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Monday, December 2, 1996

Victims of eating disorders have a profound impact on family and friendsBy Monica Paknad

Daily Bruin Contributor

With Thanksgiving behind them, most UCLA students returned to campus a few pounds heavier than when they left. But those students with eating disorders or behaviors may have found the mix of food and family an explosive one.

Family, friends, roommates, and girlfriends or boyfriends typically have difficulty understanding why a normally healthy person would deliberately abuse their body. But unresolved issues in personal relationships may be the ammunition that first triggers an eating disorder or causes relapse in a recovered victim, doctors say.

Among eating disorders, generally classified as either anorexia nervosa (self-starvation), bulimia nervosa (binging and purging) and compulsive binge eating (consuming abnormally large quantities of food), bulimia is the most frequently-treated disorder among college-aged women.

At UCLA, bulimia is the most prevalent eating disorder, said Dr. Elizabeth Gong-guy, clinical psychologist at Student Psychological Services.

Among the general population of women, anorexia has a 0.5 percent incidence rate and bulimia has a 3-4 percent rate of prevalence, according to Dr. Bita Rahber, director of the outpatient eating disorders program at the UCLA Medical Center.

These statistics are significantly exaggerated when surveying college campuses, where Rahber describes eating disorders as "rampant" with a frequency of 25-35 percent of people in college samples showing behaviors which are "less than diagnostic, but still problematic."

Perfectionists by nature, victims of eating disorders commonly believe that they can handle the problem themselves. Often, people with eating disorders will deny that the problem exists, even when they may appear visibly emaciated, said Dr. Vivian Meehan, president of the National Association of Anorexia Nervosa and Associated Disorders (ANAD).

Eating disorders result in the highest mortality rates among all mental disorders, with young women and adolescent girls constituting about 90 percent of the cases, according to the National Institute of Mental Health.

Experts say it is necessary to show support for the victim of the illness early on to prevent a victim from becoming the 1-in-10 case that ends in death from starvation, cardiac arrest or suicide.

Family members and friends should educate themselves on the subject, seek treatment for their loved ones in clinics or school counseling, and provide understanding and encouragement to keep the person in treatment.

Meehan says that one should not expect family therapy to "mend the person with an eating disorder" but rather to aid in a better understanding of what the victim is thinking.

She also says that sometimes the disorder can become a tool to control and change the family, since the illness often develops when relationships, including those within the family, are distorted in the eyes of the victim.

Family and friends should refrain from telling the victim to "eat more" because usually food is not the real issue. Food is a means of weight restoration and not a solution to deeper problems such as self-esteem, Meehan said.

It is known that "societal ideals tell us that anybody really thin will be successful and loved," Meehan says. So, it hinders recovery when those around the victim make rude comments concerning weight or appearance.

In addition, it is the family's responsibility to provide "adequate nutritional food" so the victim has access to it if they decide to eat. Once in therapy, victims of eating disorders need to assume their own responsibility for eating.

About 80 percent of people with eating disorders develop them as teenagers, according to Meehan. The remainder of the cases result from major life changes, "when life gets too unbearable."

Doctors cite life changes, such as losing a significant other, as "one of the big triggers" of an eating disorder. Experts agree that the sooner the person receives treatment, the better; however, getting the person in treatment and keeping them there can be extremely challenging.

Strains placed on the family resulting from the disorder can often be relieved through family therapy. Experts say released anger and feelings can often result in improved communication within the family. But the victims themselves must first want help.

Treatment is "difficult and ineffective if the person is not coming of their own free will," Gong-guy said.

The most supportive thing a family member can say, according to Meehan is, "if you'd like to talk, I'm here to listen."