Having roomed with many girls with several varieties of eating disorders, I've become much more aware of the habits and practices that people use to convince themselves that happiness is a few pounds away (though the truth is, you'll never reach this arbitrary number you've set for yourself). The practices I've listed below are not comprehensive, but common enough in most people with any form of eating disorder. Depending on the method used, it's not that hard for these habits to start being extreme, especially if the person is a) disciplined or b) have addictive personalities and they've already reached to the point of using drugs.
This writeup is not meant to be a tutorial for those willing to destroy their body and self-esteem for the sake of a few lousy pounds, but rather a tutorial for those who may have loved ones already doing these sorts of things. Better that you should recognize the habits and the dangers than not to notice at all.
Being aware of what they're doing is the first step. Helping them recover is what people think is the second step, and it's usually this step that most people screw up royally on. Do not yell at them; do not scream at them; do not lecture them. Do not threaten them. It's 99% likely that they already know it all, heard it all thousands of times. Sometimes advice doesn't work; sometimes begging and pleading doesn't work. The second step isn't to help them recover; it's to let them know you're around and you won't leave them. Take care of them, and don't abandon them or give up just because they're not being reasonable. Reason does not rule anyone's life; logic is inherently illogical to people; and don't think that being logical or reasonable is going to work. (Has it always worked for you? Be honest.) Be there to catch them when they fall. Then you can help them with recovery.
I've classified the symptoms into an approximate order of immediate danger, but keeping any of these habits will become eventually life-threatening.
The Mild
- Thinspiration
One extreme: skinny pictures. Sometimes you need something to keep you going. So you methodically take a magazine, or do a Google search, and you find the models to inspire you. You cut out the pictures and plaster them on the wall; you plaster it as a wallpaper on your desktop; you keep a hidden folder to take out when need is desperate. In extremes, you play with Photoshop to make the inspiration more inspirational; you airbrush in the shadows of the ribs, slenderize the arms.
The other extreme: food porn. It's the masochistic way, and isn't that the best way? Lots of people who subject themselves to this won't mind making food; or reading recipes, or staring at food. It's the eating part that's the problem. Take this particular symptom with a grain of salt, though; lots of people without eating disorders do the same.
- Exercise
Exercise is good, partly because it burns calories, partly because it cuts appetite for a brief period of time after a workout, partly because it feels like you're "doing" something about yourself. It's socially acceptable (unlike most other tactics out there). It releases endorphins, and wipes out the anger and frustration you have at the world.
At extremes, though, exercise becomes an addiction and a disorder all the same. That, too, is something to keep in mind. At the furthest extreme, though, exercise too long and too hard and you'll start burning muscle when you run out of fat to burn. You can tell when someone's reached that point because they smell awful in the gym. We're not talking about gym sweat smell, it's much worse. Once you get used to it, the smell will just remind you that someone's busy dying.
The Extreme (aka, still legal)
- Fasting
This is usually for the very strong of will, and usually only anorexic Type A people generally have the willpower to do this, and usually not even those. Most will reduce to drinking juices of some sort - orange juice, diet soda, etc, because a water diet is next to impossible without practice the first time around.
Usually by the time you catch someone fasting, the person has already gone past the most painful stage, the first 2-3 days. Usually the 2nd to 4th days are the worst in fasting; your body is screaming for food and there will be fainting spells, hunger, dizziness, etc, as the body adjusts and goes into starvation mode. The feeling of hunger fades after the 4th day, and as long as a minimal amount of water is taken in every day, fasting can go on almost indefinitely - a week (usually religious reasons), a month (also religious reasons, but usually not), longer (this is when you should really worry). Weight loss is usually at around a pound a day, closer to perhaps half a pound for girls. A lot of it is water loss early on.
If you're trying to help someone recover from fasting, don't stuff their faces; you have to go slowly, a little bit at a time. Or else they'll throw up all that food - natural body response - and you're back to square one. Start with natural foods first - juice, then fruit, etc. You'd be surprised how much the chemicals in processed foods affect your body when you haven't had them in a while - incredible headaches are the least of it.
This is good to keep in mind when you are helping those who are fasting for religious reasons as well.
Incidentally, if someone does this, be especially careful of afterwards; their metabolism is usually a lot slower and if they gain weight too fast, sometimes they'll just regress and that's really not good.
- Throwing up
This is the hallmark of bulimia, but not always. Those who take supplements will tend to get ulcers very easily (caffeine/ephedrine totally screws around with your stomach lining) and throwing up can be a symptom of that, too.
This is one of those things that are very hard to hide if you're in a dorm; especially a hallway dorm where bathrooms are shared. Everyone will know about it sooner or later, especially if you're not careful cleaning up. (I was stuck in a hallway with two of these girls, and the bathroom seats definitely showed signs.) Other symptoms: decaying teeth (and hands; stomach acid does things), bad breath.
Decaying teeth is not that pretty, but not really noticeable to an observer until it becomes extreme. What is noticeable is when the gag response becomes habitual and the person ends up throwing up anything they put down, regardlesss of whether or not they wanted to in the first place. Like fasting, start really, really small when helping them recover.
- Laxatives
Easier to hide than purging. Does horribly unpleasant things to your stomach. Totally screws over your entire digestive tract in the long run.
- Diet Supplements
These are not that hard to find. Metabolife. Hydroxycut. Xenadrine. Supplements sit on that gray area of legality; they're not illegal, per se, but neither do they have much in the way of rigorous testing (or the FDA approval). Possibly the most infamous case of a diet supplement doing permanent damage is the fen-phen scare of the 80s; users of that diet drug suffered permanent damage to their hearts, including first-time users.
Generally, active ingredients in these are some sort of caffeine type ingredient, which will cut appetite and raise metabolism very slightly. I can't say for sure what the long term effect of the new diet drugs on the market are, since it is only very recently that the United States banned ephedra (which had been the main active ingredient in most diet supplements).
Nowadays, main ingredients are: guarana (also used in the tasty drink Bawls, a favorite of programmers/gamers/me); green tea extract; citrus aurantium, etc.
The Life Threatening (the not so legal)
- Ephedrine
Also called ma huang and derived from the plant ephedra. As an herbal supplement, it wasn't regulated at all by the US FDA until this year. Previously, ephedrine was commonly used as the main ingredients of the more popular fat burning drugs - Metabolife; Ripped Fuel, Hydroxycut, etc.
When used properly and with a certain level of discretion, this drug isn't particularly that dangerous; it's only especially dangerous to those weak of heart or weak of willpower with drugs. As a chemical, ephedrine narrows the arteries and reduces urine production; it is typically paired with caffeine (a diuretic), which is why it is recommended that you drink a lot of water when taking it (both caffeine and ephedrine are monamines.) Combined with aspirin and caffeine, ephedrine forms a "stacker" effect and ups the fat burning (sometimes called "ECA Stack," which is short for ephedrine-caffeine-aspirin). The combination works particularly well as ephedrine and caffeine ups blood pressure while aspirin works the exact opposite.
In large doses, ephedrine is dangerous. Some people have a particularly weak tolerance to it; there have been cases of heart attacks in first time users. Generally coffee junkies (or anyone with a high tolerance to caffeine) tend to not "feel it" as much. Tolerance level grows with regular use as well. Also, it is not the drug of choice to take for girls on the Pill; ephedrine tends to destroy the Pill's effectiveness.
As of April 2004, ephedrine has been banned from the United States (starting with New York) and supplements that previously used ephedrine as its active ingredient have replaced it with others, most notably guarana in Ripped Fuel. Ephedrine will speed up the heart, constrict blood vessels, and cut appetite; there is a feeling of a lot of energy and takers of ephedrine will frequently find themselves doing much more in a workout than they were capable of before (benchpress more, run longer, etc.). If used without some sort of workout, users tend to get very "twitchy" and restless (and snappish).
Because the ban on ephedrine is fairly recent, it's very, very easy to find old bottles using this.
- Phentermine
The new diet drug of choice, and requires a prescription in the United States. (If anyone has watched Mean Girls, this is one of the drugs that blonde mentions.) It's meant to be a "last resort" drug, and you have to be fairly obese (and not just overweight) before the doctor can prescribe this to you. Too bad that nobody regulates online pharmacies, because you can get a bottle fairly easily with a credit card (there's no background check on the information you put in, either). A relative of the infamous fen-phen of the 80s, phentermine is essentially legalized speed (amphetamine). Cuts appetite and raises metabolism by a tiny fraction; gives absolutely miserable head-pounding headaches as an aftereffect. Standard dose is anywhere from 15 mg - 37.5 mg; if you see them taking more than 2 pills a day, then watch out (2 pills is usually for the 15 mg version, by the way).
This drug is a potential disaster for people with addictive personalities. It's technically supposed to be prescribed as a "last resort" use but there are a lot of doctors only too happy to prescribe it, unfortunately. Phentermine is not meant for long-term diet drug use; and studies of its effects have only been limited to 90 day trials. I wouldn't be surprised if its long term effects are similar to that of fen-phen (which caused permanent heart problems for those unlucky folks who took it before it was withdrawn from the market) or speed. Speed's long term effects do happen to include delusions, hallucinations, and paranoia, and off hand, I'd say that it's true simply from observation. Phentermine, like speed, is very easy to grow a tolerance to within a short period of time, and it will take increasingly high dosages to feel the same effect. I will stress this repeatedly: watch out.
There are two types of pills on the market, the brand name, and the generic version. Only the brand names has a "timed system"; the capsule releases phentermine into the system slowly. Phentermine pills are recognizable as small yellow or blue pills.
I cannot emphasize enough how much you really have to be there for the person when they're falling. Be there, love them, and hope for the best. Recovery is a choice they ultimately have to make for themselves, but it doesn't hurt to have helping hands when they've decided.
Some information courtesy of Andromache01. Corrections courtesy of Glowing Fish. Thanks!
Most of this information is off the top of my head. Also, for anyone else in my situation, always, always remember to take care of yourself while taking care of these people. I know that my self-esteem took a huge nose dive in the process. =/ Symptoms are probably accurate, I've tried ephedrine before for a marathon, had a roommate who took phentermine. |
