Generally, my posts focus on a single topic related to eating disorders, body image and related issues, and explore that topic in depth. However, this post—and the second portion, to be published next week—is a little different. It will organize 26 need-to-know facts and insights about eating disorders—one important piece of information for each letter of the alphabet. My hope is that readers don’t come away overwhelmed, but rather with a basic understanding of these complex illnesses, and an understanding of what to do next if you or a loved one is struggling with an eating disorder.
Awareness, awareness, awareness. Growing awareness of the signs and symptoms of eating disorders has resulted in expanded eating disorder treatment resources for patients and families. The field still has significant work to do in light of the finding that only one in 10 people with eating disorders receive treatment, and among those that do receive treatment, only 35 percent seek treatment at a facility specializing in the treatment of eating disorders.*
Be vigilant with friends and loved ones. More than 50 percent of teenage girls and nearly one-third of teenage boys use unhealthy weight control behaviors such as skipping meals, fasting, smoking cigarettes, vomiting, and taking laxatives.** In light of this finding, it’s likely that you will know someone with anorexia, bulimia, binge eating disorder or a related illness at some point. The best help you can provide to these individuals is to educate yourself about their illness, provide support and connect them with specialized eating disorder resources.
Co-occurring conditions are common alongside an eating disorder, including depression, anxiety, bipolar disorder, obsessive compulsive disorder and substance abuse. Understanding how the two illnesses are intertwined and addressing both effectively is important in all levels of care in the eating disorder treatment spectrum.
Don’t wait to seek eating disorder treatment. Early intervention is the best strategy to help individuals and families achieve sustainable recoveries. To an extent, eating disorders are illnesses of habit—the longer someone practices eating disordered behaviors, the more engrained those behaviors become and the more difficult it is to stop them. There are various treatment settings and experts to meet the unique needs of each patient and family. Take care to ensure your treatment teams have experience with eating disorders, as not all clinicians understand the complexities of these illnesses.
Eating disorders aren’t just about food. While an eating disorder may begin with a fixation on calories, body shape or weight, the illness generally stems from larger issues and is often an attempt to control something of substance in an individual’s life. The mistaken belief that someone can “cure” their eating disorder by “just eating” fails to acknowledge the complexity of these illnesses, which have medical, psychiatric, emotional, dietary and sociocultural aspects.
Families need support and treatment as well. Eating disorders affect whole families, not just the individual with the eating disorder. Families need to be educated about these illnesses, and understand how to support their loved one in recovery. While families don’t cause eating disorders, they are an important part of getting well and staying well.
Genetics can contribute to the development of an eating disorder. Eating disorders run in families—in fact, research has found that 40 to 50 percent of the risk of developing an eating disorder is based on genetics. Compared with the general population, a woman with a mother or sister who has anorexia is 12 times more likely to develop the disease and four times more likely to develop bulimia.*** However, eating disorders tend to be absent from the checklist of dangerous and highly-inheritable illnesses to look for in family medical histories.
Having an eating disorder is not a choice. No one chooses to have an eating disorder—they are serious mental illnesses that threaten the lives of those suffering. Eating disorders are complex, with biological, psychological and sociocultural elements, and recovering from the disease is far more complicated than simply making healthier lifestyle choices.
I have an eating disorder—what now? Specialized treatment options are available for every severity of illness. While some individuals can recover from an eating disorder by visiting a therapist, psychiatrist and/or dietitian, others—particularly those with medical complications stemming from their eating disorder behaviors—may need a higher level of care. Eating disorders thrive in secrecy and those that suffer tend to feel a lot of shame about their thoughts and behaviors, so don’t be alarmed if your loved one is initially resistant to your support.
Jokes about weight, size, shape and eating can have a serious impact on individuals’ body image and self-esteem, especially people with a genetic predisposition toward developing an eating disorder. For vulnerable groups, a seemingly innocent comment about their figure or a critique of another person’s body can trigger unhealthy behaviors related to food, eating and exercise, and in some cases, a full-blown eating disorder.
Keep a supportive network of friends, loved ones and treatment providers throughout the recovery process. Eating disorders are isolating, and individuals will often withdraw from people and activities in an effort to hide their illness. Reconnecting and nurturing meaningful relationships is an important part of eating disorder recovery.
Lasting recovery is possible, and it is likely with early recognition and effective treatment. Overcoming an eating disorder may be a long and bumpy road, but as someone living a life of recovery for over thirty years, I can assure you, it’s worth it. Don’t give up hope, and be kind to yourself and your loved ones along the way.
Medical complications are common in eating disorders, and specialized medical support is so important in effectively addressing the illness. Chronic starvation, bingeing and purging takes a serious physical toll on the body, and common medical complications edema, electrolyte imbalances, osteoporosis, constipation and organ failure.
* Characteristics and Treatment of Patients with Chronic Eating Disorders, Noordenbox, G., International Journal of Eating Disorders, Volume 10: 15-29, 2002.
** Neumark-Sztainer, D. (2005). I’m, Like, SO Fat!. New York: The Guilford Press. pp. 5.