Dear Confused!,

It sounds as though your school did a good job in raising awareness of eating disorders, but you're fuzzy on whether or not this actually applies to you.

Lots of sports — dance included — focus on attaining a certain "body type." Some people are naturally born to look a certain way, while many do not. Striving for an ideal that is not always attainable, or even realistically possible, since each body is unique, can lead some people to develop obsessions and unhealthy behaviors.

Eating disorders are not always "black and white." As a result, health care professionals use a designated set of criteria to medically diagnose an eating disorder. According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), these include:

Anorexia Nervosa

• refusal to maintain minimal body weight for age and height
• intense fear of becoming fat or weight gain despite being underweight
• misperception of body size and shape
• missed three or more periods in a row

Bulimia Nervosa

• regular and repeated binge eating bouts, followed by self-induced vomiting; misuse of laxatives, diuretics, enemas, or other drugs; starvation; or, excessive physical activity, to prevent weight gain
• both bingeing and compensatory behaviors take place about two or more times a week for at least three months
• self-evaluation is overly based on body size and shape

Sometimes people fit some of the conditions, but not all. What does this mean? They could have disordered eating and/or body image distortions, but not a fully developed eating disorder. It's preferable for a health care professional to diagnose the situation because s/he can refer someone to the right people, who can then help her or him deal more appropriately with the issues behind the eating and/or body image concerns.

If you're comfortable, you can talk with your parent(s) about your thoughts. Perhaps you could make an appointment with your own health care provider, at a nearby teen clinic, or even with one of the professionals who spoke at your school. S/he could assess your situation and help you develop a healthy relationship with food, your body, and dance.

No period and underweight — Anorexia? is another archived Go Ask Alice! Q&A worth checking out.

For further information, eating disorder resources are available on the web, including:

• The National Eating Disorders Association
• Anorexia Nervosa and Related Eating Disorders, Inc.

Alice

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