Maybe I have an Eating Problem?
Eating problems fall within a broad range of eating-related feelings, attitudes, and behaviors. Consider the following continuum:

Body image confidence is characterized by mostly positive feelings about your body shape and size. In this range, your body is seen as a good part of you that can help you enjoy life. For body confident people, all foods are seen as fitting into an overall healthy diet, without feeling that some foods are "good" and some "bad." Given the messages we all receive daily about what we "should" look like, it can be challenging to maintain your place at this end of the continuum.

Preoccupation with body shape/size and eating involves frequently thinking about food, eating, and your body. In this range of the continuum, you may find yourself thinking about what you ate at your last meal and feeling that you'll need to "make up for it." You may be a little inflexible about what you "allow" yourself to eat. There may be moments where you feel guilty or bad for what you've eaten. In addition, you may not like the way certain parts of your body look or you may consistently feel that you could lose a few pounds. In general, however, these feelings do not interfere with enjoying life and engaging in situations involving food.

Eating or Body Image Distress refers to a level where your preoccupation with eating and body size/shape does interfere with daily interactions and activities. You may find yourself thinking a great deal about food or your looks. In this range of the continuum, you may be fairly rigid in your eating patterns, you may work hard to change your body size/shape, and/or you may do some compensating for eating (e.g. vomiting, fasting, extreme exercising). Typically, however, you will not have experienced a significant amount of weight loss.

Eating Disorders most commonly refer to Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder.
ANOREXIA NERVOSA
Involves a significant fear of gaining weight or becoming fat and a restriction of food intake to the point of significant weight loss. Women with Anorexia Nervosa often stop menstruating. People who struggle with Anorexia Nervosa may or may not engage in compensating behaviors such as extreme exercising.

BULIMIA NERVOSA
Involves binge eating episodes during which the person eats large amounts of food and feels unable to control the eating. The person may also engage in behaviors (e.g., vomiting, use of laxatives, over exercising) to try to offset food eaten. Bulimia Nervosa describes a pattern where cycles of binge eating and compensating occur at least twice a week for three months. People struggling with Bulimia Nervosa often evaluate themselves extremely critically on the basis of their body shape and weight.

BINGE EATING DISORDER
Describes a pattern where binge eating occurs at least 2 days a week for a 6 month period, but without compensating behaviors.

Causes
Eating disorders are caused by multiple factors. A combination of: social and cultural influences, disturbed family relationships, low self-esteem, genetics, and faulty learning about nutrition and physiology all contribute to their development.

Social Factors often reinforce eating disorders. For example, very slim, perfectly toned bodies are often portrayed in our society as the ideal. Additionally, society's focus on control and perfectionism as methods for success also reinforce eating disorder behaviors. Confusion and conflict over gender roles and expectations have also been thought to contribute to the increase in the prevalence of eating disorders.

Biological Factors such as an inherited predisposition to depression and mood swings may also contribute to the development of eating disorders. Antidepressant medication has been found to be helpful to some individuals.

Psychological Factors also play a strong role in eating disorders. Low self-esteem and problems with self-assertion are often characteristic of individuals with eating disorders. Individuals with anorexia and bulimia have often been described as "model children" who are intelligent, high achieving and perfectionistic. They have unrealistic expectations for themselves and view life in absolutes or "black and white", thinking. Rituals and obsessions with food and weight are sometimes used to distract the person from thinking about other worries and problems.

Family Factors including family backgrounds that stress either very high expectations or provide little opportunity for developing a sense of mastery and control are known to contribute to the development of eating disorders. Control over weight and eating may be an attempt to gain control over life or life circumstances when a person has felt little control in the past.

How Do People Overcome Eating Problems?
It is important to remember that there is hope for those who suffer from eating problems. A variety of treatment approaches have been effective in preventing, reducing, or stopping the troublesome behaviors and in developing new ways of coping with underlying feelings.

An important first step in overcoming an eating problem is to acknowledge that you have an eating problem. Often this can be the most difficult step. An important aspect of this step is to realize that your distressing eating behaviors and feelings are about more than just food.

The next step is to talk with professionals who are experienced in working with people who have eating problems. Treatment for eating problems can be composed of many elements including medical monitoring, nutritional counseling, education, and individual and/or group counseling. Along with providing relief from having to keep such an important issue secret, these professionals can help you improve self-esteem, challenge negative body image messages, and develop healthy and supportive relationships, as well as guide you toward a healthier lifestyle.

Finally, some people, after having regained balanced eating attitudes and behaviors, find it helpful to take some proactive steps to change things that contribute to the development of eating problems. These steps may include working to change cultural expectations and oppressive attitudes about size and shape as well as encouraging others to find coping strategies that are healing and productive.

Do’s and Don’ts
What to do if you think someone has an eating disorder:
1. Tell your friend that you are concerned and that you care about his/her well-being.
2. Encourage him/her to talk to a counselor or therapist.  Remember you are his/her friend, not psychologist.  You cannot solve the problem for them.
3. Try to get him/her to talk about their feelings.  This will prevent the feelings from being “bottled up”.
4. Get support and educate yourself.  It is important to have a support network as well as education in the area of eating disorders.
5. Be POSITIVE, people do recover from eating disorders.

What not to do when interacting with someone with an eating disorder:
1. Don’t focus on weight, food or exercise when talking with your friend.  This may be their focus, but it does not have to be yours.  Remember, these are only symptoms of the problem—not THE problem.
2. Don’t lay guilt trips, for example, “Why are you doing this to your family and to me?”  He/she feels badly enough as it is.  Also, he/she is not responsible for your emotions, only you are.
3. Don’t treat them as though they have a handicap.  It will help if you treat him/her as normal as possible.  Remember, they are more than someone with an eating disorder.  The more you help him/her find a different identity, the easier it will be to let go of the “eating disorder” identity.
4. Don’t be afraid to discuss conflicts or problems.  These areas need to be brought out into the open, not hidden.
5. Don’t blame yourself.  Friends, family members and spouses do not cause an eating disorder.  They can help in the recovery process however.
6. Do not focus on weight gained or lost.  Focus more on his/her mental state than their physical state.  If you say, “You look thin” you are focusing on appearance and “feeding” into the behavior.  Don’t say, “You look healthy” as he/she may interpret it as thinking that he/she looks fat.
7. Don’t focus on achievements—grades, sporting events, and promotions.  Instead, talk about his/her inner qualities and strengths.  Also talk about your own failures and mistakes.  If she/he sees you as less than perfect, they won’t feel so strongly about their own imperfections.  Again, model, model, model ---be good to yourself and they will see that it is possible.