Eating Disorders In Boys: What Parents Should Know September 17, 2009
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It seems that the answer to the following question should be so obvious: Who gets eating disorders? Women and girls, right? Actually … yes, but… More and more, boys are at risk for these disorders as well. Today, anorexia, bulimia, and especially, binge-eating disorder are on the rise in the male population.
What most parents want to know, regardless of gender, is “Why?” To a large degree, the cultural pressure that has been placed on girls for decades to be perfect in achievement and appearance has now been extended to boys. With females, perfection usually translates to “thin,” whereas with boys, thin is joined by lean, muscular, and possessing a masculine physique, as the key set of issues. This insidious message is far more pervasive than a parent might think.
Take male action figures – a multi-million dollar industry in the US. In essence, action toys are to boys what Barbie is to girls. Studies reveal that over recent decades, these action figures have transformed into completely unrealistic shapes. Either they resemble the physiques of advanced bodybuilders, or they display a body that is not even humanly obtainable, especially in the area of the chest and shoulders. Only through extreme steroid abuse could any “real” person even come vaguely close to replicating these distorted figures. Yet, just as some little girls want to grow up and look like Barbie, some little boys want to become big and strong, just like the toys they play with everyday.
Anorexia is diagnosed in boys as young as eight, with an average age of onset between 12 and 14. Often the eating disorder is driven by an obsession with fitness. Either the boy is involved in sports, and sees weight loss as beneficial to performance, or he is not engaged in sports, but wants to be, and views weight loss as the key. Either way, he eats less and less, while increasing his level of daily exercise. Initially, this behavior often appears positive to parents – their son is taking care of his body, getting in shape. The problem is that anorexia is an addictive behavior. As difficult as it is for a parent to imagine, starvation can become an addiction—one that is extremely hard to break.
Body image and appearance are not the only motivating factors for boys with anorexia. As with their female counterparts, extreme weight loss in boys can be a way to exert control in a chaotic world, shift the focus of the family, or serve as a mask for their troubled emotional state.
Interestingly, boys are highly influenced by health-related concerns. Whereas a girl may engage in an eating disorder because her mother is overweight and she does not want to follow in her footsteps, a boy is more likely to do so because his father is ill. Say a father is obese and has diabetes. The fact that the father is fat doesn’t necessarily trouble the boy; but the fact that he is sick does. The boy may say to himself, “that will never happen to me,” then embark on a habit of dietary restricting.
Bulimia and binge-eating disorder, or BED, usually manifest in boys when they are well into their teens. With the former, they engage in compensatory behavior such as vomiting or extreme exercise; with the latter, they do not. With both, enormous quantities of food are consumed at one time, usually two to three times a week. This type of inordinate food consumption is in no way related to physiological hunger; instead, it is tied to emotions. Food is used as a distraction, or a method to cope with unpleasant emotions such as anxiety, depression, loneliness, or anger. Boys, in effect, find solace or comfort in food.
So … what is a parent to do? Perhaps the most important thing to do is simply observe your son. As a boy ages, he should grow. Weight gain, along with increased height, are natural and normal. If he suddenly becomes overly finicky about what he will or won’t eat and starts losing weight, you should be concerned. This is particularly true if he is simultaneously increasing his activity level and becoming compulsive about the need to exercise. In the case of bulimia or BED, other behavioral changes, especially regarding food, should be noted. And though a standard perception of teenage boys is that they always eat you out of house and home, this is different. If a boy is eating in secret, eating a large amount of food in a seemingly uncontrolled fashion, even stealing food, something is probably amiss. If a boy is involved in these types of behaviors, it’s time to take a closer look at how he is doing in school, his grades, his friendships, his mood and general attitude.
In short, it is important for parents to know that eating disorders can occur in sons, as well as daughters. But it is equally important to know that help and healing are available.
For more information about eating disorders please visit www.remudaranch.com
Self-Injury and Eating Disorders August 16, 2009
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Self-injury, particularly cutting on oneself, is becoming more prevalent in the US, especially in those with eating disorders.
Self-injury is when individuals cause physical harm to themselves on a repetitive basis, without suicidal intent. In terms of a psychiatric diagnosis, it falls under the realm of an impulse control disorder. Although cutting is perhaps the most common form of self-injury, self-injury takes a variety of other forms, including head banging, skin picking, biting, repetitious rubbing or scratching, hitting, or burning with anything from a cigarette lighter to a curling iron. Typically, the injury is caused on the arms or legs, even though other body parts can be targeted.
Certainly, the most commonly posed question is “why?” As with most psychiatric illnesses, the behaviors involved with the disorder are mystifying to those who see them happening and often to those who engage in them as well.
Although eating disorders and impulse control disorder are completely separate from one another, they often manifest together. In fact, at Remuda Programs for Eating Disorders, a full 50% of our patients engage in self-injury. The “why” usually falls into one of a few categories. Self-Punishment
The need to punish oneself is usually connected to feelings of great shame and inadequacy. The person feels that she doesn’t do things well enough. The focus is sometimes the eating disorder itself. She feels she hasn’t displayed enough discipline and should be “better” at being bulimic or anorexic. This shame leads to anger at oneself, which leads to a need for self-punishment, often expressed through self-harm. Diversion/Distraction
If an individual also suffers with Post Traumatic Stress Syndrome, she might find herself thinking about or remembering things that were highly traumatic. In order to return to the here and now and reground in the present, she may self-injure. The pain will distract her from thoughts or emotions that are deemed even more painful. Relaxation
Strange as this may seem, self-injury can have a relaxing quality for the person; this is physiological in nature. The brain releases chemicals to combat the pain caused by the self-injury. These chemicals are soothing in nature. The person’s tension and stress level are reduced.
In trying to understand self-injury or endeavoring to deal with a person who engages in the behavior, it is important to remember that a person self-injures because it works. Cutting, burning, or biting actually serves a true purpose, a real function in their life. They usually do not do it for attention, or because it is the “in” thing to do – they do it because it helps them feel better. Often, it provides release, allows the person to feel calm and less anxious. And because it works, there is an addictive quality to it. The behavior can be eliminated, but it must be replaced with a different, healthier, behavior.
Self injury can be an extremely complex issue; therefore, professional help is definitely recommended.
For more information about eating disorders please visit www.remudaranch.com
The Power of Words July 7, 2009
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The expression “sticks and stones may break my bones, but names will never hurt me,” used to be a staple around the schoolyard. Undoubtedly, it was well-intended, designed to help children who were being bullied by other kids.
If only repetition could make the second half of this expression true; unfortunately, no matter how many times we say “names will never hurt me” it often isn’t true.
Words can have an incredible capacity to hurt and wound. At Remuda Programs for Eating Disorders, we know the power of the spoken word. Literally thousands of women and girls have come to us with eating disorders, the severity of which range from life-altering to life-threatening. How many patients have we welcomed into treatment knowing that if we cannot help them, they may die? And how did this eating disorder get started? Often, by words, by cruel names they were called by classmates, siblings, and yes, even parents. Names like “fatty” or “cow” or “whale” or “lard butt.” You can imagine the litany.
Perhaps these females were overweight; perhaps they turned to food for comfort because they were lonely, unpopular, or unloved. Some were clearly not overweight. But what they weighed wasn’t the issue … it’s what they were labeled. Were they deeply wounded by these words? Yes. In fact, most of these females would have preferred to have a stick or stone break one of their bones … because at least, bones mend over time. A shattered heart can be harder to heal.
You may wonder how the situation goes from teasing at school to eventually entering a treatment facility. It runs like this. The girl takes a stand – she will no longer be humiliated by classmates. So she starts dieting, maybe becomes a vegetarian. She turns any former reliance on food to rebellion against food. She loses weight. People notice and compliment her. This feels very good. She starts cutting out fat, carbohydrates and more. Now she is skinny. The compliments stop, but she doesn’t care. Her entire life revolves around not eating; she is as addicted to starvation as a smoker is to cigarettes.
As professionals in the treatment of eating disorders, we may have little influence over the behaviors of school children, but we implore all parents to give this some thought. Think about what is said or indicated to daughters, both directly and indirectly. Please applaud your daughter’s positive actions and behaviors, not her physical attributes. Your daughter is so much more than what she looks like; she needs to know how valuable are her qualities that are not appearance-related.
Mothers, take a moment to examine your own thoughts about size and shape. Are you always talking about diets, obsessing about fat grams and calories, exercising to an extreme, doing just about anything to lose weight? Whether you recognize it or not, your daughter watches this behavior and will model it. Fathers … if you only knew how important your words and actions, and most of all, your approval is to your daughter. This is especially true when she is entering puberty and great physical transformations are taking place. Sometimes fathers are very uncomfortable with these changes because their little girl is suddenly becoming a woman right before their eyes. In an attempt to ease their own discomfort, they use sarcasm or jokes. By injecting levity and saying things like, “Hey … getting a little chunky there,” in reference to her more womanly shape, they may be helping themselves to adjust, but this can have an unforeseen, negative effect. Your daughter is also trying to come to terms with this mature body of hers – it’s new to her, too. What’s more, she may be highly sensitive to what is said, due to fluctuating hormones. Instead of viewing jokes as harmless, she can easily perceive them as criticism from you … the most important male figure in her life.
Are jokes or taunts the exclusive cause of an eating disorder? Hardly, for the factors are many and varied. However, another expression, which is actually true, states that “every little bit helps.” By reinforcing the positive, praising accomplishments, downplaying the importance of external beauty and body, you can help your daughter tremendously. Your affirming words can very possibly give your daughter that self esteem edge she will need to grow into a strong and healthy woman—and to avoid a life-threatening eating disorder.
For more information about eating disorders please visit www.remudaranch.com
Art Therapy Overview June 4, 2009
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“Communication is not always verbal; it can and does take many forms. Often, highly charged emotions or thoughts are best expressed through paint or clay.” Jennifer Williamson, Primary Therapist at Remuda Ranch
Throughout the ages, art has served as a medium of expression. Only in recent years have we discovered the incredible therapeutic value to be found in art. Especially for individuals with anorexia or bulimia. Frequently, the eating disorder has rendered our patients incapable of not only understanding their own feelings, but powerless to express their thoughts in words. When these very same patients select a color of paint, or place their hands on a formless lump of clay, they often tap into a source of deep feelings they very possibly never knew existed.
Art therapy is typically done in groups, with occasional one-on-one sessions. At the outset, patients are given an assignment that in an indirect way asks them to explore an emotion or eating disorder concept. The patient is then asked to express this concept or feeling using the creative process.
Remuda therapists always stress that there is no such thing as good or bad art. No one is ever judged on artistic skill and the art is never about creating a museum-worthy piece. Instead, it is really about the thoughts and feelings patients have when working on the piece and how those are expressed in the final product. Indeed, the art eventually serves as a teaching tool for the patient as well as the rest of the group.
When considering the art, patients are encouraged to feel, experience, then express the relevant emotion. Often this is not easy, yet remains an extremely important aspect of the healing process. By allowing patients to experience and “survive” emotion, they gain confidence in their ability to cope. Patients discover they don’t have to remain “victims” of their emotions.
At Remuda Ranch, our professional staff utilizes every possible form of therapy to help our patients heal. In art therapy, we combine the beauty and diversity of God’s world with the creativity of His children to effect positive, and hopefully permanent, change.
For more information about eating disorders please visit www.remudaranch.com
The Isolation of an Eating Disorder May 8, 2009
Posted by badbulimia in Blog.Tags: eating disorder, eating disorder recovery, eating disorder treatment, eating-disorder behaviors, recovery
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Isolation often accompanies eating disorders, growing in importance as the disorder progresses. Both adults and adolescents with eating disorders evidence a need to isolate. Adolescents often stop all socializing with peers. But they must usually be accountable to parents and therefore cannot completely separate from the world. Adults, especially when unmarried, may isolate from everyone.
This need to isolate may result from common adjunct disorders such as anxiety, panic, or obsessive-compulsive disorder. People with these disorders experience discomfort in social situations and may opt for solitude. Other women may elect to isolate due to interpersonal difficulties such as social phobia, problems relating, or conflict. Yet the primary reason that women with eating disorders choose isolation is to practice their eating disorder without interruption. Eating disorders become the person’s primary focus and interest, and relationships fade into the background.
Those with anorexia often isolate as their disorder becomes visually apparent, avoiding social interaction because it no longer garners positive feedback. In the early stages, the woman often receives positive comments about her weight loss and thin appearance. At some point, comments turn negative, with friends, relatives, and colleagues telling her she must eat more and that her dieting has gone too far. Because of her need to protect her eating disorder, these words are unwelcome. She also avoids social gatherings because they often involve food, which she will not eat. Instead, the woman with anorexia wants and needs time to practice the eating disorder, with its variety of rules, guidelines, and elaborate food rituals. The process she must go through to prepare and consume food may take hours. This could involve over-cooking food, adding many condiments, or displaying food in an unappealing or unattractive fashion–anything to guarantee the food’s undesirability to ensure that she will not overeat. These games which she plays with her mind must be done privately. In addition, the longer she is in the disorder, the fewer foods she will allow herself to eat. These various food rituals and behaviors make complete sense to her, but because they are so unusual and focused, they exclude other people.
By definition, bulimia requires a great deal of time alone. This time is spent acquiring tremendous quantities of food, ingesting it, purging it through vomiting or exercise, and then getting rid of the evidence, such as wrappers, food containers, and bags. Frequently, steps must be taken to replace the missing food. Each of these steps may be highly ritualized. These behaviors also engender intense feelings of guilt and shame. Remaining alone ensures that these activities of which she is ashamed will remain secret. Women with bulimia may also avoid people due to negative social commentary. Since these women tend to fall in the average to above-average weight range, they are often criticized for being overweight.
Though time alone is easier to achieve for single women, even married women and mothers find creative ways to get the time they need. Some work longer hours to avoid family meals, while others opt to work nights or swing shifts in order to guarantee that when they are home they are alone. Some women with eating disorders choose to be homemakers, giving them the opportunity to practice their eating disorder throughout the day when husband and children are away at work and school. In extreme cases, the illness may become so dominant that a woman will neglect her children in order to be alone and practice her eating disorder.
Clearly, isolation promotes the eating disorder and is often a necessary component thereof. Alone in the world of her eating disorder, a woman may be consumed by obsessive thoughts about food and calories, weight and fat grams, exercise and self-hatred. Nothing remains to divert her misplaced attention. An odd, distorted solipsism results.
For more information about Eating Disorders Treatment please visit www.remudaranch.com
