Eating Disorder Self Test

If you feel you have an eating disorder, it’s important that you recognize it and get help early. This
may prevent you from developing a serious and perhaps fatal problem. The following “self test” was
developed to help you learn if you have an eating disorder. Take the time to answer each question
honestly and critically.

Once you finish our test, it’s a good idea to share your answers with a trusted adult, like your
parents. However, if you feel uncomfortable with talking to your parents or another adult, it’s very
important that you share these answers with your doctor. This is also a good test to take and
discuss with your doctor if you have been diagnosed with an eating disorder and want to learn more
about how it has affected you.

What are some of the warning signs of an eating disorder?

1. Do you think about food/eating a lot? Do you worry about what you eat (or don’t eat) and
talk about how fat you think you are?
2. Have you started to avoid eating socially with others? Have you started to avoid eating in
your home? For example, do you refuse to eat anything your parent(s) cook or just get a
diet cola at the mall at lunch while your friends share a pizza?
3. In your worry about your body image, have you started avoiding going to the pool or
wearing a bathing suit, wearing baggy clothes or developing excuses not to participate in
gym class.
4. Do you “diet” all the time? Do you latch onto any fad diet you see in a magazine?
5. Do you weigh yourself daily or more than once a day? Does being weighed make you
angry? Does it make you sad?
6. While exercise is great, and while most of us probably need more exercise, have you
become compulsive about exercising? Have you taken up a new form of exercise where
you feel guilty or punish yourself if you miss a session?
7. Have you become more withdrawn from your family? Have you become more withdrawn
from doing things with your friends?
8. Have you had a significant weight loss in the last two months, say more than 10 pounds?
9. Do you have fainting spells or dizziness all the time when you stand up?
10. If you are a female, have your menstrual periods become more irregular or have they
stopped?
11. Are you cold a lot? Has your hair thinned or been falling out?
12. If you binge (eat lots of food you think is “bad” food) how much do you eat during a binge?
Where does the binging occur? (When you are alone? With certain people when you’d
rather be somewhere else, doing something else, etc.)
13. Have you ever used vomiting, diet pills, laxatives or diuretics (water pills) to counteract
binging? (This action to counteract binging is called purging.)
14. If you have resorted to purging after binge eating, where does that purging occur? Does it
happen in your bathroom, school bathroom, etc.? How do you feel after purging?
15. Have you ever vomited up blood or had blood in your bowel movements
Examining Eating Disorders
Eating disorders are VERY common. In the U.S. approximately 0.3 to 3 percent of adolescent and
young adult females have an eating disorder and the incidence of eating disorders in this country
has doubled in the past 20 years. Eating disorders are not just a problem of women; approximately
5 to 15 percent of people affected with eating disorders are male.

Are there different types of anorexia?

Anorexia has two different types: the restricting type where the person restricts calorie intake (and
often also engages in excessive exercising) and the binge-eating/purging type where the person
may restrict calories much of the time, with intermittent episodes of excessive binging or overeating
followed by vomiting, use of enemas, or diuretics to “purge” the excessive food out of the system.
This binging and purging is called bulimia nervosa.

Anorexia nervosa may be common in younger teenagers. Bulimia is more common in somewhat
older patients with eating disorders. Patterns of eating disorders may change with time. One may
start out an anorexic and swing into becoming a bulimic.

What causes anorexia and bulimia?

The exact causes of anorexia and bulimia are not known, but probably involve many contributing
factors. Genetics plays a role. If you have a first-degree relative (like a sister, mother or brother) with
an eating disorder you have a four times greater risk of developing an eating disorder. There are
neurochemical aspects of eating disorders and psychological risk factors. Many women who are
affected (men too) are perfectionists, have low self-esteem, and may be experiencing conflicts
(though often not verbalized) about their sexuality or body image. Adults in their lives may be too
controlling or over involved. Unfortunately, many victims of eating disorders have been or are victims
of sexual or physical abuse. They turn to “abusing” their own bodies because they don’t know where
to get help to stop the abuse. A plunge into developing anorexia may come at a difficult transition
time, such as going away to school/college or experiencing family divorce. It might also be triggered
by some relatively innocent comment from a friend or family member or even a coach, such as
“You’ve grown so much since I last saw you,” or “You are on the alternate cheerleading squad until
you get your thighs shaped up.”

What are the side effects of an eating disorder?

The sooner an eating disorder is recognized the easier it may be to treat or reverse. However, for
many victims eating disorders become a life-long struggle. Anorexia may cause death (as for the
singer Karen Carpenter) and it is not just a benign annoyance that can be treated outside a hospital.
Eating disorders can lead to severe electrolyte imbalances (problems with your salt balance) that
can lead to heart arrhythmias (irregular heart rhythms), which can lead to death. Most women who
have anorexia stop having their periods. This leads to decreased bone density (less calcium in the
bones) which may be a permanent after-affect even when the person is back to eating normally.
Many former anorectics have such bad osteoporosis that they suffer stress bone fractures while
they are in their 20s and 30s. Some anorectics never reestablish a very normal menstrual cycle
even after recovery, which may affect their future fertility (having children).

What is the treatment for an eating disorder?

Re-feeding during recovery from severe anorexia must be done with medical supervision, so that
heart attacks from suddenly low phosphate or sudden potassium shifts do not occur. Treatment
involves a team: your doctor, a nutritionist, a counselor for you with expertise in eating disorders and
family counseling. Sometimes treatment must involve inpatient hospitalization, followed by lengthy
outpatient follow-up. This is NOT a “quick fix” problem and the patient and his or her family must
realize this. Treatment of eating disorders deserves intensive effort from all people in the “treatment
team” if it is a disorder which will truly become a disorder in the person’s past, and not become a
life-long struggle
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A Reason for Calcium
Osteoporosis is a disease that results when the inside of bone becomes porous and thin. Over time,
this weakens the bones and makes them more likely to break after a fall or a minor injury.
Osteoporosis is often called the "Silent Disease" since adults may not realize they have the
condition until a bone breaks. The hip, arm and wrist are common places for breaks. The bones of
the spine are also thin causing the vertebrae to collapse on themselves, resulting in loss of height,
back pain and changes in posture. Occasionally the disease is discovered when x-rays are taken for
another problem.

While osteoporosis is a disease of older adults (particularly women), in the medical community it is
often described as a pediatric disease that manifests itself in old age. According to physical therapist
Katleen DeMolli Shirley, "the number one prevention against osteoporosis is building maximum
bone density during childhood and adolescence. The greatest opportunity to maximize bone
strength occurs between the ages of 10 and 18."

Bone is not a hard and lifeless structure, but a complex living tissue. During the first 30 years of life
our bones are constantly building more bone and storing calcium. Then, as we grow older, old bone
tissue begins to break down faster than new bone can be produced. This bone loss is more
significant in women after menopause when their ovaries stop producing estrogen - a hormone that
protects against bone loss. The National Osteoporosis Foundation wants people to think of our
bones as a savings account. The more calcium you deposit in your bones before age 30, the more
that will be available when you get older. "Ninety percent of the peak bone mass is achieved during
this period of dramatic skeletal growth," says Shirley. "Nutrition, specifically calcium intake, and
exercise are the integral components of bone health." Some experts believe that young women can
increase their bone mass by as much as 20 percent - a critical factor in protecting against
osteoporosis later in life.

Calcium is a mineral found in the foods we eat and 99 percent of the calcium in our bodies is stored
in our teeth and bones. The National Institute of Health recommends that teens between ages 10
and 18 consume 1200-1500 mg of calcium (4-5 servings of calcium-rich foods) per day. These are
some examples of calcium-rich foods that supply 300 mg per serving: 1 cup milk, yogurt, or calcium-
enriched juice, ½ cup cottage cheese, 1 ½ oz. hard cheese (skim milk and low fat cheeses are good
low fat choices), 1 cup dark green leafy vegetables (collard, turnip greens, broccoli and kale), and 3
½ oz. canned sardines or salmon with bones. For those allergic to dairy products, soy products are
possible alternatives. Teens who don’t eat dairy or calcium-fortified foods can take calcium
supplements (500 mg twice a day).

Foods that deplete calcium or interfere with calcium absorption should be avoided. Some examples
include caffeinated drinks, excessive alcohol, protein, salt and sugar. Smoking also depletes calcium
and has been linked to a 50 percent increased risk of developing osteoporosis. To improve bone
health, you should focus on a balanced diet including calcium-rich foods and avoid prepackaged
processed foods.

Weight-bearing exercise, such as walking or stair climbing, will also help keep your bones strong.
Greater bone growth and bone mineralization has been associated with early vigorous exercise,
especially if it occurred in pre-adolescence and adolescence rather than in adulthood. Exercises
that will help build strong bones include walking, running, jump rope, gymnastics, tumbling, yoga
and bicycle riding. Swimming, although very healthy, is not a weight-bearing exercise.

The typical teenage life-style of fast food, diet drinks, playing video games or watching television
doesn’t promote bone health. Lack of exercise places you at great risk for developing osteoporosis.
Studies have shown that moderate physical activity CAN compensate for a low calcium diet, but a
diet high in calcium will NOT compensate for an inactive life-style
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