It’s hard for most people to think of food as an enemy.

It’s not hard for someone suffering from an eating disorder.

In a society that places a high value on appearances and acceptance, there is tremendous pressure on people, particularly young women, to fit that external conformity. According to Dr. Katherine M. Smith, a clinical psychologist in Bakersfield specializing in eating disorders for 15 years, having an eating disorder is a fairly common problem among young college-age women, and is now affecting girls as young as 10 years old.

The main three types of eating disorders affecting young women are anorexia nervosa, bulimia and obesity. These disorders are psychological problems, which result in physical symptoms.

“Doctors name it manic-depressive, ADD, etc., instead of saying `We have a physical and emotional problem here,'” said Dr. Valentine Birds, a medical doctor specializing in family practice and the manager of Bakersfield’s Budget Medical Clinic, who has been dealing with psychological and nutritional problems for 35 years.

According to Suzanne Abraham and Derek Llewellyn-Jones, authors of “Eating Disorders: The Facts,” those suffering from anorexia have a relentless passion to be thin and perceive their bodies as fatter than in reality. Anorexics will try to suppress their hunger, often diet and exercise obsessively, sometimes force themselves to vomit, can abuse laxatives and diet pills and often become emaciated and amenorrhoeic (stop menstruating).

Abraham and Llewellyn-Jones say bulimics also can have a morbid fear of becoming fat and are also binge eaters, which is someone who eats a tremendous amount of food and then self-induces vomiting. Bulimics feel they’ve lost control of their eating and use food as a way to escape. Binges are often triggered by stress, unhappiness and anxiety, and can last from hours to days. The vomiting can relieve “bad” feelings, or create more guilt. Bulimia also can result in menstrual irregularities, potassium deficiency, abdominal problems and tooth decay.

“Eating Disorders: The Facts” also states obesity often results from anxiety, depression, low self-esteem and a poor body image. Those who are obese have an increased chance of becoming diabetic and developing higher blood pressure, suffering from strokes and coronary heart disease. They have three times greater a chance of dying compared with the “average” person.

Birds said a main cause of an eating disorder is self-esteem.

“It’s the inability to look in the mirror and say, `I love you. Today I will take care of you,” he said. “It’s about self-regards, self-concern, and the ability to have a good self-image.”

According to Birds, an eating disorder may become a person’s entire life if it becomes severe.

“It can be very consuming from life to death,” he said. “A lot of these people have found a way to manipulate their environment, they’ve created a belief system that’s totally disoriented. Unless they have a new programming of the belief system, they can develop self-destructive beliefs. They can’t hold a job or finish school.”

BC psychology professor Sally Hill, a recovered bulimic, said similar psychological characteristics may be found in many eating disorder patients.

“If you’re in this culture, and you came from a family that has high expectations of you and you’re overly perfectionistic, there’s a pattern there,” said Hill. “They want to conform to what the culture says is a positive thing in terms of their personality and their physical appearance.”

Hill says the first step she took to become healthy was to do research on her disorder. She said an eating disorder may start as an addiction to food, but becomes an emotional roller coaster.

“You don’t do anything than think about not eating and you avoid doing things where you’re gonna be tempted, or you arrange your life so that you have enough time to take your laxatives, or to regurgitate,” she said.

“So your life begins to revolve around your eating disorder as opposed to your eating disorder being a part of your life.”

As a result, few patients want to admit their problem said Smith.

“It’s quite shame-faced,” she said. “A lot of girls don’t want to admit it to others.”

According to Smith, several emotional factors can lead to the development of an eating disorder.

“Depression and anxiety can cause an eating disorder,” she said. “It becomes a difficult cycle, almost impossible to tell which triggers which.”

Smith explained that the media play a big part in influencing young women about their body image and that you cannot open a magazine, catalog or newspaper without being exposed to it.

“I think that there is the double standard for women,” she said. “We expect them to be young, thin and perfect from birth until death. This is a severe prejudice with women involving image.”

An essential part of recovery is family support, counseling and sometimes intense therapy, said Smith.

“Work with others related to help the girl,” Smith said. “Don’t listen at the bathroom door to catch them purging or force them to eat. These are major trust issues.”

Birds said recovery often calls for reconstruction of a person’s thinking.

“It takes a lot to do it, a change in lifestyle,” he said. “I do not put people on a diet. We have to have them be aware of what they want to be. The healthy human body is one of God’s greatest creations, but they just can’t see that.”