Mary Orear, the director of the Rockport-based nonprofit Mainely Girls, knows more about eating disorders than most people do. She sees it often in her work with girls and young women from across the state.
“It’s such a debilitating disorder,” Orear said in telephone interview Wednesday. “It is devastating to see these young girls fading away, being so much less than they could be, putting their social, emotional and intellectual development on hold, sometimes for years. It’s a really sad situation.”
That’s why Mainly Girls is working to establish a statewide network of professional eating disorder treatment teams that reaches the most rural areas of Maine. Orear said it is not enough to have a single knowledgeable health care provider or therapist in a community; it takes a coordinated effort to maintain the level of supervision and support needed to identify an eating disorder and stop it before it becomes a medical crisis.
Orear noted that while approximately 90 percent of eating disorder cases occur in adolescent girls and young women, the incidence among boys and men is on the rise.
Eating disorders, including anorexia, bulimia and binge eating, are poorly understood and hard to treat. Individuals with anorexia eat an insufficient amount to maintain health. Bulimia is characterized by eating normally or heavily, then either inducing vomiting or using laxatives to get rid of the food before the body can make use of the calories and nutrients it contains. Binge eaters experience episodes of consuming extremely excessive amounts of food.
In order to be considered a psychological disorder, such behavior must be compulsive and out of control. Typically, it is accompanied by distorted self-perception or other psychological problems. Treatment involves a tricky balance of managing imperiled physical health, derailing self-destructive food-related behavior, and identifying and treating the underlying psychological issues.
Last fall, Mainely Girls launched a three-year program aimed at developing a minimum of 30 treatment teams, each including a physician or other medical provider, a therapist and a dietitian. Eleven teams from communities across the state signed up and completed a free two-day training session, followed up with continuing education and other professional support. This year the training session will be held Oct. 23 and 24 in Freeport. A final session will be offered next year.
Orear said the goal is to ensure that individuals and families affected by eating disorders have prompt access to effective treatment and support no matter where in Maine they live.
Among the graduates of the first Mainely Girls training is Camden family therapist Mary Beth Leone. Over the 20 years she has practiced in the Camden area, Leone said, she has seen the incidence of eating disorders rise and fall.
“But it’s always there, to a greater or lesser degree,” she said. The disorders are equally likely to strike wealthy families as poor ones, and seemingly healthy families as dysfunctional ones. “It’s right across the board,” she said.
Leone said treating eating disorders requires an intensive, coordinated effort that includes school officials and other community members as well as medical professionals and family members. Because young people suffering from eating disorders often become secretive and dishonest about their behavior, it’s essential that everyone involved understands and is ready to support the treatment, she said.
“Everyone has to be willing to pick up the phone and say, ‘We told her she couldn’t go on the class trip if she lost another 3 pounds — who’s going to tell her?’” she said.
David Prescott, a psychologist at Acadia Hospital in Bangor, said the region has a high incidence of eating disorders because of the number of young people attending colleges in the area. As many as 50 percent of young women on college campuses are thought to practice bulimic behavior, he said, although he noted that occasional purging through vomiting or laxatives does not meet the definition of a disorder.
Prescott said families bring youngsters with eating disorders to Acadia from rural communities throughout northern Maine. Outpatient treatment often involves more than one visit a week for several weeks in a row.
“For a family in Millinocket, getting to Bangor two or three times a week can be a significant problem,” he said, made more complicated by the fact that many patients are too young to drive themselves.
Orear specifically mentioned Millinocket as one community where she hopes to train an eating disorders team in this year’s educational session. Eventually, she said, she envisions a statewide network of treatment teams delivering comprehensive, coordinated care to individuals and families affected by eating disorders.
Mainely Girls was founded in 1996 with a two-part mission: to assist rural communities in focusing on girls’ needs, and to advocate for public policies that benefit Maine girls.