24 Hour Counselor: I May Have an Eating Disorder

Hi, I'm John. I think you're going to be glad you came to this site. Kids our age often wonder about their body--size, weight, height, how they look. Just about every teenager will go on some sort of diet at one time or another. Some, however, get so concerned about their weight that they go on a very strict dieting program.

Since you are here, I'm guessing you're worried about your weight and your eating habits. You may have heard people at school talk about anorexia or bulimia. Because of what you've heard, you may be concerned you are becoming anorexic or bulimic yourself.

You're not sure if you should talk to someone, but it's really hard when you have to keep all your worries to yourself. If you feel that way, I have some helpful news for you. I want to introduce you to someone you'll like. Someone who is interested in you.

Wayne Grant is a new friend of mine. He is a physician who enjoys teens and works with them in his office. I think he's OK. As a medical doctor, he can discuss some of our personal concerns about anorexia or bulimia. I'll ask him some questions for you.

John: Dr. Grant, what is anorexia?

Dr. Grant: Well, John, dieting is something that just about every teenager does at some time or another. Anorexia, however, is more than just simply dieting. Anorexia nervosa, which is the medical term, is a condition in which the individual, usually a girl, has a compulsive need to lose weight through dieting. She begins to diet just a little at first, but soon moves on to a severe restriction of food intake. She likely begins with a goal of losing just a few pounds.

But when she succeeds at this, she continues to have a strong need to lose more weight, then more weight. Dieting becomes a fixed way of thinking for her, and she finds it almost impossible to stop. As a result, many physical changes begin to occur in her body.

John: What kinds of changes?

Dr. Grant: The self-starvation of anorexia will eventually lead to some fairly drastic physical changes, including not only loss of fat, but loss of muscle tissue, giving the person that thin, ghost-like appearance.

There is fatigue and there's loss of energy. The heart rate and the body temperature go down. The girl's menstrual period is usually disrupted. There tends to be a growth of fine hair over the body. If this self-starvation continues over a long period of time, serious physical illness can occur.

John: How does anorexia usually start?

Dr. Grant: Often, a casual comment by a parent or a teacher or maybe a coach that, "You could lose just a little weight" is remembered by the teenager. It becomes a focus of her thoughts. She begins to think of losing just a few pounds. When this goal is reached, she then resolves to lose another five pounds, just for safe measure. She then sets a new goal to lose just a few pounds more, and the cycle goes on and on.

John: Do guys ever get this?

Dr. Grant: That's an interesting question, John. Medical experts have discussed this a great deal. Boys do become anorexic, but it's pretty uncommon. Only about one in ten of all teens who develop anorexia are male.

John: Why is it more common in girls?

Dr. Grant: In our society, there's a great deal of pressure on girls to be thin, trim, and perfect looking. In all the media--TV, movies, newspaper and magazine advertisements--you see an emphasis on the perfect figure and the perfect look.

If a girl really doesn't feel good about herself, doesn't have a lot of self-confidence, or is worried about her value as a person, she may consciously or unconsciously start dieting. It's an attempt to become more perfect and have what she thinks will be a more acceptable figure. Therefore, she becomes a more acceptable person. She thinks more and more about this. She worries about it, dwells on it, and unfortunately becomes more compulsive about dieting.

John: That's terrible. Dr. Grant, I've heard a lot about bulimia. Is it something like anorexia?

Dr. Grant: Teens and others with bulimia are not as easily identified as ones with anorexia. Typically, they don't have the drastic weight loss or the physical changes.

John: So, what are some of the symptoms of bulimia?

Dr. Grant: Bulimia is characterized by over-eating associated with self-inflicted vomiting and use of laxatives in order to prevent excessive weight gain. A typical bulimic person will eat furiously, then cause herself to vomit. Like anorexia, over a long period of time bulimia can lead to severe physical changes.

John: What causes a person to develop an eating disorder?

Dr. Grant: John, many factors contribute to eating disorders. Certain types of personalities are more vulnerable to the pressures that we've been talking about. Individuals who are very compulsive and strong-willed are more likely to have the drive to force themselves to diet.

The root of anorexia, however, is a poor self-image. There's a lack of confidence in one's self as a person. There's a feeling that, "I'm not really worth very much as I am; I have to do something to make myself more worthwhile."

The thought of having a more ideal appearance, a more ideal weight becomes an overwhelming obsession. She has difficulty accepting herself as she is. She has a lack of confidence in herself and her value as a person.

Dr. Grant: There is one other significant ingredient. The teen that is likely to become anorexic is one who feels she doesn't have anyone to turn to for support. She feels there's no one she can trust, not even her family. She has this feeling that she must solve all of her problems by herself. Her feelings might go something like this:

"I've just got to get control of this situation. I've got to be strong." She feels like she has to be in control of her life--in control of all of it on her own.

John: So, I guess how you think about yourself--this self-image you're talking about--is pretty important.

Dr. Grant: It is. How we feel and think about ourselves is really important, John. It's important because we become what we think. We act out our thoughts about ourselves. This is exactly what is happening in the individual with an eating disorder. For whatever reasons, she feels that she has little value in herself. She feels she must prove her value by what she does. In this case, lose weight.

John: Here's where I think being a Christian would help. How should a Christian feel about himself or herself? Does the Bible have much to say about self-image?

Dr. Grant: The Bible has a lot to say about who we are and what our attitude toward ourselves should be. The Bible tells us in the first chapter of Genesis that we're made in the image of God.

John: I really like that. Are there other Bible references you could give us?

Dr. Grant: One beautiful Scripture I like is found in Psalm 139:13-14: "For it was You who created my inward parts; You knit me together in my mother's womb. I will praise You because I am unique in remarkable ways. Your works are wonderful, and I know this very well" (HCSB).¹

That whole psalm has a lot to say about why God made us and how He values us. The Bible tells us over and over that we are fearfully and wonderfully made because God loves us. That means our value as persons comes from God Himself, who made us for a purpose and continues to love us. He continues to be interested in us--who we are and what we're doing and what's happening to our lives. He loves us as children. Scripture tells us in Romans 8:16: "The Spirit Himself testifies together with our spirit that we are God's children" (HCSB). That's so important. God loves us as His very own children. And like any parent, He's interested in us as individuals, as persons.

Most of all, we know that God loves and cares for us because He was willing to send His Son to die for us when we rebelled against Him. The Bible says in Romans 5:8: "But God proves His own love for us in that while we were still sinners Christ died for us!" (HCSB). So you see, each individual is important to God--to the God who made the universe and who made us.

We don't have to earn God's love. He loves us because of who we are, not for what we do. I wish every teenager could remember that. Our value as a person is derived from the fact that God made us, and that God continues to love us.

John: So what you're saying is that we don't have to be perfect to be loved unconditionally.

Dr. Grant: That's exactly right! As we said earlier, one of the problems with teens who face this dilemma is their desire to be better, to be perfect, and their inability to accept themselves as who they are. God can help us grow through our imperfections to become more than what we are now--more like what He wants us to be. But we don't have to be perfect. Even when we fail, God still loves us.

The most important thing the teen can do is ask other people for help. But that's the hardest thing in the world for a teen with anorexia to do. At the center of her being is a need to be in control. She has a need to solve her problems by herself.

But none of us can solve the problems of life all alone. We need the help and care of other people. It's important for teenagers who feel that they may have some degree of anorexia to talk to other people they can trust. I wish that such teenagers could feel comfortable talking to their parents.

John: Some of my friends don't feel like they can talk to their parents. They feel like their parents can't understand.

Dr. Grant: John, unfortunately, that's all too true. There are some teenagers who have families in which no one listens. Their parents are too busy or have their own problems. Sometimes parents are not really able to think about and deal with the problems of teenagers in the family. In that case, the teenager might talk to his or her youth minister. He cares for young people. He is interested in them and their problems. He may be able to help the teenager sort through the feelings and the worries she has about eating disorders.

Other people can help when teens feel they don't have anyone else to turn to. There are folks like a school counselor, a pastor, a friend, or the family doctor. What is important is to take that first step and talk to somebody--somebody you can trust and somebody you know cares.

John: What's the next step?

Dr. Grant: It's important that the individual have a physician she can trust and feel comfortable with. As we discussed earlier, there are many health implications of eating disorders. The physical effects of severe dieting, vomiting, and laxatives are many, and they are very significant. The teenager's health needs to be considered and evaluated and proper measures taken to encourage good health.

Eventually, the treatment of anorexia will involve some counseling for the teenager and her family. The treatment also will involve learning about some of the medical problems of eating disorders. There's a need to correct the diet. And sometimes, it's necessary to treat diseases that develop because of poor nutrition.

This needs to be done along with help for the family and the teenager to improve self-image and attitudes. But treatment must begin with the teenager being willing to ask for help. The teenager must be willing to let other people who care get involved.

John: Sometimes the teenager might have to go to the hospital, right?

Dr. Grant: Treatment of anorexia does at times require a hospital stay, but not always. It depends on how long the condition has been going on and how severe the malnutrition has become. Maybe I could give you an example of two teenagers who had anorexia and what's happened to them.

One girl I'm thinking about is Joan. She first began to diet seriously when she was about 14. She began for several reasons. She had gone to summer camp, and it became obvious to her that she was a bit heavier than the other girls. People kidded her about how she looked in her bathing suit.

She came back from camp with a resolve to lose a lot of weight. She started on this diet program with the approval of her parents. The problem was, she didn't stop. She just kept dieting and lost a lot of weight. She became like a ghost. Finally her parents were worried and she even got worried. They decided to talk to the family doctor, who rather quickly diagnosed her as having anorexia.

Fortunately, her problem had only been developing for a few months. She was treated as an out-patient at a medical clinic. She and her family received some counseling. Her anorexia was controlled and she got back into the youth program, became one of the leaders in the Sunday School department, was able to become a vivacious, pleasant person.

She continued to be a compulsive person who worried a lot about her diet. But she was able to control it. Joan's outcome was positive and hopeful. And I know her now as a college student who is a beautiful, happy, wonderful person.

John: Do you have any other stories?

Dr. Grant: Marsha. She first began to develop symptoms when she was about 12. Her family was mixed up. At first Marsha had been involved in the youth group at church. She'd been a leader and very compulsive about everything she did at church and at school. She began to diet. She started acting differently, and started having trouble controlling herself and paying attention to her duties. Eventually she withdrew from the youth group. No one really knew what her problem was or paid much attention to it.

By the time her anorexia was diagnosed, she was 17. At that time her health was shattered. She had a lot of emotional problems. She had to be in the hospital for over a year. And even now as a young adult, she has a lot of trouble controlling her anorexia. She has a lot of trouble getting along with people, and she isn't doing well in her college studies.

These are two very different cases, but they point out that anorexia can be treated and cured if steps are taken early. But if ignored, it can become a very serious problem that can be treated only with a great deal of difficulty. So please, if you're worried that you may have some tendency toward anorexia, ask for help.

John: Thanks, Dr. Grant. I know a lot of teenagers have been helped by this. What final comments do you want to share?

Dr. Grant: Well, let me say this. If you are a teen who is worried about having an eating disorder, you can overcome your problems with the help of God and other people. A while back, a 16-year-old girl who had this problem told me, "I like the person I'm becoming."

You can like the person you are becoming through the grace of God. Remember, God loves you and so do a lot of people.

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¹Unless otherwise noted, all Scripture quotations are taken from the Holman Christian Standard Bible^® Copyright © 1999, 2000, 2002, 2004 by Holman Bible Publishers. Used by permission.

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The 24-Hour Counselor
© 1999, Broadman and Holman Publishers.
All rights reserved. Compiled by Richard Ross.