Eating disorders: separating fact from fiction

Have you ever considered skipping a meal to lose weight, or doing something drastic like vomiting or spending hours at the gym to eliminate food from your body? Imagine feeling compelled by fear to do these things constantly. Let’s take a look at some common misconceptions about eating disorders.

Myth 1: Eating disorders affect teenage girls who end up underweight.
Disordered eating can occur in anyone, regardless of gender, body size, or age. Eating disorders are increasingly diagnosed in young kids of both genders, as well as in adults of both genders. People in any body size can also develop eating disorders. Since eating disorder behaviors can often look very similar to typical “dieting” behaviors, it can be especially difficult to identify eating disorders in people who claim to be dieting in an attempt to control their weight.

Myth 2: I’ll notice if someone I care about is throwing up after meals or just not eating.
When someone is in the grips of an eating disorder, they are extremely capable of hiding their eating disorder behaviors. This is because someone affected by an eating disorder may feel ashamed of what they are doing, or fearful that someone will make them stop if they are found out. What can be a tip-off of an eating disorder? Preoccupation with food, fear of eating in front of others, making excuses for not eating, consuming only “safe” or “healthy” foods, elaborate food rituals, disappearing (often to the bathroom), and excessive exercise are, moving food around on the plate to make it appear like they are eating it, among many others, indicators that someone might be struggling with an eating disorder.

Myth 3: Eating disorders are a choice and people who have them just need to be reminded they are beautiful.
Eating disorders are complex medical and psychiatric illnesses that do not have a consistent cause. Five different eating disorders are defined by the American Psychiatric Association:

1. Anorexia Nervosa
2. Bulimia Nervosa
3. Binge Eating Disorder (BED)
4. Avoidant Restrictive Food Intake Disorder (ARFID)
5. Other Specified Feeding or Eating Disorder (OSFED).

Those who develop eating disorders also commonly deal with other mental health concerns such as major depression, anxiety, social phobia, and obsessive-compulsive disorder.

Eating disorders are considered bio-sociocultural diseases in that they are typically induced by a complex combination of biological predisposition, societal factors such as body ideals perpetuated in the media, and environmental factors such as life stressors and bullying. This perfect storm can cause a psychiatric illness that affects how an individual perceives and uses food to manipulate their body and circumstances.

Myth 4: Strict diets and food rules aren’t a problem.
Although some behaviors are considered to be part of mainstream dieting and do not necessarily meet criteria to be symptoms of a clinically diagnosable eating disorder, these disordered eating behaviors may lead to an eating disorder. Additionally, even sub-clinical disordered eating behaviors can lead to nutrition deficits that can impact body development and/or overall health, and should thus be taken seriously and appropriately addressed.

Eating disorders such as bulimia nervosa and OSFED have been found to have death rates nearly as high those seen in anorexia nervosa. If disordered eating becomes a full-blown eating disorder of any type, the sufferer may face severe health or mortality consequences.

Myth 5: Someone in my life has an eating disorder, but I can’t help them until they are ready to recover.
Treatment does not have to wait until someone is “ready” to recover. Often the person struggling may not fully realize that they have an illness, or they may be afraid to discontinue their behaviors even if they recognize the problem. Early intervention has been shown to correlate with greater likelihood of recovery, so treatment should begin as soon as someone is aware of the problem. If the person is under the age of 18, treatment should be immediately initiated. If the person struggling is an adult, that person’s loved ones should consistently express concerns about the eating disorder and encourage the person to seek professional help.

What can I do?
If you are concerned or learn that you or someone in your life is struggling with an eating disorder, take them to a physician or encourage them to see medical evaluation. In addition to medical care, recovery also typically includes working with a dietitian as well as a mental health professional.

The National Eating Disorders Association (NEDA) is a wealth of information on eating disorders, identifying eating disorders, and how to help yourself or someone who has an eating disorder. You can find NEDA online at www.nationaleatingdisorders.org.

Jamie Marchetti, MS, RDN, LD, is a Registered Dietitian at Campbell County Health. For a one-on-one nutrition counseling session, call 307.688.1731. Learn more at www.cchwyo.org/diet.