When child's pain leads to eating ills

OREM — Jessica Setnick vividly remembers an 8-year-old patient who suffered from such anxiety about attending school that she constantly made herself throw up.

And while the girl's case of bulimia seemed less about food than fear, Setnick said the girl's father remained focused on the vomiting.

"The key is not, 'What is making her throw up?' " but, 'What feels so bad that throwing up feels better?' " said Setnick, a Texas-based dietician who spoke to health professionals Friday at Center for Change, an eating disorder treatment center in Orem.

As someone who has dealt with her own "food-related issues," Setnick said that she has come to realize that behind every eating disorder is an issue that drives someone — even young children — to cope by either eating or not eating.

While Setnick isn't sure if eating disorders are on the rise, she said they are appearing increasingly in children as young as six years old. And many children without serious disorders are more concerned about dieting and weight than is healthy, she said.

"Our children are confronted with this stuff so much earlier," Setnick said. "Whereas we might have heard about dieting for the first time in eighth grade, it's now second grade or kindergarten."

Setnick won't place the blame for eating disorders on any particular source, but said Americans put too much emphasis on looks and size.

"The magazine advertisements, the magazine covers, the women depicted on television, the birthday cards that joke about weight, those are not the things that create eating disorders. Those just reflect what we as a culture already believe," Setnick said.

"The bigger influence is the idea that since the outside of your body is the only thing that people see when they first meet you, then you really have to work on making that perfect."

That pressure to look good is exacerbated, she said, in stressful situations. And rather than lash out against problems, Setnick said some people, particularly women, turn inside and use food as a secret remedy.

"Everyone that I have met with an eating disorder is very smart," Setnick said. "An eating disorder is a very intelligent coping skill a very smart brain uses to protect it from pain. That's why treatment must provide patients with another solution, rather than just taking away the eating disorder."

Ken Cozzens, business director for Center for Change, said that his facility uses the same approach to eating disorders.