Feed your mind: Understanding eating disorders
Of all the major health concerns that we face these days, one of the most common types that we may overlook is a disorder that affects over 30 million Americans at some point in their lives. It can cause emotional and physical issues and has the highest mortality rate of any mental illness. We’re talking about eating disorders. In light of National Eating Disorder Awareness Week, we decided to talk to an expert in the field of psychiatry to shed some light on this important health concern that has been a growing issue for decades.
According to Heather Lewerenz, M.D., psychiatrist at St. Helena Napa Valley, eating disorders all have one thing in common: An unhealthy obsession with food in some way. Beyond that, there are three major categories: Anorexia nervosa, where the individual severely restricts their food and calories which results in a very low body weight percentage; Bulimia nervosa, where the individual consumes large amounts of food and then engages in self-induced vomiting, laxative or over-exercise to avoid weight gain; And Binge Eating Disorder, which involves ingesting large quantities of food without engaging in the “purging” behaviors found with bulimia.
Beyond the three most common disorders, there are also many variations that might not fit the criteria for one disorder in particular, and these are classified as EDNOS—or Eating Disorder Not Otherwise Specified. This can include Night Eating Syndrome, Purging Disorder and Atypical Anorexia, to name a few.
With the exception of anorexia (where the person feels their eating habits might be the only thing they can control), eating disorders tend to give the individual a feeling of being out of control, especially during a binging and purging episode. Bulimia also commonly goes hand in hand with other compulsive behaviors, such as alcohol and substance abuse. Anxiety, depression and other mental disorders can also complicate the troubling world of eating disorders.
“What’s interesting about these disorders is that they seem to be culturally-based and the rates of them change,” she says that an example is that anorexia nervosa was rare in the early 1900s, and by the 70s and 80s it reached a prevalence of 1-3 percent of the population. Binge eating disorder is more common and recognized now as the overweight and obesity crisis in America continues to gain momentum. And with the social pressures placed upon young men and women to look “perfect,” it’s not surprising that so many of us can fall into the grips of disordered eating patterns.
It is oftentimes assumed that these disorders only happen to women, but that’s simply not the case—at least not anymore. “Incidents of all eating disorders are becoming more popular in men,” says Dr. Lewerenz. And according to the National Eating Disorders Association (NEDA), 30 million people in the U.S. will suffer from a clinically significant eating disorder in their lifetime, and 10 million of them will be men.
Risk factors are hard to quantify when it comes to eating disorders. Family history, social pressures, body dissatisfaction and other mental illnesses may all play roles in developing these illnesses. While there have been many strides in the past few years to promote body positivity, the media still glamorizes thinness and bodies that aren’t necessarily healthy.
As with many diseases and disorders, prevention is possible when it comes to eating disorders. There are universal programs that attempt to educate large populations and change public policy to spread awareness—particularly when it comes to media literacy and unrealistic body standards. There’s also targeted and selective prevention programs designed to educate and encourage adolescents and young adults about self-esteem and healthy behaviors.
Dr. Lewerenz says that one of the top concerns with eating disorders is the low rate in which people seek treatment. Only about 10 percent of individuals with the disorder will get help, and of those, only about 30 percent will get treatment in a specialized environment. Why are these numbers so low? “I think it has a lot to do with the social stigma, shame, and the guilt that prevents people from getting treatment more often,” she says, and insurance coverage can also play a role in determining what necessary treatment is on a case-by-case basis.
Can anyone truly recover from an eating disorder? According to Dr. Lewerenz, it is highly possible. “While anorexia nervosa has the highest mortality rate of any psychiatric illness (about 4 percent)—and most of us know of a few celebrities that have fallen victim to this—it’s not all doom and gloom as far as the prognosis goes,” she says. “Whether through treatment or on their own, people can absolutely go into recovery and long-term remission.”
While it may not be a disorder we hear about on the daily news, eating disorders are a major part of our culture as the pressure continues to rise when it comes to unrealistic beauty standards. As we continue to work towards healthier communities, coming together and breaking down the stigma of eating disorders is the first step to major change. If you think you may suffer with any of these issues and want to seek treatment, check out these resources or locate a doctor here.