For many of us, eating disorders are a great mystery. What causes them? Why are they so difficult to cure? Why doesn't the young girl battling anorexia just eat? We want to rationalize something that's difficult to understand. One common rationalization is that young people with anorexia or bulimia have controlling or demanding parents, and so the disease manifests as a way to take control of their own lives, even if it's only about what foods they do or don't put into their mouths.
When I sat down and talked with a woman who knows more about the issue than anyone, I found it's much more complicated than just control. There are actually five factors loved ones can look for to determine whether a person is more likely to develop an eating disorder.
Jennifer Lombardi has been a recovered anorexic for the past 18 years. She is also a mother of two, a licensed marriage and family therapist, as well as the Executive Director of Summit Eating Disorders and Outreach Program (SEDOP) in Sacramento. SEDOP is a nationally recognized eating disorder treatment center that is unique because it is medically supervised. They have medical doctors, nurses, nutritionists, and more supporting positions on staff.
Lombardi said one-third of her patients are children, and they are coming to SEDOP younger each year. "Hospitalizations for eating disorders in children under the age of 12 have increased by 119 percent in just the past few years, and in the past two years, we are seeing double the number of middle school kids," she said. "I am seeing kids as young as 7 these days. It's heartbreaking."
Lombardi explained that why a person develops an eating disorder is like a five-piece puzzle. All five pieces are indicators that a person is at risk, though some factors can be more prevalent than others. "The first two have to do with nature, or the cards we're dealt at birth," she said. "The last three have to do with nurture, or a person's environment."
Here are the factors to look for in yourself, your child, or a loved one:
#1. Mood (nature)
Some people are simply born with a stronger predisposition for anxiety or depression, which are predominant moods that people with eating disorders have.
#2. Personality (nature)
If a person is more driven and/or a people pleaser, both are factors that need to be monitored.
#3. Culture (environment)
It could be a person's school, family, or even in what city he or she lives. For example, the greater culture of technology kids live in today exposes them to many more confusing messages and images than past generations experienced. Pro-anorexia boards on social media sites have become more common.
And women are not the only ones who struggle with eating disorders - more than one million males are fighting an eating disorder, and it has even been given a name: "manorexia" (which can be anorexia and/or binge eating). Nearly one-third of teenage boys use unhealthy forms of weight control, including skipping meals, fasting, smoking cigarettes, vomiting, and taking laxatives, according to Lombardi. Surely the culture boys live in today feeds these messages.
#4. Trauma or a loss (environment)
A particularly painful time in life can make people more susceptible to hurt themselves.
#5. Relationship issues (environment)
This can be the aforementioned controlling parents, but it could be an array of other relationship situations as well.
Kids and adults can develop an eating disorder because of one or more of these reasons. "They may stumble onto a diet site or read something about skipping meals, and while others would move on, it actually is much more tempting for them," said Lombardi.
Patients explain how they feel to Lombardi, telling her things like, "I just like how I feel when I don't eat," expecting to be put down by her. "Yet there's actually biological truth to how they're feeling - they're wired differently, and it probably does feel better to them to not eat," explained Lombardi. "At places like Summit, patients are given coping tools to deal with the hand they've been dealt."
As a recovering anorexic, even Lombardi said events and feelings still trigger old ideas of anorexic behavior. But because she's learned coping skills like how to be more assertive in conflicts and how to "let things go" by making a conscious effort to be less of a perfectionist, she's able to stick to her current healthy habits. "I recognize the urges now," she said, "Though they have become less powerful and less frequent over time." They usually come when she's "tired, stressed, or when she hasn't given herself enough self-care."
At SEDOP, patients are given the tools to work with their own unique circumstances. They are then practiced, and support is there for the long haul.
Summit offers three levels of care, ranging from outpatient to partial-hospitalization. They see an array of eating disorder diagnoses like anorexia and bulimia, but also more atypical ones such as food phobias, picky eating syndrome, and body dysmorphia.
A free assessment can be given in person or over the phone by calling (916) 574-1000. "Sometimes the conversation stops there," said Lombardi. "But wondering about someone suffering, but not pursuing help for them, is a dangerous game to play."
If callers do need more help and they do not live in Northern California, they can still be referred to a treatment center near them.
"Eating disorders have the highest mortality rate of any mental illness," said Lombardi. "Therefore, it's extremely important loved ones are persistent with people they think may be suffering. Patients rarely call for themselves - so expect pushback because it is such a private disease."
Julie Samrick is a stay-at-home mom of four young kids and the founder of Kid Focused, a site devoted to children and family issues. Subscribe to the free Kid Focused newsletter delivered weekly to your inbox and connect with us on Facebook too. Permission granted for use on DrLaura.com.