Her name is Brenda*. At least, that's what we're calling her. Brenda is a junior in high school who's been studying ballet since grade school. She had excellent grades, good friends, and regularly attended church with her parents. She was a beautiful, vibrant, healthy young girl. You would never know these things to meet her now.

Lately, Brenda doesn't look well. Her face is drawn, and her body is very thin. Her collar bone sticks out as if announcing to all her problem, as do the bones in her wrists and on her shoulders. She looks gaunt to everyone but herself. In just a matter of months, she has become part of a statistic: she is one of every one hundred girls in their teens and twenties with an eating disorder.

The National Association of Anorexia Nervosa and Associated Disorders estimates that eight million people in the United States struggle with eating disorders; seven million women and one million men. Of those eight million people, 86% report that the illness began before they reached the age of twenty, and only 50% report being fully cured.

In spite of growing research efforts, it isn't really clear why an eating disorder begins. Teens and young adults are most vulnerable. Whether it is a response to physical or hormonal changes of adolescence, or the psychological pressures that come with maturing, at some point these young women find they no longer like they way they look. They may be of normal weight or slightly overweight when the eating disorder begins, but once it starts it takes on a life of its own.

Brenda started losing weight after she got sick with the flu. When she got back to school her friends noticed and commented how good she looked. From this relatively simple and innocuous beginning things spun out of control. First she wouldn't eat anything with fat on it. Then she started to exercise all the time. Not only did she start running every afternoon, but she couldn't sit still. She would do sit-ups and run in place in her room. She would pretend to eat and hide the food in her room. As her weight dropped, her clothes became baggy, but when she looked at herself in the mirror she still looked fat. With each drop in her weight she felt a brief sense of control, only to be followed by anxiety to set a new lower weight goal.

Brenda suffers from Anorexia Nervosa, an eating disorder that shows up with changes in diet, preoccupation with weight and body size, excessive exercising, loss of menses. Depression and anxiety are common. Not all patients with eating disorders lose weight and most people with an eating disorder will try to conceal the extent to which a preoccupation with food and weight has taken over their lives. Even so, these are some of the warning signs that the 'diet' a daughter or friend is following may be something more serious.

  • Look for unusual social behaviors such as a decreased interest in hobbies, withdraw or isolation from social activity, or avoiding social activities that involve food.
  • Physical signs can include rapid weight loss or gain, or changes in condition of the hair, skin or nails.
  • Other physical signs can be reduced ability to concentrate, dizziness, fainting, hypoglycemia, dehydration, fatigue, or something called "edema" - retention of body fluids which cause skin to look "puffy".
  • Look, also, for behavioral signs like slow eating, hoarding food, trips to the bathroom after meals, a change in clothing style (not necessarily a change to baggy clothes, though that is a sign), and excessive exercise.

Fortunately, Brenda is getting help for her eating disorder. Her parents are aware of her struggle, and have agreed to explore possible forms of treatment, including counseling. It is estimated that only 1 of 10 patients with an eating disorder is being treated. Though she still has a ways to go, Brenda is at least on her way. Which is more than can be said for many other young men and women.

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