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EATING IS PART OF EVERYDAY life. It is necessary for survival, but it is also a social activity and part of many happy occasions. People go out for dinner, invite friends and family for meals in their homes, and celebrate special events such as marriages, holidays, and birthdays with food. Yet for some people, eating is a source of worry and anxiety. Are they eating too much? Do they look fat? Is some new weight loss promotion going to be the answer?
Obesity has been identified as a major health problem in the United States; some call it an epidemic. The number of obesity-related illnesses among children has increased dramatically. At the same time, millions of women are either starving themselves or engaging in chaotic eating pat-terns that can lead to death.
OVERVIEW OF EATING DISORDERS
Although many believe that eating disorders are relatively new, documenta-tion from the Middle Ages indicates willful dieting leading to self-starvation in female saints who fasted to achieve purity. In the late 1800s, doctors in England and France described young women who appar-ently used self-starvation to avoid obesity. It was not until the 1960s, however, that anorexia nervosa was established as a mental disorder. Bulimia nervosa was first described as a distinct syndrome in 1979 (Anderson & Yager, 2005).
Eating disorders can be viewed on a continuum, with clients with anorexia eating too little or starving them-selves, clients with bulimia eating chaotically, and clients with obesity eating too much. There is much overlap among the eating disorders: 30% to 35% of normal-weight people with bulimia have a history of anorexia nervosa and low body weight, and about 50% of people with anorexia nervosa exhibit bulimic behavior. The distin-guishing features of anorexia include an earlier age at onset and below-normal body weight; the person fails to recognize the eating behavior as a problem. Clients with bulimia have a later age at onset and near-normal body weight. They usually are ashamed and embarrassed by the eating behavior.
More than 90% of cases of anorexia nervosa and buli-mia occur in females (American Psychiatric Association [APA], 2000). Although fewer men than women suffer from eating disorders, the number of men with anorexia or bulimia may be much higher than previously believed, many of whom are athletes (Glazer, 2008). Men, how-ever, are less likely to seek treatment. The prevalence of both eating disorders is estimated to be 1% to 3% of the general population in the United States (Anderson & Yager, 2005).
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