Eating disorders are complex illnesses, which makes the treatment of them hard. This is the experience of one individual struggling to recover, told through the lens of one morning on an inpatient ward in England. Desperate to recover, she was struggling to eat enough to do just that. A battle in her head became a […]
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A healthy relationship with food is absolutely necessary for mental and physical health. It seems so natural and simple. A baby is born and Nature provides the mother with milk that’s complete nourishment for the beginning months of life. Or if the mother can’t, or prefers not to, breastfeed the baby, there are excellent prepared ‘formulas’ that keep the infant well-nourished. Then comes “baby food” and the gradual addition of a variety of foods to provide balanced, healthy nourishment for the growing child.
But human beings are complex creatures and this basic requirement for nourishment sometimes becomes psychologically complicated, troublesome and occasionally damaging to physical health and emotional well-being.
When does a negative relationship with food begin? For each person who develops an eating disorder, the problem begins at a personally vulnerable time with a unique set of circumstances that may cause the troublesome perspective on food to worsen as months and years go by.
An eating disorder is a persistent disturbance of eating or eating-related behavior that results in the consumption of food that is not typical or not suitable for the person’s age, circumstances and nutritional needs. An eating disorder is diagnosed when that disturbance impairs physical health or psychological or social functioning.
The most common eating disorders are anorexia, bulimia, binge-eating and avoidant or restrictive food intake disorder.
About 25 million Americans are currently affected by eating disorders and about 25 percent of those are men. Eating disorders affect people of all ages, races and socio-economic levels.
The confusing thing about eating disorders is that they are not actually based on food, but are brought on by biological, psychological and social factors.
Abundance and Mixed Messages
Societies in the developed world are fortunate to have, in most communities, a wide variety of fruits, vegetables, meats, cheeses and breads that are often available year-round, thanks to transportation and refrigeration. But within that abundance, the U.S. and other Western countries have, for complex reasons, valued “thinness” to an extreme, even casually repeating the phrase, “You can never be too rich or too thin.” Well, that’s frighteningly incorrect and dangerous.
Being too thin, as in the case of anorexia, can cause serious health problems and in extreme cases, even death. Concerned health professionals, educators and parents are making efforts to increase awareness that the extreme thinness of fashion models sets a twisted and dangerous ideal of beauty.
A survey of 1,000 adults conducted for the National Eating Disorders Association found that 70 percent believe encouraging the media and advertisers to use more average sized people in their advertising campaigns would reduce or prevent eating disorders.
Scientific research on a wide range of illnesses has prompted society as a whole to understand the health benefits of fresh, pure foods.
But scientific knowledge, abundance and choice can be overridden by psychological and emotional imprints that cast a shadow over the natural impulse to eat what the body needs to survive and be healthy.
When Does a Food Choice Become an Eating Disorder?
Let’s say, for instance, a coworker brings in a cake for an office birthday celebration. Some people voice concerns about sugar and calories and refuse a piece of cake, while others voice the same concerns, but eat a piece of cake anyway, thereby setting up an internal contradiction – eating the cake, but at the same time feeling guilty about sugar intake and worried about getting “fat.”
This example of people in a self-contradictory state about something as traditional as birthday cake does not describe an eating disorder. But if you intensify and multiply this or others conflicted behaviors for every meal, and almost every interaction with food, you get an idea of the agonizing daily physical and emotional challenges of a person with an eating disorder. Combined with a distorted view of body image, it sets up an unhealthy relationship with food.
When you take these sometimes casual remarks about food, calories and being fat and repeat them so often in society that children begin to live with confusion and guilt about what they eat, it becomes an environment with the potential to increase eating disorders, which often begin in adolescence, especially among girls. These contradictions and suggestions of “guilt” about food, weight and body image are creating a troublesome, and at times deadly, health crisis.
The Troubling Statistics on Eating Disorders
In the United States, 20 million women and 10 million men suffer from a diagnosable eating disorder at some time in their life, including anorexia nervosa, bulimia nervosa, binge eating disorder, or other specified feeding or eating disorders.
Dissatisfaction with their own bodies or weight is increasingly common among young children and teenagers. Here are some more troubling statistics from the survey done for the National Eating Disorders Association:
- By the age of 6, many girls start to express concerns about their own weight or shape.
- 40-to-60 percent of girls ages 6-to-12 are concerned about their weight or becoming too fat.
- More than one-half of teenage girls and nearly one-third of teenage boys use unhealthy weight control behaviors such as skipping meals, fasting, smoking cigarettes, vomiting or taking laxatives.
Disorders Related to Food and Eating
Anorexia: A diagnosis of Anorexia Nervosa is made when a person has restricted their food intake so much that they have a significantly lower body weight than others in their general range of age, sex and physical development. The person has an intense fear of gaining weight or becoming fat. They may have a distorted view of their own body shape and be unable to recognize the seriousness of their extreme low body weight. Anorexia is 10 times more common in females than males, according to the Diagnostic and Statistical Manual of Mental Disorders, or DSM-5. Anorexia often develops in adolescence or young adulthood and is sometimes associated with a stressful life event.
Bulimia: A diagnosis of Bulimia Nervosa is made when binge eating occurs and the person feels unable to stop eating or control how much is eaten. To compensate for this binge eating, the person often takes unhealthy steps to prevent weight gain, such as self-induced vomiting, laxatives, diuretics, fasting or excessive exercise. The person is overly concerned about body shape and weight. Bulimia is 10 times more common in females than males.
Binge Eating Disorder: Although this has factors in common with bulimia, the person with a binge eating disorder does not take compensatory measures, such as self-induced vomiting or use of diuretics. Those with a binge eating disorder tend to eat very quickly, often eat until they are uncomfortably full, eat large amounts of food when they are not physically hungry and often eat alone because they are embarrassed by how much they eat. They often feel depressed or disgusted with themselves after an episode of binge eating.
Avoidant or Restrictive Food Intake Disorder: In infants or young children, this restricting of foods could result in lower than normal growth and development. This disorder often appears as a lack of interest in eating. In some children the avoidance food could be associated with sensitivity to the appearance, color, smell or texture of the food. This may sometimes occur in individuals with heightened sensory sensitivities associated with autism.
Treatment for Eating Disorders
The main goals in treatment are restoring adequate nutrition, bringing weight to a healthy level, stopping binging and purging, and reducing excessive exercise.
Psychotherapy is an important factor in gaining understanding and skills to develop healthy eating habits and body image. In some cases, where depression or anxiety is a prominent factor in the eating disorder, medication may be prescribed.
Individual, group or family counseling mcetay be a part of the treatment plan and can be a critical factor in creating a support network.
In cases of extreme malnutrition, a person may be hospitalized for a time until the condition is stabilized.
Hope for Those who Suffer from Eating Disorders
Research is continuing on the complex biological, psychological and social factors that combine to create an eating disorder. The most important step is to first acknowledge that there is a problem. Human beings are tremendously capable of growth and improvement in the face of enormous challenges, but until an issue is addressed and acknowledged, work to change cannot begin. Being able to talk about it with a trusted friend can be helpful and can diminish the sense of isolation and shame that is often a significant part of the problem. Being able to seek treatment from a professional therapist can also open a path towards healing and renewal. Eating disorders often occur in combination with other problems such as depression or anxiety, so developing a path to good health must be designed specifically for each individual. The most promising fact about eating disorders is that with professional, compassionate and consistent treatment, a complete recovery and hope for flourishing is very possible..
American Psychiatric Association, “Feeding and Eating Disorders,” Diagnostic and Statistical Manual of Mental Disorders: DSM-5, Arlington, Va., 2013
The Alliance for Eating Disorders Awareness, “What are Eating Disorders?”
National Eating Disorders Association, “Get the Facts on Eating Disorders,” New York, 2016
National Institute of Mental Health, “Eating Disorders: More Than About Food,” Bethesda, Md., 2014