Eating Disorders: A complex but treatable disease
Eating disorders are defined by that American Psychiatric Society as “a behavioral cognition that is characterized by severe and persistent disturbances in eating behavior and the associated stressful thoughts and emotions”. The most important thing is that eating disorders are classified as a mental illness and treatable.
Kristin Francis, MD, psychiatrist at Huntsman Institute for Mental Health, gives her expertise in identifying and diagnosing eating disorders, suicide risk, and common triggers. “With early detection and intervention, we can reduce the severity and recurrence of eating disorders,” says Francis. â¯
Types of Eating Disorders
the National Association for Eating Disorders defines the most common diseases:
Anorexia nervosa – A type of eating disorder characterized by weight loss and difficulty maintaining a reasonable body weight for your age, height, and stature. âWe often compare how a person has grown in the past and what body mass index (BMI) percentile they performed best at before the eating disorder set in,â says Francis.
Francis makes an important distinction between the BMI percentile and the raw BMI. “The raw BMI is calculated by dividing a person’s weight by their height,” she says. âIt’s an out of date measuring tool and shouldn’t be the hallmark of what a ‘healthy’ weight is for someone. The BMI percentile is the comparison of a child’s weight with that of other children of the same age and gender and is a better tool for tracking weight gain / loss in children. ”
There are two subtypes of anorexia nervosa: âbinge purge subtypeâ and ârestrictive subtypeâ. In the former case, people may have “subjective” binge eating, in which they ingest a normative amount of food, rather than the high-calorie amount normally associated with a “binge,” but feel intense guilt and shame and then through voiding behavior ( self-induced vomiting) or exercise).
bulimia – A cycle of binge eating and compensatory behaviors such as emptying (self-induced vomiting, taking laxatives, exercise, restriction) to help alleviate the effects of the binge eating.
Binge Eating Disorder (BED) – The most common eating disorder, characterized by recurring episodes of consuming large amounts of food, followed by feelings of shame and guilt.â¯ In contrast to bulimia nervosa, people do not compensate for these binge eating by restricting or detoxifying behavior (including exercise).
Other Specified Eating and Eating Disorders (OSFED) – Characterized for people who do not meet the strict diagnostic criteria for anorexia nervosa or bulimia nervosa, but still have / had significant eating disorders that affect their functioning, mood, relationships and health.
Ruminant disorder – People vomit their food (chewed, swallowed again, spat out) for more than a month.â¯This often happens involuntarily and the food is not mixed with digestive juices and therefore does not have an unpleasant taste.
Orthorexia – The term was coined in 1998 and describes an obsession with “proper” or overly “healthy” diet. This obsession often leads to increasingly limited food variety and intake, and requires increasing amounts of energy, time, and focus with unintended health consequences.
Compulsive exercises – Characterized by excessive and extreme exercise, which significantly affects areas of life.
Q: Is There a Clear Cause for Eating Disorders?
ONE: Diet is the best-studied cause of causing an eating disorder. Most eating disorders are genetic and require a situational stressor that can be as simple as deciding to lose five pounds for a trip, experiencing an illness followed by weight loss, or asking a doctor to lose weight. A family history of eating disorders is another well-studied factor that can predispose someone to developing an eating disorder.
Q: What are the most common triggers and what is the best way to spot them?
ONE: Dieting, or “changing the way we eat to affect our size or shape” is the most common cause. Restrictions (physiological and psychological) are the biggest triggers that cause physiological changes that increase our focus and cravings for “forbidden” foods. Noticing that the variety and amount of food you eat has decreased, observing dietary rules and your physical and emotional wellbeing while eating, and seeing that you avoid social situations based on food expectations can all be helpful clues that your eating behavior is disrupted. Additionally, the decline in your physical health (energy, mood, self-esteem, social responsiveness, and thoughts that life is stressful or stressful) can be warning signs that you have an eating disorder.
Q: What should you do first when you know someone who may be struggling with an eating disorder?
ONE: Talk to them! Express your concern about the changes you have seen in them (food variety, quantity, energy, eating habits, mood, withdrawal from social circles).
Q: What are the best ways to get help?
ONE: The first step is to realize that your attitude towards food and your body can affect your life. Then, seek help from a doctor to assess the severity of your symptoms and review treatment options. There are doctors who specialize in medical and psychiatric support and therapists who can coach you on health changes so you can have the full life you deserve. There are also specialist nutritionists who can educate you about food demoralization – “all food is fine, there is no good or bad food” – and will work with you to increase your diversity and intake. Or, they can help you plan meal times and snacks to nourish your body and reduce binge eating and restrictions.
Q: What can you do in your spare time to help yourself if you feel like you are struggling with an eating disorder?
ONE: There are excellent online resources (AEDWEB.org, Nationaleatingdisorders.org, Ellyn Satter Institute, Intuitiveeating.org) initially to further educate yourself. Start with the resources above. Also, try not to be hard on yourself; realize that you are not alone and that our society’s unrealistic images and values ââof slimness condition us from an early age to body dissatisfaction without our recognition or permission. You did not cause this and you have the strength and support to change your diet and life.
Try not to be hard on yourself; realize that you are not alone and that our society’s unrealistic images and values ââof slimness condition us from an early age to body dissatisfaction without our recognition or permission. You did not cause this and you have the strength and support to change your diet and life.
Kristin Francis, MD
Eating Disorders and the Link to Death from Suicide
Hunger makes people depressed, anxious, and suicidal, says Francis. Much of what we know about the effects of hunger on mood comes from the Minnesota Starvation Study and the concept of “set point theory” that weight is genetically determined and our bodies have an individual range of weights that we feel, function, and eat best at. Statistically, over 28 million Americans currently suffer or suffer from an eating disorder, and 26% of those people attempt suicide – but fewer than 6% of these people are considered medically “underweight,” the reported National Association for Anorexia Nervosa (ANAN).â¯
Eating disorders are life-threatening mental illnesses and should be treated accordingly.
- 9% of the US population will have an eating disorder at some point in their life.
- 91% of women in a college campus survey admitted that they managed their body weight.â¯
- Athletes are more likely to have an eating disorder than non-athletes.â¯
- About 26% of people with an eating disorder attempt suicide.â¯
- One death every 52 minutes – eating disorders are among the deadliest mental illnesses.â¯
Eating disorders are often secretive, and “People of any size can go hungry,” says Francis. Of those who suffer from eating disorders, 86% report they started before the age of 20. Anorexia Nervosa has been suggested to be the highest death rate a psychiatric illness, estimated at 10%.
Eating disorders are serious medical conditions, but help is there out there. The first step is to realize that you are not alone with this, and that you did not cause this.
If you or someone you know is struggling with an eating disorder, see a doctor in your area.