Dear Dr. Beal: I think my sister has some type of eating problem. She barely eats, if she does, she will go to the restroom. My sister’s portions of food looks like she is feeding a two-year-old. She used to be normal but ever since she came home from college she is different. I didn’t think Black people had real eating problems, except overeating. Should I be concerned?
For years eating disorders have been associated with white females and were often underdiagnosed in African American women. The myth existed that African American women are satisfied with being shapely, big boned, and having curves that the questions that would lead to a diagnosis were often overlooked. Part of the African American culture is built around food being the center of family gatherings by showing love and appreciation. People have been known to eat without being hungry but for emotional comfort. Just like any other mental health disorder there are certain criterias that must be met before a diagnosis is made. The two most common eating disorders are anorexia nervosa and bulimia nervosa.
According to the Diagnostic and Standard Mental Disorder 5 (DSM 5) there are three key features that must be met for a diagnosis of anorexia nervosa. The first is a marked restriction of overall food intake, resulting in a significantly low body weight relative to a person’s age and development. This is accompanied by an intense fear of gaining weight. The third is a distorted view of what represents a normal body weight and shape. This means that the persons view of themselves is totally different from what the world sees. They have a constant desire to lose weight and their mind continues to focus on that goal. The second most common eating disorder is bulimia nervosa.
Bulimia nervosa shares some of the same features but there is a difference. Bulimic patients not only have a distorted view of one’s body and an intense fear of gaining weight, but also experience periods of binge eating. During which excessive quantities (much more than average) of foods are eaten. These behaviors must occur at least once a week. These bouts are usually associated with a perceived loss of control over their eating behaviors. Afterwards they may try to compensate by including self- induced vomiting, excessive exercise, the use of laxatives or diuretics or extreme periods of fasting.
The cause for eating disorders is unknown, but appear more in women than in men. Serious psychological, physical, and social consequences often develop as a result of having an eating disorder. Both disorders are tied to emotional needs, self-esteem, and how the individual views themselves. Emotionally, how they handle stress or trauma may also be associated with either one of the disorders. Overall, underlying mood disturbances and mental health conditions often lead to unhealthy eating behaviors. Most people try to hide their behaviors from others for fear of detection. Early detection and early treatment are highly recommended to combat these disorders. If you feel that your sister may meet some of the criteria mentioned, encourage her to seek professional help.
Eating Recovery Center/ Insight Behavioral Health
7515 Main St. Ste.400
Eating Recovery Center Houston
Dear Dr. Beal: My son is six and a half years old and still sleeps in our bed. My husband has been trying to get him out of our room for over a year. We will put him in his room, but he will wake up in the middle of the night and walk back to our room. I am pregnant with my second child and the delivery date is October. How do I get him to sleep in his own bed?
Dear Reader: It is not uncommon for children to sleep with their parents when they are young. The name for this is “co-sleeping” and usually lasts for a long period of time, maybe until the age of two and a half. Both you and your child may find that sleeping with a parent gives a sense of security. However, there is a time for them to become independent and sleep in their own room. Your son is almost seven and with the newborn on the way it is definitely time for a transition. Here are a few strategies that may work.
- Develop a nightly routine; dinner, bath time, reading and bed. It is important that consistency with children removes the fear of the unknown.
- Begin to wean your child by going in their room and laying down with them until they fall asleep. Second, you may transition to sleeping on a mattress until they fall asleep and you return to your room.
- Make a chart and place it in their room and for each night he is able to remain in his room, he gets a star. If he is able to remain consistently, plan a reward. Always give praise for the short accomplishments as you reach toward the larger goal.
- You may want to use a baby monitor where your child can communicate with you from his room. You may be able to talk him into laying down or you may have to go to his room.
- Remove all stimulus like cell phone, TV, video games etc. Talk about how important it is to get a good night’s sleep.
- When the pandemic is over let him invite a friend over to spend the night. He will want to be in his own space.
- Lastly, do not try and shame him into his room. Use a positive approach!!!
How long the transition takes depends on your child’s temperament and your level of consistency. Congratulations on your new addition to your family!!! Being a big brother is a big deal! Let him help with the planning and the transition may happen automatically.
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