A Lifelong Struggle: Battling Adult Anorexia And Bulimia

Transcript

Event Date(s): 05/14/2011 | Description: INT TODAY SHOW STUDIO, NEW YORK CITY, NEW YORK Today Show anchor Amy Robach is joined by Today diet and nutrition editor Madelyn Fernstrom and by Today contributor and psychiatrist Gail Saltz ROBACH: Gail Saltz is a TODAY show contributor and psychiatrist, and Madelyn Fernstrom is TODAY's diet and nutrition editor. Ladies, good morning. Dr. GAIL SALTZ (Today Contributor and Psychiatrist): Good morning. Ms. MADELYN FERNSTROM (Today Diet and Nutrition Editor): Hi, Amy. ROBACH: And, Madelyn, let me start with you. We're now hearing this term "midlife eating disorder," but how do you know when you actually have a problem, you should be concerned? Ms. FERNSTROM: You know, these are extreme behaviors. These aren't people who are saying, `Oh, I'm going to lose a few pounds. I want to be focused on a diet.' It's extreme meaning there--it's food aversions, food restriction, extreme weight loss. On the other end, overeating, a lot of guilt and shame, sometimes purging by vomiting or laxative abuse, or overexercising. These are big signs. Another sign is going online looking for social support in these pro-anorexia and bulimia sites, of saying this is a good thing and trying to fight. ROBACH: Oh. Ms. FERNSTROM: And the guilt and shame is something that women know about. TEXT: Adult Eating Disorders Dieting is a $40 billion-a-year industry 50% of women are dieting at any given time ROBACH: Well, and it's interesting, because we said earlier this is something we usually attribute to teenage girls, young girls. Is it perhaps because in your 30s and 40s--and we can all speak from experience here... Ms. FERNSTROM: Right. ROBACH: ...your body is going through a lot of changes. Your metabolism slows down, gravity takes hold. TEXT: Over One Person's Lifetime 50,000 men and women will die from an eating disorder each year ROBACH: Is this why we're seeing a recurrence? Ms. FERNSTROM: You know, it's biology and behavior. Not the 30s and 40s, but the 50s as well, where your metabolism slows down, where you have to eat less to maintain your weight. But also, there's a lot of life changes. There are empty nesters, aging parents, you have young children. So there's a lot of things that are happening. And this is really not about food. It's about coping with stress, about managing better, and having the skills to be able to do this. And there's two kinds of people, the kind that are--we saw in the piece. These are someone who relapse. They had an eating disorder at a younger age... ROBACH: Right. Ms. FERNSTROM: ...and stress or other factors can precipitate another episode. Or some newly diagnosed women in midlife, which is a growing--of growing concern because these are people more concerned with image. They find it's hard to lose weight, and use extreme behavior. So there's two very different groups. ROBACH: And, Gail, obviously there's a huge mental component here... Dr. SALTZ: There is. ROBACH: ...the stress of dealing with all the pressures in the outside world and then the need to see--you know, to be thin again if perhaps you're starting to lose the body you once had. Dr. SALTZ: In fact, actually, issues of needing to be a perfectionist, people who have difficulty with impulse control, people who are struggling with depression and/or anxiety, those are the people who ripe for developing an eating disorder. ROBACH: And, Gail, what if you're in the gray area? How can you fix some of the problems on your own? You're not perhaps the extreme case... Dr. SALTZ: Right. ROBACH: ...but you can see yourself maybe going there. Dr. SALTZ: Correct. Well, first of all, obviously, you have to own up to the fact that you are going there... Ms. FERNSTROM: Mm-hmm. Dr. SALTZ: ...because I think what usually happens is people are in denial about this until they've really crossed over the line. But if you can say to yourself, `I think I might have a problem,' then what you have to do is, first of all, tell people around you, because it's the secretiveness that often keeps it going for a very long time. ROBACH: Mm-hmm. Dr. SALTZ: You need to break rituals. So people like this tend to eat in secret or they have some ritualistic behavior: `After the meal I will do X, Y, Z,' or, `I can only eat these certain foods.' ROBACH: Right. Dr. SALTZ: So you have to--you have to break those rituals and, of course, not go to online sites and that kind of thing. Ms. FERNSTROM: Right. Dr. SALTZ: And stop weighing yourself and looking in a mirror, because that is very much what perpetuates it. Those things you can do on your own. ROBACH: Right. Dr. SALTZ: But to be honest, most of the time when you've crossed into an eating disorder area, you really need professional help. Ms. FERNSTROM: Right. Dr. SALTZ: This is a very difficult thing to manage on your own, and the professional's going to help you treat the underlying emotional issues like anxiety and depression... Ms. FERNSTROM: Right. Dr. SALTZ: ...may even be able to medicate you for some things that cause purging and that kind of thing, but really help you, frankly, to gain the weight back. And one thing that's tough about midlife eating disorders is we look for signs in eating disorders like you've lost your period for a number of months in a row... Ms. FERNSTROM: Right, right. ROBACH: Wow. Dr. SALTZ: ...but midlife women are already doing that, maybe because they're in perimenopause. So it can be hard to spot. Ms. FERNSTROM: Yeah. ROBACH: Right. Dr. SALTZ: You've got to spot the behavior. ROBACH: It's about acknowledgement. Ms. FERNSTROM: Because you don't actually have to look--you don't have to really look very different, especially if you're a binger and purger... ROBACH: Right. Dr. SALTZ: You probably won't. ROBACH: Right. Ms. FERNSTROM: ...your weight--you probably won't. Your weight can look pretty normal, so to the outside world there's nothing happening, but you have this guilt and shame and you're trying to have all of this control and... ROBACH: Right. Dr. SALTZ: And often it's other people will notice. ROBACH: Right. Ms. FERNSTROM: That's right. Dr. SALTZ: So other people, if you see your girlfriend or your mother or your family member... ROBACH: Mm-hmm. Dr. SALTZ: ...you need to be the one... ROBACH: Speak up. Dr. SALTZ: ...to say, `You need some help.' ROBACH: Gail Saltz, Madelyn Fernstrom. Thank you both so much. Ms. FERNSTROM: You're welcome. Dr. SALTZ: You're welcome. ROBACH: An important topic.