By Megan Purzarang, Contributing Writer

They can start with something as simple as a critical comment, a billboard image or a magazine cover. They affect all age groups but primarily older children and teenagers. The two most common forms are polar opposites but equally detrimental.

They are eating disorders, and despite decades of study and attempts to raise awareness, anorexia nervosa and bulimia nervosa are becoming more prevalent. In the past decade, anorexia-related hospitalizations for children 12 years old and younger have increased by as much as 199 percent, according to a brief by the Healthcare Cost and Utilization Project.

Columbia student Cassandra Sheets remembers her first experiences with eating disorders as a preteen.

“Basically, I was always thinking about food,” Sheets said. “My grades were really terrible, and I didn’t have a lot of friends. All of my time was spent thinking about what I could eat and what I wanted to eat and thinking about certain arbitrary numbers that I wanted to get to.”

Now a member of The F Word, Columbia’s feminist club, Sheets runs Body Positivity workshops so students have an opportunity to share stories. The next workshop will take place during The F Word’s April 13 conference in the Alexandroff Campus Center, 600 S. Michigan Ave.

“I wish that somebody had been willing to talk to me about it, somebody who had gone through it and was OK and has made it from hell and back,” Sheets said. “It was hard for me to find people at first because I wouldn’t talk about it, but once you start talking about it, you realize just how many people are going through the same thing.”

She attended therapy sessions several times as a teenager, but it was not until college that her perspective changed.

“I started calling myself a feminist and discovering all of these great ways to analyze the media and analyze all of the harmful messages about how my body was wrong, and knowing now that it’s not wrong,” Sheets said. “I have a lot of good things going for me in my life now, and I don’t want my eating disorder to mess that up. I realized it was more important to have energy for school, for friends and feminist stuff than it was for me to lose weight.”

The project defines anorexia as a psychiatric condition in which a person idealizes an unrealistically thin body image and strives to lose weight by not eating. The condition is similar to obsessive-compulsive disorder, as the individual obsesses about weight to an unhealthy degree.

According to project authors, people with anorexia tend to avoid social situations where food or drink is involved. Usually there is a significant weight loss, such that an individual is at least 15 percent underweight for his or her size. When this happens, bones become noticeable beneath the skin and there is a serious risk of weakening of the heart muscle, which can cause disturbances of the heart’s rhythm. There is also the risk of outright starvation.

Cynthia Bulik, director of the University of North Carolina’s Eating Disorders Program and author of “The Woman in the Mirror: How to Stop Confusing What You Look Like with Who You Are,” said the increase of anorexia among children is especially dangerous.

“With children, anorexia can take hold fast,” Bulik said. “Since they are already small, falling off the growth curve can happen very fast and their weight can [drop] like a stone, so you have to be vigilant.”

Bulimia is another psychiatric condition that causes an individual to obsess about body weight. It is marked by the use of self-induced vomiting to hold weight down. This habit often pairs with “binge eating,” in which people eat as much as they want without worrying about caloric repercussions because they regurgitate afterward.

Signs of bulimia often go unnoticed because they are not as visible as those of anorexia. Bulik added that family members should watch for a pattern of sudden leave-taking after meals, the disappearance of large amounts of food and marks on the palms or knuckles from sticking hands in the mouth to induce vomiting if they suspect a loved one has an eating disorder.

Dr. Martha Levine, assistant professor of pediatrics and psychiatry at the Pennsylvania State University Hershey Medical Center, said she believes the media influence the frequency of these disorders among youths.

“A multitude of magazines are targeted toward making women feel that there are always problems with how they look and present themselves,” Levine said. “Advertisers do this because by making people feel uncomfortable, they can try to convince them to buy their products.”

Eating disorders are not always a lifestyle choice. They can have a genetic component as well, said Nancy Matsumoto, co-author of “The Parent’s Guide to Eating Disorders.”

“It is [likely] that eating disorders are a combination of genetic and environmental factors,” Matsumoto said. “You don’t have to be genetically susceptible, but it would be far more likely that you would get an eating disorder if you had a genetic predisposition.”