Thursday, July 17, 2008


Published in Times Review
Dear Eugenia,

My daughter is 19 years old and she has me very worried over her weight. She gained some extra weight rather quickly when she entered puberty and since a couple of years ago she went on a strict diet to lose the weight. The bad part is that she lost the weight but is still continuing to diet. She picks at her food and eats a few bites of salad. Other times she secretly eats a lot of chips, pizza, or donuts and she then makes herself throw up in the bathroom so she won’t gain weight. She is very thin but she thinks she is fat. I don’t understand what’s going on. Our family doctor says that if she continues like this, she will need to go to the hospital for treatment. Can she get better?
“Desperate Mother”

Dear Desperate,
Your daughter has a disorder that is called Anorexia Nervosa (lack of desire to eat due to a mental condition). In our youth-oriented society, where the words beautiful and thin are often interchangeable, young girls like your daughter tend to be preoccupied with their appearance and they constantly focus on their weight. Your daughter started out gaining weight which was unsettling to her, and led her to become scared of being overweight and fat. In her desire to become thin and stay thin, she began to starve herself, binge secretly and purge the food in order not to gain any weight. Just like anyone with anorexia, she has not lost her appetite in fact she longs to eat. Anorexics usually obsess and dream about foods, some of them even at times eat uncontrollably. Patients in treatment who are anorexic tell us that they spend 70-85 percent of time daily thinking about food, creating menus, baking, feeding family or friends, worrying about what to eat next, bingeing on food and purging to get rid of food eaten. Your daughter is afraid of food and afraid of herself. In her determination to lose weight however she continued and progressed in developing a morbid fear of gaining back any lost weight. She became determined to stay thin at all costs. Like all anorexics, she has a distorted body image (thinks she is fat). To her, gaining weight means being weak, undisciplined and unworthy. Dieting becomes “a safe place to go”, that helps her cope with low self-esteem, failure, dissatisfaction, or the need to be unique, to be special, a success and in control. The good news is that there is hope for your daughter. She should see a physician to assess her physical condition. She should also start seeing an experienced counselor who is specifically trained in eating disorders, for individual and group therapy. The counselor could work with the physician and a nutritionist as a team. Being a recovered anorexic/bulimic myself, I treat individuals with eating disorders by following a course that includes educational insight, allowing the patient to correct faulty thought patterns to regulate one’s tensions and moods among others. Once the patient has internalized his/her abilities and has gained new skills, he/she no longer needs to get into self-destructive behaviors (using food) to meet his/her needs, soothe emotions and feel in control. The individual will have learned new tools to go on with life.

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