Eating disorder awareness
Portsmouth Herald - 2/27/2017
The last week in February (Feb. 26-March 4) is National Eating Disorder Awareness Week. This week, spearheaded by the National Eating Disorders Association, has been established as an opportunity to increase public awareness of and education about the various forms of eating disorders and related resources. This year’s theme is “It’s Time to Talk About It.”
Eating disorders have a number of emotional undercurrents that present themselves as abnormal behaviors around food and sometimes physical activity. They differ from “disordered eating” (which may be due to someone just not knowing how to eat or lose weight appropriately) because of this psychological base.
Often difficult to identify, they may be hidden in the guise of exercise, healthy eating, weight change during periods of active growth/development, fussy eaters, or the cultural trend of dieting for weight loss. A true eating disorder actually qualifies as a mental illness and the observed behaviors are not just because of lifestyle choices.
For many, the eating disorder is not only a symptom of the underlying psychological issues, but may temporarily act as a coping mechanism for dealing with overwhelming emotional issues. Examples of some possible benefits perceived by the victim could be a temporary feeling of control (when they are really out of control), a distraction or numbing of difficult emotions, a form of structure in the midst of emotional chaos or improvement of body image. These feelings often perpetuate denial about the eating disorder and make it more difficult for the individual to choose recovery.
Eating disorders are not limited to any specific part of the population. They can affect any age, gender, ethnicity or income level. For many, they tend to happen at times of life transitions. Even seemingly healthy individuals, like athletes, may fit criteria for an eating disorder.
When not addressed, eating disorders can lead to a number of medical health concerns, and in some cases can be life-threatening. They can also worsen other mental health issues such as depression and anxiety. They can negatively affect relationships and promote social isolation. Feelings of shame and the need for secrecy make some eating disorders even more difficult to identify and treat.
Note that just treating the eating behaviors does not necessarily mean the individual has addressed the underlying emotional issues. The individual may then move on to other negative behaviors as a replacement for what the problematic eating had provided.
Anorexia nervosa and bulimia nervosa are probably the most well-known eating disorders. Others include binge eating disorder, avoidant/restrictive food intake disorder and other specified feeding or eating disorder — previously termed “eating disorder not otherwise specified.” Note that some people may move from one type of eating disorder to another during their lifetime.
With the current trend toward healthier eating, a few other terms have surfaced. “Orthorexia” is an eating pattern where the person has taken healthy eating to an extreme. Self-imposed food rules often result in the person limiting foods over time to fewer and fewer options. This can result in inadequate nutrient and possibly calorie intake, as well as anxiety and shame when the food rules are not strictly followed. “Clean Eating” is another term that for some individuals can mimic orthorexia.
Because eating disorders are multi-faceted, a team of professionals appears to be the most effective treatment. This generally includes a mental health professional (therapist), a medical professional, a registered dietitian and possibly a family therapist and psychiatrist as applicable.
Family members and friends can be an asset in identifying problem behaviors and expressing their concern. Showing caring by being calm, unemotional and non-judgmental can be helpful. You can share concerns you have about what you have observed (like isolation, increased anxiety, worsening depression, etc.). You can even ask if there is something you can do to help.
It is not uncommon, however, for even the most tactful comments to be met with denial and sometimes anger. Keep in mind how distressful all of this may be for the individual and do not take it personally. Eating disorders can exert a lot of power over a person.
Early diagnosis and ongoing treatment tend to have the best outcomes. Once the eating disordered individual has the support of an eating disorder team, friends and family can feel comfortable fulfilling the role of caring, love and support. It has been said that “eating disorder recovery is not a sprint but a marathon.” Real recovery takes time.
Be patient and try to keep the lines of communication open. Continue to ask how you can best help. Be a good listener and try not to tell the person what he or she should and should not do. Validate feelings by acknowledging that you know this must be difficult to go through.
For many, the eating disorder has become their identity. Possibly encourage them to think about longer-term life goals that may not be consistent with their eating disorder. Remind them of what has been important to them in the past and to consider what else could give their life value. This may help to move their thoughts from the present eating disorder to the future.
There are a number of eating disorder resources, programs and professionals available. Seek out credible sources/individuals and learn the most effective ways of helping a friend or family member who may be suffering from some form of eating disorder. A good starting point to learn more would be www.nationaleating disorders.org.
—Pam Stuppy, MS, RD, CSSD, LD, is a registered, licensed dietitian with nutrition counseling offices in York, Maine, and Portsmouth. She is also the nutritionist for Phillips Exeter Academy, presents workshops nationally, and is board certified as a specialist in sports dietetics. Visit www.pamstuppy nutrition.com for nutrition information, healthy cooking tips and recipe ideas.