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Sushama Kirtikar



Have you ever been out to a restaurant and found that your child's college friend excuses herself frequently to run to the restroom every 20 minutes or so? Have you ever wondered if she was unwell or the meal did not agree with her? Have you ever found your child hoarding food under the bed to eat it later?

Bulimia Nervosa is a disorder of binge eating (eating in less than two hours an excessive amount of food with lack of control over eating) and purging (self-induced vomiting, misuse of laxatives, diuretics/water pills and enemas) or excessive exercising, restricting and fasting.

The uncontrolled eating is overcompensated by desperate attempts to flush out the food. Bulimia affects the entire body: anemic blood, dizziness, irregular heart beat, dehydration and electrolyte imbalance, irregular periods, intestinal disorders, stomach ulcers, weakened muscles, throat ruptures, dental diseases, swelling of cheeks, and abrasions on knuckles. The onset of bulimia typically occurs in late adolescence to early adulthood. Statistics show that women outnumber men 9 to 1 in this area.

Often the person is unable to cope with stress, overwhelming emotions and unrealistic expectations (self imposed or parental). The bulimic person has not learned ways of expressing or dealing with emotions, especially the negative ones. It starts off by self medicating with food to stuff down anxiety and therefore she overeats. "I desired only carbohydrates all day long … I could not resist the candy at the office …" Once she gives in to the urge, there is a feeling of satiation which is but a fleeting flash in the pan.

Quickly, a sense of feeling 'bloated' surges up which she often reports as 'gross.' A shroud of guilt and depression settles over her as she battles with feeling out of control. "I am bad … I am a burden … I am not deserving." These thoughts lead to throwing up or other ways of getting rid of the food along with the negative feelings. It is an attempt to regain control by running in the opposite direction. The cycle becomes unstoppable.

What we may fail to realize is that any other addiction such as drugs, alcohol or nicotine can be avoided by the person who is battling with it. He can abstain from these substances completely. However, food cannot be avoided as it is needed for basic nourishment. He has to learn to regulate it without giving it up totally. It is a heftier challenge than it appears on the surface.

An article in the Journal of Adolescent Research (2003) states, "Among American women, eating disturbances are equally as common among Native, Asian or Hispanic Americans as they are among Caucasians." The U.S. department of Health and Human Services concurs, "Research shows that as women of color are more exposed to images of thin women, they are more likely to get eating disorders." This is startling and yet admittedly, not entirely unbelievable that it exists here in the U.S. Now, how many of us know if it exists in India? Research by Khandelwal and Saxena (1990) showed distinct prevalence of this disorder in India as well. Let us wake up; we are not in any impermeable bubble.

Sushama Kirtikar, a licensed mental health counselor in private practice, can be reached at (813) 264-7114 or e-mail at

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Dr. Ram P. Ramcharran

There are many organizations in the Tampa Bay area that focus on helping special needs children but the one organization that everyone should know about it is STAND (Statewide Advocacy Network on Disabilities Inc.) This not-for-profit organization, which has been around since December 1996, was organized by a group of parents and attorneys to help educate people on their rights.

STAND's purpose it to inform the families of children with disabilities of their rights. It is dedicated to getting a child with a disability the right education that they are entitled to under the law. The three main laws that STAND is concerned with are: Individuals with Disabilities Education Act, Americans with Disabilities Act and Section 504 of the Rehabilitation act of 1973. It focuses on three topics: advocacy, legal rights, and above all, education.

This year, STAND will be hosting SPARC 2007 – Stand Pinellas Accessing Resource Conference. The organization’s goal is to provide parents, teachers, therapist and other professionals with resources that help children with disabilities make achievements in their life. STAND focuses on children with Special Needs and they take this mission very seriously.

This year SPARC 2007 will be held at Morgan Fitzgerald Middle School in Pinellas Park, on Saturday, Sept. 29, from 7 a.m. to 4:30 p.m. Morgan Fitzgerald is at 6410 118 Ave. N., Largo, FL 33773. Cost for the conference is $25 for pre-registration. That will include one entry to the conference, a lunch ticket and a program.

(Dr. Ram Ramcharran will be a guest speaker at the STAND event. He will be discussing how to better understand and deal with children with special needs. If you have any questions regarding this event, contact Melissa Tremblay, SPARC chairperson at (727) 784-8493 or visit

Dr. Ram P. Ramcharran can be reached at

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