In honor of Eating Disorders Awareness Month (February), our local Hispanic radio show asked me to join them on their Salud Con Ritmo (Health with Rhythm) Program to answer questions on eating disorders (EDs). I share my responses with you below:
Q: What is disordered eating?
A: There's a difference between "disordered
eating" and "eating disorders"...it is one of degrees. Disordered
eating is actually a common occurrence in westernized cultures: when we
skip meals or we continually eat beyond fullness or we consistently
ignore our bodies hunger or engage in dieting behaviors ... these are
all forms of "disordered eating." Disordered eating IS NOT a balanced
or healthy approach to eating and can be, depending on the behavior
and how often it happens, just as physically dangerous and emotionally
draining as a full-blown ED.
Eating disorders on the other hand must fit specific criteria from the Diagnostic & Statistical Manual for mental health issues. There are three major classifications of EDs: Anorexia is when we do not eat enough; bulimia is when we binge (eat a lot of food in one sitting with a feeling of being out of control) and then get rid of the calories through purging and Eating Disorders Not Otherwise Specified (EDNOS) which includes all the other diagnosable forms of EDs, the main one being binge eating-which is like bulimia except that there is no purge after the binge.
The characteristic that often indicates that we've stepped over the line from disordered eating to a full blown ED is "obsessionality." If we are obsessing over food, weight, eating, exercise, that's often when we may become diagnosable. Again, it's a matter of degree.
An important point to make is that although it may sound odd or counter intuitive, EDs are often a way to cope with overwhelming emotions or events...they can develop as a way to help a person survive intolerable feelings or situations.
Q: What are some of the possible signs and symptoms?
A: Extreme emotions, attitudes, and behaviors surrounding weight, body and food...so what we'll often notice is the person is:
• counting calories
• engaging in extreme physical activity
• frequently skipping meals
• feeling guilty when they eat; eating in secret
• experiencing weight fluctuations
• experiencing bloating/nausea/abdominal pain/constipation
• withdrawing from friends
• no longer having periods or their periods are irregular
• experiencing thinning hair
Q: What are the main causes attributed to EDs?
development is actually pretty complex and as varied as the people who
suffer with them but five of the main contributing factors include
1.Genetics; 2.Temperament and certain character/personality traits; 3.
Familial influences 4. Dieting; and 5. Our culture. To explain a bit
more on each:
➢ Genetics: Genetics & neuro-biology have been found to play significant roles.
➢ Temperament/character/personality traits: Those with a tendency towards depression, anxiety, obsessive/compulsive behavior, or extreme sensitivity and vulnerability are at greater risk.
➢ Familial: First I have to state that parents do NOT cause EDs but we can contribute to their development or their continuance simply because we, too, are products of western culture and attitudes. If we insist on perfection or have an ongoing weight or fitness focus, if we are dieting, or continually insulting our own or others' bodies then our behaviors can create a toxic environment for those we love.
➢ Dieting: Dieting increases obsessive thoughts of food and causes binge eating. The number one predictor of who will develop an ED is having a parent who diets.
➢ Cultural: Magazines, television, marketers who give us the message that the only thing of value about us is our looks and that the ideal body is thin. Thus, if we are not beautiful and thin, then we must do everything possible to become so...because it is only then that we will achieve true happiness and feel that we have worth.
Q: Who is at risk?
A: Nearly everyone, especially those who have three or four of the contributing factors we just talked about...EDs affect both males and females, all races and ethnicities that are exposed to western culture, all socio-economic and educational levels--we're seeing those who suffer as young as five and as old as 95. It is during major life transitions or events that we often see an increase in ED behaviors: from childhood to teen, teen to adult, elementary school to middle; middle to high; high school to college; college to "life"; young adult to middle age; middle age to old age; marriage, birth of children, divorce, serious illness or traumatic experiences or even common surgical procedures such as the pulling of wisdom teeth. Anything that promotes an initial weight loss that then gets complimented and reinforced.
Q: What are the treatments?
A: It is very important to state that complete healing IS possible. I have met far too many previous sufferers to doubt that fact! But it is rare for a person to heal on their own: professional treatment is always needed with an ED.
How treatment looks depends on the behaviors involved and the needs of the patient (An important side note: if purging is involved in any amount the individual MUST be seen by a doctor well-versed in EDs to be sure the heart is not starved: a person can look and feel fine and actually be close to death).
The methods involved in treatment are not as important as the trust and relationship a person has with their treatment providers and the fact that the patient and their family are a part of the team working together towards healing. This team can be pulled together individually or it can be a pre-existing team affiliated with a treatment center or program...
In addition to the patient and their family, the team needs to include as many of the following as possible: an individual therapist, a psychiatrist, a family therapist, a health care provider, a nutritionist/dietitian and an exercise physiologist. All of them need to be well-informed and experienced in successfully treating EDs. Then, depending on the person's needs, the team will determine the level of care from outpatient to partial or full hospitalization.
Q: How can we prevent EDs?
A: Prevention really begins inside...we need to look at changing how we think, feel and especially how we speak about food, weight and looks. There are two MAJOR things we can do to help prevent eating disorders:
1. We need to LOVE and accept our bodies as they are today. If love and acceptance are too difficult then let's at least RESPECT our bodies. We can start by getting rid of any fitness or fashion magazines we may have (they just make us feel lousy about ourselves and our bodies).
2. No body bashing or food talk...We call this "FAT TALK" We've all heard it (or said it ourselves). Researchers have found that Fat talk can actually contribute to eating problems! Fat Talk sounds like this: "Do I look fat in this?" or "She shouldn't wear that!" or "My thighs are disgusting!" or "I can't eat that--I'd gain a ton!" or "You look great...Have you lost weight?" or "You'd be so pretty if you weren't so fat!"
I can now imagine how much better it would have been if instead of continually insulting my own body in front of our daughters, I had instead celebrated and honored how strong and able my body is...without it I would not have been able to give birth--and its lumps and bumps and rolls are a proud testament to a life LIVED!
May this month of ED Awareness bring additional understanding and compassion of these all-too-often misunderstood disorders.
Blessings until next time,