We currently live in an environment where there is much concern with the impact food choices make on a person's perceived body image. Unfortunately due to a variety of reasons including mixed messages sent through multimedia an emphasis on youth culture genetics emotional disorders including low self-esteem and depression and other complex issues body image perception is manifesting itself in an alarming overall growth rate in eating disorders (ED). Marked by extremes ED run the gamut from extreme reduction of food intake as in anorexia nervosa or extreme overeating that occurs in binge eating disorders. Preoccupied with food and body weight these individuals can focus on little else. As implied the etiology of eating disorders is very complex while science has yet to fully elucidate the mechanisms involved in their development.

Bulimia characterized by binge eating and a compensatory purging or self-induced vomiting as well as anorexia can be life threatening with both conditions affecting more women than men. In contrast binge eating disorder (BED) affects a larger portion of males. While there is agreement that the medical impact of the disorder is just as damaging to men as it is to women research has shown that the number of men seeking treatment is far lower than the estimated number of male sufferers.

And while the health consequences of BED are not as dire or life-threatening it is more prevalent than either bulimia or anorexia and can still be serious enough to adversely affect overall health as it significantly increases the risk of developing cardiovascular disease obesity and diabetes.

Signs and symptoms of each condition can to a degree be very specific. In anorexia for instance due to the extreme lack of overall caloric intake the individual will obviously appear excessively thin. But for more practical and interventional purposes being aware of red flags such as denials of hunger intense fear of gaining weight social withdrawal flat mood or lack of emotion could provide more predictive clues of future behavioral pathology. Bulimia is characterized by overeating to the point of discomfort followed by frequent trips to the bathroom during or after meals in order to void the consumed food.  Long term this will lead to damaged teeth and gums a product of acidic erosion. Also laxative use and excessive exercise are used to offset possible weight gain. Binge eating is a much more tangible condition marked by increased speed of eating during binging episodes without compensatory overeating behavior such as vomiting post-binge and obvious rapid weight gain.

Sadly children are particularly vulnerable to this class of illness as 95% of those with ED are between the ages of 12-25. Possibly most disturbing is that 95% of 10 year olds are afraid of becoming fat. Also ED has the highest mortality rate of any mental illness.

At the risk of over simplifying a complex and multifactorial condition by pointing fingers at mainstream media and its apparent obsession with image consciousness its influence can certainly go a long way in explaining why young children can have such an eroded sense of identity manifesting itself as an unrealistic perception surrounding one's body. Perhaps not surprisingly measures of socioeconomic status (including parental education) household income and parental marital status were not significantly associated with any eating disorder presentation indicating a certain commonality and universality to this class of disorder. This ubiquity may underline the evidence surrounding the possible cultural and multimedia influence in the pathogenesis of these conditions.

As mentioned earlier genetic predisposition appears to have a somewhat significant role in the development of eating disorders. Could there be an obsession/binging gene? In a recent study researchers found that common genetic factors may indeed underlie both alcoholism and certain ED symptoms such as binge eating and purging habits that also include self-induced vomiting and the abuse of laxatives.

Michael Fuhrman D.C.