How many of these people have an eating disorder? (photo by cesarastudillo)
How can you find a solution to a problem without really knowing the problem? This is the question plaguing physicians, psychologists, therapists, dietitians, and other professionals who treat patients with disordered eating. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM), a book that lists and defines all psychiatric disorders, patients can be classified as having anorexia, bulimia, or an Eating Disorder-Not Otherwise Specified (EDNOS).
The clinical definitions for anorexia and bulimia are so rigid, that over half of the patients with eating disorders cannot be diagnosed as one of those and instead are diagnosed with EDNOS. There is a wide range of patients who are given this diagnosis, but as researchers point out, conditions vary greatly and many patients can identify more with the symptoms and criteria of anorexia or bulimia.
This leads to several problems. First and foremost, there is little research that discusses how clinicians should treat EDNOS patients. From a patient perspective, some insurance companies will not cover medical expenses related to this diagnosis.
I have a problem with how the term “not otherwise specified” can be misinterpreted as a less serious eating disorder, or not quite an eating disorder yet. This notion may cause patients to be less motivated in participating in their own treatment, or cause loved ones to dismiss it. Even though all psychiatric disorders include a not otherwise specified diagnosis, the percentage of patients with this diagnosis is far less than the astonishing 50% of EDNOS diagnoses.
So what can be done? And why? Many professionals believe that reducing the stringency of the anorexia and bulimia definitions would allow more patients to be diagnosed as one or the other, and maybe even both. Experts also see a need for a defined binge eating disorder and a separate purging disorder for patients who purge but do not binge.
Why is it important to have these clear diagnostic criteria available?
These changes may seem small, but once a psychiatric condition is listed in the DSM, there is an increase in research of the condition, as well as an increase in the general awareness. As a result, clinicians will be able to better treat patients with disordered eating, and patients will take their diagnosis more seriously and will be more accountable for their recovery. Additionally, Insurance companies may reimburse for more diagnoses, and there could be an increase in the coordination of care among health care professionals because there will be a standardized language for the various diagnoses. With these changes, patients will definitely see an improvement in the level and quality of their care.
Demi Moore recently discussed the end of her lifelong struggle with her body image. She stated she has come to realize externals do not bring happiness. I am so encouraged to have famous women discussing their real thoughts about their bodies. This further emphasizes the point that body image has nothing to do with how you look. It is a mental state.
It would be hard to argue that Demi Moore is unattractive. Yet she felt that way. I’m pretty sure you feel that way sometimes too. But in your case, you think it is justified. Well, she did too. Body Image is a mental state often used to distract you from real feelings under the surface.
You see, if you just focus on your body (instead of work or boyfriend or finances, etc.), it feels like something you can control. You will just get to the gym everyday and eat less. Voila! That should make you happy–to have the body you always wanted.
Have you ever said, “When I get to X number of pounds, then I will LOVE my body”? If you actually got there with your methods, I’m pretty sure you found what everyone, including Demi, finds: you are still not happy. Well, maybe you haven’t lost enough–there are still some trouble areas. Wrong. It will never be enough, because changing your body is not the solution. You need to change your attitude about your body. You need to see body image thoughts for the emotional cover-up they are.
So Kate Beckinsale has also recently stepped out discussing her previous battle with anorexia. She decided she was either going to die or be a real person. Not everyone is faced with such a straightforward decision because not everyone is on the brink of death with their disordered eating. However, if you have a bad relationship with food, you are not really living. You would benefit from choosing to be a real person as well.
Portia de Rossi is releasing a memoir chronicling her struggle with an eating disorder. Every time a celebrity comes out of the closet about their eating disorder, my heart leaps in my chest. I am just so grateful that women and girls who try to look like celebs can see it is not healthy or realistic. Even celebrities cannot do it–because that is not how people are really ‘supposed to look’.
Next time you turn on the TV or open up a magazine, remind yourself of two things. First, all of those pictures have been retouched. Those people do not look like that–you certainly shouldn’t try to. Second, many of those people are struggling with eating disorders and body image issues. That’s right, the people you want to look like don’t even like the way they look. Love the real you–honor your genes, not your jeans.
According to a new study, there is hope in the recovery from binge eating disorder. The study found people to be successful in decreasing binge eating behaviors with the following program:
It appears utilizing both an educational component and a support component is the key to overcoming this disorder. Binge eating disorder may be the most common form of eating disorders in the population. Until recently it has lacked its own diagnosis in the DSM manual. Hopefully now that it is getting some respect, it will be more widely understood and treated appropriately (say no to diets!).
If you feel you may be struggling with BED, there is help. It is critical to find a support team that understands eating disorders. Ideally you would have a therapist, nutritionist, and physician on your team. To find out more about emotional eating the criteria for binge eating disorder, check out my main website: Healthy Lifestyle Balance.
Have you seen the movie Sixth Sense? Remember the creepy part when the kid says, “I see dead people…and sometimes they don’t know they are dead.” Well, that is my situation. Only I see people with eating disorders, everywhere, all around me.
Most of them don’t know they have one. That is because disordered eating and disordered body thoughts are pretty commonplace in our culture. Just because something is practically the norm doesn’t mean it is healthy.
I have a colleague, Jessica Setnick, who was asked her opinion on the pro-eating disorder sites. I’m sure the interviewer was expecting her to burst with outrage. Instead she made an important point: what you see in every women’s magazine are the same things you see on those sites.
Those sites are set up to help people engage in their eating disorders. News flash…the magazines set women up to have the same thinking, only they don’t know it is a problem. It is hard to find a magazine that does not have dozens of photoshopped images or at least one article on diet (often disguised as ‘healthy eating’).
On that note, consider this:
I can certainly identify with the issue of the unknown eating disorder. As a teenager I was obsessive about eating healthy and exercising. I thought this was how you maintain a healthy weight. I believed that without this hyper-vigilance, I would be doomed to out-of-control weight gain.
It wasn’t until I began working in eating disorders that I could see I had been engaging in unhealthy behavior. So then I got to thinking…how many others are living with an eating disorder and don’t know it?
Here are some questions to ask yourself:
1. Are you dissatisfied with your eating patterns?
2. Do you believe you’re fat when others say you’re not?
3. Does your weight affect the way you feel about yourself?
4. Do you ever eat in secret?
5. Do you worry you have lost control over how much you eat?
6. Have you recently lost over 14 lb in three months?
7. Do you make yourself sick or exercise because you feel too full?
8. Would you say that food/weight dominates your life?
If you answer yes to 2 or more of the above questions, you may be struggling with an eating disorder—regardless of your weight. The mental and physical impact of all types of eating disorders can have grave consequences. If you or someone you know is struggling with any of the above eating disorder symptoms, seek help immediately.
If you don’t know you have an eating disorder, you won’t seek treatment for it. Even if that doesn’t result in death, a life lived with an eating disorder is barely living at all. It is time to take your life back (even if you never knew it was lost).
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