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Could I (or somebody I care about) Have an Eating Disorder?

This can be a scary question to ask about yourself or somebody you care about. In this blog, I will address some of those fears and provide information that can help you or your loved one move forward on a path to recovery from a challenging and potentially deadly relationship with food. Although eating disorders can be difficult to treat, the good news about eating disorders is that total recovery is possible. Additionally, the chances of recovery go up significantly with family or friend support, particularly if the symptoms are caught early and the person receives treatment from providers specifically trained in the treatment of eating disorders.

People with eating disorders usually experience severe disturbances in their eating behaviors, related thoughts, and emotions, and become preoccupied with food and body weight or shape. They can develop severe medical complications as a result of restrictive eating or purging behaviors.

Eating disorders affect millions of people in the United States, and often people deny or hide that they have a problem. Eating disorders also have the highest rate of mortality of all mental health diagnoses, and cause of death is most often due to suicide or cardiac problems from malnutrition or purging behaviors.

Eating disorders can be difficult to cope with, for individuals with the eating disorder as well as the people connected to them.

How do eating disorders come about?

Eating disorders often run in families, and there can be genetic and biological factors that increase the chances of developing one. Other mental health challenges such as anxiety, depression, and trauma reactions including Post Traumatic Stress Disorder (PTSD) can contribute to the development of an eating disorder. Social and cultural factors can play a role as well, such as influences from media that emphasize unrealistically thin or muscular images.

Myths about eating disorders

One of the most common misconceptions is that people can tell if somebody has an eating disorder just by looking at them. People sometimes can think there’s an easy solution. They may even say “Why don’t you just eat?!” That said, eating is one behavior that is simple, but not necessarily easy for someone with an eating disorder. Another false belief is that only young, white, cis-gendered females can develop eating disorders. The truth is, eating disorders can often occur in people who identify as male (whether cis- or transgender), as well as in those who identify as nonbinary or as part of the LGBTQ+ community.

What does healthy and unhealthy eating look like?

That depends on many factors which can include not just a person’s internal motivations and thought processes, but also age, family history, medical history, and whether they belong to a traditionally privileged group or a marginalized community due to their ethnicity, sexual orientation, gender presentation, body shape, body size, or economic class. We hear so much information about food, diets, and physical activity from our families, in school, and society in general that it can be confusing and frustrating.

A person’s eating behaviors can fluctuate during different phases of their life, and can sometimes cover the range from healthy eating to disordered eating patterns, to a diagnosable eating disorder. Getting a thorough, accurate assessment of a clinically significant eating disorder requires evaluation by a trained health care professional to determine the degree of symptom severity and an appropriate level of care (outpatient treatment, partial hospital treatment, or residential treatment after a period of medical stabilization in a hospital setting.)

But there is a brief screening process available for non-professionals which can clearly indicate if a person needs to seek medical help for their struggles with food:

1) Do you make yourself sick (induce vomiting) because you feel uncomfortably full?
2) Do you worry you have lost control over how much you eat?
3) Have you recently lost more than approximately 15 pounds in a 3-month period?
4) Do you believe yourself to be fat when others say you are too thin?
5) Would you say that food dominates your life?

If you or your loved one answers “yes” to two or more of the questions above, you should make an appointment for an assessment with an eating disorders professional, such as a therapist, dietitian, or physician.

An additional factor that can influence whether disordered eating turns into an eating disorder is related to one’s current level of stress. The global coronavirus pandemic has raised stress levels for people all over the world, and has often led to an increase in symptoms for those who have successfully managed their eating disorders prior to COVID-19. If this sounds familiar to you, please try to offer yourself some compassion and reach out for help again. A slip doesn’t have to turn into a fall if you can get some support.

How can I help you with your eating disorder?

Each person’s needs around eating behaviors, activity levels, and communication patterns are different, so I’ll work with you where you are and with your specific struggles. We’ll address themes that commonly occur, as well as your thoughts and beliefs about food and meals based on what you learned in your family. We’ll talk about your behaviors around eating, meal timing, and weight goals as well as your thought patterns and belief systems about food and control. We’ll explore any communication difficulties you might have with friends and family. I will support you and challenge you in a gentle and conscientious manner. I will validate your feelings because feelings are neither right nor wrong, they just are, and it’s what we do with them that matters most.

Freedom

One other question you may have after reading this is “What does recovery look like?” From many people, I’ve heard that answer summed up in one word—freedom. Freedom from constantly thinking about what they should or shouldn’t eat. Freedom from worrying about what the number on the scale will be, or how to handle the next family gathering that focuses on a special meal. Freedom from whether they should go exercise because they need to fit into a smaller pair of pants or burn a certain number of calories, and not just because they enjoy moving their bodies and spending time in nature or simply playing. Food can be scary and difficult and isolating, and it can also be one of the greatest sources of pleasure and connection in one’s life to the self, loved ones, and culture. If you’re struggling with food and want to move towards a place of contentment with it, please reach out for help. It can get better.

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