ROANOKE TIMES
Copyright (c) 1996, Roanoke Times
DATE: Tuesday, February 6, 1996 TAG: 9602060041
SECTION: EXTRA PAGE: 1 EDITION: METRO
COLUMN: Personal health
SOURCE: JANE BRODY
This week 2.5 million students at more than 600 colleges and universities are being invited to participate in the first nationwide screening program for some of the most common serious illnesses among teen-agers and young adults: eating disorders.
Those who participate in the free, anonymous screening will hear an educational presentation, complete a questionnaire and meet individually with a health professional.
Recent studies indicate that 1 in 10 college students suffers to a significant degree from anorexia, bulimia or binge eating disorder. Most by far are young women.
Therapists report that treatment is most likely to be effective and long-lasting if the problems are caught in their early stages. Early reversal of destructive eating patterns also diminishes the chances of irreversible health damage, like stunted growth or loss of reproductive ability.
Most people with eating disorders are highly secretive. Those with the most common problem, the binge-and-purge disease called bulimia, typically maintain a normal or slightly above-normal weight. After a binge that may contain more than a day's worth of calories, they attempt to get rid of the excess by vomiting, taking laxatives or exercising.
Riddled with shame for being unable to control their disorder, they hide binges and purges even from their closest friends and boyfriends.
Those with anorexia, much rarer but sometimes fatal, typically pick at meals and refuse food. Even their steadily diminishing weight and eventual skeletal thinness may fail to give them away because they often hide under baggy clothes. No matter how thin they become, they think they are too fat.
Binge eating disorder, the most recently recognized eating problem, could well turn out to be the most common. Here the binges are not followed by purges, and those affected usually become obese. Binging is nearly always done in private; in public, sufferers tend to eat normal or even less than normal amounts.
But unless the disorder is properly treated, those affected typically fail at all attempts to lose weight and keep it off.
Casual observers may blame advertising, fashion and entertainment for idealizing a female body that at best only 1 percent of women can hope to achieve. But researchers have not pinpointed any single cause. Instead, they list many ``risk factors'' and precipitants of eating disorders.
Dr. Kathy Hotelling of Northern Illinois University in DeKalb, president of the Association of University and College Counseling Center Directors, says that women with eating disorders often feel overwhelmed trying to play multiple roles perfectly. She explained, ``They try to find something they can control in a world that seems increasingly uncontrollable, and they turn to what they put in their mouths as something they can completely control.''
A high level of perfectionism - the ``perfect little girl'' syndrome - has often been cited among girls with eating disorders. ``Many people with anorexia and bulimia have in common a low self-esteem and a cruel perfectionism that allow them no flaws in appearance or performance of any activity undertaken,'' writes Kaz Cooke, author of a new book, ``Real Gorgeous: The Truth about Body and Beauty'' (W.W. Norton, $13).
Twin studies have suggested that some people inherit a tendency to develop an eating disorder. There are also strong family influences. A child's risk is greater if another family member also has had an eating problem.
Dr. Ruth H. Streigel-Moore, psychologist at Wesleyan University in Middletown, Conn., who is president of the Academy for Eating Disorders, cites as contributing factors to bulimia a family preoccupation with dieting and weight, a history of childhood sexual abuse, high levels of family conflict, and ``inadequate parenting - parents who are overcontrolling yet underinvolved.''
There is often also a precipitating event. For the popular singer Karen Carpenter, death from anorexia was the end result of a diet she began after a newspaper article called her ``chubby,'' Ms. Kaz reports.
Finally, Hotelling said, there are ``perpetuating factors.'' These might include a comment like ``Gee, you look good, did you lose weight?'' that plants the idea that people would look even better if they lost more. Others are events like the suicide of a peer or such an anniversary.
The National Association of Anorexia Nervosa and Associated Disorders (ANAD) at Box 7, Highland Park, Ill. 60035, operates a phone line from 9 a.m. to 5 p.m., Monday through Friday; the number is (847) 831-3438. Free information, telephone counseling and nationwide referrals to therapists, support groups and physicians are available.
The American Anorexia-Bulimia Association Inc. can also provide information on eating disorders and referrals to clinics, therapists, hospital programs and support groups. The address is 293 Central Park West, Suite 1R. New York, N.Y. 10024; phone (212) 501-8351.
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