We all have to eat, but choosing the right foods can be hard. Many people also have trouble controlling how much they eat.
Instead of eating reasonable portions of fruit, vegetables, whole grains, and other healthy foods, lots of people eat too many cookies and chips. Many people just eat too much food in general.
One result is an epidemic of obesity that has swelled the waistlines of millions of adults and kids. This increase in obesity has led to increases in the occurrence of diabetes, heart disease, cancer, and other illnesses (see "Packing Fat ").
Some people have trouble controlling how much they eat. Others are so worried about getting fat that they strictly limit how much they eat and may end up starving themselves.
But for other people, food becomes the enemy. They worry so much about getting fat that they either severely limit what they eat or make themselves throw up right after eating. Doctors say that these people have eating disorders.
Eating disorders among teens are much less common than obesity is. Yet the health consequences of eating disorders can be just as severe.
Not eating enough can lead to heart attacks, weak bones, organ damage, and fainting spells. Repeatedly throwing up causes chemical imbalances in the body, erodes teeth, and destroys the stomach lining.
Researchers are zeroing in on what causes certain people to develop eating disorders, why some people are more at risk than others, and what kinds of education programs work best to keep people from taking drastic measures to lose weight or stay slim.
It's important to learn how to recognize signs of disordered eating in yourself and your friends, doctors say, because research shows that getting treatment early on is the key to a quick recovery.
In the United States, eating disorders affect as many as 10 million girls and women and 1 million boys and men.
One type of eating disorder is called anorexia (or anorexia nervosa). People with anorexia eat only tiny amounts of food. They're often obsessed with measuring food portions or counting calories. They may exercise for hours every day to burn off the few calories that they do consume. Someone who weighs 100 pounds can drop to an unhealthy weight of just 80 pounds, or even less, if they develop anorexia.
People with anorexia may be obsessed with measuring food portions, counting calories, and checking their weight.
Instead of starving themselves, people with an eating disorder called bulimia (or bulimia nervosa) eat a huge amount—like a quart of ice cream, a giant bag of chips, or a package of cookies—in a short time. Then, they try to get rid of the food by forcing themselves to vomit.
Both disorders often begin around puberty, when kids' bodies change in important ways. These changes can be stressful, especially for girls.
People have long blamed eating disorders on a culture that idolizes skinny women and muscular men. The idea is that pictures in movies and magazines become unrealistic goals for people, who then take dangerous measures to change the way they look.
One of the most surprising findings in recent years, however, is that genetics and biology may also play a role. Anorexia and bulimia run in families, says Kelly Klump, a psychologist at Michigan State University in East Lansing.
Genes and hormones
Klump and her coworkers have found that the family connection starts to emerge after puberty, usually in the early teen years. That's when levels of certain hormones start to change in kids' bodies.
Hormones are chemical compounds that help keep our bodies working properly. Hormones control how quickly cells make and digest proteins. They play roles in how fast we grow, how hungry we are, and how we feel.
Klump suspects that each person's genes determine his or her particular hormone levels. That's what makes some people more likely to develop unhealthy eating behaviors. Hormone differences may also explain why eating disorders are more common among girls and women than among boys and men.
In one eating disorder, a person may be tempted to eat everything in sight, then try to get rid of the food by throwing up.
Finding a genetic link, however, doesn't mean that fate determines who will end up with an eating disorder. "You're not doomed," Klump says. It only means that some people are at greater risk.
Whatever your risk for an eating disorder, one thing is certain: Media images have a big impact on how people feel about themselves.
Some studies have shown that girls who try to look like movie stars and fashion models are more likely to make themselves vomit than other girls are, says Alison Field. She's an eating disorder expert at Children's Hospital Boston.
And studies by Harvard psychiatrist Ann Becker showed that the occurrence of bulimia skyrocketed in Fiji after television was introduced to that South Pacific island in 1995. After just 3 years of watching commercials for exercise equipment and TV shows full of good-looking, superthin actors, the number of Fijian girls who said they vomited to lose weight jumped from 3 percent to 15 percent.
Media and advertising images can be misleading. Photos of models and actors are often touched up to make them look better.
Learning to resist the allure of media images may be the most important way for kids to protect themselves from eating disorders, Field says. After all, pictures can be deceiving.
The images that we see have usually been altered in various ways to make models and actors look even better than they do in person. "There's manipulation behind all ads," Field says. Ads are supposed to make you feel bad about yourself so that you buy stuff.
Many schools today teach students about the hazards of obesity and the importance of staying lean. However, some studies have shown that kids who diet end up gaining more weight than those who don't. The more people try to restrict their food intake, the more likely they are to think about food. And the more they think about food, the more likely they are to head for the kitchen.
The best strategy, Field says, might be to teach kids about obesity and eating disorders. After all, the underlying message is the same. If you eat well and get enough exercise, your weight and health should fall into place.
School-based educational programs can be quite powerful. In one recent study, 500 middle-school girls participated in a program called Planet Health. The program taught the girls about nutrition and fitness within the context of other school subjects. After 2 years, the number of girls who were using diet pills or vomiting to lose weight dropped from 6.2 percent to 2.8 percent. It might be worth encouraging your school to adopt a similar program.
In the meantime, if you or any of your friends are showing signs of eating disorders, it's important to get help right away. Talk to a parent, a teacher, a doctor, or some other adult you trust.
You need to realize that you're not alone, Field says. You can really benefit from the help that other people can give.