability to maintain a regular and stable condition within your body- this effects metabolism (weight), mood, and temperature. EAT HEALTHY! Use food to nourish and fuel your body.  Eating or not eating becomes unhealthy when it is used to fill an emotional need. We all misuse food at one point or another, so do not feel you must strive for perfection, but understand the role food should play in your life, and keep that in mind when making decisions about being the best YOU, you can be! 

Finally, make sure you are surrounding yourself with positivity and support. If you feel put down, or as if you are being pulled away from being the best you can be when around family or friends, find friends who pick you up when you are down, and who encourage you to succeed. Creating a new environment for yourself can be life-changing and difficult, but empowering.

There is so much more information on signs, symptoms, and treatment available through various organizations. For more information, please do not hesitate to contact me at:

FeedingTheNeedToSucceed@gmail.com 
Follow @Feed2Succeed
-Michelle Eisen BSc. MA in Child Study and Education

Helpful Resources: 

Sheena’s Place
-a free, non-clinical resource and environment providing counselling, and support

Canadian Mental Health Association 
-resources and support for those with or those who know someone with mental illness 

National Eating Disorder Information Centre

-information on eating disorders and weight preoccupation, curriculum activities for healthy living and eating disorder prevention.

Even If It Kills Me

- a realistic fiction book by Dorothy Joan Harris. This will help you and your children gain a deep understanding of how anorexia nervosa can begin and manifest.