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Anorexia, or self-starvation, is a disease and it can be fatal if left untreated. Recognition of its symptoms can be the first step
toward saving yourself or someone you love from this dangerous disease.
The following is a list of the observable symptoms:
•Refusal to maintain body weight
•Fear of gaining weight
•Talks about "feeling fat"
•Difficulty with eating full meals
•Rigidity with what they will eat
•An obsessive preoccupation with body size
•Over-exercising
•Intense dissatisfaction with physical appearance
•Personality change from outgoing to withdrawn
•Limit food intake to "arrow selection of low-Cal foods
•Hoarding, concealing, crumbling or throwing away food
•Menstrual difficulties
Behavioral Characteristics.
Anorexic patients see their restricted caloric intake as a very brave and arduous thing to do. They tend to prize challenges over
comfort. By contrast, bulimic patients view their behaviors as shameful and disgusting. In order to recover, patients need help
learning to understand the connection between their beliefs about themselves and their eating disorder behaviors. They often
view themselves with such hatred that they feel deserving of the painful eating disorder behavior. They need to see that their
eating disordered behavior is not an achievement, hut avoidance of true life challenges; not distinctive, hut simply stereotypic.
They need to realize their behavior does not clarify their life, but confuses it; and they need to see that the disorder does not
serve higher goals, but actually blocks the realization of those goals. The individual suffering from destructive eating disorder
behavior must begin to challenge a negative mindset and learn to create and allow positive feelings and thoughts about
themselves.
Anorexia Nervosa
Bingeing and Food Control Excessive dieting, food control, and fasting. Collects recipes, and likes to cook/bake, but sometimes
refuses to eat with family. Tension at mealtime, Fear of food; avoidance of consumption.
Purging Compulsive exercising. Fasting
Eating Behavior Food ritual; calorie counting, rigid rules and schedules.
Sleeping Behavior Insomnia and early morning awakening.
Clothing and Dressing Rituals Frequent weighing, layering of clothes.
Social Behavior Social withdrawal, physically and emotionally. Focus on job and or school work.
Abusive Behavior Slow suicidal progression. Self hatred and feeling of unworthiness
Emotional and Cognitive Characteristics
Individuals suffering from eating disorders have restricted emotions and often cannot identify their feelings. What they are
aware of is extremely negative thoughts related to their body - an effective diversion from their emotional turmoil and pain.
Their thoughts are obsessively locked onto the Irrelevant and their feelings are avoided and hidden, even from themselves.
Anorexia Nervosa
Body Image Problems Intense fear of becoming fat. Distorted body image.
Perfectionist Behavior Perfectionist: thinnest, smartest, neatest. Dichotomous thinking: all or nothing, black or white.
Self-Esteem Depression and low sense of self-worth.
Sexuality Decreased interest in sex.
Social Behavior Self-centered and non-social, isolation from others, irritable.
Cognitive Symptoms Difficulty thinking clearly, potential severe cognitive deficits due to malnourishment.
Adapted from Mary Pabst, MSW, Maryland Association for Anorexia Nervosa and Bulimia (MANA) from Panhellenic Task Force

Anorexia Linked To Pleasure-Regulating Brain Chemical
Women who suffer from anorexia have increased chemical activity in a part of the brain that controls reward and
reinforcement, something that may explain why they are driven to lose weight but don't get any pleasure from it, according to a
new study. Researchers used brain-imaging technology on 10 women who had recovered from anorexia and 12 healthy
women. In the anorexic women, they found overactivity by dopamine receptors in a part of the brain known as the basal ganglia.
Dopamine is a brain chemical that is associated with regulating pleasure. "The take-home message is dopamine in this area
may be very important in how we respond to stimuli, how we view positive and negative reinforcement," said Dr. Walter Kaye, a
psychiatry professor at the University of Pittsburgh Medical Center and one of the researchers involved in the study. Dr. Guido
Frank, a child psychiatry fellow at the University of California at San Diego and also a leader of the study, said the hope is that
the research can lead to the development of drugs to treat anorexia. "It's very, very hard to treat. They recognize it's wrong, but
they still don't eat," Frank said. The research was reported this month online in the journal Biological Psychiatry. About 1
percent of American women suffer from anorexia, a disease than can also affect men. It has the highest death rate of any
psychiatric illness, Kaye said. Women suffering from anorexia have obsessional personalities, avoid harm and prefer routine,
said Dr. Douglas Bunnell, past president of the National Eating Disorders Association and clinical director of the Renfrew Center
of Connecticut. These women tend to resist therapy and have a distorted perception of themselves, he said. Although only a
small number of women get anorexia in its purest form, there are many more people who suffer from some form of an eating
disorder, Bunnell said. Making the connection between anorexia and what's happening in the brain is important for
understanding and treating eating disorders, he said.
"There's still considerable stigma attached to these disorders, particularly for families. People think it reflects something you
did as a parent," Bunnell said.
Dr. Craig Johnson, director of the eating disorders program at Laureate Psychiatric Hospital in Tulsa, Okla., said anorexia was
historically viewed as a disease brought on by its victims or just a diet gone bad. "Up until this point we have been left with more
sociocultural explanations for the illness and regretfully that has resulted in some levels of minimization, if not glamorization, of
the illnesses," Johnson said. Though the ultimate goal from the latest study would be to develop treatments for anorexia, the
work may also provide data important in anorexia prevention and identifying people at risk of developing the disease, Johnson
said. Frank said researchers still don't know what is causing the dopamine receptor to be overactive, but more research may
provide an answer.
Behavioral Characteristics.
Bulimia Nervosa
Bingeing and Food Control Eating, in a discrete period of time (e.g. within any 2 hour period), an amount of food that is definitely
larger than most people would eat during a similar period of time and under similar circumstances. Fear of inability to stop
eating voluntarily (bingeing), a feeling that one cannot stop eating or control what or how much one is eating.
Purging Compulsive exercising. Vomiting, laxative, diuretic, or diet pill abuse; or use of other emetics ( syrup of ipecac).
Eating Behavior Secretive food foraging and hoarding, especially at night. Shoplifting and or petty stealing of money to buy binge
food.
Sleeping Behavior Various sleep disturbances
Clothing and Dressing Rituals Other obsessive-compulsive patterns, such as trying on clothes five times a day.
Social Behavior Social irregularities, alternating withdrawal with erratic need for social contact and approval. Chaotic
relationships and interaction.
Abusive Behavior Drug and/or alcohol abuse. Suicidal gestures or attempts. Self-hatred and self-mutilation. Feelings of self-
disgust.
Emotional and Cognitive Characteristics
Individuals suffering from eating disorders have restricted emotions and often cannot identify their feelings. What they are
aware of is extremely negative thoughts related to their body - an effective diversion from their emotional turmoil and pain.
Their thoughts are obsessively locked onto the Irrelevant and their feelings are avoided and hidden, even from themselves.
Bulimia Nervosa
Body Image Problems Preoccupation with appearance and "image".
Perfectionist Behavior Perfectionist: high performance and achievement expectations. Perfectionist inside, but sometimes
chaotic outside. Facade of normalcy, seemingly "got it together".
Self-Esteem Low self-esteem: self-loathing, self disgust, and depression.
Sexuality May be promiscuous or confused about sexuality, a mask for a desire to he accepted and respected.
Social Behavior Constant feeling of being out of control; vacillates between isolation and extreme need for external validation.
Cognitive Symptoms Inability to accurately identify and express feelings. Out of touch with one's feelings, (e.g. anger, affection,
humor). Thoughts obsessive and focused on the eating disorder cycle.
Adapted from Mary Pabst, MSW, Maryland Association for Anorexia Nervosa and Bulimia (MANA) from Panhellenic Task Force
Bulimia not always about looking thin
Freshman Jane Felton said she would purge to make herself feel better in comparison to other women, who made her feel
insufficient.
"I always thought I was chubby - chubbier than the rest of the girls in my class," Felton said. "Most of the time I wouldn't eat,
unless I was stressed out or I was really hungry. In those situations, I would just eat a lot of junk food, because that made me
feel sick quicker. Then I would run to the bathroom, stick my finger in my throat and throw it all up. I wanted to be pretty," she
said.
According to Dr. Donald McAlpine, a psychiatrist and the director of the eating disorders services at the Mayo Clinic in
Rochester, Minn., bulimia, also referred to as bulimia nervosa, is a psychological eating disorder that involves repeated
episodes of overeating. This is followed by inappropriate ways of trying to rid the body of the food before weight gain occurs, he
said.
In most cases, the disorder is not solely about being thin. It can also become a way to "gain total control of some aspect of their
life," Judy Blackstone, a UW-Eau Claire counselor said.
According to the National Eating Disorder Association, overwhelming lifestyles full of never-ending homework, significant other
pressures, difficult family relationships and additional stressing aspects are common causes for self-induced purging.
"None of the eating disorders are about food," Blackstone said. "They're about the way we feel about ourselves."
Cases of bulimia may start in post-adolescence due to unattainable standards of American society and continues all
throughout college, she said.
The Spectator News
1.Tend to hide and bottle up feelings - especially anger
2.Hypersensitive to criticism, though have a critical spirit themselves
3.Shame to control self and others
4.Impulsive in thought and action
5.Has great difficulty with intimacy, both sexual and emotional
6.Obsession with weight, though tend not to be extremely overweight
7.Addicted to the scale
8.Tend to have very strong need for other's approval, but feels as though they never get it
9.Very secretive, deal with very high amounts of guilt
10.Obsessive in thought about physical body
11.Believes that God disapproves of them
12.Tremendous physical exhaustion
13.PMS tendency, irregular periods
14.Dizziness, headaches, constant thirst
15.Digestive disturbances, extreme, bloated
16.Electrolyte imbalance resulting in muscular weakness
17.Dental problems
18.A life of extremes in relationships, spirituality, and emotions
19.Chronic low self-esteem
20.Disturbed metabolism.
What works in treatment?
1.Whole person approach
2.Non-diet approach
3.Self-esteem retraining
4.Nutritional reeducation
5.Spiritual renewal
6.Relationship enhancement
7.Identity development
Bulimia Symptoms
•95% to 98% female
•84% have some college education
•Usually white-this is changing
•64% are closer to proper weight
•On the average, binges occur 11 times per week
•Average number of calories consumed: 4,800
•Average age at onset: 18
•Estimated number of bulimic college women - 20-30%
•Very unhappy and have low self-esteem
•Often depressed
•Tend to be passive individuals
•Tend to rely on others, especially me" for self- validation
•Afraid of rejection
•Perfectionists
•Isolated
•Very secretive
•Unsure how to cope with stresses of life
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These are Prothinspo Member Tips that were given to me over time to put this list
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Tips and Tricks (PRO-MIA)

-When purging, stick your fingers as far down as you can and keep them their until you
can't anymore. This will be hard the first few times, but it'll get easier after time,
unfortunately.

-Eat liquidie type foods that come up easily (ice cream, soup, milkshakes)

-Weigh yourself before purging and after purging to make sure you got rid of everything is
a pro ana mia trick.

-If you plan on eating and purging.....Don't eat chips or meat. Avoid spicy foods and
chocolate. Chocolate tastes awful coming up and spicy foods can burn your nose These
can hurt to purge

- Don't go to brush your teeth immediately after purging....Wait to brush your teeth.
Brushing right away can help the acid decay your teeth. Garggle water or mouth wash,
then after an hour brush. Use a mouth wash or tooth paste that has an enamel protector in
it.

-Using the end of a toothbrush can be good for stimulating a gag reflex to prevent your
hands being damaged from acid, but it takes long and can often hurt, but many bulimic's
use this method.

-Splash your face with cold water after purging to help reduce redness and teary eyes.

Always keep q-tips in your bag to clean up any eye make- up that runs while purging, not to
mention a little cover up and some blush to retouch up if you are a public purger.

-Always gargle water after a purge, the stomach acid can build up in your salivary glands
and make your face swollen (criteria in diagnosing Bulimia that psychologists and doctors
look for) This is why so many bulimic's have the chubby cheek look.


Once again I will say that none of this is recommended to do but there are foods that
bulimic's recommend for purging...
Recommended foods for purging:
Water
Frozen yogurt
Soup
Juices, smoothies, shakes
Bananas, other soft fruits
Yogurt
Well-cooked soft vegetables
Oatmeal
Macaroni and cheese

Not Recommended foods:
Anything spicy
Apples
Chocolate
Meat
Anything swallowed in chunks
Potato, rice, cooked grains
Anything with small sharp pieces, like popcorn or chips
Nuts
Raw crunchy vegetables
Salad



Techniques

People pressuring you to eat? Try these excuses:

1. Oh, thank you, but I already ate.

2. "Well, I haven't really been feeling well today. I'm gonna drink some tea and lie down."

3. "Man, I've got a massive headache. I'll take some aspirin and lie down"

4. "Well, I had a really HUGE meal earlier and I'm still full from that ... Maybe later."



Feeling hungry and tempted by food?

-Make a list of things that will look better if you get to your goal weight.

-Write in a journal, join a blog group....Talk to another pro-ana/pro-mia person.

-Count sheep..... In your head of course.

-Look at your thinspiration/trigger picture/reverse trigger picture
click here for thinspo
choices.

-Create a scrapbook of what you would like to look like,
visualization is key to success...
click here.

-Clean your room/house

-Don't leave snacks lying around. If you don't see them you won't crave them as much, if
you really can't control your snack attacks, get something such as the
hoodia pops ( click
here to get a sample)or crave controller (click here to read more about diet defense),
these really help.

-Work out! Replace food with exercise,
click here to go to the exercise index page to find
something that works for you.

-Drink tea or lemonade to silence your stomach from those nasty hunger pains.

-Freeze diet soda in the freeze in a cup or ice cube trays and treat them like ice cream.
Great for filling you up!



Fasting? Here are some quick tips...

Try the hoodia lipgloss to help you stick to your fast,
click here to read more.

-Crystal light packets! They have one calorie per packet and taste delicious!

-Add a bit of lemon to your water, studies show that lemon has amazing health benefits.

-Drink fresh squeezed orange juice... 110 calories per serving, but if you split it up into
portions throughout the day it makes your stomach feel better

-Boil 1 or 2 bullion cubes in water (the kind you get in glass jars, the Mexican, soft, kind
have 15 calories) and add a few spices to it. Each cube has 5 calories.  The bullion is pure
sodium and restores what you have drained from your body.




Purging AND KEEPING IT SECRET....

-Be discreet and as quiet as possible, after a while my girlfriend could purge and you
couldn't even hear her.

-Play music in the bathroom or keep a faucet running, this is an old druggy trick from the
'80's.

-Say you are going to take shower, turn the water on, and purge.

-When inducing a purge, don't take your fingers/instrument out the first time you gag. This
can make it harder to bring your food back up, sorry so disgusting to talk about, but you all
wanted to know.

-If people ask why your eyes are red, say you got something in your eye, or allergies. Hello,
pot smokers use this excuse all the time.

-Place toliet paper in the toliet so the water and your vomit doesn't splash up and hit you...
Tip, you put the lid down before flushing. Always check to make sure it flushed all the way
down.

-When you leave the bathroom, try to compose yourself before entering the room.

-Don't immediately run to the bathroom unless you're alone. Wait 15 or 20 minutes to purge
when around people, some say that if you wait more than an hour your body will have
already absorbed most of the calories.

-Wash your hands! Stomach acid can ruin your hands and nails (another feature
psychologists are supposed to look for according to the DSM IV)


There are two sub-types of bulimia nervosa:
•        Purging type bulimics self-induce vomiting (usually by triggering the gag reflex or
ingesting emetics such as syrup of ipecac) to rapidly remove food from the body before it
can be digested, or use laxatives, diuretics, or enemas.
•        Non-purging type bulimics (approximately 6%–8% of cases) exercise or fast
excessively after a binge to offset the caloric intake after eating. Purging-type bulimics
may also exercise or fast, but as a secondary form of weight control.[16]
A Prothinspo member’s purging tips
purge in the shower
use two fingers (helps if there wet)
drink water through out your meal
when throwing up when it starts come up press your two fingers down on the back of your
tounge
if you cant throw up gulp down three glasses of  cold water really fast that usually helps

*i dont recommend purging its not good for your health but theres always those times you
mess up
Overcoming bulimia and binge eating may be one of the hardest things you'll ever do!
Counseling is the safest, healthiest treatment for eating disorders.
Learning to resist the compulsion to binge and purge is one aspect of overcoming bulimia.
When you're struggling with the compulsion or know it'll hit at a certain time, one key to
overcoming any compulsion is to be prepared. Plan a walk, exercise class, or put some
music on and just dance.  Effectively treating this eating disorder often involves
distraction.

To Overcome Bulimia, Eliminate Purgie Foods
Purgie foods are those that are easy to binge and purge. They are listed above...
When you're overcoming bulimia, make sure you don't have these foods in the house. If
it's someone else's food, picture yourself confessing that you ate all their food (binged)
and threw it up (purged) it already.
To Overcome Bulimia, Seek Help.....Finding a counselor who specializes in cognitive-
behavioral therapy for eating disorders can help you successfully overcome the
compulsion to binge and purge. Keep a journal and try to analyze yourself.
Before you can start treatment for eating disorders, you need to recognize the signs of
eating disorders.
When you inhale a quart of cookie dough ice cream, a pan of fudge brownies, 8 bags of
Dorito's and 4 bags of Orio's and a gallon of soda all in one sitting....Then you know you
have an eating disorder.

When you then rush off to the bathroom to purge by forcing yourself to throw up or using
laxatives – then your eating disorder is more serious and harder to kick.

*** This is a graphic page****2006-2010 Anorexic and Bulimic updates "starving for
perfection", 'dying to be thin" Tyra Banks' interview on extreme dieting and Dr. Phil... this
page is very graphic and is about eating disorders that have become life threatening.
click
here.

*** This is a graphic page****Skinny Kids with Anorexic and Bulimic Behavior... 4 steps to
kicking a food addiction and CBT and what it is and why they are using it for treating eating
disorders...
click here.
ANA ACRONYMS
Heard someone say something and you have no idea what it means? Here's a few common acronyms and
what they stand for.
Ana:   Anorexia Nervosa

Mia:   Bulimia Nervosa

Coe:   Compulsive Over-eating disorder

Ednos:   Eating disorder not otherwise specified

BED:   Binge eating disorder.

ED:   Eating disorder

SI:   Self injury

MiAna:   Having both anorexia and bulimia (this term is what I came up with for my first website, and since
has been used on the net a lot ... I have never seen the term used before until my first site went on the net.)

Pro-ana:   This term infers being pro-active in the ED community, usually online. It does not mean promote
ED's in any way, shape or form.

Thinspiration:   Collection of thin looking peoples pictures, used to inspire those with ana/mia.

Anorectic:   One who has anorexia.

Ana Buddy:   An online friendship between pro-ana individuals. Ana buddies guide one another toward
recovery or are penpals, sometimes becoming real life friends.

Fasting Buddy:   An online friend (or friends) who compete in weight loss competitions and attempt to keep
one another motivated to lose more weight.

Wannarexic:   Someone who wants to develop an eating disorder, usually under some confusion about the
consequences. Wannarexics are USUALLY unwanted at most websites aimed at sufferers, including pro-ana
websites.

Wannarexia:   The act of wanting to develop an eating disorder. Wannarexia is USUALLY discouraged at
most websites aimed at sufferers, including pro-ana websites.

CW:   Current weight.

HW:   Highest weight.

LW:   Lowest weight.

GW:   Goal Weight.

STGW:   Short term goal weight.

LTGW:   Long term goal weight.

FGW:   Final goal weight.

IP:   In patient.

BMI:   Body Mass Index.

*BOOKS*
I know that there are so many books out there on anorexia, mostly about recovery. But I love reading
autobiographys of people who have had anorexia. You learn so much, and you'll see how much you have in
common with them. Here's a list of books that I know of-
Stick Figure: By Lori Gottieb ~ This was really good, the only thing was it's by an 11-year-old. Well she was
that age when it happened. So it's better for younger anas. It's got some funny bits too.
To die for: By Carol Lee ~ Another good book, except it's written by the godmother of the anorexic girl. It
does have some of the girls words and that in it though, and it's good to see it from an outsides point of
view.
Second star to the right: By Deborah Haukig ~ An excellant book; one of my favourites.
Eli's Wings: By Elizabeth Best ~ This is the one I'm reading right now, it's quite good. This girl had pretty bad
depression and the other things that come with ana.
California Diaries #8, Maggie: By Ann M. Martin ~ This one isn't actually real, it's part of a teenage series but
it's still quite interesting.
Bronte's Story: By Bronte Cullis ~ This is actually a quite famous story, and very good also, though a main bit
of it is foccased on her recovery. You can visit the Bronte Foundation Website by clicking here:
http://www.thebrontefoundation.com
A Journey Shared: By Jan Cullis ~ This is the book written by Bronte's mum.
Here's a few more I havn't actually read yet, but have heard of-
Wasted: By Marya Hornbacher
Diary of an anorexic girl: By Morgan Menzie
The Passion of Alice: By Stephani Grant




Here's a list of songs that have to do with ED's
Ana's song- Silverchair
Fiona Apple - Paper bag
Lucy at the Gym- Jill Sobule
Anorexic beauty- Pulp
4 stones 7 pounds- Manic Street Preachers
Tunic- Sonic Youth
Beautiful- Christina Aguilera
Bleed like me- Garbage
Casting such a Thin Shadow


For more information on Pro Ana...
click here to go to the pro ana religion page.