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Dec 22 2021 13:15

Leann Bentley, Huntsman Institute of Mental Health

Eating disorders are defined by the American Psychiatric Association as “behavioral cognition characterized by a severe and persistent disruption of eating behaviors and associated distressing thoughts and emotions”. The most important thing to note is that eating disorders are classified as a mental health problem and are treatable.

Kristin Francis, MD, psychiatrist at Huntsman Institute of Mental Health, uses its expertise to detect and diagnose eating disorders, suicide risk and common triggers. “With early detection and intervention, we can reduce the severity and recurrence of eating disorders,” explains Francis.

Types of eating disorders

the National Association of Eating Disorders defines the most common disorders:

Anorexia nervosa – A type of eating disorder characterized by weight loss and difficulty maintaining an appropriate body weight for your age, height and stature. “We often compare a person’s historical growth and the body mass index (BMI) percentile they were performing best at before the onset of the eating disorder,” says Francis.

Francis makes an important distinction between the percentile of BMI and gross BMI. “Gross BMI is calculated by dividing a person’s weight by their height,” she says. “It’s an outdated measurement tool and shouldn’t be the hallmark of what a ‘healthy’ weight is for someone. The percentile of BMI is the comparison of a child’s weight to that of other children of the same age and sex and is a better tool to use for tracking weight gain / loss in children.

There are two subtypes of anorexia nervosa: the “excessive purging subtype” and the “restrictive subtype”. In the first case, people may have “subjective” binge eating attacks where they eat a normative amount of food rather than a high amount of calories usually associated with “binge”, but experience intense guilt and shame, then compensate with purging behaviors (self-induced vomiting or exercising).

Nervous Bulimia – A cycle of binge eating and compensatory behaviors such as purging (self-induced vomiting, use of laxatives, exercise, restriction) to lessen the effects of the binge.

Binge eating disorder (BID) – The most common eating disorder characterized by recurrent episodes of consuming large amounts of food followed by feelings of shame and guilt. Unlike bulimia nervosa, people do not compensate for this binge eating with restricting or purging behaviors (including exercise).

Other specified eating and eating disorder (OSFED) – Characterized for people who do not meet the strict diagnostic criteria for anorexia nervosa or bulimia nervosa, but who still have / have had significant eating disorders that affect their functioning, mood, relationships and their health.

Rumination disorder – Individuals regurgitate their food (re-chewed, swallowed, spat out) for more than a month.This is often unintentional and the food is not mixed with digestive juices and therefore does not have an unpleasant taste.

Orthorexia This term was coined in 1998 and describes an obsession with eating “good” or too “healthy”. Often, this obsession results in increasingly limited food variety and intake and requires an increasing amount of energy, time and focus with unintended consequences on health.

Compulsive exercise – Characterized by excessive and extreme exercise that significantly interferes with areas of life.

Question: Is There a Separate Cause of Eating Disorders?

A: Weight loss diets are the most studied cause of onset of an eating disorder. Most eating disorders have a genetic basis and require a situational stressor, which can be as simple as deciding to lose five pounds for a trip, illness with subsequent weight loss, or being told by a health professional that you should lose weight. Another well-studied factor that can predispose a person to developing an eating disorder is having a family history of eating disorders.

Question: What are the most common triggers and what are the best ways to spot them?

A: Dieting or “changing the way we eat to influence our height or shape” is the most common cause. Restrictions (physiological and psychological) are the main triggers that cause physiological changes that increase our focus and our desire for “forbidden” foods. Noticing if the variety and amount of your food has decreased, paying attention to dietary rules and how you feel physically and emotionally when eating, and seeing that you are avoiding social situations due to food expectations can all be clues. useful that the diet has become messy. Additionally, the decline in your physical health (energy, mood, self-esteem, social responsiveness, and thoughts that life is difficult or burdensome) can be a red flag that you have an eating disorder. .

Question: What should you do first if you know someone who might be struggling with an eating disorder?

A: Talk to them! Express your concern about the changes you have observed in them (variety of foods, quantity, energy, eating habits, mood, withdrawal from social circles).

Question: What are the best ways to get help?

A: The first step is to recognize that your attitudes about food and your body can interfere with your life. Next, seek the help of a healthcare professional to assess the severity of your symptoms and review treatment options. There are doctors who specialize in medical and psychiatric support and therapists who can help change your health so that you can have the abundant life you deserve. There are also dieticians who can teach you about food demoralization – “all foods are good, there are no good or bad foods” – and work with you to increase your variety and intake. Or they can help you plan meal and snack times to nourish your body and reduce binge and restriction cravings.

Question: What can you do in your spare time to help yourself if you feel like you are struggling with an eating disorder?

A: There are some great online resources (,, Ellyn Satter Institute, to get started to educate yourself. Start with the resources above. Also, try not to be hard on yourself; realize that you are not alone and that our society’s unrealistic images and values ​​surrounding being thin condition us into body dissatisfaction from an early age without our realization or permission. You did not cause this and have the power and the support to change your diet and your life.

Try not to be hard on yourself; realize that you are not alone and that our society’s unrealistic images and values ​​surrounding being thin condition us into body dissatisfaction from an early age without our realization or permission. You did not cause this and have the power and the support to change your diet and your life.

Kristin Francis, MD

Eating disorders and link to death by suicide

Starvation makes people more depressed, anxious and suicidal, says Francis. Much of what we know about the effects of starvation on mood comes from the Minnesota Starvation Study and the concept of “set point theory,” that weight is genetically determined, and that our bodies have a range of. individualized weight that we feel, function and eat. best at. Statistically, over 28 million Americans are currently or have battled an eating disorder, and 26% of these people attempt suicide, but less than 6% of these people are considered medically “underweight.” reported on National Association of Anorexia nervosa (ANAN).

Eating disorders are life-threatening mental illnesses and should be treated as such.

  • 9% of the American population will have an eating disorder in their lifetime.
  • 91% of women admitted to monitoring their body weight in a college campus survey.
  • Athletes are more likely to have an eating disorder than non-athletes.
  • About 26% of people with an eating disorder try to kill themselves.
  • One death every 52 minutes: Eating disorders are among the deadliest mental illnesses.

Eating disorders are often secretive and “people can starve to death regardless of their size,” says Francis. Of those with eating disorders, 86% say they started before the age of 20. It has been suggested that anorexia nervosa has the highest death rate of all psychiatric disorders, estimated at 10%.

Eating disorders are serious medical conditions, but help is the low. The first step is to recognize that you are not alone in this situation and that this is not what happened to you.

If you or someone you know has an eating disorder, find a healthcare professional near you.