Many health issues are easy to identify in ourselves and those we care
about. That’s not always the case when it comes to eating disorders. People
who have them may not know it. Or, if they do know, they may be so ashamed
that they hide the problem — not only from their family and friends, but
also from their doctor.
Dr. Dolores Roman, a
20-year veteran of emergency rooms and a medical director at Independence
Blue Cross, has witnessed the impact that eating disorders can have on a
person first-hand.
“Too often, there is shame and a stigma associated with having an eating
disorder that create barriers to timely care,” said Dr. Roman.
“Unfortunately, these barriers can result in the disorder going undetected
until the condition has progressed to a severe stage. At that point, the
individuals suffering have no other choice but to seek emergency care.”
Eating disorders are serious
mental and physical illnesses
that stem from how someone thinks about food, their eating and exercise
habits, and their perception of how their body looks. Symptoms commonly
appear in
adolescence and early adulthood, but eating disorders can affect people of all ages.
“This is not just a youth-specific health concern,” said Dr. Roman.
“Diagnosis can happen at any time from childhood through advanced
adulthood.”
Causes
Genes play a large role
in determining someone’s risk for developing an eating disorder, but
specific life experiences and events are often triggers, including:
• Abuse during childhood
• Bullying
• Fat shaming
• Having a mental illness
• Stress
• Dieting
• Life transitions such as going through puberty, starting college, getting a
new job, and starting or ending a relationship
“Many of the the life experiences and events that trigger eating disorders
were particularly exacerbated during the pandemic,” Dr. Roman said.
The COVID-19 pandemic was an extremely stressful life experience that
changed the ways we lived practically overnight. It disrupted the ways
people ate, worked, went to school, and spent time together. During this
period, the number of young adults and adolescents seeking treatment for
eating disorders
increased significantly.
Types of eating disorders
Three of the most common eating disorders include binge-eating disorder
(BED), bulimia nervosa, and anorexia nervosa.
Binge-eating disorder (BED)
People with
BED
regularly consume large amounts of food in a short time and feel like they
can’t stop.
Those who have this disorder come in all shapes and sizes. Some are chronic
dieters and try to limit how much they eat before and/or after bingeing to
“make up” for their behavior.
The biggest health risk from BED is becoming obese, which increases the risk
of many other conditions, including Type 2 diabetes and cardiovascular
disease.
Bulimia
Bulimia is when a person has periods of out-of-control eating that are immediately
followed by efforts to get rid of the calories consumed by inducing vomiting
and/or using diuretics or laxatives. People with bulimia also may
over-exercise or fast to avoid gaining weight.
Those who suffer from this eating disorder tend to be overly concerned with
their weight and body shape. They can range from mildly underweight to
overweight.
Bulimia can cause numerous health problems, many of which result from
constantly exposing the throat and mouth to stomach acid due to induced
vomiting.
Anorexia
Among the three most common eating disorders,
anorexia
is the least prevalent one but the most dangerous. People who have it
typically perceive themselves to be overweight, even if they are severely
underweight. They are also known to severely restrict their caloric intake
and exercise excessively.
Left untreated, anorexia can cause many health problems. They can include
things such as thinning of the bones; mild anemia; muscle wasting and
weakness; low blood pressure; dizziness or weakness; infertility; heart
damage; brain damage; and organ failure. Being anorexic also significantly
increases the risk of death by suicide.
Two other less commonly recognized eating disorders are Avoidant Restrictive
Food Intake Disorder (ARFID) and pica.
Avoidant Restrictive Food Intake Disorder (ARFID)
ARFID is a recently recognized eating disorder. People with it limit the amount
(or variety) of foods they eat to the point that it can lead to medical
issues, nutritional deficiencies, or psychosocial problems.
People with ARFID often:
• Feel full before eating or have no appetite at all
• Only eat foods with certain textures
• Fear that eating could cause them to choke or vomit
• Become pickier about food until it severely limits what they can eat
Pica
This disorder involves eating things not normally considered to be food,
including dirt, clay, crayons, paper, hair, or cigarette butts. People with
pica may experience stomach problems, fatigue, and other serious health
issues.
Pica is often
triggered by nutrient deficiencies that cause cravings for things that are
not food. For example, pregnant people and others who have iron-deficiency
anemia may crave substances that contain iron. Among children, pica is more
frequently seen in those with autism spectrum disorder and those with
developmental or intellectual disabilities.
Management
Management for eating disorders
usually involves a combination of:
• Medical treatment for any physical conditions resulting from the disorder
• Monitoring and maintenance of those conditions
• Nutritional guidance and education
• Cognitive behavioral therapy
• Medication, if needed
Depending on the severity of the disorder, a doctor may recommend
hospitalization, a residential treatment program, or a day treatment
program.
For those who seek help, the odds are in their favor. According to Dr.
Roman, “The vast majority of people progress to complete recovery with
appropriate care and treatment.”
If you are concerned about your own eating behaviors (or those of a loved
one), the first step is to talk to your health care provider. They can help
you identify a problem, determine the best course of treatment, and prevent
the issue from getting worse.
If you are worried that a loved one may be suffering from an eating
disorder, it’s important to approach them with compassion. Express your
concerns with care and empathy. If they’re open to talking with you, provide
them with a safe place to share their struggles without fear of judgement,
and encourage them to seek professional help. Your understanding and support
may make all the difference in their journey towards recovery.
Resources
There’s plenty of resources available for guidance on eating disorders.
Organizations that provide educational information and support include:
• National Eating Disorders Association
• Eating Disorder Hope
• Eating Disorders Coalition
• Substance Abuse and Mental Health Services Administration
• National Association of Anorexia Nervosa and Associated Disorders (ANAD)
ANAD also operates the
National Eating Disorders Helpline, which provides 24/7 support at
1-888-375-7767.
All Independence Blue Cross (IBX) commercial health plans cover
nutrition counseling
and
behavioral health treatment. Members can find eating disorder treatment resources on the organization’s
Provider Finder
and can access Registered Nurse Health Coaches at any time by calling
1-800-ASK-BLUE (1-800-275-2583) (TTY/TDD: 711).
