Food for Thought

While food can be delicious, it can also be a triggering topic for some.

By Skylla Mumana and Mallory Harris

According to the National Association of Anorexia Nervosa and Associated Disorders, 28.8 million Americans will be diagnosed with an eating disorder in their lifetime. Eating disorders affect up to 9% of the global population and are among the deadliest mental illnesses, second only to opioid overdoses, the group reports. While progressive conversations within the media continue to bring about awareness for eating disorders, continuing to foster open discussion is key. 

In an issue surrounding food, we wanted to share foundational information on how to talk about disordered eating and eating disorders and lay out facts about behaviors of those facing them. If you or a loved one is suffering from an eating disorder or disordered eating, reach out to a friend, medical professional or loved one to talk about it and seek treatment. First off, it’s important to note that there is a difference between disordered eating and an eating disorder. The National Eating Disorders Collaboration provides clarity on the two. Disordered eating is a spectrum of troubling eating behaviors and practices that are less severe and occur less frequently than what is required to meet the full criteria of an eating disorder diagnosis. In fewer words, it’s a less severe eating behavior that hasn’t developed into an eating disorder yet, but can quickly lead down that path. An eating disorder, however, is often referred to as a fatal illness associated with severe disturbance in one’s eating. While there are different types of disorders, one must meet the criteria listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Both paths can affect any individual regardless of age, weight, sex, race and socioeconomic status and can cause prolonged health issues.

When having a conversation about eating disorders with a friend or loved one, keep in mind how sensitive a topic it can be for them and how much impact talking about it can have. According to the National Eating Disorders Association, many of those in recovery have said that the support of their loved ones was key in them seeking help and getting well. While it’s not always easy having such a discussion, come to the conversation prepared. And so, to better prepare for those conversations the National Eating Disorders Association put together a list of advice.

First, educate yourself. Have an open mind while researching and have facts prepared for your conversation. This can help you avoid making broad assumptions about their disorder and about what they might be going through.  

Make sure to start the conversation gently. Be in a safe, private environment and ask about how they’re doing. Don’t immediately jump to talk of food and disorders. Ease into it and then start to express concern for their well-being.

Concentrate on behaviors you’ve observed and express why you have concerns. It’s important to note that bringing up negative behaviors may evoke emotion from all parties during the conversation, but it’s important to not be overwhelmed.

Try to remove any potential stigma. Let them know that millions of people struggle with eating disorders every year.  It could happen to anyone, and there’s no shame in acknowledging it and seeking help. 

Avoid blame, manipulation and judgment. Let your loved one know that you want to be supportive. You’re here for them, not against them. 

Avoid automatically giving solutions. Focus on listening to their story, and try not to be overly simplistic. Giving them a half-hearted solution can leave them feeling frustrated and misunderstood. Listen to their stressors.

Encourage them to seek help. The road to recovery can be long, and it’s hard trying to navigate it alone. Reaching out to a medical professional or a therapist can help. 

 Be prepared for their response. Since this is such a sensitive topic for many people, it may be hard to anticipate how they will react. In the case of receiving an adverse or nonchalant reaction, let them know that you care and that you’re willing to support them if they reach out, and leave the conversation open. 

Common Types of Eating Disorders

  • Anorexia Nervosa: Where one actively restricts their food intake, leading to a significantly low body weight in the context of age, sex, developmental trajectory and health status. It is regularly associated with having a negative body image, intense fear of weight gain, lack of behavior acknowledgment and/or severity of their illness.
  • Bulimia Nervosa:A disorder where one binge-eats (excessively consumes a large amount of food in a relatively short period of time without control), then purges or engages in other compensatory behavior (i.e. self-induced vomiting, laxative or diuretic abuse, insulin misuse, excessive exercise, fasting, diet pills, etc.), once a week or more on average for at least three months.
  • Avoidant & Restrictive Food Intake Disorder:With this disorder, it means one has persistently failed to meet appropriate caloric and/or nutritional needs without concern for their shape or weight. One may experience significant weight loss, nutritional deficiency or dependence on nutritional supplementation. Sensory aversions to food, such as specific food textures, temperatures, colors or smells may also appear. One may also develop extremely selective eating, disrupted appetite cues, lack of interest in food, sensory processing difficulties or anxiety regarding the consequences of eating (illness, vomiting, choking, etc.).
  • Other Specified Feeding & Eating Disorder: A disorder that doesn’t meet full criteria for one of the above disorders but involves specific disordered eating behaviors such as restrictive intake, purging or binge eating as key features. 
  • Binge-Eating Disorder:Eating a large amount of food in a relatively short period of time,  associated with a sense of loss of control in overeating in the absence of compensatory behavior at least once a week for three months or more. These episodes are associated with eating rapidly, regardless of hunger, until extreme fullness. Another association to these episodes can be depression, shame or guilt.
  • Source: Academy of Eating Disorders

Common Treatment Options for those Struggling with Eating Disorders

  • Pyschological Therapy: Oftentimes, eating disorder treatment may require seeing a psychologist or another mental health profession on a regular basis. Therapy can last anywhere from a few months to years and can help you learn how to monitor your eating and your moods, teach you problem-solving skills and help you explore healthy coping mechanisms for stressful situations.
  • Nutrition Education: Registered professionals can help you understand your eating disorder and develop a plan to help you achieve and maintain healthy eating habits. With their guidance, they can help you work toward a healthy weight, teach you about how nutrition affects the body and help to establish regular eating patterns. 
  • Medication: While medication can’t cure an eating disorder, it’s most effective when combined with psychological therapy. Certain prescribed medications may help with reducing symptoms of depression or anxiety, which commonly occur alongside eating disorders. You may also need to take medication for health problems caused by your eating disorder.
  • Hospitalization: Hospitalization could be necessary if you develop serious physical or mental health problems as a result of your eating disorder. In most cases, the goal of hospitalization is to stabilize any critical symptoms and begin the recovery process. 
  • Hospital Day Treatment Programs: Day treatment programs are ones that typically require attendance for multiple hours a day several days out of the week. They include structured eating sessions, nutrition education, therapy and medical care if needed. 
  • Residential Treatment Programs: Residential treatment programs are ones that require you to live at a treatment facility. This method of care may be necessary if you need long-term care for your eating disorder, or if you’ve been hospitalized on numerous occasions but your condition hasn’t improved. 
  • Source: Mayo Clinic

Troubling Eating Behaviors May Include

  • Fasting
  • Binging
  • Purging
  • Using diet pills
  • Laxative, diuretic, enema misuse
  • Consistent meal skipping

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