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Let's Talk About: Eating Disorders

This week is National Eating Disorders Awareness Week! This week we'll talk about Eating Disorders in our blog, have links for resources, and hopefully work towards destigmatizing people suffering from eating disorders.

Did you know that eating disorders are the second most lethal mental health disorder (after opioid use disorders)? According to the National Eating Disorder Awareness (NEDA), it's estimated that 20million women and 10million men have had an eating disorder at some point in their lives. There are a range of biological, social, and psychological risk factors for developing an eating disorder. These can include having relatives with an eating disorder or other mental health issue, having anxiety disorders, trying to diet, having body dissatisfaction, striving for perfection, bias around body weights, and limited social interactions. These factors can come together to create a variety of eating disordered behavior.

The typical representations of eating disorders tend to be anorexia and/or bulimia, but there are many different types of eating disorders. They range in severity and consequence. In television shows and media representation, we tend to see a person suffering from anorexia as only restricted calories, or someone with bulimia throwing up after a meal. However, the diagnostic criteria for these disorders is much more complex. People with a diagnosis of anorexia have generally fallen below an ideal body weight or had biological consequences of their dieting, but could be restricting or binging/purging. People with bulimia may be restricting calories, or purging, or they may be forcing themselves to exercise a certain amount for eat calorie they eat. This may or may not cause weight loss or even weight neutrality.

There are other eating disorders in which those with diabetes might purposefully change their insulin dosages to try to lose weight, or ones in which people are afraid to eat because of a choking incident. There are eating disorders associated with Obsessive Compulsive Disorder or a psychotic disorder, in which someone might be refusing to eat because they think their food is poisoned or contaminated. Another eating disorder involves eating things that aren't considered food or have no nutrient value.

It's important to know that eating disorders are not a choice. They aren't something a person can just "stop." They are complex disorders with complex causes and need individualized treatments. Someone can be biologically or genetically predisposed to an eating disorder and have some environmental event (like an illness or bullying or other stressor) that sets off their disordered eating. Eating disorders aren't caused by "bad parenting." They occur in many different age groups, gender identities, socioeconomic backgrounds, and races.

We've often heard people say they aren't "strong enough" or "controlled enough" to have an eating disorder or restrict their eating. This is dangerous terminology. Restricting your calorie intake to a point where your body is literally shutting down isn't something to celebrate. We need to be careful with our terminology. It's also important to recognize that while many of us have disordered patterns of eating or relating to food, having a true eating disorder is rare. Eating disorders can be fatal. Not only is there severe harm caused to the body by restricting, binging, purging, etc., but those suffering from an eating disorder are at risk of death by suicide.

Our current societal obsession with weight loss and perfect body image is a contributing factor to disordered eating. Media portrayals of people with eating disorders as something to be glamorized, insistence in certain sports or circles (dance, modeling, etc.) on weight restriction, constant advertisements of diets, and stigma against being fat are all around us all the time. Labeling foods as "good" or "bad," "health" or "unhealthy," all play a part in disordered eating. The tipping point into an eating disorder is still not fully understood.

There are many takeaways from this blog post: If you or someone you know is struggling with an eating disorder, reach out for help. Try to limit how much exposure you are allowing yourself from different types of media telling you to lose weight or be skinny. Recognize your relationship with food, and try to find ways to heal it. Below you'll find links to different websites with more information on eating disorders.

We here at SahaPsychiatry love to follow @yourlatinanutrionist ( @kidseatincolor ( and @jameelajamil on instagram. These are just three examples of great women who are helping the world overcome disordered eating. Follow them for inspiration on how to have healthy relationships with food.

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