Eating disorders affect as many as 30 million people in the United States. Since it’s Eating Disorders Awareness Week, let’s bust the myths and clarify the facts about these conditions.
What exactly are eating disorders?
Eating disorders are a mental condition, not an “eating” or gastrointestinal disorder. There are specific types of eating disorders:
- Anorexia (AN)
- Bing eating disorder (BEN)
- Eating Disorders Not Otherwise Specified (EDNOS)
These conditions are less about food, and more about feelings and self-expression. Very often they develop as a need to relieve stress or seek control of a situation.
Who might have an eating disorder?
Anyone can have an eating disorder.
Women who are between the ages of 16 and 25 are most likely to be diagnosed with eating disorders, but certainly, others can be, too. All socioeconomic and ethnic groups can develop an eating disorder.
When are eating disorders diagnosed?
About 90% of those diagnosed with anorexia or bulimia are women, but men may have these disorders, too.
Compared to other mental illnesses, eating disorders are more likely to go undiagnosed and/or undertreated. About 1 in 100 who seek treatment for anorexia die from the direct impact of nutritional deficits. And, up to 20% die as a result of complications such as suicide.
This begs the question: Why aren’t these disorders promptly diagnosed and treated?
Often, women don’t recognize that they have an eating disorder. This is especially true for pregnant or lactating women. (They might erroneously think it’s just those hormonal changes.) For others, it just denial.
But some women don’t seek treatment because of the stigma associated with mental illness.
What’s the treatment?
There are several treatments for these eating disorders including:
- Individual counseling focused on behavior modification
- Family therapy to address underlying causes
- Medical assessment and intervention, including antidepressants
Interestingly, though, medications aren’t all that effective. A study in the Journal of the American Medical Association showed no benefit in treating AN with medication.
In a review of the literature related to double-blind, placebo-controlled antidepressants and AN, Marvanova and colleagues concluded that “Antidepressants should not be used as sole therapy for AN…” and selective serotonin reuptake inhibitors (SSRIs) were ineffective as an acute treatment. “Use of SSRIs—primarily fluoxetine and to some extent citalopram, sertraline, or mirtazapine—may aid in relapse prevention and improvement of psychiatric symptomatology in weight-restored anorexic patients.” (Note the word relapse.)
What are some first steps to recovery?
If you, your client, or someone you love has an eating disorder, arrange for help from a mental health professional who has experience with one or more of these disorders. Most importantly, note that this is not something that will just magically disappear. In addition, just like any other issue — a broken leg, depression, diabetes, whatever it is — it won’t go away.
There are, however some first steps you might want to explore
- Books, including those recommended by HealthyWomen
- Associations, including National Eating Disorders Association (NEDA)and the Academy for Eating Disorders
- Websites with Spanish resources, such as National Eating Disorders Associations
- My podcast with Krystal Karges, RD, who explains that eating disorders can and do occur during pregnancy and lactation. She also explains how these disorders can co-exist with other conditions, such as postpartum depression.
- My podcast with Jacklyn Novatt. Jackie explains that some women go into live-in settings to recover. She went for all-day outpatient treatment, and she did well. Her story is fascinating; she explains the techniques that she and the staff used to help her overcome her anorexia. She was later able to conceive and breastfeed twins!
Certainly, I urge you to find more resources, more details and specific questions.
Whether you’re a healthcare professional, family or friend, or someone looking for a little help for yourself, please keep in mind this quote:
The first step toward change is awareness. The second step is acceptance.-Nathaniel Branden
During this week of Eating Disorders Awareness, what can you do to help yourself or others? Let me know in the comments below!