The popular media regularly come out with trendy new "disorders," often proposing a provocative new slant on an emerging form of disordered eating or a weight management behavior. While I remind myself that these "disorders" aren't official clinical diagnoses, but rather are merely headline-worthy, clinical-sounding names for observed conditions and behaviors, I can't help feeling slightly frustrated. In my opinion, making eating disorders trendy can actually downplay the severity of these diseases, which are the deadliest mental illness.
Keep in mind that while these "disorders" may characterize emerging behaviors and patterns for weight loss or management, they aren't necessarily eating disorders. Anorexia nervosa, bulimia nervosa and eating disorder not otherwise specified (EDNOS) are the only three clinical diagnoses with official criteria outlined in the DSM-IV, the healthcare profession's trusted manual for clinical assessment, with a fourth -- binge eating disorder -- slated for inclusion in the upcoming DSM-V.
While these weight management behaviors can be harmless and temporary in many, they can trigger the development of a serious eating disorder in the small subset of the population that has the genetic predisposition for developing an eating disorder or spur a relapse for a person in recovery from his or her eating disorder. Research has shown eating disorders, particularly anorexia, to be highly inheritable. When someone has a family history of eating disorders, environmental pressures can represent what is commonly referred to as the precipitating event, or the event that launches disordered eating behaviors.
Recently, "pregorexia," "bridearexia" and "orthorexia" have been among the media's trendy types of eating disorders:
Pregorexia is used to describe the fear and avoidance of the natural weight gain associated with pregnancy. For women already struggling with an eating disorder prior to pregnancy, or those that have a genetic predisposition to developing an eating disorder, this weight gain can trigger a serious illness that can jeopardize the lives of mother and baby alike. Women that display mild "pregorexia" may watch or monitor their diet and exercise. Other women with more severe behaviors might restrict their food intake, purge any food consumed -- either by vomiting or using laxatives -- or engage in over-exercising behaviors in an effort to cancel out calories consumed to maintain their current weight. Women engage in these behaviors despite their body's natural compensation for keeping their fetus healthy.
Bridearexia, recently popularized by Kate Middleton's weight loss prior to the royal wedding, is used to describe attempts to lose a significant amount of weight -- often through unhealthy means -- prior to one's wedding. Behaviors may include excessive dieting and exercise, as well as the use of weight loss aides such as diet pills, laxatives or diuretics. Weight loss aids are used most frequently when trying to achieve short-term results. While a bride-to-be's desire to lose weight is quite common and won't necessarily result in a full-fledged eating disorder for most women, some will take their pre-wedding weight loss efforts too far, marking the beginning of an eating disorder or the precipitating event for a relapse.
Orthorexia is a term for men, women and children who display an obsession with avoiding foods perceived to be unhealthy. While the list of "bad" foods is subjective and varies by individual, people obsessed with consuming only healthy foods will often nix processed foods, artificial flavors, colors or preservatives or rigidly follow a lifestyle diet such as veganism, gluten-free or the raw food movement. While healthcare professionals across the country will encourage a healthy diet, balance and flexibility is key. Obsessively-rigid thoughts and behaviors can sometimes result in the emergence of an eating disorder's biological, psychological and sociological characteristics for those with the genetic predisposition.
For many, attempts to stay fit during pregnancy, lose weight for a wedding or eliminate perceived unhealthy foods from a daily diet may mirror signs of anorexia but won't result in an eating disorder. However, these trendy new "disorders" can trigger more serious disordered eating behaviors should an individual be genetically predisposed to an eating disorder.
In general, always err on the side of safety if you suspect that you or a loved one is displaying worrisome weight management behaviors and talk to a healthcare professional or eating disorders specialist. Experienced professionals can recommend treatment options to keep mom and baby healthy, or resources for help achieving a healthy, balanced diet. Addressing these patterns early can serve as a healthy reminder and could even be a life-saving intervention for individuals whose behaviors are likely to spiral into an eating disorder.
Follow Kenneth L. Weiner, M.D., FAED, CEDS on Twitter: www.twitter.com/EatingRecovery