Category: Eating Disorders

Categories
Eating Disorders

When A Bit Too Much Is An Issue

While some mental illnesses may present themselves independently under certain  scenarios, it’s important to acknowledge that some are interconnected as the side effects of one illness result in symptoms of another. The overlapping of various mental illnesses can especially be seen in the connection between anxiety and eating disorders, whether that be bulimia, anorexia, or other forms of disordered eating.

Before we begin to break down this web, we have to define anxiety, at least in the context of this situation. Many studies conducted have used the cognitive approach to anxiety, which is the thought that anxiety is the designation of specific stimuli as an excessive threat,  no matter how small or innocent it may seem (Pallister & Waller, 2007). Consequently, a bias against the stimuli is formed, evoking negative thoughts and fear from the individual. In order to deal with the effects of this bias, people may utilize different strategies of coping mechanisms. 

When it comes to generalized anxiety disorder, simple procrastination of tasks, overthinking, and organizing every little detail are one of the many mechanisms demonstrated. In terms of disordered eating, however, overeating or undereating is also a very common tactic. One study of 271 subjects found that 71% of individuals with an eating disorder had a comorbidity, a presence of two or more diseases at the same time, with anxiety (Godart et al., 2006). Another study found that the percentage of comorbidity was 64%, supporting the fact that there is an evident relationship between anxiety and eating disorders  (Godart et al., 2006).

Using food to relieve stress from stressful situations isn’t just seen in people with mental illnesses. Comfort eating, or emotional eating, is common within the general population too. The most common scenarios that come to mind are stuffing yourself with junk food after a bad breakup, or increasing your sugar or caffeine intake to pull all nighters (Pells, 2019). With that frame of reference in mind, it’s easy to see how food can be a diversion from the problems being faced, and how it might offer a brief respite from the tension and stress of dealing with it all.

However, the act of associating eating with stress relief would have more consequences than usual for those with a comorbidity for anxiety and disordered eating. The presence of these illnesses would mean that the stressor is most likely to affect the individual at a stable, frequent basis, which could encourage coping behaviors such as comfort eating. However, the dependence on these behaviors can eventually cause a continuous cycle of more harm than good without the realization or acknowledgement of it. Just like the consequences of any other mental illness, these behaviors need to be acknowledged and treated with the help of a professional who can validate the individual’s progress and guide them towards healing.

 

References

Godart, N., Berthoz, S., Perdereau, F., & Jeammet, P. (2006). Comorbidity of anxiety with eating disorders and OCD. The American Journal of Psychiatry, 163(2), 326; author reply 327–326; author reply 329. https://doi.org/10.1176/appi.ajp.163.2.327

Pallister, E., & Waller, G. (2008). Anxiety in the eating disorders: Understanding the overlap. Clinical Psychology Review, 28(3), 366–386. https://doi.org/10.1016/j.cpr.2007.07.001

Pells, J. (2019, April 16). Anxiety and overeating – What’s the overlap? Eating Disorder Hope. https://www.eatingdisorderhope.com/treatment-for-eating-disorders/co-occurring- dual-diagnosis/anxiety/anxiety-overeating-whats-the-overlap 

Categories
Eating Disorders

Common Misconceptions about Eating Disorders

Having an eating disorder is more common than most people realize. It is an all-consuming disease that impacts at least 9% of people worldwide. The scientific community only recently began to investigate eating disorders. That being said, there are many misconceptions regarding eating disorders, which contributes to the negative stigma surrounding them. These are just some of the many myths about eating disorders that continue to persist today.

The biggest misconception circulating about eating disorders is the idea that they are entirely a choice that stems from vanity. Not only is this false, but it is incredibly dismissive of the severity of eating disorders and the experiences of people who suffer from eating disorders. Oftentimes a desire to get healthy or exercise more can spiral out of control, thus resulting in an eating disorder (University of Rochester Medical Center, 2021). Eating disorders are a mental illness as well as a physical one. In addition, most eating disorders occur alongside other mental illnesses such as depression, anxiety, and obsessive-compulsive disorder. There are a lot of factors that play into eating disorders, which illustrate how they are not merely the result of a personal choice or decision. They are illnesses that need to be addressed by a medical professional or expert. Furthermore, eating disorders like anorexia are mainly about self-image rather than external appearance to others.

Another common myth about eating disorders is that they only affect a small subset of people. It is important to recognize that eating disorders look different for different people, and they can impact someone regardless of gender, race, sexual orientation, or background. In the United States, approximately 10 million males will develop an eating disorder at some point (National Eating Disorders, 2018). Men do not get a diagnosis early on since they might not exhibit physical signs of having an eating disorder until much later, which can prolong the suffering and damage done to the body. As a result of the stigma and gender bias, most men are unlikely to seek treatment for their eating disorder. Creating these unnecessary misconceptions only adds to the lack of information and representation that exists within the eating disorder and health communities.

Lastly, a pervasive misconception about eating disorders is that they center around weight fluctuation. As stated previously, eating disorders are mental as well as physical, so being overweight or underweight does not mean that someone is not suffering from an eating disorder. Someone who is of a normal weight can also have an eating disorder. In fact, eating disorders are often paired with self-esteem issues, so changes in eating patterns do not fix the underlying mental health issues (Health Talk, 2019). Focusing on weight actually makes it harder for those who are suffering to seek help. Centering the conversation around weight instead of mental illness makes it harder to destigmatize eating disorders.

Engaging in a conversation around mental illness and eating disorders can help alleviate some of the negative stigmas surrounding them. In addition, educating others who do not have eating disorders can have a positive impact in changing the way we look at eating disorders. If you know someone who is struggling with an eating disorder, it’s important to support them and encourage them to seek professional help.

 

References

Eating disorders in men & boys. (2018, February 26).

Eating disorders (young people). (n.d.). Retrieved April 19, 2021.

Myths about eating disorders. (n.d.). Retrieved April 19, 2021.

Eating disorder myths. (2019, August 22). Retrieved April 19, 2021.

Categories
Eating Disorders

When Food Aversion goes Too Far: The Story of ARFID

Oftentimes, children are classified as “picky eaters” when they refuse to eat all of the food on their plate, or they don’t like certain foods that are commonly eaten. However, there are times when picky eating can manifest into something more extreme, an eating disorder known as avoidant/restrictive food intake disorder, or ARFID. Thus, it’s important to make the distinction between picky children and children who suffer from ARFID, because grouping them in the same category contributes to the misinformation surrounding eating disorders. 

ARFID is an eating disorder in which individuals “experience disturbed eating either due to a lack of interest in eating or distaste for certain smells, tastes, colors, textures, or temperatures,” (Petre, 2019). This causes the sufferer to purposely engage in restrictive eating habits in order to avoid certain foods, which ultimately causes them to severely restrict their calorie intake. It is important to note that picky eaters and ARFID are not the same things, as ARFID goes beyond the scope of picky eating. It typically develops during early childhood, but it is not exclusive to children and can extend into adulthood. There is nothing specific that causes this type of eating disorder. Rather, there is a list of contributing factors that can influence a person’s predisposition for ARFID. ARFID and anorexia are similar, as both foci on restricting food intake. However, those who suffer from ARFID do not share the same concerns about body image or weight as those who suffer from anorexia. 

Children who have ARFID can experience serious health consequences due to their restrictive eating habits. This can lead to stunted growth and a lack of weight gain, whereas in adults, the main health concern is extreme weight loss (National Eating Disorders Association, 2018). Other symptoms include impaired immune function, dizziness, gastrointestinal problems, and menstrual irregularities (National Eating Disorders Association, 2018). Since the body is essentially starved of essential nutrients, serious health problems can arise from eating disorders such as ARFID.  If a child has other mental illnesses where eating disorders may be one of the symptoms—such as anxiety, developmental delays, or autism—these co-occurring diagnoses might make the mental health issues worsen. In addition, if a person is genetically or biologically predisposed to ARFID, a stressor or traumatic event may trigger their eating disorder tendencies (“What is ARFID,” 2020). Recognizing how ARFID interacts with other co-occurring illnesses is essential in order to get the proper care for it. 

While this disorder is serious, there are treatment options available. Eating disorders are mental health disorders as well, and need to be evaluated as such (Petre, 2018). As always, seeking help from a professional is important to overcome unhealthy eating patterns and ways of thinking, but there are other methods that can be used to treat ARFID, like specialized care programs and cognitive therapy. There are many ways that eating disorders can affect the body, so seeking treatment can help prevent further health conditions and mental health issues. 

 

References

Avoidant Restrictive Food Intake Disorder (ARFID). National Eating Disorders Association. (2018, February 22). https://www.nationaleatingdisorders.org/learn/by-eating-disorder/arfid. 

Petre, A. (2019, October 30). Learn about 6 common types of eating disorders and their symptoms. Healthline. https://www.healthline.com/nutrition/common-eating-disorders.

What is ARFID: Symptoms, causes, and complications. (2020). https://centerfordiscovery.com/conditions/arfid/.

Categories
Eating Disorders

The Differences Between Orthorexia and Anorexia Nervosa

Eating disorders are commonly misunderstood, and orthorexia and anorexia are no different. While their names have similar origins and meanings, these eating disorders are often mistakenly grouped together when there are noticeable differences between the two. While they both have to do with restricting food intake, they are fundamentally different when it comes to their relationship with food.

Orthorexia is defined as an obsession with “clean” eating (Center for Discovery 2019). The main characteristic of orthorexia is that it is centered around food quality and diet (Petre 2020). This means that people who suffer from this eating disorder tend to be so fixated on eating healthy foods like fruits and vegetables that it consumes their daily life. Extreme forms of orthorexia and this clean eating cycle can lead to the individual isolating themselves from their friends and family, and suffering health consequences like bone or muscle loss, heart problems, partial or complete absence of a period in women, decreased testosterone levels in men, gastrointestinal problems, among other things, as a result of only eating certain types of food (Mayo Clinic 2018). Unfortunately, orthorexia has yet to be recognized as an eating disorder by the American Psychiatric Association, but it is beginning to gain more acknowledgement within the eating disorder community. 

On the other hand, anorexia nervosa is defined as having a distorted body image that leads to a severe fear of gaining weight (Center for Discovery 2019). Thus, people who suffer from anorexia typically do whatever they can to avoid gaining weight, which can include taking on restrictive eating habits, over-exercising, and counting calories. There are two subcategories of anorexia nervosa: restrictive eating and binge-eating or purging (Center for Discovery 2019). Most people only know of the restricting type, which is where people restrict their food intake in order to lose weight. However, the other type, binge-eating, is where people will not eat for long periods of time and then eat a lot of food all at once. This is followed by self-induced vomiting or other behaviors like excessive exercise or laxative reliance. 

Anorexia nervosa primarily centers around body image and appearance as opposed to orthorexia, which centers around obsessive healthy habits. Both of these eating disorders can pose serious health risks, as previously mentioned. These health conditions can have long term effects on one’s body. Understanding the differences between orthorexia and anorexia is important because it not only helps dispel misrepresentation around them but also helps bring more attention to potential treatment options. 

Eating disorders affect more people than one might think. According to the National Association of Anorexia Nervosa and Associated Disorders (ANAD), 9% of the population worldwide suffer from some sort of eating disorder. Over 28 million Americans will have some sort of eating disorder in their lifetime, and less than 6% of people with eating disorders are classified as “underweight” by their doctor (ANAD 2021). This makes it harder for people who have eating disorders to get properly diagnosed because the diagnosis is based on looks and not off of mental health or internal factors. Despite the prominence of eating disorders in society, many people and medical professionals are still unaware of the best treatment options for eating disorder patients, or even what the general signs of an eating disorder are.

Anorexia nervosa and orthorexia are just a few of many eating disorders. However, they are among the most commonly known in society and in modern times. Many of these disorders are rooted in a desire for control, so relinquishing that desire and working towards recognizing the signs of an unhealthy relationship between food is a good start to overcoming an eating disorder. Once these patterns are identified, it’s important to seek medical help from a professional or contact the Association of Anorexia Nervosa and Associated Disorders for better treatment options. Many people around the world struggle with some form of disordered eating, and overcoming anorexia or orthorexia is a journey, not just a one-time battle. 

 

References

The Difference Between Anorexia Nervosa and Orthorexia Nervosa. Center For Discovery. (2019, October 22). https://centerfordiscovery.com/blog/anorexia-nervosa-orthorexia-nervosa/. 

Eating Disorder Statistics: General & Diversity Stats: ANAD. National Association of Anorexia Nervosa and Associated Disorders. (2021, March 3). https://anad.org/get-informed/about-eating-disorders/eating-disorders-statistics/?gclid=Cj0KCQjw3duCBhCAARIsAJeFyPUAe8yMKfqArkWdEn-SeHydHnwaOqNHZr_RL_efGvz5Tr5TN18y0uAaAjGUEALw_wcB. 

Mayo Foundation for Medical Education and Research. (2018, February 20). Anorexia nervosa. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/anorexia-nervosa/symptoms-causes/syc-20353591. 

Petre, A. (2020, April 2). What to Know About Orthorexia. Healthline. https://www.healthline.com/nutrition/orthorexia-nervosa-101.

Categories
Eating Disorders

Emotional Eating: Spotting the Warning Signs for an Eating Disorder

Contrary to popular belief, disordered eating doesn’t always start in the same way. It can be a gradual process that is hard to recognize at first, but after a while can turn into something more serious. Having an unhealthy relationship with food can begin as easily as snacking during the middle of the night, or simply turning to food during times of extreme stress, boredom, or other emotional situations.

Emotional eating is defined as “the practice of consuming large quantities of food—usually ‘comfort’ or junk foods—in response to feelings instead of hunger” (Stoppler, 2018). Many people use food as a coping mechanism because it gives them a sense of comfort or control over bad life circumstances, like a breakup or a bad grade on a test. However, the initial feeling of happiness or relief is quickly replaced with guilt as a result of excessive eating, which can begin the vicious cycle of disordered eating. Suddenly, food has more control over you than you do over it, causing an overreliance on food and an unwillingness to face the problem head-on (Smith et. al, 2020). Eating disorders are as much a mental battle as they are a physical one. Emotional eating can lead to a negative self-image, since the aftermath of binging can lead to feelings of guilt or shame. It can be tough to break the cycle of emotional eating, and eventually, a full blown eating disorder like bulimia or binge eating can develop. 

Having a disordered relationship with food can cause a variety of changes within one’s body. The most common characteristics of emotional eating are low-self esteem, preferences to junk food over healthy food, sudden cravings, and intense feelings of hunger, even when full (Hunnicutt, 2020). These symptoms are easy to hide from others, which makes stopping unhealthy habits all the more difficult. It’s important to understand that food is meant as a source of nutrients, not a source of comfort. Once the lines blur, it can become difficult to overcome the physical and emotional barriers that come with  overreliance on food. 

Eating disorders can also create a chemical imbalance in the brain, leading to increased levels of serotonin that are satisfied when food cravings are fulfilled, and cortisol levels fluctuating as a response to stress. Some notable signs of a developing eating disorder include lethargy, dehydration, dizziness, low blood pressure, and constipation (Hunnicutt, 2020). Without proper treatment, these side effects can have long-lasting consequences on the body. First, it can cause a disconnect between the stomach and the brain, which leads to the stomach not knowing that it’s full because eating quickly doesn’t allow certain hormones time to signal to the brain that you are full. As a result, you keep eating. In addition, many individuals have certain triggers that cause them to resort to emotional eating. It’s important to identify these triggers so they become easier to overcome. 

While the fight to stop emotional eating can seem like an uphill battle, there are many other, healthier mechanisms that can be used to break unhealthy eating cycles and provide positive emotional support. Positive self-talk, meditation, and eating healthy foods are also good ways to form better habits and an overall better relationship with food. Learning how to cope with stress in a constructive way is essential to breaking the cycle of disordered eating, and speaking to a therapist or seeking support overall can be helpful as well.

 

References

Hunnicutt, C. (2020, October 9). Is Emotional Eating a Warning Sign for Eating Disorders?: Clementine – Adolescent Eating Disorders. Clementine. https://clementineprograms.com/warning-sign-eating-disorders/. 

Marcin, A. (2018, August 29). Emotional Eating: What You Should Know. Healthline. https://www.healthline.com/health/emotional-eating#What-causes-someone-to-eat-because-of-their-emotions?

Smith, M., Robinson, L., Segal, J., & Segal, R. (2020, September). Emotional Eating. Emotional Eating – HelpGuide.org. https://www.helpguide.org/articles/diets/emotional-eating.htm. 

 Stoppler, M. (2018, December 21). Definition of emotional eating. https://www.medicinenet.com/emotional_eating/definition.htm. 

Categories
Eating Disorders

The Freshman 15 and the Stigma Behind College Weight Gain

College can be a stressful time for people. The overwhelming workload, being in a new environment, and adhering to an unfamiliar routine can be a difficult adjustment, especially in the first couple of months. All of these changes can lead to a drastic shift in eating patterns, causing unhealthy eating habits to form. The stigma surrounding gaining weight in college is incredibly detrimental to students, because students feel pressure to compare themselves to others and look a certain way, and these unhealthy habits can have adverse long-term health consequences.

The term “freshman 15” is often associated with excess weight gain, roughly about 15 pounds, that students tend to gain during their first year of college. However, this phrase is merely an umbrella term; some students gain more or less weight, and some even lose weight during their freshman year. The wide variety of choices in campus dining halls is a significant contributing factor to some students’ weight gain, as they are exposed to more options than they have ever had before (Scott, 2020). Furthermore, having more dining options means students are more prone to snacking or eating during late-night study sessions, which can also contribute to weight gain (Scott, 2020).  This idea of the freshman 15 puts “a label on the possibility of weight gain,” which can lead to “an unhealthy thought process that can then lead to concerning behaviors, such as disordered eating and excessive exercise,” (Woodall, 2018). The idea of the “freshman 15” ties weight to self worth, which puts pressure on students to not fall into a stereotypical category. As a result, any sort of normal weight gain becomes a negative thing to that individual because of this stereotype. Contrary to popular belief, eating disorders are more than just choosing to skip meals at certain times throughout the day. It is a thought process that can affect everyday life.

Gaining weight in college is often a result of stress brought on by acclimating to a new lifestyle, which is a normal part of the college experience. Stigmatizing that puts unnecessary stress on students. Some students develop eating disorders as a way of maintaining control over their life, while others fall prey to the unrealistic expectations of diet culture that exist at their college campus. On the opposite end of that spectrum, some students are overwhelmed with the vast array of choices at college, and eat due to stress or comfort, leading them to gain the aforementioned “freshman 15.” Oftentimes the warning signs of an eating disorder can go largely unnoticed due to the lack of parental influence and the newfound freedom that a student has (Kuhn, 2018). It’s important to recognize that eating disorders can vary from person to person, and there is no way to physically tell when someone is struggling with disordered eating. 

Since college can be an overwhelming experience, it’s especially important to prioritize self-care. This means listening to your body’s needs, prioritizing mental health, and staying active are crucial to having a successful first year at college. Finding healthy outlets for emotions and stress is important for students if they find themselves practicing unhealthy eating habits (Ekelman, 2019). If you or someone you know is struggling with an eating disorder, contact the National Eating Disorder Hotline, or speak to a licensed counselor or therapist. There are many resources in college that are designed to help students, and taking advantage of them is the best way to get the most out of your college experience.

 

References 

Ekelman, R. (2019, June 18). “Freshman 15” – breaking the stigma of 1st year college weight gain. Retrieved February 22, 2021, from https://www.eatingdisorderhope.com/programs/colleges-and-universities/breaking-the-stigma-of-the-freshman-15

Scott, E. (2020, October 03). Is the ‘Freshman 15’ due entirely to stress? Retrieved February 22, 2021, from https://www.verywellmind.com/what-causes-the-freshman-15-3145170

Staff, S., & Kuhn, S. (2018, October 14). The weekender: Fearing the freshman 15: CONFRONTING body image issues and eating disorders in college. Retrieved February 22, 2021, from https://www.dailycal.org/2018/10/13/fearing-the-freshman-fifteen-confronting-body-image-issues-and-eating-disorders-in-college/

Woodall, G. (2018, August 29). Rethinking the “freshman 15”: Talking about our bodies with kindness. Retrieved February 21, 2021, from https://www.nationaleatingdisorders.org/blog/rethinking-%E2%80%9Cfreshman-15%E2%80%9D-talking-about-our-bodies-kindness

Categories
Attention-Deficit/Hyperactivity Disorder Eating Disorders

ADHD and Eating Disorders: A Connection

It’s the third time in the last hour that you’ve ventured into the kitchen, searching for a quick snack. It’s okay, you tell yourself, I’ll just eat a cup of zucchini for dinner. Your eyes scan the room, searching high and low for that thing that will satisfy the itch in your brain. You weren’t even hungry, but the urge to get up and do something, anything, was too powerful to overcome, and you gave in for the third time. I guess I’m kinda hungry, you say, convincing yourself that the slight dissipation of painful fullness is actually hunger. You take a couple of bites of your prized snack (maybe a couple more), exit the kitchen, and return to your interrupted activities. This is just one situation that could be familiar for those with comorbidity for binge eating and ADHD. Binge eating disorder is just one of several eating disorders that researchers found to have associations with Attention-Deficit/Hyperactive Disorder.

Attention-Deficit/Hyperactive (ADHD) is a complex common brain disorder that millions of people worldwide have. It can influence attention, behavior, and impulsivity and can manifest itself in a variety of symptoms under the three types: hyperactive-impulsive, inattentive, and combination (Web M.D. n.d.). The hyper-impulsive type is notably characterized by restlessness while the inattentive type is characterized by forgetfulness and low attention. (Mentalhelp.net, n.d.). A contributing cause of ADHD development is deficient amounts of the neurotransmitters norepinephrine and dopamine in the brain (Greenblatt, 2019). These neurotransmitters are involved in attention, rewards, learning, and memory (Ranjbar-Slamloo & Fazlali, 2020). With low levels, individuals may experience issues with attention, forgetfulness, and impulsivity. These symptoms could apply to eating schedules in which individuals may experience decreased awareness of biological hunger cues (resulting in eating until overstuffed or uncomfortably full). Individuals may also experience an increased desire to eat rewards foods, potentially leading to an eating disorder (Greenblatt, 2019). ADHD can also affect eating differently, by being used as a form of self-medication. In one survey completed by women with ADHD, carbohydrate-based snacks and foods were reportedly used “as a means of self-calming” and stimulation against boredom which could cause overeating and/or eating disorder development (Quinn & Nadeau, 2020). 

ADHD has a relatively high rate of comorbidity — the presence of having two or more chronic conditions — estimated to be occurring 60-80% of the time with other conditions, including eating disorders (Mentalhelp.net, n.d.). Evidence supporting comorbidity and associations between eating disorders and ADHD have been found in various studies, one study found that girls with ADHD were “3.6 times more likely to a clinical or subclinical ED [eating disorder] and 5.6 times more likely to clinical or subclinical BN [bulimia nervosa]” (Bleck, 2015). Another study observed that 21% of newly admitted inpatients at a treatment facility for eating orders displayed six or more ADHD symptoms (Bleck, 2015). Other studies conducted on both men and women have also seen strong associations of ADHD eating disorders, especially with bulimia nervosa (Ziobrowski et al., 2018). 

Though more studies are still being conducted to demonstrate correlations between ADHD and eating disorders, present information gives strongly supporting evidence of an association between the two. With more research being conducted, more information on ADHD and eating disorders (as well as other possible comorbid disorders) will be accessible, ultimately resulting in improvement in how to properly recognize and effectively treat them.  

 

References 

ADHD Comorbidity. Mentalhelp.net (n.d.). Retrieved February 20th, 2021, from https://www.mentalhelp.net/adhd/and-comorbidity/ 

Attention Deficit Hyperactivity Disorder (ADHD). Web M.D. (n.d.). Retrieved February 19th, 2021, from https://www.webmd.com/add-adhd/childhood-adhd/attention-deficit-hyperactivity-disorder-adhd   

Bleck, J. R., DeBate, R. D., & Olivardia, R. (2015). The Comorbidity of ADHD and Eating Disorders in a Nationally Representative Sample. The journal of behavioral health services & research, 42(4), 437–451. https://doi.org/10.1007/s11414-014-9422-y 

Greenblatt, J. “ADHD and Disordered Eating .” (2019) Walden Eating Disorders, https://www.waldeneatingdisorders.com/blog/adhd-and-disordered-eating/ 

Quinn, P., and Nadeau K . (2020) “Is There a Link Between Eating Disorders and Women with ADHD?” ADDitude, ADDitude,, www.additudemag.com/adhd-and-eating-disorders-why-women-can-struggle-with-both/.  

Ranjbar-Slamloo, Y., & Fazlali, Z. (2020). Dopamine and Noradrenaline in the Brain; Overlapping or Dissociate Functions?. Frontiers in molecular neuroscience, 12, 334. https://doi.org/10.3389/fnmol.2019.00334 

Ziobrowski, H., Brewerton, T. D., & Duncan, A. E. (2018). Associations between ADHD and eating disorders in relation to comorbid psychiatric disorders in a nationally representative sample. Psychiatry research, 260, 53–59. https://doi.org/10.1016/j.psychres.2017.11.026

Categories
Depression Eating Disorders

Eating Disorders: The Consequences

Eating disorders are a set of widespread and life threatening conditions.  According to a new study published in Biological Psychiatry based on the largest national sample of U.S. adults of 36,309 people, around “0.8 percent of adults will be affected by anorexia nervosa in their lifetime; 0.28 percent will be affected by bulimia nervosa; and 0.85 percent will be affected by binge eating disorder” (Udo & Grilo, 2018).  Furthermore, eating disorders affect people of every age, sex, gender, race, ethnicity, and socioeconomic group and could have severe consequences on a person’s emotional and physical health (“Risk Factors”, 2018).

Eating disorders affect every organ system in a person’s body, including the brain.  Because of this there are many health consequences associated with having an eating disorder.  By consuming fewer calories, the body starts to break down muscle and tissue for fuel. Due to this, the heart has fewer cells and less fuel to pump blood with and pulse and blood pressure begin to drop and the risk of heart failure increases (“Health Consequences”, 2018).  In the case of orally purging the body of food, the body is losing electrolytes which “can lead to irregular heartbeats and possible heart failure and death” (“Health Consequences”, 2018). Not only does purging cause electrolyte imbalances in the body, it has severe consequences on the gastrointestinal system.  Purging can lead to a deteriorated esophagus and stomach problems such as blocked intestines from undigested food, bacterial infections, constipation, intestinal perforation and in severe cases stomach ruptures (“Health Consequences”, 2018). In addition, purging and malnutrition can cause of pancreatitis or an inflammation of the pancreas (“Health Consequences”, 2018).

Neurologically, due to the restriction of calories in the body, the brain will not receive enough nutrients to function and could lead to a toxic cycle of obsessing about food and difficulties concentrating (“Health Consequences”, 2018).  Furthermore, not eating enough can create difficulties falling or staying asleep, numbness and tingling in the extremities of the body due to damage to the neuronal insulations, seizures and muscle cramps due to electrolyte imbalance, and fainting or dizziness (“Health Consequences”, 2018).  Even more alarming, in the endocrine system sex hormones decrease and can increase bone loss and starvation can cause high cholesterol levels (“Health Consequences”, 2018).

However, the consequences of eating disorders are not merely confined to the physical body.  There are many cognitive and emotional effects associated with restrained eating. People suffering from eating disorders have their cognitive performance and function disrupted by thoughts of food and/or weight (Polivy, 1996).  People with a history of dieting were also found to have more difficulty concentrating than their peers and experience feelings of irritability and negative emotionality and heightened affective responsiveness (Polivy, 1996). Self-harm, suicide attempts and death constitutes as some of the highly associated risks with eating disorders (Keski-Rahkonen & Mustelin, 2016) .  

In fact, according the the National Association of Anorexia Nervosa and Associated Disorders, eating disorders have the highest mortality rate of any mental illness.  One in five people with anorexia die by suicide (“Eating Disorder Statistics”, n.d.). This statistic does not include those that die due to pure self-starvation. The Standard Mortality Ratio, how likely one is to die over the study period compared to same aged peers of the general population, is 5.86 times more likely for people suffering from anorexia nervosa and 1.93 times more likely for people suffering from bulimia nervosa (“Eating Disorder Statistics”, n.d.).  

As eating disorders are complex in nature, the risk factors of eating disorders involves an interaction between a range of biological, psychological and sociocultural factors (“Risk Factors”, 2018). Eating disorders are extremely prevalent and consequential and with more information, education, and funding for research there can be more support for those fighters and survivors of eating disorders.   

References

Eating Disorder Statistics • National Association of Anorexia Nervosa and Associated Disorders.

(n.d.). Retrieved February 10, 2019, from

https://anad.org/education-and-awareness/about-eating-disorders/eating-disorders-statistics/

Health Consequences. (2018, February 22). Retrieved February 10, 2019, from

https://www.nationaleatingdisorders.org/health-consequences

Keski-Rahkonen, A. & Mustelin, L. (2016). Epidemiology of eating disorders in Europe. Current

Opinion in Psychiatry, 29(6), 340–345. doi: 10.1097/YCO.0000000000000278.

Polivy, J. (1996). Psychological Consequences of Food Restriction. Journal of the American

Dietetic Association,96(6), 589-592. doi:https://doi.org/10.1016/S0002-8223(96)00161-7

Risk Factors. (2018, August 03). Retrieved February 10, 2019, from

https://www.nationaleatingdisorders.org/risk-factors

Udo, T., & Grilo, C. M. (2018). Prevalence and Correlates of DSM-5–Defined Eating Disorders

in a Nationally Representative Sample of U.S. Adults. Biological Psychiatry,84(5),

345-354. doi:https://doi.org/10.1016/j.biopsych.2018.03.014

 

Categories
Eating Disorders

What is Orthorexia?

Our global community has become increasingly health-conscious, often pushing for strict workout regimes and meticulous diets. Celebrities and social media influencers have turned into our health gurus, guiding us through a plethora of diets, all of which come with appealing promises (weight loss, health benefits, toxin removal, reduced animal cruelty, etc). While it is important to prioritize one’s physical wellbeing, healthy eating can turn dangerous, when it becomes an obsession. The obsession with healthy eating is called orthorexia and in a study conducted by Carla E. Ramacciotti and colleagues, there was a 57.6% prevalence in the population examined by the said researchers.

Most diets that are currently gaining popularity have a list of “good” foods and a list of “bad” foods. For example, the Paleo Diet focuses on weight loss and health improvement through the consumption of unprocessed foods. “Good” foods in this diet include fresh fruits and vegetables; meat (free-range chicken/grass-fed); wild-caught fish; nuts; and herbs. “Bad” foods include corn, potatoes, processed foods, “junk” foods (soda, chips, candy), pasta, corn, soy, and refined sugar. The strict guidelines and restrictions attached to most diets make an individual susceptible to developing a fixation with food and feeding habits.

According to dietician nutritionist Bridget Komosky, orthorexia may become comorbid with obsessive-compulsive disorder (OCD), because of the preoccupation with ritualistic eating habits. In Komosky’s words: “If foods considered “unhealthy” are consumed, thoughts can often become so distressing that individuals feel the need to perform a compulsion (which can often include over-exercising and/or fasting in order to relieve anxiety).” Symptoms shared by orthorexia and OCD include: an obsession with reading food labels and the nutritional value of food; a religious focus on social media platforms about healthy living; the expression of extreme anxiety in the presence of “bad” foods or in the absence of “good” foods; and the complete exclusion of a wide variety of foods from one’s palate. Additionally, orthorexia also makes it very difficult for individuals to enjoy a meal outside the comforts of their personal settings (i.e. a restaurant or a friend’s house).

What makes orthorexia stand out from many other eating disorders is that those affected by it aren’t generally preoccupied with their body image. In other words, while most disorders such as bigorexia, anorexia, pregorexia, bulimia, and diabulimia all revolve around the fixation with one’s physical appearance, individuals with orthorexia are focused on the specifics of what they consume and how healthy their lifestyle is. Treatment for orthorexia includes cognitive behavior therapy, dialectical behavior therapy (a mixture of cognitive, behavioral, and meditative therapies), medication, and consultation with nutritionists.

Orthorexia is very ironic indeed, as it is hard to imagine that one can exacerbate one’s well-being while trying to improve it. Although orthorexia isn’t strictly revolved around body image, the resulting obsession with food and feeding habits mirror most other eating disorders. Additionally, while those inflicted with orthorexia are focused on eating healthy, the OCD-like symptoms and habits concentrated on food restriction can have very serious negative consequences. As a result, it is important to raise awareness about the importance of discussing diets in ways that are less restrictive or less “good” or “bad,” and more lenient and follower friendly.

 

Sources:

Kelly, D. (2018, January 22) A Detailed Paleo Diet Food List of What to Eat and Avoid. Everyday Health. Retrieved November 25, 2018, from https://www.everydayhealth.com/g00/diet-nutrition/paleo-diet/detailed-paleo-diet-food-list-what-eat-avoid/?i10c.encReferrer=&i10c.ua=1&i10c.dv=22

Komosky, B. (n.d.) The Relationship Between Orthorexia and Obsessive Compulsive Disorder (OCD). Walden Behavioral Care. Retrieved November 25, 2018, from https://www.waldeneatingdisorders.com/the-relationship-between-orthorexia-and-obsessive-compulsive-disorder-ocd/

“Orthorexia.” (n.d.) Mirasol Recovery Centers. Retrieved November 25, 2018, from https://www.mirasol.net/eating-disorders/orthorexia.php.

Ramacciotti, C.E., Perrone, P., Coli, E., Burgalassi, A., Conversano, C., Massimetti, G., & Dell’Osso, L. (2011). Orthorexia nervosa in the general population: a preliminary screening using a self-administered questionnaire (ORTO-15). Eating and Weight Disorders, 16(2), 127-30.

Categories
Eating Disorders

The Weight of the Issue

“If you develop an eating disorder when you are already thin, to begin with, you go to the hospital. If you develop an eating disorder when you are not thin, to begin with, you are a success story. So when I evaporated, of course, everyone congratulated me on getting healthy.” These resounding words were spoken by poet Blythe Baird, when she was reciting her poem “When the Fat Girl Gets Skinny” at the 2015 National Poetry Slam. Her words shine light on yet another hidden group in the eating disorder community, overshadowed by the stereotypical face of eating disorders that is primarily young, white, skinny, and female. Moreover, referencing the third sentence of Baird’s poem, we as a society contribute to the exacerbation of disordered eating in overweight, obese, or even normal weight individuals by complementing and encouraging the weight loss, before inquiring about its cause.

A study led by Jason M. Nagata from the University of California San Francisco revealed that overweight and obese individuals were twice as likely to engage in disordered eating behaviors (binge eating, meal skipping, fasting, vomiting). However, overweight and obese individuals were also half as likely to be diagnosed with an eating disorder, because of the common misconception that only underweight individuals can be affected by eating disorders. Additionally, a harrowing finding made by Mayo Clinic psychologist Leslie Sim revealed that there was a nine-month delay in the diagnosis of individuals who were once overweight or obese, in comparison to individuals who were underweight or of normal weight.

Overweight and obese females aren’t the ones at risk as their male counterparts are perhaps even more overlooked. After 16-year-old Zachary Haines was classified as obese following a physical examination, he became preoccupied with extreme exercise routines and calorie intake. While Haines’s preoccupations allowed him to lose 100-pounds, they also severely diminished his physical well-being, causing him abdominal pains, irritability, and a lowered pulse rate. Despite these ailments, it would be more than a year before Haines was hospitalized and diagnosed with an eating disorder. According to his mom, Haines’s eating disorder was dismissed by specialists including “a primary-care physician, two endocrinologists, a liver specialist, and nutrition experts” all of whom applauded the weight loss, instead of addressing the glaring health problems and the exact manner in which the 100-pounds were lost.

An important issue that Haines’s story brings to light is that of positive reinforcement and its effect on individuals with eating disorders. In Baird’s poem, there is a line that reads:

Girls at school who never spoke to me before stopped me in the hallway to ask how I did it. I say, “I am sick.” They say, “No, you’re an inspiration.” How could I not fall in love with my illness? With becoming the kind of silhouette people are supposed to fall in love with? Why would I ever want to stop being hungry when anorexia was the most interesting thing about me?

While it may come from a well-meaning place, positive reinforcement can at times be a toxic source of encouragement for individuals with eating disorders. In Baird’s case, the positive reinforcement created the illusion that her anorexia was the key to leading a life of intrigue and popularity. Similarly, in Haines’s case, encouragement from doctors further promoted his behavior and thus exacerbated his health.

We live in a society where skinny equates to pretty. I hear the phrase “Did you lose weight? You look so good!” at least three times a week, from well-meaning friends and family members. It is hard not to resist the temptation to skip a meal here and there and push myself a little harder at the gym, when doing so comes with the promise of beauty and acknowledgment. To be completely honest, I have pushed myself to lose weight by going without food or by pushing a 1-hour workout to a 2 hours and while I did lose weight, I wasn’t happy. Being hungry, being nauseous, being dizzy to the point of fainting did not make me happy. We need to break out of the mindset that skinny equates to pretty. We need to become aware of the fact that a person doesn’t have to be underweight in order to have an eating disorder. So the next time you notice that someone has lost a significant amount of weight, ask them how they lost weight and strive to encourage healthy weight management.

 

References:

 

Button Poetry. (2015, November 3). Blythe Baird – “When the Fat Girl Gets Skinny” (NPS 2015) [Video File]. Retrieved November 14, 2018, from https://www.youtube.com/watch?v=16Tb_bZZDv0

 

“Eating Disorders and Obesity: How are They Related?” (2009, March 6 ). NEDIC. Retrieved  November 14, 2018, from http://nedic.ca/eating-disorders-and-obesity-how-are-they-related.

 

Miller, A. (2014, December). Losing weight, but not healthy. American Psychological Association. Retrieved November 14, 2018, from https://www.apa.org/monitor/2014/12/losing-weight.aspx.

 

Monaco, K. (2018, June 13). Eating Disorders Common in Overweight, Obese Young Adults. MedPage Today. Retrieved November 14, 2018, from https://www.medpagetoday.com/primarycare/eatingdisorders/73467.

 

Muller, R. (2015, March 26). Anorexia Affects More Men Than Previously Thought. Psychology Today. Retrieved November 14, 2018, from https://www.psychologytoday.com/us/blog/talking-about-trauma/201503/anorexia-affects-more-men-previously-thought.