There are many misconceptions about eating disorders, which can affect people from all backgrounds, experts say.
For an illness that affects so many people, there are many misconceptions about eating disorders, experts warn.
According to ANAD, an American non-profit association that provides support services to people with eating disorders, these types of disorders affect almost one in ten people worldwide.
However, in a culture where people continue to be discriminated against for being overweight and where restrictive eating is valued, there is a risk of normalizing eating disorder behaviors, said Jennifer Rollin, founder of The Eating Disorder Center in Rockville, Maryland.
However, he added, when living with eating disorders, it is not possible to live a healthy and happy life. As part of Eating Disorders Awareness Week, experts share advice on how to spot eating disorders and what to do about it.
What defines an eating disorder
A simple definition is to say that an eating disorder is “a psychiatric disorder characterized by changes in eating behavior that significantly impair a person’s ability to function normally,” explained Stuart Murray, professor of psychiatry and behavioral sciences and director of Translational Research in Eating. Disorders Laboratory at the University of Southern California.
More specifically, eating disorders are biopsychosocial illnesses, added Leah Graves, vice president of nutrition and cooking at Accanto Health, an organization that specializes in treating eating disorders.
There are several factors that contribute to someone developing an eating disorder: genetic characteristics, personality and temperament traits, and also social factors such as bullying, social stigma and traumatic experiences.
But just because someone in your family has an eating disorder, or possibly inherited a predisposition to eating disorders, doesn’t necessarily mean you’ll develop an eating disorder, Graves said.
What is not an eating disorder
Eating disorders are not a choice, said Lauren Smolar, vice president of education for the National Eating Disorders Association.
Some people think that just changing one’s eating habits will make one get better and stop having an eating disorder, Smolar said, but it’s a much deeper problem.
Murray, from the University of Southern California, points out that eating disorders can affect anyone, not just young, white women with money, as the stereotype most people have in their heads.
Nor is it just a matter of fashion or trying to lose a few pounds before a wedding or for an Instagram photo shoot, added the expert. For dieting and other body-changing behaviors to be considered disorders, they have to be repeated or permanent, and have a huge impact on a person’s life.
It is true that even if a behavior does not fit into any of the disorders described and possible to diagnose, this does not mean that a person cannot have a problem. It is necessary to be aware of a “constellation of behaviors that deviate from what is considered typical eating behavior and that can even be disabling and affect the normal functioning of a person”, said Murray.
According to the National Eating Disorders Association, anorexia nervosa is usually characterized by weight loss, reduced calorie intake, and an intense fear of gaining weight.
Warning signs for this condition include: overestimation of weight and appearance, strict rules regarding food intake, checking ingredients, secrecy and avoiding social situations involving food or showing your body, Murray said.
Bulimia nervosa is a cyclical condition in which someone overindulges and then compensates for the excess with purging, such as vomiting or taking laxatives.
People with bulimia tend to use the bathroom right after a meal or say they’re going to work harder at the gym, Murray said. You can also take laxatives or diuretics, he added.
compulsive food intake
It is one of the most common eating disorders. The National Eating Disorders Association explains that, in this case, people eat huge amounts of food in a short time, to the point of feeling bad.
It doesn’t seem all that different from what many of us do from time to time, especially for celebrations and special occasions, Murray said. But in the case of those who suffer from this disorder, there is a loss of control over food. And also shame and secrecy.
Restrictive/avoidant eating disorder
One of the most recently recognized eating disorders, notes Graves of Accanto Health, is restrictive/avoidant eating disorder.
In this case, the person avoids food groups. It can be mistaken for a person “weird” with food or “picky”, Murray said, but it’s more serious than that.
According to Rollin of The Eating Disorder Center, people avoid certain foods with specific characteristics or may have excessive concerns about the consequences of eating certain foods, such as being afraid of vomiting or choking.
Typically, people with this disorder are only comfortable eating certain foods and become distressed if they have to step out of their comfort zone and eat foods outside of that range, she added.
This type of disorder can lead to weight loss, nutritional problems, affect growth and even psychological and social behavior, Rollin said.
Other eating disorders
When someone suffers from an eating disorder but their behavior falls outside the above diagnostic criteria for eating disorders, they may be given a diagnosis of Other Eating Disorders, explained Smolar.
There are also behaviors that are being discussed in the medical community but are still undiagnosed.
Orthorexia, for example, is a term used to describe a fixation on eating that a person has determined to be healthy but which becomes overly rigid and can cause stress when the person fails to meet the demands he or she has set, Rollin said.
Vigorexia, or muscle dysmorphic disorder, is associated with behavior patterns similar to those of anorexia or bulimia nervosa, such as restricting calories, following strict rules and doing strenuous exercise, as well as controlling protein intake, all to achieve a muscular body, he said. Murray.
how to seek help
If you notice signs in a person close to you, try to talk to them in a sensitive, non-judgmental way, explaining what behaviors seem troubling to you, Graves said.
If you are concerned about your own behavior, it is important to seek professional help. Rollin recommended seeking out therapists who specialize in eating disorders, who can make an assessment and then recommend necessary therapies.
In the US, the National Eating Disorders Association has an online screening tool that can be used by people aged 13 and over to figure out if it’s time to ask for help.
[Em Portugal, o SNS tem uma página com mais informações sobre distúrbios alimentares. Pode consultar essa página aqui.]