Dual energy X-ray absorptiometry (DEXA). In 1987 the first commercially available dual energy X-ray absorptiometer (DEXA) was designed to measure the bone mineral content of the skeleton, especially at the spine, hips and wrist because they are common sites for osteoporosis. The machines, however, can accurately measure three body components (bone, fat and lean body tissue) both regionally and for the whole body and are now common in most hospitals. The method enables measurement of total fat as well as regional body composition. They use a very low dose of X-ray and scan a person in 20-40 minutes. DEXA is taking over from underwater weighing as the validation standard in fat measurement and body fat research, largely because of its accuracy, comparative ease of use, and widespread availability.

*70\186\4*

A father remarked: “Lisa seems to live at McDonald’s. All that junk can’t be good for her-can it?”

“Cookies! I think that girl exists on Oreos! What should I do?”

“I swear, she starts a different diet every week.”

“She eats nothing all day, and then gets ravenous just before bedtime. Is this just a teenage phase? Or should I worry?”

“I can’t understand it. Every day she eats exactly the same thing. The same foods, in the same order, every meal. Even breakfast. Is something wrong?”

Adolescence: Spell it T-U-R-M-O-I-L. Hormones surge. Emotions run amok. Bodies change so fast that their owners don’t recognize themselves in the mirror.

The physical transformation alone is hard enough to handle. But a teen’s whole world is in upheaval. Socially speaking, the pressure’s on. Suddenly a person whose age has barely reached double digits has to cope with enormous changes and choices. Sexuality. Dating. Demanding teachers. Those twin temptations, drugs and alcohol. New roles and responsibilities.

Some of this confusion and fear is bound to rub off onto the parents. They watch their sweet, obedient child transmute into an anxious, volatile creature from another world.

Everything in the kid’s life is changing, and eating patterns are no exception. Unusual diets, strange menus, or just plain bad food habits do not always mean that an eating disorder has struck. Switching to vegetarianism or an occasional food binge represents nothing unusual.

Sometimes, though, there is cause for concern. Those habits may not be a phase, but a sign that something is wrong. The body could be changing so fast that it can’t keep up with itself. Emotions may spin out of control. The pressure gets to be too much. For a lot of people, eating-or the discipline of not eating-provides relief, comfort, or just plain distraction.

You may think (or know) that something is wrong with the way your child is eating. Or you may be worried about a close friend or relative-or yourself. You may have witnessed bizarre behavior-for example, wolfing down a dozen bananas or six hot dogs in a row-that makes you suspicious. Maybe your daughter takes forever at the dinner table, picking at her food, eating nothing. Or she disappears into the bathroom two or three times during a meal. Or perhaps another person’s casual remark-”Barbara’s losing an awful lot of weight, isn’t she?”-sets off an alarm in your head.

When does a “diet” become a disorder? What exactly are eating disorders, anyway? Why do they strike, and how do they affect the people who have them? This chapter will help you find out. To start, look over this list of warning signs that indicate something is wrong.

The warning signs of eating disorders

Severe weight loss

Preoccupation with being thin and /or an intense fear of being overweight

Severe diets or odd behaviors about food

Signs and symptoms of depression

Loss of menstrual periods

Hyperactivity, compulsive exercising

Distorted body image

Unexplained medical problems

Hair loss

Slow pulse (bradycardia)

Intolerance to cold (shivering, blueness of the skin and fingers, etc.)

Edema (swelling of the ankles)

Low blood pressure

Low body temperature (hypothermia)

Dental damage (due to vomiting)

Weakness

Sleep disturbance

*8/35/5*

Today, Melonie weighs in at a svelte 135 pounds. She slimmed down, she says, by learning to identify the emotional sources of her physical hunger. -

Melonie, a 38-year-old Seattle resident, had been overweight for as long as she could remember. “I’d been on the weight-loss roller coaster, trying every diet on the planet to slim down,” she says.

Then Melonie started walking for just a few minutes, a few days a week. “I was so physically out of shape that walking was the only thing that I thought I could tolerate,” she explains. “I’ll never forget my first walk. I was out of breath in 3 minutes. I had to be very patient with myself.”

Her patience paid off. Those 3-minute, 3-days-a-week walks gradually got longer and faster, and Melonie started dropping pounds. As a bonus, her energy level soared.

Inspired, she began looking for ways to improve her eating habits, too. Through what she calls a journey of self-exploration, she soon realized that she had fallen into a pattern of eating even when her body didn’t really want food. “I was misinterpreting feelings of fatigue, loneliness, dissatisfaction, or low motivation as hunger,” she recalls. “I discovered that in order to remodel myself outside, I first had to remodel myself inside.”

Melonie learned how to face her feelings head-on and how to remedy them without food. Now, whenever she has the urge to eat, she asks herself what she really needs. Is her hunger genuinely physical? Or are her emotions calling out for sustenance? “If I realize that

I’m bored, I get out a craft project or go shopping or find some g other constructive way to occupy my time,” she says. By learning to distinguish between physical and emotional Q 1 hunger, Melonie stopped eating for the wrong reasons. In 2 years, she lost 90 pounds. Now, even 3 years later, she can proudly say, “I no longer have a weight problem.”

WINNING ACTION

Feed your hunger, not your mood. This has been such an important lesson for me! I constantly found myself thinking about food or even rummaging through the kitchen for something to eat—all because I was really feeling sad, scared, lonely, or just plain bored. The next time you find yourself searching for something to eat, stop and ask yourself, “What do I really need right now?” You may realize that you don’t need food at all and that you’re really hungry for a chat with a good friend.

*62\89\8*