As many as 20% of females in their teenage and young adult years suffer from anorexia nervosa or bulimia nervosa (Alexander-Mott, 4). Males are also afflicted by these eating disorders, but at a much lower rate, with a female to male ratio of six to one. Those with anorexia nervosa refuse to maintain a normal body weight by not eating and have an intense fear of gaining weight. People with bulimia nervosa go through periods of binge eating and then purging (vomiting), or sometimes not purging but instead refraining from eating at all for days. Both of these disorders wreak havoc on a person\'s body and mental state, forcing them to become emaciated and often depressed.
There is no known exact cause of either anorexia nervosa or bulimia nervosa, but many factors play a role in the initial onset, such as: personality traits, low self-esteem, and social and cultural influences (Costin, 21). Many anorexics have specific personality traits that urge them to refrain from eating. Many are perfectionists that will diet and exercise and not eat until their bodies are perfect. Unfortunately, however, he or she never thinks their body is perfect, and continues their destructive cycle. Anorexics that are perfectionists also tend to want to be in control at all times. Often , they feel as though others are trying to force them to do
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things, and so, take complete control of their bodies. Marcia, an anorexic, wrote in her diary \"I am in control; people are just jealous because I have will power\" (D., 6).
Another factor is low self-esteem. One anorexic said of her low self-esteem, \"My goal in life was to please; like a chameleon, I\'d change to suit whomever I was with. I always felt I was in the way…\" (D., 1). Anorexics with low self-esteem often feel they are worthless and do not deserve to eat. Not only do they not eat, but they constantly berate themselves with insults. They hate their bodies, and cannot realize their true appearance, instead seeing a distorted image. When she weighed a mere 98 pounds, Marcia told herself, \"You are a pig. You are disgusting. You must suffer\" (D., 5). Bulimics also suffer from low self-esteem and feel ashamed of their behavior. Feeling guilty after eating is a common characteristic of bulimics. K.D.K., a 22-year-old with bulimia, wrote \"Sometimes I would go to different snack machines in different places so people wouldn\'t notice. And then I would find an isolated bathroom and atone for my sins\" (K.D.K., 1).
Another factor contributing to anorexia and bulimia is social influence. \"Historically, men are judged more for what they do and women for how they look\" (Costin, 46). Most ads and diet products have been aimed at females in the past, but now are directed towards all people. Ads for clothing and swimsuits portray incredibly thin models showing off their

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perfect bodies, and many people are lead to believe that beauty is measured in pounds. Amazingly, most female fashion models are 23% below what is considered a healthy, normal body weight (Costin, 45). Anorexics and bulimics wish to look like these models, and starve, binge, and purge in an attempt to achieve their goal.. \"Thinness has come to symbolize not only control, but wealth, independence, and freedom\" (Costin, 48). Anorexia and bulimia are a means for losing weight, which means fitting in, which leads to acceptance - exactly what an anorexic or bulimic is looking for.
Anorexia and bulimia do not distinguish between sex, skin color, or religious background. Women living in the western hemisphere in their teens and early adult years, however, are afflicted with eating disorders more than women anywhere else in the world (Costin, 47). Males can also be anorexic or bulimic, but it occurs far less often.
There is no cure for anorexia or bulimia, but there is treatment available. Before treatment can begin, an anorexic or bulimic must admit they have a problem and need help. Becky, an anorexic and bulimic, said of this first, crucial step, \"Realizing something was wrong, that I needed a change in my ways, was the hardest part for me. Before I admitted to needing help, I thought everything was fine and never worried about it (Thayne, 99).
Once someone is ready to accept help, they are put on not only a healthy eating program but also a healthy thinking program (Alexander-
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Mott, 105). In addition to sometimes taking drugs to increase appetite, an anorexic or bulimic in treatment is encouraged to eat healthy, regular meals. They are allowed to exercise, but not in excess. The most important part of the treatment is the psychological part. A therapist helps the patient to understand why they feel they have to be so dangerously thin. The patient must be determined to try to change their thinking about food, to gain a positive attitude. The patient must separate their \"Healthy Self\" from their \"Anorexic/Bulimic Self\" and take control of the situation (Costin, 112).
A person in treatment will almost certainly lapse back into anorexia or bulimia for short periods of time. On average, most survive their eating disorder, while only 2-10% die from it (Costin, 114). The time it takes for a person to fully overcome anorexia or bulimia varies greatly from person to person. For a few, triumphing over their eating disorder can take as little as a year. For many, they spend five to twelve years battling it, and for very few, they battle it for the rest of their lives (Alexander-Mott, 111).
Eating disorders like anorexia and bulimia are devastating to a person\'s body, causing them to be dangerously underweight. Many factors can contribute to the onset of these disorders, but they are attributed mainly to a person\'s distorted self-image, low self-esteem, and a need for control. \"Eating disorders are not about food or weight but about a disordered \'sense of self\' looking for approval and finding it, however

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temporarily, in the pursuit of thinness or the comfort of food\" (Costin, 48). Treatment is an option for anorexics and bulimics, though it can take years, and sometimes it never succeeds. Hopefully, though, friends and loved ones of anorexics and bulimics will see the warning signs and seek help for them.

Bibliography
Alexander-Mott, LeeAnn. Understanding Eating Disorders. Washington,
D.C.: Taylor & Francis Ltd., 1994.
Costin, Carolyn. The Eating Disorder Sourcebook. Los Angeles, CA: Lowell
House, 1996.
K.D.K. \"My Story.\" Online. March 3, 2000 ~kdk2/mystory.html>
D., Marcia. \"My Story.\" Online. March 3, 2000 Tripod.com/~MarciaD/index.html>
Thayne, Becky. Hope and Recovery. New York, New York: Emma Lou
Thayne, 1992.