What is an eating disorder?
Eating disorders are psychological disorders associated with irregular eating habits and extreme distress about body weight and/or shape. They are impacted by biological, psychological, and social factors in our everyday lives and can have serious health consequences.
The most common types of eating disorders are anorexia nervosa, bulimia nervosa, and binge-eating disorder. Individuals with anorexia nervosa typically engage in self-starvation and demonstrate significant weight loss. Individuals with bulimia nervosa typically experience episodes of binge eating followed by compensatory behaviors (such as purging or excessive exercise) to counteract episodes of binge eating. Individuals with binge eating disorder typically experience recurrent episodes of binge eating in which they feel out of control and without regular use of compensatory behaviors.
However, a majority of individuals diagnosed with eating disorders fall into the Other Specified Feeding or Eating Disorder (OSFED) diagnosis. This means that an individual might meet some of the criteria for an eating disorder that causes significant distress or impairment in their daily lives, but not all the criteria. This diagnosis was developed to include individuals who did not meet the strict criteria for anorexia nervosa or bulimia nervosa, but still had a significant eating disorder. Symptoms of an eating disorder don’t always fall into specific categories of specific diagnoses. So, if disordered eating symptoms are impacting your functioning or a loved one’s functioning and well-being, it could still meet for a diagnosis and should be addressed.
Research on eating disorders has increased over the past few years and helps to combat stereotypes and misunderstandings related to eating disorders.
It's not just about the food
Research indicates that the best-known environmental contributor to the development of eating disorders is our society’s idealization of thinness and portrayal of this in social media and various entertainment outlets. Golden and colleagues (2016) found that 40% of overweight girls and 37% of overweight boys experience teasing from peers or family members about their weight. This in turn can lead to weight gain, binge eating, and extreme measures to control weight.
Research also indicates that dieting was one of the most important predictors of eating disorder development in a study of 14 and 15-year old girls. They found that those who dieted moderately were FIVE times more likely to develop and eating disorder than those who did not. Another study of teenage girls found that social media users were more likely to have an internalized drive for thinness and were overly critical of their body weight/shape.
One of the most common misconceptions about eating disorders is that food is “causing the problem” and they should “just eat”. What most people don’t realize is that restricting food intake or compulsively exercising is a way of coping with something else going on in that person’s life. This could be stress from school, pressure from athletic coaches to maintain performance standards, lack of control in all areas of your life, or depression. Therefore, telling someone with an eating disorder to “just eat” is not only unhelpful, but perpetuates the stereotypes and judgments associated with eating disorders.
Warning Signs
Eating disorders can sometimes be difficult to recognize in our friends and family. There are emotional, behavioral, and physical warning signs that you or a loved one might have an eating disorder. Here are some (but not all) things to look out for:
- Preoccupation with food, weight, calorie intake, dieting, or body image
- Abnormal, secretive, or ritualized food or eating habits
- Withdrawal from usual activities and friends
- Compulsive excessive exercise
- Discoloration or staining of teeth
- Feelings of anxiety, depression, isolation, or irritability
- Evidence of purging behaviors (i.e., frequent trips to bathroom, periods of fasting, self-induced vomiting)
- Evidence of binge eating (i.e., disappearances of large amounts of food)
"I'm worried about you"
It can be pretty difficult to talk about your worries for someone when it is friends or family. However, if you notice some of these warning signs, it is appropriate for you to discuss your concerns in a supportive and caring way.
One of the first things to do before approaching a friend or family member about some of the warning signs you notice is educating yourself on eating disorders. It’s important to recognize that it’s not “just about the food”. Individuals with eating disorders typically experience anxiety, shame, depression, guilt, or even denial. Understanding this can help you empathize with what your loved one might be going through.
It’s also important to discuss your concerns in a safe and comfortable environment, like at home. It may be helpful to avoid meal times or times in which either of you are tired, irritable, or emotional.
Finally, it’s time to talk to your loved one. There are a few communication tips that can be beneficial when you want to express care and concern for a friend or family member.
- Using ‘I’ Statements
- “I’m worried about you because I see you use the restroom immediately after
every meal.”
- “I care about you and hate to see you so upset after we get food”
- Reassuring your loved one that it’s safe to talk to you
- “ I love you so much and only want to see you feel better”
- “I love you and will never judge you. You can always talk to me”
- Encouraging your loved one to express how they feel, not just saying how you feel
- “How has this been for you?”
- “How have you been feeling?”
- Listen actively and respectfully to what your loved one has to say
- Encourage your loved one to seek help and express that you will be there to support them
- “You can always talk to me and I will be here to listen, but it might be helpful to talk to someone who has more knowledge on how to help you feel better”
It can be hard to know how to help a friend or a family member with an eating disorder. The following are a list of resources to help you understand more about eating disorders and how to help a loved one:
National Eating Disorder Alliance
International Association of Eating Disorders Professionals
We know that eating disorders are complex and it can be difficult to find help and the information provided here is not exhaustive. The Carruth Center forPsychological and Psychiatric Services offers free individual and group counseling if you need someone to talk to or would like to learn about different ways to better understand eating disorders. You can call (304) 293-4431 to schedule an appointment.
Taylor Allen is a second-year doctoral student in Counseling Psychology at WVU. She is a supervised advanced trainee at the Carruth Center, where she provides individual counseling to students. She received her master’s degree at Florida State University in Sport Psychology and has worked as a supervised performance coach with collegiate athletes. Outside of school, Taylor can be found at Crossfit, hiking around Morgantown and Ohiopyle (weather permitting), and listening to live music.