BY NADINE ROBINSON
When Dove brand skincare products launched their “real beauty” campaign with advertisements celebrating realistic and healthy body images, eating disorder clinicians collectively breathed a sigh of relief. Clinicians, like those at the Sault Area Hospital (SAH) Eating Disorder Program, often feel they are fighting an uphill battle against the media portrayal of “the thin ideal.”
Eating disorders primarily affect teenage girls and young women, with peak onset between 14 and 18 years of age. Individuals more at risk are often perfectionists, experience family pressures, are being bullied, and receiving weight based criticism. Such criticism can come from peers, parents, and coaches, especially those involved in activities like dance, gymnastics, figure skating, and modeling.
Two per cent of the population is genetically predisposed to eating disorders, which can be triggered by stressors that cause anxiety and depression. “It can start off with a girl looking to lose five pounds for any number of reasons, but then it flips,” said Janet Arnold, a registered nurse and one of two part-time clinicians in the out patient program at SAH. “Patients turn to the eating disorder to cope with distressing emotions. It also allows them to exert control over at least one facet of their lives.”
One in four
A recent study in Ontario showed that more than one in four teenage girls is engaging in highly problematic food and weight behaviours, yet girls as young as eight are being assessed and treated through the SAH Eating Disorders Program. Assessment involves distinguishing between the normal weight concerns of 80 per cent of women and actual eating disorders like anorexia and bulimia nervosa, and their sub-types (whether binging or purging or neither is involved). Treatment involves retraining, changing exercise patterns, and therapy - all with the goal of strengthening the patient’s body, self-worth, and coping skills.
Anna Gartshore, a registered social worker, knows that eating disorders can take over families, and agrees that family therapy is key for treating children and adolescents. “We need to lift the blame from both the parents and the patient, reminding them that the ED is not their fault.” Gartshore also helps families separate the eating disorder from the individual. “The eating disorder is like an internal bully,” she said. “We need to get the parents and patients on the same side--to battle the monster together. Love and support is the key to recovery.”
Both Arnold and Gartshore work diligently at dispelling misconceptions around eating disorders. “People think you must look underweight if you have anorexia nervosa. Or they assume that only those with bulimia use purging to control weight,” said Arnold.
“Weight is also not the primary issue,” added Gartshore. “‘I’m fat’ is equated with ‘I’m disgusting’ and ‘I’m worth nothing,’ so we need to address underlying issues causing the internal self-loathing dialogue before serious damage is done.”
Eating disorders can lead to serious physical and psychological consequences, including death from starvation, heart complications, or depression leading to suicide.
“The untreated mortality rate is around 20 per cent,” said Arnold. “As most eating disorders begin in adolescence, the hope is that patients get referred to us as soon as possible.”
Arnold focuses on older teens and adults with eating disorders, including senior citizens, but “it is much tougher to beat ED in adults as it becomes a chronic mental illness,” she noted.
Denial, shame
The SAH clinicians attribute the low number of self-referrals to patients’ denial, shame or guilt about their ED, as these feelings cause them to become extremely secretive. Most adolescents get help for an eating disorder only at their parents’ insistence, though referrals also come from other concerned relatives, schools and doctors. “Warning signs to look for include a preoccupation with food or exercise, loss of menstruation, avoidance of family meals and trips to the bathroom after eating,” said Arnold. “Also, watch for sudden weight changes, the wearing of baggy clothing, irritability, mood swings, depression, and/or withdrawal.”
The SAH Eating Disorders Program is part of the Sudbury-based Northeast Mental Health Centre’s Regional Eating Disorders Program, and covers the Algoma District, including Sault Ste. Marie, Wawa, Elliot Lake and Spanish. The program receives more than 500 adult visits a year, and recently expanded to include a children and adolescent’s program in December 2010.
More information is available from the National Eating Disorder Information Centre website at www.nedic.ca. To refer a patient or seek treatment from the SAH Regional Eating Disorder Program, call (705) 759-3434, extension 4634. A crisis line (though not specific to eating disorders) is also available 24 hours a day at 1(800) 721-0077.
Nadine Robinson is a freelance writerbased in Sault Ste. Marie.
