There are tons of misconceptions revolving around eating disorders. Some think that they are culture-driven, that you don’t have a disorder unless it's visible (i.e. you are overly skinny), or that people with eating disorders can just simply reverse their disorder by eating healthy meals again. Well, I’m here to tell you that it’s just NOT THAT SIMPLE. I’m here to de-bunk these myths surrounding eating disorders.
First off, I want to begin by quickly examining the different eating and feeding disorders characterized by the DSM-V
Info received from Cusack and McGlone
Persistent eating of non-nutritive, non-food substances over a period of at least one month (eating chalk, sand, etc.)
Repeated regurgitation of food over a period of at least one month.
Obsession with healthy, clean foods. (Not in DSM)
Avoidant / Restrictive
Food Intake Disorder
An eating or feeding disturbance as manifested by persistent failure to meet appropriate nutritional and/or energy needs (mainly seen in kids, but not exclusive to children)
Restriction of energy intake leading to a markedly low body weight, fear of gaining weight, & disturbance in the way in which one’s body weight or shape is experienced.
Binging and purging to lose weight at least once a week for 3 months.
Binge Eating Disorder
Eating an amount of food that is definitely larger than most people would eat in a similar period of time under similar circumstances.
Are Eating Disorders the direct consequence of new media and culture?
Info received from Reilly
Eating disorders have been around for centuries:
- Some of the first accounts of eating disorders occurred in the 4th-8th centuries (i.e. The Bearded Saint, Al-Mut'tazz Billah)
- Then, an increase in anorexic behaviors were seen during the renaissance where saints in Italy restricted their food intake with the idea that it would bring them closer to God
- Over time, eating disorders were attributed to various causes: loss of appetite, coy's to get attention, and "fasting girls" claiming they didn't need to eat
- The first medical description of Anorexia Nervosa was coined back in 1874 by Sir William Gull
OK, but does culture have ANY effect on eating disorder susceptibility?
Info Received from Menzel
There are several cultural theories that are highlighted when discussing eating disorders that may have some effect on the development. I'll highlight a few:
Sociocultural Theory: There are specific messages that reflect a culture's ideology and are conveyed by socialization agents that influence an individual's behavior
- There's been a significant decrease in the "ideal" female body size during the 20th century and this does coincide with increased rates of eating disorders
- Some sociocultural models suggest that the "sources of cultural messages place pressure on individuals to adopt cultural norms and adapt to them." (Menzel).
Internalization of the Thin Ideal: The extent to which a person buys into the desire to be thin or desires the thin ideal
"Effects of media on eating disorder risk factors are smaller or non-significant, but for participants with high internalization of the thin ideal, media exposure produces a significant increase in body dissatisfaction." (Menzel).
- Culture is mostly tied to body dissatisfaction and dieting behaviors
So then, what are the other causes? Are there susceptibility factors that make some people vulnerable to dieting and weight loss, or bingeing and weight gain?
Info received from Kaye and Wierenga
Researchers have found that eating disorders might be something neurobiological and makes some people more susceptible, i.e. etched into the structure of their brain.
When you ask people with Anorexia Nervosa what their childhood was like, they'll describe themselves as perfectionists, achievement oriented, sensitive to criticism, difficulty with change, inflexible, and emotional. However, there is a time when good traits can go bad, where childhood traits turn into dieting and weight loss. This suggests that it is more likely to be encoded in the structure of our brain. Many research studies and experiments have been done, all with findings that are consistent with the theory that eating disorders might be something neurobiological.
A quick overview of the findings:
- Research found that people with Anorexia Nervosa have:
- Decreased reward sensitivity - they don't feel pleasure from eating
- Increased ability to inhibit behavior - better than most at controlling behavior
- Hunger isn't a motivation
- Dietary restraint causes anxiety to be reduced
- Research found that people with Bulimia Nervosa have:
- Increased reward sensitivity - more pleasure than most from eating
- Increased ability to inhibit behavior - worse than most at controlling behavior
- Fullness doesn't de-value reward
- Overeating may relieve anxiety
Why are eating disorders so important? Are there consequences of having one?
Info received from Kumer
First off, it is NOT easy to distinguish between someone who has an eating disorder and someone who does not. The media today tends to focus on a false portrayal of what an eating disorder looks like, when in reality, an eating disorder can come in all shapes and sizes. You can be malnourished even with a normal or high BMI.
There are several medical consequences that coincide with eating disorders and virtually every system in the human body is affected by eating disorders, some of which is irreversible:
- To name a few: Anxiety disorders and depression, substance abuse, physical symptoms, brain changes, cardiovascular issues, low heart rate and blood pressure, hypothermia (always cold), altered cognition (memory, learning, organization, judgment), electrolyte abnormalities, decreased reproductive and sexual functions
- Russell's sign - Callus on your hands from self-induced vomiting
- Lanugo - Very fine hair that people develop on their bodies to try to keep them warm
- Stunted growth
- Acrocyanosis - Poor circulation leading to having blue hands
- The number one cause of death of eating disorders is related to cardiovascular complications and the second cause of death is suicide.
How can I help?
If you or someone you know is struggling with an eating disorder, I advise you to seek treatment for yourself or for your loved one!
CLICK HERE to get help today from UCSD's Eating Disorders Center for Treatment and Research
& as always, feel free to email/text/call me with any questions or advice <3
Cusack, Anne and McGlone, Karlee. (2017). Eating Disorders 101. [Powerpoint Presentation]. Retrieved from UCSD Eating Disorders Center for Treatment and Research.
Kaye, Walter H. and Wierenga, Christina E. (2017). Neurobiology of Eating Disorders. [Powerpoint Presentation]. Retrieved from UCSD Eating Disorder Center for Treatment and Research.
Kumer, Maya. (2017). Medical Complications of Eating Disorders. [Powerpoint Presentation]. Retrieved from UCSD Adolescent Medicine Rady Children’s Hospital.
Menzel, Jessie. (2017). Culture and Eating Disorders: It’s in the Jeans. [Powerpoint Presentation]. Retrieved from UCSD Eating Disorder Center for Treatment and Research.
Reilly, Erin E. (2017). A Historical Perspective on Eating Disorders. [Powerpoint Presentation]. Retrieved from UCSD Eating Disorders Center for Treatment and Research.