By: Diana Bello Aristizábal
DORAL, FL – Between February 25th and March 3rd, the National Eating Disorders Awareness Week will be celebrated with the purpose of opening conversations around this issue that, according to the National Eating Disorders Association (NEDA) has a profound mental and physical impact, including death.
Although there is currently a higher level of awareness, the statistics are still concerning. According to NEDA, national surveys estimate that 20 million women and 10 million men in the United States will have an eating disorder at some point in their lives. Also, anorexia nervosa, one of the most common disorders, has the highest mortality rate among psychiatric disorders.
Given the scope of this problem, which affects children, adolescents, and adults of both genders, it is time to not only extend the talk about this but to know its causes, understand the background of eating disorders and take preventive measures to encourage healthy behaviors around food.
Binge eating, bulimia, and anorexia
When people think about eating disorders, anorexia and bulimia usually come out because these have been the dominant disorders over the years. However, in recent years binge eating disorder has become the most common one in the United States.
“In 2014, when the diagnostic manual was updated, this disorder was added. It refers to someone who eats large amounts of food, usually in secret, hiding and very fast,” explains Stacey Rosenfeld, psychologist, a certified specialist in eating disorders.
According to Dina García, registered dietitian nutritionist, a specialist in emotional and binge eating and promoter of intuitive and mindful eating, binge eating normally occurs within a two hours time period and is associated with feelings of guilt and shame.
“Often times, people claim to have no control over their food intake or not remembering what they ate as if they were not aware of what was happening because they kind of go into autopilot,” says the expert.
The big problem with this disorder is that many times, people end up having bulimia as well after attempting to compensate the body for overeating, through purging, taking laxatives or doing strenuous exercise routines to get rid of the extra calories.
This means that individuals who binge eat and then eliminate calories with such aggressive methods, not only suffer from binge eating disorder but also bulimia.
It should be noted that sometimes those who start with anorexia, by restricting their food intake, develop bulimia or binge eating disorder later on. “People tend to move from one disorder to another,” explains Stacey Rosenfeld.
The vast majority of experts on this issue agree that the diet culture in which we live in is the main reason why so many people end up with an eating disorder because it has been proven that a high percentage of individuals who start a diet develop one.
“The diet culture very much perpetuates the need for restriction and restriction is the dragging force behind binge eating because studies have shown that when an individual restricts its food intake being on a diet, he or she is more likely to binge eating as a response to stress,” says Dina García.
On this line, it is necessary to understand the difference between having a healthy eating regime and dieting. For Stacey Rosenfeld, the big difference lies in the reason behind eating a certain way
“If, for example, you tell me that you feel good eating fruits and vegetables because these provide more energy, allow you to sleep better or have good health, I would not say that you are dieting because you are doing it for other reasons than to lose weight,” says Rosenfeld.
However, aside from the cultural factor, other aspects can be associated with the appearance of an eating disorder taking into consideration that although we are all constantly bombarded with messages to lose weight, not everyone develops a disease of such kind.
It has been found that the genetic component, the personality, the family environment and the psychological history of an individual can contribute to the development of an eating disorder. In this way, those who suffer from anxiety, depression, have had a psychological trauma or problems with alcohol or drugs are at higher risk.
Regarding the family environment, it is one of the most important aspects because many adults are unable to accept themselves as a result of growing up listening negative messages about their bodies from family members or peers or for living in a family that paid too much attention to physical appearance. “It is a behavior that is passed down from generation to generation,” says Dina García.
On the other hand, people with very controlling parents are also at risk of developing an eating disorder due to having many limitations and restrictions at home, which makes them feel that food is the only thing they can control on their terms.
For all of this, many times children and adolescents are the ones who are most at risk since, in those ages, they usually receive their first feedback about food. “It used to be common to observe these disorders in adolescents and mainly in girls, but now we see more disorders in boys who start as early as in elementary school,” says Stacey.
Prevention and action
Having so many risk factors at play, the best way to fight this issue is prevention, which in the first stages of life falls on parents, who even have the genetics or personality factor against can still do a lot.
According to Metee Comkornruecha, Director of the Division of Adolescent Medicine at Nicklaus Children’s Hospital, it is essential to start early. “We need to be careful when talking to our children about the way they look because although we do have many problems with obesity and gaining weight, we should be more focused on who they are as people and not their physical appearance,” explains the doctor.
On the other hand, the doctor also suggests watching over the information children receive on television, social media or the Internet, which in his opinion should not be used as babysitters or shape the kid’s thinking.
“We need to help them understand what they see and explain that not everything exposed on social media is real, that just because someone is smiling looking a certain way, does not mean is happy because looks are not necessarily correlated with feelings,” says doctor Comkornruecha.
He also recommends parents to meet their children’s friends and peers and explain to them that just because these friends go to the same school, does not mean that they share the same values of the child, which is why he or she should not repeat conducts that do not seem right. “We have to teach them that good friends help you become a better person,” states Comkornruecha.
Also, it is essential to help them recognize and understand their emotions, because frequently eating disorders arrive as a result of an inability to process feelings properly.
“A critical skill for the kids to learn is being able to say ‘Mommy I don’t feel good’ or ‘Mommy, I’m scared’ because by communicating their feelings to mom and dad, instead of keeping them in their heads or bodies, we can help them understand what they feel so that they can feel validated,” says Stacey Rosenfeld.
According to the psychologist, this is a skill that adults should also have even if it was not learned during childhood due to the fact that a better understanding of a feeling and where it comes from, helps a long way to find healthier ways to deal with it, such as asking for advice to a friend, going out to breathe fresh air, reading a book or listening to music.
Additionally, it is vital to speak positively about food, without judgments or guilt, explaining that there is no good or bad food, teaching them to accept their bodies by being an example of that, and telling them that there is no need to restrict food but rather eat balanced.
Lastly, the experts agree on the importance of watching red flags, both in children and adults, in an individual such as anxiety or depression associated with food, isolation, not eating in public, refusing to eat for apparently a lack of appetite, stating that the food will be taken somewhere else or later, being unable to maintain a healthy weight or, in children, significantly lowering in the growth curve.
Other signs that there may be a problem are going to the bathroom frequently during meals, moving food around the plate or cutting tiny bites to prolong their intake.
Those who suspect of having an eating disorder or are concerned about a family member or friend can check the website: https://www.nationaleatingdisorders.org/screening-tool to determine whether or not it is time to seek professional help.