“Mary Jones” was a very sick 14-year-old. The name isn’t real but the disease is: She had bulimia and it could have been fatal. Mary had been forcing herself to throw up for almost two years, a common symptom of an eating disorder. A good friend was with her when she vomited blood, and persuaded her to go and see her doctor.
Mary’s physician talked to her and recognized other symptoms — abnormal eating habits, preoccupation with body image, swollen glands, a burst blood vessel in her eye. He referred her to the Center for Eating Disorder Recovery (CEDaR), a Westchester-based facility that offers comprehensive eating disorder treatment services under one roof. Mary made an appointment — and fortunately she kept it.
“She was very scared,” says Judy Scheel, Ph.D., founder and director of the Center. Mary had every reason to be frightened, according to Dr. Scheel. Serious illness — and even death — often accompanies eating disorders.
According to the National Institute of Mental Health (NIMH), “Eating disorders are not due to a failure of will or behavior; rather, they are real, treatable medical illnesses in which certain maladaptive patterns of eating take on a life of their own.” The disorders are anorexia nervosa, bulimia and compulsive/binge eating; they usually develop during adolescence or early adulthood, but may affect people in their middle and older years, as well as children as young as 10.
“Anorexia nervosa is self-starvation,” explains Dr. Scheel, 44, whose doctorate and master’s degrees are in social work. “Bulimia is eating/bingeing and forcing oneself to get rid of the food by vomiting, laxative abuse or exercise. Compulsive eating is frequent overeating when one is not hungry, ‘grazing’, or eating large quantities of food in a short period of time.” Parents who notice any of these symptoms in their children should not nag, particularly at mealtimes, but should seek immediate medical attention.
An eating disorder illness is usually accompanied by physical problems such as loss of or irregular menstruation; cardiac involvement; chronic fatigue; gastrointestinal disorders; anemia; bone density loss; and chronic bloating and gas. Emotional damage is almost always present.
NIMH reports that “eating disorders frequently co-occur with other psychiatric disorders such as depression, substance abuse and anxiety.” CEDaR, with offices in Mount Kisco, Scarsdale and Nyack, operates on the premise that an eating disorder acts as a distraction from underlying conflicts. When asked why a person develops such a disorder, Dr. Scheel stresses these issues:
· feelings of worthlessness or inadequacy; · feelings of shame or self-disgust; · fear of intimacy; · the need to please others and to be perfect; · conflicts around autonomy and dependence; · conflicts around angry feelings; · depression and anxiety; · conflicts about sexuality; · history of sexual abuse; · conflicts in family relationships.
Approximately 10 percent of sufferers are males. The Center has just hired its first male therapist because of an increasing number of young men with these disorders.
“The males, many of whom are athletes, are even more reluctant than the females to admit that they have an eating disorder,” says Dr. Scheel.
“Diet is not the answer,” she continues. “Anorexics who may be emaciated see themselves as fat. They are obsessed with calorie and fat gram counting.”
CEDaR’s staff includes clinical social workers, psychologists, nutritionists and consulting psychiatrists who work together to “alleviate chaotic eating behavior by delving into underlying conflicts.”
“We advise families to listen to their children,” Dr. Scheel says. “Don’t say, ‘Oh, don’t feel sad,’ but rather, ‘You have a right to feel sad.’ Parents must understand that their children may be turning to food when they have feelings they can’t tolerate and about which they feel ashamed and guilty.” She adds that though the world is “diet crazy”, diets don’t work and are not the answer to eating disorders.
Typically, insurance plans cover no more than 50 percent of the treatment costs for eating disorders, and there is usually a cap. Dr. Scheel urges support for a plan pending in Congress, sponsored by Senator Hillary Clinton, to put mental health care on a par with physical care.
CEDaR’s program typically takes two years. “The illness didn’t suddenly fall from the sky,” says Dr. Scheel.
For further information • CEDaR, 67 So. Bedford Rd., Mt. Kisco. (914) 244-1904; 1075 Central Park Avenue, Suite 412, Scarsdale. (914) 472-4019; and 99 Main Street, Nyack. (845) 348-7660. www.edrecoverycenter.org; email: firstname.lastname@example.org.
• National Association of Anorexia Nervosa and Associated Disorders,
(847) 831-3483. www.anad.org.
• National Eating Disorders Association, 603 Stewart Street, Ste. 803, Seattle, WA 98101. 1-800-931-2237. www.nationaleatingdisorders.org; email: email@example.com.
• National Institute of Mental Health, Department of Health and Human Services, 6001 Executive Blvd., #8184, Bethesda, MD 20892. www.nimh.nih.gov; email: firstname.lastname@example.org.
• Teachman, B. et al. Helping Your Child Overcome an Eating Disorder. Gurze Books.