Eating Disorders: Definitions, Symptoms and Treatment

Eating disorders plague many young women, men and families around the world. Sometimes the symptoms are obvious, sometimes they are not. Eating disorders should not be ignored. They are symptoms within themselves that may hint of a psychological problem which, if not treated, will remain for life.

Anorexia Nervosa

Characterized by over-dieting and the need for perfection. They appear to want to please all, all the time. They have a distorted self-image. Even at 90 pounds, an anorexic will look in the mirror and see fat. These people are usually over-achievers, always willing to help everyone else except him or herself. They do not realize that there is a problem.

Some of the symptoms include: weight loss, becoming withdrawn, excessive exercising, symptoms of Raynaud's syndrome (hands and feet always cold), tiredness, weakness of the muscles, obsession with food and caloric intake, depression with mood swings, fainting, dizziness, missed periods or amenorrhea (no period). When questioned, the person (usually a child or teenager) will become very defensive and angry; this is a common symptom.

It is noticeable that they will surround life with food, not the consumption of it, but its avoidance. They may prepare a meal for the family and busy themselves with cleaning up while making an excuse to eat later and never actually eating. They noticeably cut food into very small portions or may take predetermined (two to three) bites of any food choice. They become obsessed with food and become defensive if their obsessiveness is brought to their attention. Again, an anorexic does not see that there is a problem. Some may start wearing oversized clothes, hiding the effects of the excessive dieting. The scale becomes their friend, and you will find them weighing themselves daily. Anorexics feel they have failed not only themselves but also others when they don't eat. In striving for perfection, they have lost sight of reality.

With proper counseling and nutritional training, they can recover; but they may relapse, so ongoing treatment is a must. The need for counseling cannot be stressed enough. People suffering with this disease have a high relapse rate. Family counseling is also suggested due to the high stress levels that develop from fear of losing your child, or lack of understanding the disorder.

Bulimia Nervosa

Bulimia is characterized by excessive bingeing and purging. Put in more common terms, it's eating and either vomiting or taking excessive amounts of laxatives to remove what they have just put into their system. The logic behind this behavior, regardless of how it sounds, is to remove the calories before they are absorbed into the system. They have a fear of weight gain; weight gain means failure. Most people who do not understand this condition think that purging is simply vomiting, but this is not true. Bulimics have been known to use things such as enemas, diuretics and laxatives to rid themselves of the over-abundance of calories they feel they have ingested. For some, a simple ice-cream cone is bingeing; others may eat many calories by eating a box of cookies, Twinkies, candy, cakes or any other food source.

Some symptoms of Bulimia are: binge eating, secretive eating, hiding to eat or eating during the night when everyone is sleeping, weight fluctuations, broken blood vessels usually in face or eyes from forced vomiting, bathroom visits after meals, tooth decay caused by the acids of the stomach from vomiting so much, fatigue, weakness, sore throat, irregular heartbeats.

The emotional side effects include: low self-esteem, self-criticism, self-worth determined by how much they have lost or gained, fear of not being able to stop eating, guilt from eating, avoiding functions that involve eating including social outings, substance abuse (laxatives, recreational drugs, diuretics).

The side effects of bulimia can lead to many other health problems including stress on the heart and kidneys, and decreases in potassium and magnesium, which are needed to keep the heart nourished with proper electrolytes. The body becomes weakened and unable to function properly.

Bulimics realize they have a problem, so the treatment is much easier than would be for an anorexic. A relapse after treatment may happen; but with proper counseling and nutritional assessment, it can be cured or controlled. Counseling with families cannot be stressed enough as families tend to blame themselves for this disorder. Once an understanding of the disorder is achieved, a lot of stress is lifted and proper treatment is able to begin.

Compulsive Overeating

A person who eats excessively for comfort characterizes compulsive overeating. They find comfort in food, bringing a short-lived satisfaction. Often during stressful times, they binge and feel that they cannot stop eating. Their self-worth is all based on weight and what they feel society sees as normal.

Symptoms of compulsive eating include: binge eating, starting and stopping most any new fad diet that hits the market, being overweight but never eating a thing in public and eating in the privacy of their own home away from people. Sneaking food becomes a habit, but also very comforting.

Emotional symptoms include: anxiety of not being able to stop eating voluntarily, depression with crying spells, embarrassment about weight, distorted views about themselves, weight and foods are the focus of life. Regardless of the person's size, they are malnourished and need to be treated. They are commonly those that try all the fad diets; and when results are not seen quickly, they slide back into the eating disorder. Constant emotional support is needed for these patients. Once the desired weight is achieved, they will still have a poor body image and think that they are large, when in fact they are not. This could lead the patient back into the vicious cycle of compulsive overeating.

Like bulimics, compulsive overeaters know they have a problem, so they are more easily treated than an anorexic. With proper counseling and nutritional guidance, they can resume a normal lifestyle. Families also need to have counseling on how to deal with such a problem. Understanding the disorder is the first step to recovery for the family.

Overview:

With all eating disorders, there is the constant threat of relapse. In an unhealthy setting, this will be a roller-coaster ride for some families. There is no quick fix and treatment may take anywhere from several weeks to several years. Treating the entire family is as important as treating the patient. Once the family recognizes the signs, they can more quickly get assistance in helping their child or loved one to receive treatment.

Often families do not want to admit that they are suffering from an increased amount of anger over these disorders. The anger is a normal progression when the patient chooses not to help him or herself, thus leaving the family to feel as though they have failed. Anger management counseling for the entire family, and not just a single member, is recommended if you feel overwhelmed. Family members, such as siblings, may even feel embarrassed or ashamed; this too is completely normal. A well-established child and adolescent counseling service in your area will help the siblings understand and cope with their feelings.

High stress or demanding situations are unhealthy for patients suffering with eating disorders. The tendency is to run back to what they feel is the only thing in their lives that they can control, their eating habits.

Distorted Relations to Food

At times, control and perfectionism are at the core of eating disorder behavior. Compulsive
behaviors provide the individual with predictability and comfort at a time when their lives may be feeling out of control and chaotic. With this compulsivity comes rigid and/or ritualistic behaviors centered around food. For example, one may begin to eliminate certain foods such as fats or sweets, or have ritual eating patterns such as cutting food into very small pieces. As the individual becomes more and more obsessive, attention to and ability to manage feelings and personal relationships get blocked out. Often they become emotionally empty, withdrawn and depressed. The eating patterns and obsessive focus on food will become a means to cope with difficult underlying emotions. It is an attempt to control one's self, and relationships with others.

Differentiation of Good/Bad

There is a growing differentiation of "good" and "bad" as the individual becomes more and more rigid. Perfectionism has a very narrow margin of error and all else will be unacceptable. The girl who plays a complicated piano recital piece all the way through with one small error is devastated by her total failure. This way of thinking allows no room for error, and therefore no room for growth. It is often from small mistakes that we learn new tasks. Good/bad labeling can be a cover-up for feelings of shame and worthlessness. Good/bad, all-or-nothing thinking styles can be transferred to eating habits and can be self-destructive.

Coping Using Food

Most experts agree food and eating habits are not the central problem of an eating disorder. Ways that one may use food to cope could include:

• Gaining an increased sense of control.
  
  
• Gaining an increased self-esteem and self-worth.
  
  
• Gaining an increased ability to numb self from difficult feelings.
  
  
• Gaining an indirect way to express anger and rebellion.
  
  
• Gaining an increased ability to manage depression.
  
  

By restricting food, bingeing or bingeing and purging, one can attempt to shift focus to something other than the struggles she has with boyfriends, family members or developmental changes, such as going to college.

Here is how it works:
One Model of Eating
Disorder Behavior

Trigger

Need to Disconnect from Feelings

Binge Binge/Purge Restrict

Back to Sense of Self-Control

Instead of dealing with the feeling directly, the individual will disconnect from, say anger, and use the eating disorder to stabilize themselves. For example, one may avoid experiencing anger at a discounting message from one's boyfriend. Instead of talking directly with her boyfriend, having to face possible rejection, she will turn instead to the refrigerator and binge and purge on a gallon of ice cream. Now the anxiety and shame is about food instead of the boyfriend - and a familiar sense of self-control replaces worries about having out-of-control anger at the boyfriend.

Common Thinking Errors

Chronic use of thinking errors can result in many unwanted and painful feelings. These are unrealistic ways we look at events which help us control how we feel. It can cause us to become defensive rather than accept and deal with our feelings.

• All-or-nothing:
  seeing things in black and white categories. If it is not "perfect" then it is total failure.
  
  
• Over generalization:
  seeing a single negative event as a never-ending pattern of defeat.
  
  
• Mental filter:
  picking out a single negative fact and dwelling on it exclusively, all reality becomes darkened.
  
  
• Rejecting the positive:
  rejecting positive experiences by saying they don't count. This helps maintain a negative attitude.
  
  
• Jumping to conclusions:
  saying something is bad even though there are no definite facts.
  
  
• Mind reading:
  concluding that someone is reacting negatively to you without checking it out first.
  
  
• Fortune teller:
  anticipating a bad result and feeling convinced you are right.
  
  
• Magnifying or minimizing:
  exaggerating the importance of things or shrinking things until they appear tiny.
  
  
• Emotional reasoning:
  assuming your negative emotions reflect the way things really are.

Defensive Thinking Styles

Some use defenses to avoid dealing with their feelings and problems. It is important to learn which defenses you use in order to face your problems. Remember, everyone uses defenses, however, when they are used to an extreme, it results in ineffective coping.

• Acting-out: giving in
  to impulses to avoid stress by using destructive behavior.
  
  
• Blaming: saying
  someone/something is responsible for your behavior, poroblems or the way you feel.
  
  
• Denial: refusing to
  believe what is true.
  
  
• Distortion: changing
  your thinking from what is real to suit your needs.
  
  
• Grandiosity: acting
  like you know everything and are always right.
  
  
• Humor: making
  something funny in order to avoid dealing with it.
  
  
• Isolation: social
  withdrawing to avoid problems.
  
  
• Justifying: having to explain the reason behind your action.
  
  
• Maximizing: blowing things out of proportion.
  
  
• Minimizing: making things sound better than they are.
  
  
• Projecting: believing
  because you think and feel a certain way, someone else does too.
  
  
• Sarcasm: a sharp remark used to help deal with an action.

Self-acceptance is a vital part of good mental health. A part of self-acceptance is the realization that we have some physical characteristics we cannot change. Setting unrealistic goals to achieve
the impossible leads to frustration and disappointment. Understanding what influences our body's weight and shape can help us set realistic goals.

• Each person's body weight and body shape, like his or her intelligence and personality, is unique and deserving of respect.
  
• Like it or not, our genes have a primary influence in establishing and defending a "set-point" weight range. This natural and healthy weight differs for each person. Some people are simply destined to be heavier or lighter than others.
  
• Cultural factors try to invalidate both the facts of biology and our respect for individual differences by insisting that all women be slender or a least spend a lot of time and energy trying to become thinner.
  
• "Swallowing" cultural messages about the value of slenderness lead many people-in particular girls and women-to mistrust their bodies and their brains and to diet in search of a slender, "fat-free" body.
  
• In the long run, whether you are male or female, dieting below your set-point causes binge eating and tends to promote weight gain.
  
• People who do not opt out of the "diet game" run the risk of developing an eating disorder.

Eating Disorders: Binge eating

Binge eating is the consumption of unusually large amounts of food in a discrete time period. Individuals with bulimia nervosa and binge eating disorder practice binge eating. Those with bulimia nervosa follow binge eating with some type of purging behavior (i.e. self-induced vomiting, laxatives, etc.). Those with binge eating disorder do not practice purging, but have feelings of lost control and marked distress over their eating behavior. Normal or overweight individuals who meet the criteria for bulimia nervosa, but who do not practice purging or other compensating behaviors, are diagnosed with binge eating disorder.



The prevalence of binge eating disorder in the
general population is unknown but studies suggest that approximately 25-50 percent
of obese individuals binge eat. Studies also suggest that those suffering
from binge eating disorder have difficulties with impulse control in other
areas of their lives.



Binge Eating Disorder - Warning Signs


In the early 1990s, a new eating disorder was recognized, binge eating disorder. This disorder is characterized by episodes of uncontrolled eating. Most binge eaters are obese and have a history of weight fluctuations. Co-occurring psychiatric illness is also common, especially depression.

Warning signs of binge eating disorder are listed below:

• Frequently eats an abnormal amount of food in a discrete period of time.
  
• Eats rapidly.
  
• Eats to the point of being uncontrollably full.
  
• Often eats alone.
  
• Shows irritation and disgust with self after overeating.
  
• Does not use methods to purge.
  

Binge Eating Disorder - Medical Consequences

Compulsive binge eating disorder involves compulsive, uncontrolled eating and bingeing. Some common medical consequences that often result from this behavior are listed below:

• High blood pressure, elevated cholesterol levels and elevated triglyceride levels cause hardening of the arteries, heart disease and heart attacks.
  
  
  
• Overeating simple carbohydrates -- sweets and junk food -- places stress on the pancreas. At first there is an abnormally low amount of glucose in the blood. Later in life, secondary diabetes can result.
  

Eating Disorders: Bulimia Nervosa

Bulimia nervosa is an eating disorder characterized by binge eating, the consumption of abnormally large quantities of food in a discrete period of time. The binge is followed by some form of purging behavior designed to prevent weight gain.



Common purging behaviors include:

• Self-induced vomiting
  
• Emetic abuse
  
• Laxative abuse
  
• Diuretic abuse
  
• Fasting
  
• Excessive exercise
  

Some Important Facts About Bulimia Nervosa

• There are two types of bulimia nervosa; purging and nonpurging.
  
• It occurs in 0.5 percent to 2.0 percent of adolescents and young adult women.
  
• It appears to be relatively uncommon in men.
  
• It typically develops in early to mid-adolescents.
  
• It is usually preceded by dieting behavior.
  
• Bulimics are usually of average or above average weight.
  
• Self-evaluation is unduly influenced by size and weight.
  
• A complex lifestyle develops to accommodate eating disorder behaviors.
  
• There are ongoing feelings of isolation, self-deprecating thoughts, depression, and low self-esteem.
  
  
• There is full recognition of the behavior as abnormal.
  

Bulimia Nervosa -- Warning Signs



Bulimia is an emotional "weight control" disorder characterized by episodes of binge eating followed by some form of purging or restriction. Binges are the secretive, periods of rapid consumption of high-caloric foods over a discrete period of time. Most bulimics follow bingeing with self-induced vomiting. However, the purging may take the form of laxative, emetic or diuretic abuse, excessive exercise or fasting. The binge-purge cycle is normally accompanied by self-deprecating thoughts, depression, and an awareness that the eating disorder is abnormal and out of control. Because most bulimics are within a normal weight range, the illness may go undetected by others for years.



Bulimia should be considered when a normal-weight person frequently:

• Makes excuses to go to the bathroom after meals.
  
• Shows mood swings.
  
• Buys large amounts of food which suddenly disappears.
  
• Has unusual swelling around the jaw.
  
• Eats large amounts of food on the spur of the moment.
  
• Laxative or diuretic wrappers frequently found in trash can.
  
  
• If there is unexplained disappearance of food in the home or residence hall setting.

Bulimia Nervosa - Medical Consequences



Bulimia nervosa is the consumption of excessive amounts of food followed by one or more methods of purging. Common medical complications that result from this bingeing/purging cycle are listed below.

• Vomiting, laxatives and diuretics flush sodium and potassium from the body resulting in an electrolyte imbalance. Arrhythmia (irregular heartbeat) can result, which can ultimately lead to heart failure and death.
  
• The stomach acids in vomit can erode tooth enamel, resulting in damage such as cavities and discoloration.
  
• Self-induced vomiting can result in irritation and tears in the lining of the throat, esophagus and stomach.
  
• Laxative abuse can create a dependence and result in an inability to have normal bowel movements.
  
• Abuse of emetics to induce vomiting can result in toxicity, heart failure and death.
  

Eating Disorders: Anorexia Nervosa

Anorexia nervosa is an eating disorder affected by complex mixture of social, physical and psychological problems.


The four major characteristics are:

• An intense drive for thinness.
  
• An intense fear of gaining weight or becoming fat.
  
• A disturbance in body image.
  
• In women- a cessation of the menstrual cycle (amenorrhea) for at least three months.
  
• In men- a decreased sexual drive.
  

Some important facts about Anorexia nervosa:

• There are two types of anorexia nervosa: restrictive and binge eating/purging.
  
• It typically develops in early to mid-adolescents.
  
• It affects about 1 in 2400 adolescents.
  
• 90-95 percent of individuals with anorexia nervosa are female.
  
• It is usually preceded by dieting behavior.
  
• Psychological problems are displaced onto food.
  
• Unusual food behaviors are practiced.
  
• Need to vicariously enjoy food by cooking it, serving it or being around it is common.
  
• Preoccupation with body weight and image.
  
• Dieting becomes increasingly important.
  
• Denial of the condition can be extreme.
  
• Body image disturbance (misperception of body size and shape) is common.
  
• Pronounced emotional changes are common.
  
• One-third of anorexics subsequently develop Bulimia Nervosa..
  

Anorexia Nervosa - Warning Signs


Anorexia nervosa is an emotional "weight loss" disorder characterized by physical, social and psychological symptoms. Weight loss is achieved by a variety of obsessive behaviors. Most individuals with this disorder strongly deny it. A feeling of control is gained by severely
restricting the amount of food eaten and the ability to do without food is viewed as success in attempting to cope with life's stresses.



Because early detection is important to successful recovery, it is important to recognize the common warning signs of Anorexia nervosa.

• Significant or extreme weight loss with no known medical illness.
  
• Reduction in food intake.
  
• Ritualistic eating habits such as cutting up meat into extremely small bites or chewing every bite excessively.
  
• Denies hunger.
  
• Critical and intolerant of others.
  
• Exercises excessively.
  
• Chooses low to no fat and low calorie foods.
  
• Says he/she is too fat, even when this is not true.
  
• Practices highly self-controlled behavior.
  
• Hides feelings.
  

Anorexia Nervosa - Medical Consequences



Anorexia nervosa is intentional starvation that deprives the body of protein and prevents the normal metabolism of fat. In an effort to protect itself, the body slows down.

• The heart muscle changes and its beat becomes irregular. The ultimate result can be heart failure that results in death.
  
  
• Menstruation often stops, even before extensive weight loss. This is called amenorrhea.
  
  
• Dehydration, kidney stones and kidney failure may result.
  
  
• A fine body hair, called lanugo, develops on the arms and can even cover the face.
  
  
• Muscles atrophy or waste away, resulting in weakness and lost muscle function.
  
  
• Delayed gastric emptying caused by a lack of energy and slowed body function results in bowel irritation and constipation.
  
  
• Loss of bone calcium leads to osteoporosis.
  

Making Peace With Codependency and Teen Eating Disorders

Eating disorders among teenagers are rising. With all of the media exposure, competition and concern to look great in a thin body, kids are showing dangerous signs of self-abuse. The numbers are overwhelming. To avoid some of the pitfalls, parents should be aware of how to eliminate some potentially serious problems.

Kids as young as six years old are already beginning to show concerns about their body image, and signs and symptoms of eating disorders. However, it is in the early teen years where we see the beginnings of full-blown eating disorders. A few years ago I was asked to address the topic of eating disorders to a freshmen class at a local private high school. After a three-hour lecture, several teenage girls came to me to talk about their concerns and fears about their own struggles with food. With tears in their eyes, they admitted to being bulimic and/or anorexic. Some were obviously quite ill. They told me that it had been a painful secret not even their parents knew! With early intervention, and a will to get treatment, many of these girls can be helped.

It is a "family affair," stated Dr. Judy Hollis in her book of the same name, which I believe is a great resource for parents wanting to know more. She too has suffered the pangs of eating disorders. The preoccupation with weight and attempting to look like teen idols is natural to a point. However, as teens seek to find their own identity, it is wise for parents to notice how they themselves deal with these issues. A neighbor of mine, a little girl about the age of five or six, shared with me her fear of getting fat! She told me that her mother had already put her on a diet. If I had not been aware of eating disorders and knowledgeable about signs and symptoms, that comment would not have bothered me. However, the comment made me think about what is going on in that family, and with thousands of young girls and boys today. (The number of boys with eating disorders is not as high as girls, but statistics tell us that those numbers are rising.) I wondered what the mother must have been thinking? What is her concern and belief system? How does she feel about her own body image? How can her thoughts about food help or hinder her children? There are many reasons a child eats inappropriately. People need food to survive, and that makes eating disorders one of the hardest cases to treat. If food is used to abuse oneself, there is definitely an issue going on.

The definition of an addiction is this: "The continuous use of a mood-altering or mind-altering substance (including food), regardless of the harmful consequences." Food does alter the mind and mood; there is question about that. But not all people will end up addicted to it. Addiction is about control, regardless if the food is eaten. Whether it is about bulimia (binge and vomit) or anorexia (stopping of food intake), it is all about control.

Why is control a factor?

In a nutshell, people who feel out of control will use the only means of self-control they have. What goes into or out of the body is in their control. They have a sense of control of themselves when they make the decision to eat or not eat. It is empowering when they feel powerless inside. Many things contribute to lack of power. When a child has been abused (sexually, emotionally, physically or any combination thereof) eating disorders can appear. When the home is a scary unpredictable and stressful place, a child may eat for comfort. If a parent is absent or unavailable emotionally or physically, it creates a feeling of abandonment in the child. The food acts as a shield and has a nurturing quality; something the child may not get in her or his environment. A child needs to feel secure.

Having a sense of control over the outside world is welcoming when the world inside is falling apart. With the pressure of being perfect in an imperfect world, having to do everything right and having low self-esteem and low self-confidence, a young teen will lose touch with her or his feelings. Using food or drugs assists in numbing the bad feelings. Binging and purging gives the person a sense of having feelings and having control over something. Even bad feelings are feelings. The temporary feeling that comes with the purge is, at best, a feeling of release from pressure, which gives back control (although almost always coupled with the shame).

Although not all eating disorders can be blamed on family dysfunction, most are. The truth is that most families do have some degree of dysfunction. I know kids and adults who come from somewhat "normal" healthy families, but who suffer the pains of eating disorders. Food does have its chemical makeup which, when turned into sugar, causes imbalances in the brain. Some people lack the necessary release of seratonin in the brain, and find that eating certain foods in abundance gives a boost to this release. Sexual activity does the same thing, as do behaviors that cause a rush. This causes a kind of euphoric feeling, as it is when chocolate is eaten, causing a kind of peaceful, serene and relaxed sensation. Turkey is known to have L-Triptophane, which creates a similar feeling. We just want to fall asleep in a big, fluffy chair after having a big Thanksgiving dinner.

Codependency

So, how can we parents avoid becoming codependent with our children who have eating disorders or potential eating disorders? First, the definition of a codependent is someone whose life is intertwined with the person who has an eating disorder or any other kind of addiction for that matter. It could be alcohol abuse, sex addiction, gambling or even someone married to a computer! A codependent's mission in life is to cure the abuse in those they love and adore. They forget their own lives to help another.

The codependent has often been overlooked in the rehabilitation process (if the family is in rehab). Actually, they are partners in keeping the abuse continuing. In the early 1960s when alcoholism treatment programs were beginning to take form, no one paid attention to family members. It was assumed that these people had no specific needs. We found that when a spouse's drinking stopped, depression sometimes emerged in the partner. Some family members actually worked to sabotage the alcoholic's treatment! Many formerly helpful spouses sought divorce instead. They had stayed during all the bad times, but when change came, they had to leave. They would often leave to marry another alcoholic. Without examining their own needs and wants as codependent personalities, they are doomed to repeat the same endless cycle.

We have all been affected by other people's addictive behaviors. As parents, we want to help our kids. We feel frustrated when we don't know what to do. We must see how much our lives are intertwined with others. I heard a joke one time about a codependent. "If you see someone else's life flash before your eyes prior to death, you know you are codependent." It is safe to say that a codependent is someone who is addicted to another's addiction. They take on curing the addicted person as their mission in life. They become obsessed with solving there loved one's problems. On the one hand, codependents get excited about the idea of discussing their child's eating problems; yet often have great difficulty talking about their own lives.

Sometimes being perceptive, compassionate and aware of another person is an asset. These people make great nurses, doctors and counselors. In some families, however, this codependency can lead to a tangled web where a parent can lose identity in service to the child. It may take long-time counseling to untangle.

Parents and family members who learn to speak for themselves and develop a sense of separateness are healthy. Parents can unknowingly disrespect and rob their kids or even their spouse the chance to feel like an exciting, evolving person if they assume they have them figured out. We don't always know what they are thinking or feeling. Being enmeshed means that parents and family members may easily lose their own identities and needs in the service to others. Codependent parents may insist on being able to solve the problems associated with their children's eating disorders. Anorexic girls often control their mothers by alternately demanding and rejecting help. The mother, being codependent, starts to suffer as much as the child. Parents beware: Real compassion is not helping others solve a problem and feeling it more than they do. We as parents have an emotional involvement with our children. We hurt when they do. We are invested strongly in helping them, maybe more than they are helping themselves.

How would you know if you have impending codependency? Check the following and see:

These are a few of the typical behaviors and thoughts of codependents.

If my child has a bad day, I react. If you have problems, I feel I must come up with a solution for you. I need to be needed. When your are hurting, I often feel it more deeply than you do. I don't develop many of my own interests but respond to yours. I feel safest when I am giving. I know more clearly what you want than what I want. I only feel good about myself if I have your approval. I diminish my social life to get overly involved in yours. I am critical and judging, and then I feel guilty. I think I can convince you to like yourself.

Do you force diets? Do you check on diets? Do you hide food from overeaters? Do you throw food away so the problem eater won't find it? Are you constantly disappointed when you see a relapse in your child? Are you embarrassed by the over/undereater's appearance? Have you excused the erratic, sometimes violent, mood swings resulting from the child's or adult's addictive behaviors?

A family who struggles with these disorders (reminder: It is a disorder, not a judgment against you personally) can feel comfort in knowing there is assistance and hope. Codependency and eating disorders are a matter of life and sometimes death. Learning to become detached for the health of yourself and the family is a gift. When we seek ways to focus on ourselves in order to feel the happiness within, we are also giving to our kids. It gives them permission to love themselves too. Parents can model for their children the idea that it is OK to be strong, independent and self-confident.