Anorexia is often seen as an eating disorder reserved for white middle-class teenage girls, research has revealed that anorexia doesn't discriminate based on race, age, class, or gender. Though predominately a condition afflicting females, over 2.5 million Americans-boys and girls, men and women, rich and poor, Asian, Latino, Caucasian, and African American-suffer from anorexia, and it is now being seen in patients as young as 9 years old.



People with anorexia resist maintaining a healthy body weight, have an intense fear of putting on weight, and exhibit extreme behaviors resulting in severe weight loss. They lose pounds mainly by severely restricting the amount of food they eat and by over-exercising. Anorexics have distorted body images. They look in a mirror and see themselves as overweight even though they are precariously thin.

The causes of anorexia are not clear, but it is likely a combination of multiple factors:

1. Genetics. Recent research reveals that anorexia may be attributed to genetics, similar to alcoholism or depression. While such diseases can be triggered by stress or trauma, they are rooted in genes and brain chemistry.

2. Family Environment. Parents who stress appearance and criticize their children's bodies increase their chances of having an anorexic child. The likelihood of developing anorexia also increases if somebody else in a family suffers from it.

3. Culture. American society stresses extreme skinniness. With the images the media presents, beauty has become synonymous with thinness.

4. Psychological State. Anorexics sometimes feel they would be happier and more successful if they were thin. Someone with anorexia may feel helpless and hate the way she looks, and she sees anorexia as an outlet for self control and perfectionism.

So while the exact causes of anorexia are unknown, the effects are and they can be fatal. Anorexia has one of the highest mortality rates of any mental illness. Anywhere from 5-10 percent die, with death caused by starvation, electrolyte imbalance, or suicide. About half of anorexics recover; the rest spend their lives battling the disorder.

Despite its caustic effects, thousands of anorexics persist in their dangerous habits and find support on a recent trend of pro-anorexia Web sites. Such sites contain countless postings:

"Starting a seven-day water fast tomorrow. Looking forward to it. Only problem is that mom will try to make me eat. Any tips on how to get through seven days of dinners without my mom making me eat?"

Parents concerned their child might harbor similar thoughts can be on the lookout. Anorexia has several physical, emotional, and behavioral signs and symptoms besides weight loss:

-fears gaining weight

-won't eat in front of others

-weighs food and counts calories

-has dry skin and thinning hair on the head, fine hair all over their body, and brittle nails

-acts moody or depressed

-doesn't socialize

-has absent or irregular periods

-feels cold frequently

-has difficulty concentrating

-takes pills to urinate or have a bowel movement (BM)

-doesn't eat or follow a strict diet

-constantly exercises

-moves food around the plate; doesn't eat it

-talks about weight and food all the time

-adopts rigid meal or eating rituals

-feels fatigued or dizzy

-has a flat mood, or lack of emotion

-frequent checks the mirror for perceived flaws

-wears baggy clothes to hide appearances

One of the difficulties in treating anorexia is that people suffering from the disease usually don't consider it an illness. They deny that they even have a problem. While there are no FDA-approved medications to treat the condition, help is available to anorexics and their families. Hospitals, clinics, and specialized eating disorder centers can provide care. If the condition poses an immediate threat, emergency care may be needed for dehydration, psychiatric issues, and electrolyte imbalances. Treatment usually entails a team effort with professionals trained in eating disorders, including medical providers, dieticians, and mental health professionals:

1. Medical Providers. Hospitalization may be required as people with anorexia often need frequent monitoring of vital signs, hydration level, and electrolytes.

2. Dieticians. A dietitian helps outline and implement a healthy diet by providing specific meal plans and monitoring calorie requirements.

3. Mental Health Professionals. Therapy takes place individually, as a family, or with a group. One or multiple approaches may be beneficial.

While concerned parents can't force children with anorexia to stop, it is important to love and support them their struggles. The National Eating Disorders Foundation (www.edap.org) offers the following advice:

Learn as much as you can about eating disorders. Read books, articles, and brochures.

Know the differences between facts and myths about weight, nutrition, and exercise. Knowing the facts will help you reason against any inaccurate ideas that your child may be using as excuses to maintain their disordered eating patterns.

Be honest. Talk openly and honestly about your concerns with the child who is struggling with eating or body image problems. Avoiding it or ignoring it won't help!

Be caring, but be firm. Caring about your child does not mean being manipulated by them. Your child must be responsible for their actions and the consequences of those actions. Avoid making rules, promises, or expectations that you cannot or will not uphold. For example, "I promise not to tell anyone." Or, "If you do this one more time I'll never talk to you again."

Compliment your child's wonderful personality, successes, or accomplishments. Remind your child that "true beauty" is not simply skin deep.

Be a good role model in regard to sensible eating, exercise, and self-acceptance.

Tell someone. It may seem difficult to know when, if at all, to tell someone else about your concerns. Addressing body image or eating problems in their beginning stages offers your child the best chance for working through these issues and becoming healthy again. Don't wait until the situation is so severe that your child's life is in danger. Your child needs as much support and understanding as possible.