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In discussing risk factors for eating disorders, Weingarten and Smye point out a crucial one that I had not thought of at all, and which accounted for what I sensed was their slight apprehension in speaking to me. (At least, they seemed a little anxious about my specific purpose). It would seem that there is an element of

fatal vomit

More insidious than the ineffectiveness of purging as a weight loss tool, is the damage that self-starvation and binge-purging wreak on the body. Perhaps the most obviously harmful effect is simply that of starvation, in which

Bulimia is an insidious form |

of self-mutation. The vicious

binge-purge cycle causes esophagel bleeding and can eventually lead to death.

contagion to eating disorders, particularly bulimia. "There is a strong. social component,” Weingarten says. "We know that every bulimic knows someone else who is one. There are studies of how it spreads in college dormitories. People can tell you in graphic detail how they learned (how to purge). Even someone in your position may encourage it. People want to figure out how to

do it, not how to help it."

Gensey concurs with Weingarten and Smye about this kind of eating disorder-acquisition. She believes that "there is a group of in-betweens who do whatever their peers are doing.” She feels this is especially a danger “if it is popularized in a non-deviant way." For instance, she points out that an article in Playgirl refers to anorexics in a_ virtually congratulatory fashion, calling them "the golden girls," and stressing that they are usually "extremely attractive."

Smye says that she and some of her colleagues had considered making a film about eating disorders but decided against it, for fear that they would "encourage and sensationalize it." There are people whose line of reasoning is, as she puts it, "Anything for weight-loss.

It is just this sort of rationale that is commonly seen as one of the biggest ironies of bulimia. For although purging is employed for losing weight, it is ultimately ineffective to this end. Says Weingarten. "It is not uncommon that as (bulimics) purge more and more, they're still gaining weight, (even though) they say they're just going to purge enough to lose ten pounds.”

. This physiological paradox owes to the fact that the dieting in which most bulimics engage, especially if it leads to a rapid weight loss, will eventually lead to just as rapid a weight gain, plus a higher level of body fat than before.

essential biological events cease in response to vitamin, mineral, and amino-acid deficits. The lean body mass is consumed in order to full the most essential functions. It scarcely needs to be elaborated, and according to Weingarten, some 18% of anorexics die.

Perhaps less apparent to most of us are the deteriorative effects of

’ the behaviors in which bulimics

and bulimic anorexics engage. According to Boskand-White and White, self-induced vomiting over a prolonged period of time leads to spontaneous regurgitation, permanent erosion of tooth enamel, gum disease, esophageal bleeding, infected salivary glands, and an increased risk of esophageal cancer. The abuse of ipecac ‘ _— syrup as an emetic has a pernicious quality of its own, namely serious heart problems and even death. In fact the death of Karen Carpenter has been

" linked to this substance.

Laxative abuse does little to rid the body of unwanted calories and also has a long list of serious side effects, including electrolyte imbalance due to dehydration, decreased intestinal muscle tone, and loss of bowel control which may not be fully recoverable. There is hardly anything enticing or glamorous about eating disorders.

Why are these behaviors _

continued by people who may at least partly realize their destructive outcome? According to Weingarten, anorexics “have not lost their appetite, but have the ability not to eat under extreme _ hunger." According to Bruch, "they are panicky with fear that they might lose control over their eating... they use eating, or refusal to eat, for the pseudo-solution to personality difficulties and problems of living."

-"Bulimics," Weingarten

says,"really want to be thin. It's the biggest problem in their lives..

Bulimics feel out of control. They want to lose weight yet are absolutely driven to binge... It is

VERY distressing." He says also that when a bulimic, for example "eats a gallon of ice-cream, she isn't Savouring the ice-cream." That eating isn't usually an enjoyable experience for bulimics is evident in Smye's example of a patient who reported bingeing on dry flour

because her mother had locked ua their food. There are also negative social

consequences for eating disordered behavior that makes it seem all the more incomprehensible. Weingarten points out that people who are utterly preoccupied with food become socially withdrawn and may suffer family breakdown. As well,

withdrawn

according to Smye, there are financial problems for people who find themselves spending $30 a day on binge-food.

So wherein lies the inducement to starve, binge, or purge? Weingarten and Smye believe than

situation.” - but also for benefits that it yields to its members. In the group, "they talk freely among themselves," she says. Everyone has equal status, and "no one is seen as THE expert... They have the attitude that you can really empathize with my situation". Perhaps most importantly, the comraderie and support offered by the group may also serve as a bulwark against binging episodes. "They establish friendships there. They can phone up someone to say, ‘look, I'm on my way’... If you sit at home alone with it, you can think things up. Crazy things in your head grow like monsters."

A support group for eating disorders used to exist at the YMCA in Hamilton. Says Sensey emphatically, "I would like to see self-help at McMaster."

This is not at all to discount the valuable help that health care professionals may provide to people with eating disorders. Perhaps the most ideal resource would be a combination of psychiatric care and support group membership, if the latter is available.

The National Eating Disorders Information Centre has suggestions for helping someone whom you knew or suspect to have an eating disorder. You should let her know you are concerned, and that she can rely on you for emotional support. You should also encourage her to seek professional help, and you should try to become informed about the disorder.

What not to do? Don't tempt her with high calorie foods, or try to force her to eat. The National Eating Disorders Information Centre can also answer any questions. (483-3219) At

suffering

This nineteen year old anorexic weighed only 75 pounds.

an addiction analysis is realistic. That is to say, a person with an eating disorder gets hooked on her

own neurotic behavior patterns. —

Gensey, whose research includes the observation of eating disorder support group sessions, emphatically agrees with the addiction approach to treatment. Whereas Weingarten and Smye frown on self-treatment in favor of relying on the expertise of the health-care professional, Gensey observes that "Alcoholics Anonymous has cured more alcoholics than medicine ever has."

Gensey praises the self-help group setting not only as an excellent focus for the study of eating disorders,- "The other members of the group hold the speaker in check. You can't fib. Validity is built into the structured

McMaster, the student counselling centre refers eating disorders directly to a psychiatric specialist at MUMC.

Weingarten maintains that a person with an eating disorder can't be properly treated unless she is ready and willing to give up her disordered behavior. He sees this as analogous to the situation of most smokers. According to Boskand- White and White, most bulimics don't feel ready to be treated until they realize that their behavior isn't helping them to lose weight, that in fact it is completely self- defeating.

According to Weingarten, anorexia and bulimia "are not trivial disorders" in terms of their physiological and psychological effects. Gensey stresses the pain of the eating disordered. "I find them very nice people,” she says. "I guess it's because they suffer a lot of pain that they're really down to earth... the people I've seen are

really suffering.”