Eating Disorders and the One Thing You Need to Know About Them

As a psychiatrist with more than 30 years of experience treating eating disorders, I look forward to sharing research, insights, commentary and practical advice to help readers recognize, address and overcome these devastating illnesses, which now affect over 10 million women, 1 million men and a growing number of children and adolescents in the United States.

There are myriad eating disorder topics to address over the coming months, and it's nearly impossible to organize them in order of importance, because each topic in itself is critically important to understand. So for my first post, I thought I'd answer a question that I'm often asked by members of the community, and that I hope will provide some necessary context to emphasize the importance of my subsequent blog entries: What is one thing people really need to understand about eating disorders?

While there are many vital issues individuals should acknowledge about eating disorders, my answer is generally as follows: Eating disorders are the deadliest mental illness, and therefore it's incredibly important for physicians, therapists, patients, families and friends to take these diseases very, very seriously.

Despite rising eating disorder awareness among the general population and healthcare professionals alike, the illnesses aren't known for their severity or for the high mortality rate associated with them, which is higher than any other mental illness, including depression, bipolar disorder and schizophrenia. Anorexia nervosa is an eating disorder characterized by refusal to maintain a healthy body weight and an obsessive fear of gaining weight. It's the most lethal eating disorder, with 0.5 percent of patients dying every year and a mortality rate of 20 percent within 20 years, meaning that one in five people that have had anorexia for two decades will die as a result of the illness.

Even for patients whose eating disorders don't prove fatal, there are often severe medical complications associated with starvation and purging. In addition to the generally debilitating psychological implications of an eating disorder, the disease will eventually take a toll on a person's physical health, resulting in bone disease, cardiac complications, gastrointestinal distress and various other organ problems.

While eating disorders are devastating to individuals and families and boast the highest mortality rate of any mental illness, there is good news to share. First and foremost, it's important to note that full recovery is possible with effective treatment. The community has amassed a wealth of educational resources detailing what potentially causes eating disorders and the telltale warning signs to look for, how to help someone with anorexia nervosa, bulimia nervosa, binge eating disorder or other disordered eating behaviors and strategies for seeking help for eating disorders.

The other piece of good news about eating disorders? The women, men and children suffering from an eating disorder are generally wonderful people with a horrible illness. They're often the best and the brightest, come from good families that care deeply about their own well-being and, on the surface, look like they have everything in the world going for them. That said, seeking help for eating disorders and committing wholeheartedly to recovery really opens the door for individuals to thrive and experience happy, successful futures.

Of course, there are so many more things I want you to understand about eating disorders, so be sure to join me here to learn more about eating disorders, treatment and recovery, and to discuss these issues.

Please feel free to comment below with other eating disorders topics you'd like me to discuss on this blog.

 

Follow Kenneth L. Weiner, M.D., FAED, CEDS on Twitter: www.twitter.com/EatingRecovery

Comments

[Donna Gallagher]

10:21 PM on 06/20/2011

Dr Weiner,
Thank you for starting this blog. I am a nutritionist in New Jersey who exclusively treats patients who suffer with eating disorders. The one thing I find very distressing is the minimizing of physiological symptoms by the sufferers themselves. There is also the sense of being immortal which perpetuates the extreme behaviors. Unfortunately, those of us in the field see first hand the toll these illnesses take on the sufferers and their loved ones. I think another very important message to convey to everyone is that anorexia, bulimia and binge-eating disorder are illnesses...not choices. I look forward to reading all your future posts.

[NorthernCalifornian]

04:52 PM on 06/16/2011

Dear Ken,
Perhaps you could write in the future about the Maudsley model of Family Based Treatment
for eating disorders. A review funded by the NIH found this approach to have the strongest base of evidence to support it. http://www.ncbi.nlm.nih.gov/pubmed/18444053
In addition, see http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3038846/?tool=pmcentrez Thanks

[Kathleen Owens]

12:39 PM on 06/16/2011

I would like more information about SED. Selective Eating Disorder. Particularly as it applies to a male, 23 year old who eats only meat (hamburgers w/ cheese, steak), chicken, (the meat and chicken has to be grilled) pizza, pretzels w/ peanut butter, hot cheetos, chips, granola bars, milk, orange juice. No vegetables, no fish, no pasta, rice, essentially no fruits unless prepared as a smoothie. If you were to observe him in a situation where any of the "no" foods are placed in front of him to eat, you would say he looks like a "deer caught up in headlights". He cannot tolerate eating the "no" foods.
Although the specialized eating has an impact on his body as a system and is relatively easy to demonstrate the very negative impacts of this disorder, I am more interested in information about the psychological and social aspects of this disorder. They are more hidden and not so quantifiable.
What would be the expectation for this individual's life?

[juniorhuffer]

09:08 PM on 06/15/2011

I have had bulimia waxing and waning (mostly waning the last 10 years) for 25 years. I understand it can be very dangerous, and I am lucky I was not hurt during my worst years in my late teens/early 20s. I have had a moderate case, have learned to manage (never more than 3 binges/purges a week) and mitigate some of the side effects (baking soda neutralizes stomach acid, for example). I am a healthy woman, 5'2", 130 lbs, 110/60, healthy heart, annual physical checkups, exercise regularly but not obsessively, I purge only after a binge of high sugar food, not after regular meals. I eat a healthy diet. I make sure the healthy food stays down. I binge because I get a "high" from a rush of sugar to the brain. I feel it helps me think better and distracts me from sadness or other emotional distress. Also after weight loss, I am tempted to binge. There are healthier ways to deal with emotional problems, but sometimes it's the easiest thing. I use it like a recreational drug. I do not plan to seek treatment for bulimia, but I am always looking for ways to improve my emotional life in healthier ways. I wonder how many other "moderate" bulimics there are who have managed it over a lifetime.

[DrHRankin]

10:14 AM on 06/14/2011

As someone who has run a inpatient and outpatient eating disorders facility, that is a nice first post. For what it's worth, my first post would have been that eating disorders are really misnamed -- at their core eating disorders aren't really about eating or food. They are about the management of emotions.

[Kenneth L. Weiner, M.D., FAED, CEDS]

11:24 AM on 06/15/2011

Thank you for reading, Dr. Rankin—you make a good point. In addition to the biological function of eating disorders, there are certainly psychological and sociological elements to consider. Looking forward to the dialogue in the coming months.

[CAELadyJane50]

02:13 AM on 06/14/2011

I have never experienced bulemia but I was mildly/temporarily anorexic. I think eating disorders isn't just about wanting to be super model thin but to strive for perfectionism. You look at the models on television, magazines, catalogs, and fashion shows and you get this idea or belief that to live your life on a pedestal, you have to be perfect to get there. To please your parents or someone of influence to you who has such "difficult to reach" expectations of you, again comes the feel or need to be perfect. To be perfect, you have to have total control. What to eat, how much to eat, how to eat, when to eat or not to eat at all, is all about that need for control to be perfect. I think the solution is for photographers and modeling agents to stop expecting super models to look so perfect. I think it would help for parents to sit down with their children and watch those beauty pagaents together; explain to them that beauty contestants may not look as thin as those super models but they are each at their own healthy weight where it should be. They should also tell their children that no one is without physical beauty flaws, beauty is really skin deep.

[Kenneth L. Weiner, M.D., FAED, CEDS]

11:25 AM on 06/15/2011

I agree, communication between parents/role models and children is very important in order for children to grow up with realistic views of beauty and a positive self-esteem and body image.

[jojojessie]

09:59 PM on 06/13/2011

Thanks so much for this posting. I was diagnosed with an eating disorder at age 43 . It was a late onset and very frightening for me and my family. Thankfully now at 50 and after a lot of hard work and wonderful support, both professionally and from my family, I am confident to say that I will not relapse. There is much yet to learn about this illness and I am grateful that whilst you emphasise the seriousness you highlight the hope. Thanks again.

[Kenneth L. Weiner, M.D., FAED, CEDS]

11:25 AM on 06/15/2011

I’m so glad you found this first blog post interesting and helpful. I wish you the best of luck in your continued recovery.

[Tara Ione Ann Clelland]

10:52 AM on 06/13/2011

Thank you for this article and future articles. I myself am a recovering (will be for the rest of my life), bulimic and binge eater. I have not had any symptoms now for 3 years. They come and they go. It all depends on my stress level. Physically, I am still on the mend and will be for some time. There is so much damage that has been done. For me fixing me mentally was the biggest challenge. I did it tho. With a good support system and EDUCATING myself. The one thing I want people to know is "you are never alone" there is always someone to talk to or relate to. You just need to find them.

[Kenneth L. Weiner, M.D., FAED, CEDS]

11:26 AM on 06/15/2011

You’ve touched on two very important components of recovery: education and support. Eating disorders can be very isolating, so connectedness is key. Congratulations on your recovery, today and in the future!