What You Don’t Know About Eating Disorders

tape measure and utensils - Eating Disorders Awareness Week

In honor of National Eating Disorders Awareness Week (#NEDAWeek2015), our thoughts are with those who have ever struggled with disordered eating behaviors, as well as their families and friends. Like most health conditions, eating disorders conjure a “typical image.” For instance, one might picture a teenage girl, emaciated and frail. While this stereotype is pervasive for a reason (the majority of individuals with eating disorders are young women), there is much more to eating disorders than anorexia. And there are many more types of people affected besides teenage girls.

This year’s NEDA Week theme is “I had no idea,” so we thought we’d highlight some of the more surprising facts about eating disorders:

There are many types of eating disorders besides anorexia and bulimia.

When most people think of eating disorders, they think of anorexia nervosa or bulimia. Anorexia is a condition characterized by inadequate food intake, extreme fear or weight gain, and distorted body image. Bulimia is characterized by episodes of binge eating, followed by purging.

There is a growing “grey area” in eating disorder diagnosis, however, which has resulted in the classification of several other types. For an individual to be diagnosed with anorexia, for example, he or she must fall in a certain body mass category. If he or she exhibits all of the signs of anorexia but maintains a normal body mass, he or she is not diagnosed with anorexia. Similarly, if patients show signs of anorexia or bulimia on a less-frequent basis, they do not fit the official diagnosis criteria.

This has resulted in a tertiary category of diagnosis that may be most common of all: eating disorders not otherwise specified (EDNOS). EDNOS was added to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorder (DSM) in 1994. In 2013, DSM-5 added even more categories by splitting EDNOS into two additional categories. The first is “Other specified feeding eating disorders,” (OSFED) includes disorders that span anorexia, bulimia, and binge eating disorder. Then there is “unspecified feeding or eating disorders “(UFED), a diagnosis made when disordered eating behavior does not fall within anorexia, bulimia, binge eating disorder, or OSFED. According to U.S. Health News, “More than 80 percent of adolescents and 75 percent of adults with eating disorders have EDNOS​​.” Jennifer Thomas, Ph.D., co-director of the Clinical Research Program at Massachusetts General Hospital, calls this condition “Almost Anorexic” but stresses that it is just as serious.

And then there’s orthorexia, a condition in which an individual’s quest for healthy eating morphs into unhealthy fixation on healthy eating. Orthorexia is not officially recognized in the current DSM-5.

Needless to say, the realm of eating disorders is complex and confusing to navigate.

Eating disorders do not just affect teen girls.

We’ve talked about how teens consume an average of 7.5 hours of media per day. The media’s distorted body image ideals impact boys, too. Experts used to estimate that about 1 in 10 eating disorders occurred in males, but some newer research reveals much higher estimates. According to Huffington Post, boys are more likely to view themselves as underweight, even if they are actually overweight. Whereas young females tend to focus on losing weight, young males with disordered eating tend to fixate on becoming more muscular.

Additionally, more and more children are getting diagnosed with eating disorders. According to the American Academy of Pediatrics, from 1999 – 2006, eating disorder-related hospitalizations for children under age 12 increased by 119%.

The modern connotation of eating disorders must extend far beyond teen girls who obsess over being thin. The truth is that eating disorders may even involve gaining weight and muscle. And they can occur in males and children, too.

There’s much more to eating disorders than food.

Eating disorders typically stem from a host of psychological, behavioral, social, and emotional factors, from poor body image to feeling a lack of control, to stress, loneliness, or anxiety. Unrealistic ideals promoted by retouched images in the media, a constant barrage of comparisons via social media, and even excessive emphasis on healthy eating may all help explain why half of girls and one third of boys use unhealthy measures to control their weight.

Here’s what you can do.

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