Wellness Inside and Out: National Eating Disorder Awareness Month

Eating disorders are serious conditions related to persistent eating behaviors that negatively impact one’s health, emotions and ability to function in areas of life. There is rarely a simple explanation for an eating disorder—rather, it is often an extremely complex problem which may be caused by a number of factors, which may include family and cultural pressures, chronic stress and heredity.

As February closes, we aim to bring understanding to this topic at the conclusion of National Eating Disorder Month. Some foundational facts about eating disorders are that teenage girls and young women are more likely than teenage boys and young men to have anorexia or bulimia, but males can have eating disorders, too. Although eating disorders can occur across a broad age range, they often develop in the teens and early twenties. The most common eating disorders are anorexia nervosa, bulimia nervosa and binge eating disorder, which are characterized by abnormal eating habits. Some of the more common types of disorders are:

Binge-eating disorder: An individual who has a binge-eating disorder regularly eats too much and feels a lack of control over eating. They may eat quickly or eat more food than intended, even when they’re not hungry, and may continue eating after they’re uncomfortably full.

Anorexia Nervosa: Anorexia is an eating disorder which is characterized by low weight, food restriction, fear of gaining weight and a strong desire to be thin. Many people with anorexia see themselves as overweight, even though they are in fact underweight. They often deny that they have a problem with low weight and weigh themselves frequently, eat small amounts and usually only certain foods. Some will exercise excessively, force themselves to vomit, or use laxatives to lose weight. Complications may include osteoporosis, infertility or heart damage, among others.

Bulimia nervosa: Individuals with bulimia have episodes of binging and purging that involve feeling a lack of control over eating. Many people with bulimia also restrict their eating during the day, which leads to more binge eating and purging. They usually eat large amounts of food in a short time, and then try to rid extra calories in an unhealthy way, such as exercising in excess or using laxatives. People with bulimia may have a normal weight or be a bit overweight. They are very preoccupied with their weight and body shape.

How might family, teachers, or the individual themselves be aware that an eating disorder is occurring? A few of the behavioral symptoms to note may include:

• Feeling overweight, despite weight loss or low body weight.
• Sudden interest in weight loss diets or specialized diets.
• Excessive/compulsive exercise.
• Binge eating.
• Self-induced vomiting.
• Laxatives, diuretic, and/or diet pill abuse.
• Self-induced vomiting.

Certain factors may increase the risk of developing an eating disorder, including:

• Family history. Data suggests that eating disorders are significantly more likely to occur in people who have parents or siblings who’ve had an eating disorder.
• Other mental health disorders. People with an eating disorder often have a history of an anxiety disorder, depression or obsessive-compulsive disorder.
• Dieting and starvation. Diet is a risk factor for developing an eating disorder. Starvation affects the brain and influences mood changes, rigidity in thinking, anxiety and reduction of appetite.
• Stress. Life stresses, such as heading off to college, moving, landing a new job, or family or relationship issue, can bring stress that may increase the risk of an eating disorder.

For the individual who has struggled with an eating disorder and needs help, it’s important to find the program that best suits their needs. Jeril Goss, MS, RDN, LDN, CDCES, Manager of the Penn Highlands Diabetes Nutrition Wellness Center, and Deloris Gibson, Diabetic Educator at Penn Highlands Healthcare, both advise that treatment should involve a multidisciplinary team approach possibly including a physician, registered dietitian nutritionist, psychologist/therapist and psychiatrist. This way, an effective treatment plan can be developed to include a combination of psychotherapeutic modalities, nutritional education, individualized meal plans and family therapy.

Gibson and Goss both agree that it is important for an individual to see a dietitian, who can provide valuable information and accountability. Nutrition counseling typically includes education on various nutrients and how the body uses those, as well as information on how much food someone of a particular size, age and gender needs to eat to be healthy. Dietitians can also provide education on how the metabolism works and how to recognize physical cues of hunger and fullness. “Dietitians will start in the shallow end of the water with the patient, not making them jump into the deep end alone,” Goss explains. Encouragement will be given to eat small, frequent meals and select fiber-rich nutrient-dense foods.

Goss and Gibson agree that recovery is no longer thinking about Will this food make me fat? or having constant feelings of shame or guilt about a specific food. “Food is fuel,” Goss says. As an individual learns about healthy eating, they’ll come to understand food as a source of sustenance and pleasure.

Insights about eating disorders can offer many of us a reminder about healthy diet habits. Depending on the type of disorder an individual is dealing with, they might benefit from following these tips:

• Eat when you feel hungry. Hunger, a growling stomach, feeling irritable and headache are some signs you’ve waited too long to feed your body.
• Eat until you are full.
• Try not to eat while isolated or alone
• Allow 20 to 30 minutes from the time you start eating for a signal to get to your brain that your body has had enough food.
• Eat a meal or snack every three to four hours.
• Eat protein-rich foods and foods that contain fat and complex carbohydrates.
• Gradually increase the variety of foods and food groups you consume daily.
• Understand that returning to an ideal weight is a vital component of recovery from anorexia nervosa.

Learn more about the support we offer for nutrition and emotional and psychological needs at www.phhealthcare.org.