By Barbara A. Brehm, Ed.D.

Many of us are careful about what we eat and are conscientious about our exercise programs. We strive for fitness because we want to stay healthy and feel good weight control is an important goal in our health and fitness programs, since being overweight is associated with an increased risk of high blood pressure high cholesterol and diabetes.

Unfortunately, healthy concern about weight control can turn into unhealthy preoccupations with food and body weight that can lead to disordered eating behaviors and distorted body image perceptions.

What are eating disorders?

People with eating disorders do not have a normal relationship with food. They may compulsively diet or overeat, and are obsessed with food. Two of the most serious eating disorders are anorexia nervosa and bulimia. Severe food restriction and excessive weight loss are symptoms of anorexia. People with anorexia continue to diet after reaching ideal weight believing they are still much too fat. In some cases, people with anorexia can actually starve to death.

Bulimia often begins with a crash diet that leaves the dieter feeling very hungry and deprived. Uncontrollable food cravings lead to bingeing on enormous amounts of high-calorie food, such as ice cream and cookies. To prevent weight gain from these binges, the dieter induces vomiting or takes large doses of laxatives or diuretics in an attempt to purge excessive caloric intake. Binge/purge cycles may occur several times a day, until the dieter can no longer eat a normal meal without having the desire to vomit afterward.

Most eating disorder victims are young women ages 12 to 30, although men and women of all ages can be affected.

What causes eating disorders?

No one knows for sure what causes eating disorders. Many girls with eating disorders are from upper-middle class backgrounds and have good grades and a desire to achieve. Researchers suspect that these girls and young women develop a dissatisfaction with their bodies, perhaps because that to be perfect, they must look like fashion models and actresses. They may begin following crazy diets that eventually lead to preoccupation with food and thinness.

How can you tell if someone has an eating disorder?

Unless that person is a family member or close friend, you usually can't tell. Some people are naturally very thin they may have some illness or metabolic disorder. Athletes may be very lean because they exercise a lot, yet they often have very healthy appetites.

If a teenage daughter consumes large amounts of food or always runs to the bathroom after eating, you might be suspicious. If a friend rarely eats and has been losing too much weight, you could gently express your concern about her health.

People with eating disorders usually need professional counseling to help them get over their distorted body perception and compulsive behaviors. Family therapy is often helpful if the victim is young.

How can I help my teenage daughter lose weight without causing her to develop a problem with food?

Children and teens are often overweight because they are too sedentary and eat too much of the wrong foods. When you watch television, your metabolism drops, and all those food commercials cause you to make too many trips to the kitchen.

Children need unconditional love from their parents, and teens are no exception. Criticizing and nagging your daughter may do more harm than good. Examine your own attitudes about food and body weight, and try to set a good example.

Family meals can focus on low fat healthful eating. Keep junk food out the house. Go for walks together and help your daughter choose after-school activities such as sports or scouting that are appealing and fun. Work for better physical education programs in her school.

Anything you can do in an encouraging, loving way to increase her level of physical activity will be helpful.