Steamboat Springs — “Struggling with an eating disorder is a horribly painful way for a young girl or woman to live her life,” said Margy Bookman, certified psychiatric clinical nurse specialist of Steamboat Springs. “The eating disorder is with her every minute of the day. It will be her closest companion and worst enemy. Sometimes it feels there will never be a way to escape its presence.”

Bookman has seen the devastating effects an eating disorder can have on an individual and his or her family. She and her fellow Steamboat psychotherapists have been privately counseling clients with eating disorders for years.

According to the Eating Disorders Awareness and Prevention organization, 8 million women and adolescent girls and 1 million males struggle with eating disorders. Of those, 20 percent will fully recover, 50 percent will develop a different eating disorder and 10 percent will die. Their deaths are a result of complications caused by one or a combination of three identified disorders.

Anorexia nervosa is characterized by self-induced starvation and excessive weight loss. Bulimia nervosa entails compulsive or binge eating in which an individual can consume up to 20,000 calories in one episode. The binge-purge cycle involves binge eating followed by self-induced vomiting to rid the body of calories just eaten.

What causes an eating disorder to develop? The National Centre for Eating Disorders reports brain chemicals such as serotonin and melatonin may play a role. Also being studied are the hormone CCK, insulin and compulsive behaviors. Cultural influences that glorify thinness and expect women to change their shapes according to fashion have a profound effect on females in the Western world.

Home environment is frequently a major contributing factor. Examples include the family that must appear “perfect on the outside” or demanding parents who place extraordinary emphasis on achievements. Children exposed to this pressure develop an exaggerated sense of perfectionism, an intense fear of failure and a constant feeling of not being good enough.

These kids grow up to be pleasers and high achievers. Their feelings of helplessness due to a perceived lack of control may result in lowered self-esteem, emotional stress, anxiety and/or depression. Many women and children who suffer from eating disorders have been victims of verbal, emotional, physical and/or sexual abuse. They are left feeling that the one remaining area of control in life is how much to eat and weigh.

Struggling for this control may force the individual to develop secretive, irrational or ritualized thoughts and behaviors. Anorexic symptoms include severe dieting, excessive weight loss, compulsive exercise and self-weighing, pretending to eat when food is really being pushed around on the plate or secretly thrown away, reluctance to eat in public, pretending to have already eaten elsewhere, abuse of laxatives and a preoccupation with food.

Those living with a bulimic or binge-purge eater may notice these symptoms: large quantities of food suddenly missing, excessive or prolonged trips to the bathroom, the smell of vomit, bloodshot or broken blood vessels in the eyes or compulsive exercise.

Recovery, while lengthy and complex, is possible. According to the NCED, the best outcomes involve early intervention and treating the whole individual using a variety of approaches. These include behavioral, cognitive, medical, nutritional, psychological, individual and family therapies.

If you have questions regarding an eating disorder, please contact your health-care provider, psychotherapist, school nurse or counselor for professional help.

Dot Haberlan, RN, BSN, is employed by the Visiting Nurse Association. She spends her time exclusively in the Steamboat Springs School District as team leader for School Health Services.