FROM THE EMBODY LIB ARCHIVES:
NOTE: This post is the second of a two-part series on eating disorders and mental health, featured on Rebel Housewife.
For Part One of this post, titled “Food is Hard” click here
PART TWO
Do you remember the first time you went on a diet? If you were anything like me (a chubby, frizzy-haired, sensitive fourth-grader who aimed to please her parents and everyone around her) it was the day after you noticed that your outgrew your training bra, and your crush at school started leading the “Fatty Patty” chant during recess. It was the day after your father started making comments on how much you are eating and how “boys don’t like fat girls.”
If you were anything like me, you naively mistook puberty for something abnormal and started paying more attention to what foods you snacked on and tried not to clean your plate, even if it was your favorite meal. You glare at your growing body in the mirror after showering every night, confused as to what had changed between six months prior and then.
Unfortunately, more than a few women (and men) I know have had similar childhood experiences. What we didn’t know was how much those experiences would pave the way to harmful relationships with food and our bodies as we moved into adulthood.
Eating Disorders (ED) are serious mental and physical illnesses that affect people of all genders, sexual orientations, ethnic and racial backgrounds, body shapes, and weights. People who suffer from Eating Disorders often hold obsessions with food, their body weight, and shape, which can immensely affect a person’s health. Eating Disorder rates have more than doubled worldwide between 2000-2018, while tens of millions more remain undiagnosed. Unfortunately, the sharpest rate increases we have seen have been in younger children, boys, and children of color.
While there are many biological, psychological, and sociocultural risk factors to take into account, a history of disordered eating is a large predictor in the development of Eating Disorders, especially when it occurs during childhood or adolescence. My disordered relationship with food started when I went through early puberty. And for many, it starts around that time or during adolescence when children developmentally become more sensitive to the opinions of peers and adults they look up to.
How is disordered eating different from an Eating Disorder? In many ways, it’s not. It only differs in the sense that disordered eating focuses on a set of individualized behaviors that by themselves do not warrant an Eating Disorder, but if they are grouped with other criteria (usually weight-based, which is highly flawed), it can lead to an official diagnosis.
Disordered eating behaviors include:
Intentionally restricting your eating through smaller amounts of food or omitting food groups as a way to control your weight or shape, otherwise known as “dieting”
Compulsive or binge eating (often after periods of restriction),
Purging using one or more methods
Chronic compensatory exercise (as a way to “make up” for what you ate)
Use of diet pills, shakes, teas or supplements to suppress hunger
Other irregular or chaotic eating patterns
Disordered eating was normalized in my household growing up, and I didn’t see anything wrong with my eating patterns until I was well underway in treatment for my Eating Disorder. With so many folks viewing disordered eating as “normal” it’s hard to recognize the destructive patterns that can lead to a more serious diagnosis later on.
In addition to disordered eating, another strong predictor of developing an eating disorder is exhibiting anxious, perfectionist, or obsessive-compulsive personality traits. Children that experience anxiety around having to follow the rules and are overly concerned about mistakes due to perfectionism are much more likely to develop an Eating Disorder later in life. This is especially true for women.
Very much like many parents who were not born in the United States, mine valued high academic achievement, an immaculate home, and model behavior around their peers. Expectations were high and my perfectionist personality thrived in getting everything just right. Moving through adolescence, my perfectionism, obsessive-compulsive tendencies and anxiety became more concerning. As a result, I struggled with severe disordered eating behaviors, low self-esteem, and negative body image but it was never taken seriously because I was never severely underweight. But other behaviors I was exhibiting warranted enough attention to seek professional help which led to an official diagnosis of Bipolar Disorder when I was 19 years old.
97% of individual receiving treatment for an Eating Disorder also had one or more co-occurring conditions
The presence of Eating Disorder symptoms coupled with another mental illness is not an anomaly; a large study shows that 97% of individuals receiving treatment for an eating disorder also had one or more co-occurring conditions. Results showed that 94% of patients also had a mood disorder (mostly Depression), 56% were diagnosed with an anxiety disorder, and 25% of patients exhibited symptoms of post-traumatic stress disorder (PTSD).
Interestingly enough, anxiety disorders are also very closely correlated to Irritable Bowel Syndrome (IBS), a chronic gastrointestinal disorder. IBS is not very well understood, but most evidence concludes that it results from a combination of abnormal gastrointestinal tract movements, sensitivity to bodily functions, and communication disruption between the brain and the GI tract. IBS is often treated with restrictive diets, through prescribed elimination diets or self-directed food restrictions. This practice of restriction can further progress or place individuals at risk for disordered eating patterns. On the flip side, there is research that shows that disordered or restrictive eating patterns can lead to IBS-like symptoms, especially when entire food groups are omitted from a person's diet for prolonged periods of time.
Your environment also plays a part in developing behaviors that can ultimately lead to an Eating Disorder. What kinds of messages do you hear as home, at work or school, or on social media about food and your body? If you are constantly being told that you need to have a certain body type or weigh a certain amount to be considered “beautiful”, “healthy”, or “worthy” (I’m looking at you diet culture), it reinforces the false need to modify your body through dieting or over-exercising, which increases the propensity of developing a full-blown eating disorder.
Eating disorders are serious conditions that can have a profound impact on your health and have the highest mortality rate of any mental illness. But don’t fret. It is also very treatable and many people who choose recovery live long and fulfilling lives.
Contrary to popular belief, Eating Disorders aren’t just for affluent, thin, white women and teenagers. Men are at risk for Eating Disorders. Those that identify as LGBTQ+ are at risk for Eating Disorders. Black and brown communities are at risk for Eating Disorders. Economically disadvantaged individuals (those that experience poverty) are at risk for Eating Disorders. Folks who aren’t emaciated, “thin” by conventional standards, or large-bodied are ESPECIALLY at risk for developing an Eating Disorder. As it becomes more common, becoming aware of causes, symptoms, and myths are super important. Because addressing Eating Disorders is addressing mental health.
And it’s time we started talking about it.
REFERENCES AND RECOMMENDED READING:
Prevalence of eating disorders over the 2000–2018 period: a systematic literature review from The American Journal of Clinical Nutrition
Statistics and Research on Eating Disorders from the National Eating Disorder Association
Eating Disorders: About More than Food from the National Institute of Mental Health
Eating Disorders from the National Alliance on Mental Illness
Common Mental Health Disorders associated with Eating Disorders from the Center of Discovery
Irritable Bowel Syndrome, Disordered Eating, and Eating Disorders from Gastroenterology & Hepatology, May 2019 Issue
Intuitive Eating and IBS from Rachel Hartley Nutrition
PODCASTS TO LISTEN TO
“The Truth about Digestion and Gut Health with Marci Evans” from the Food Psych Podcast
Check out the Listener Question from the Episode “How to Combat Fat Stigma with Cat Pause” from the Food Psych Podcast