Eating Disorders: 101
What are Eating Disorders?
Eating disorders are complex issues that disrupt a person’s relationship with food and negatively impact their mental and physical well-being and functioning. Contrary to popular stereotypes, eating disorders impact people across genders, races & ethnicities, ages, and socio-economic classes. There are several types of eating disorders:
Anorexia Nervosa – involves a pattern of restrictive eating. The individual may or may not experience low body weight.
Bulimia Nervosa – involves a pattern of bingeing and some type of compensatory behavior. Self-induced vomiting is not the only form of compensatory behavior. An individual may use exercise, fasting, or medication as compensation for eating food.
Binge Eating Disorder – involves a pattern of eating large quantities of food while experiencing a sensation of feeling out of control during episodes of bingeing.
Avoidant Restrictive Food Intake Disorder (ARFID) – involves a pattern of limited eating for reasons other than body shape/weight concerns. Subtypes of ARFID include fear of aversive consequences, lack of interest in eating, and sensory sensitivity issues.
Other Specified Feeding and Eating Disorder (OSFED)– a category for eating issues that cause impairment in someone’s life but do not fully fit in the other diagnostic categories.
Pica (eating items that are not typically considered food) and Rumination Disorder (regular regurgitation of food) are also diagnosable eating disorders. Orthorexia Nervosa is not yet a formal diagnosis but a known pattern of obsession and preoccupation with eating only healthy food.
How Eating Disorders Affect the Body
Eating disorders have a significant and wide range of impact on the body’s organ systems. Here are 5 common side effects of eating disorders:
1. Brain – mood dysregulation, irritability, low energy, preoccupation with food
2. Gastro-intestinal – slow digestion of food, constipation, stomach pain, abdominal distention
3. Endocrine – irregular or absent menstrual cycles, low testosterone, impaired fertility or virility
4. Muscles/Bones – decreased muscle mass, decreased bone density, poor dental health
5. Heart – low heart rate, low blood pressure, electrolyte imbalances
Eating disorders can lead to severe and life-threatening medical issues.
Are Eating Disorders Common?
A systematic literature review completed in 2019 and published in the American Journal of Clinical Nutrition concludes that the prevalence rate of eating disorders increased from 3.5% for the 2000–2006 period to 7.8% for the 2013–2018 period. This study noted that the prevalence rate of eating disorders is particularly high in women, though noted that the prevalence rate of eating disorders in men is increasing. Of note, this data and study was before the COVID-19 pandemic occurred, during which record numbers of medical visits and hospitalizations related to eating disorders was recorded.
Simply speaking, eating disorders are becoming increasingly more common. Future blog to come with my thoughts of why this is the case.
Can eating disorders be prevented?
Research is still limited in helping us figure out how to prevent eating disorders. Here are 3 tips I give parents to help them foster their child’s positive relationship with food and body:
1. Model a balanced relationship with food. Research shows us that there is a genetic link to eating disorders, which could be further impacted by parents modeling disordered food behaviors (e.g. restricting, bingeing, compensatory behaviors). If you struggle with your relationship with food, there is no shame in this! Diet culture does not make it easy to have a balanced relationship with food. Choose to model asking for help!
2. Avoid labeling food as good or bad, healthy or unhealthy, clean or unclean. There is no morality to food. All food can fit in a balanced relationship with food. Talk about food in terms of its qualities (sweet, sour, fresh, flavorful, chewy, bitter), talk matter-of-factly about what the food can do for your child’s body, and talk about the many purposes of food (e.g. it physically nourishes us, it gives us energy, it helps us bond socially, it holds memories and traditions)
3. Avoid judgmental comments (good or bad!) about your body and other people’s bodies. Stick to neutral and functional comments about the body.
Who diagnoses eating disorders?
Information is increasingly available online about eating disorders. This has led to an increase in self-diagnosis and for the most part, I am here for it! Accounts of people’s lived experiences with eating disorders are breaking down stereotypes and stigma and this is helping more people seek and receive help *AND* there are risks of self-diagnosis. [To learn more about the skill of holding two truths at one time, click here: https://www.sheppardpratt.org/news-views/story/dbt-101-what-does-dialectical-even-mean/]
Eating issues are incredibly nuanced and so is diagnosing them. Stay tuned for a longer blog post with my thoughts on the pros and cons of diagnoses. What I’ll say for now is that receiving the correct diagnosis for your current experience with food is key to receiving effective, efficient care. So while I’m all for empowering yourself with information, I encourage you to seek an evaluation by a trained professional who specializes in eating disorders. In general, a trained professional who is qualified to diagnosis an eating disorder is a physician, such as a psychiatrist, or a licensed therapist, such as a psychologist, counselor, or social worker.
What should I do if I have an eating disorder?
If you think you or a loved one might be struggling with an eating disorder, get on the road to recovery by scheduling an evaluation by an eating disorder specialized provider who is licensed in your state of residence. If you are located in the state of Michigan, you can message me here or e-mail me at hello@alexishartlmsw.com. If I am not available to complete the evaluation, I will send you referrals for other specialists who can. If you are located outside the state of Michigan, here is a resource to guide your search: https://map.nationaleatingdisorders.org/