TRANSCRIPT: Eating Disorders: Types, Causes, Symptoms & Support
Speaker: Dr. Peggy Mitchell Clarke
Eating Disorders: Types, Causes, Symptoms & Support
Hi, I'm Dr. Peggy Mitchell Clarke.
I'm a clinical psychologist and psychology professor.
I taught psychology for almost 20 years at colleges and universities.
I'm so glad you've decided to view this important video.
We're going to discuss eating disorders.
Did You Know That...
If you're like most people, you love food and you love to eat; but did you know that millions of people have an eating disorder?
Eating disorders have the highest mortality rate among all psychiatric disorders.
The suicide rate for people with eating disorders is 50 times higher than the general population, and eating disorders occur in both men and women.
Eating and food are two of life's simple pleasures; but for the up to 24 million people of all ages and genders who suffer from an eating disorder, mealtime can be excruciating painful.
For a person with an eating disorder, death most commonly results from medical complications associated with the eating disorder or from suicide.
What Is An Eating Disorder?
What is an eating disorder?
An eating disorder is a persistent disturbance in eating behavior and body image that results from a person's obsessive fear about gaining weight.
There are three types of eating disorders...anorexia nervosa, bulimia nervosa, and binge eating disorder.
We'll explore each of these in more detail.
Development Of Eating Disorders
The development of eating disorders commonly begins during adolescence or young adulthood when many young people are concerned about their appearance and body image.
Onset is often associated with a stressful life event, such as leaving home for college; and many people usually start as a result of experimentation with dieting.
In a recent survey of college students, 1.2% of students reported that in the last 12 months an eating disorder affected their academic performance; 1.1% reported that they were treated for anorexia; and 1% reported that they were treated for bulimia.
Anorexia Nervosa
Anorexia nervosa is characterized by a restriction of calories that leads to a significantly low body weight.
The restriction of calories is motivated by an intense fear of gaining weight or of becoming fat.
A person with anorexia also exhibits a disturbance in evaluating their own weight or shape, which is referred to as a "distorted body image.” For example, they might be grossly underweight and yet look in the mirror and perceive themselves as fat.
Despite the existence of medical complications related to their body weight, which I'll describe in a moment, a person with anorexia lacks recognition of the seriousness of just how underweight they are.
They will also persistently demonstrate behavior that interferes with weight gain...
for example, throwing away food or skipping meals.
Bulimia Nervosa
Bulimia nervosa is characterized by repeated episodes of binge eating, which is eating large amounts of food while experiencing a lack of control over eating during the episode.
A person feels like they just can't stop themselves.
Binge eating is followed by purging, which is inappropriate compensatory behaviors intended to prevent weight gain...such as self-induced vomiting, misuse of laxatives, diuretics, enemas, fasting, and excessive exercise.
Someone with bulimia nervosa evaluates themselves based on their body shape and weight.
For example, if they're dissatisfied with their body, they would think poorly of themselves.
Despite their binge eating behavior, individuals with bulimia typically have normal appetites and maintain a normal weight.
Unlike someone with anorexia, whose low body weight and restricted calorie intake are apparent, you might not know from looking at them that someone has bulimia.
Binging and purging behaviors are usually done in secret, and people tend to feel a great deal of shame.
Binge-Eating Disorder
Binge eating disorder is characterized by repeated episodes of binge eating but without the purging.
Similar to someone with bulimia, the person eats rapidly and feels uncomfortably full.
They also eat when they're not hungry.
They eat alone, due to embarrassment; and they feel disgusted, depressed, or guilty afterward.
Men & Eating Disorders
While the majority of individuals with eating disorders are women, men can still develop an eating disorder.
Men, however, are more likely to focus on muscle gain while women are more likely to focus on weight loss.
As a result, eating disorders in men tend to involve overexercise and steroid misuse.
Men are also less likely to seek and receive help due to stigma and bias in diagnosing.
Despite stereotypes and myths, there is no correlation with eating disorders and sexual orientation.
Eating Disorders & Sports
Despite the popular perception that athletes are healthy, eating disorders are common among athletes.
While most athletes with an eating disorder are women, male athletes are also at risk.
The risk is greatest, especially for those in sports that focus on making weight, maintaining a certain body size, or appearance.
Examples of these kinds of sports include gymnastics, swimming, diving, rowing, body building, wrestling, figure skating, dancing, and track and field.
Why Are These Students At Risk For Developing An Eating Disorder?
Consider the following examples and identify why these students are at risk for developing an eating disorder.
A male athlete joins the wrestling team.
He consistently can't make weight and might get cut from the team.
He's at risk because he's in a sport that's focused on being a certain size or weight, and the stakes are high if he doesn't achieve those goals.
A female freshman is homesick and has started dieting to fit in a dress for the big homecoming party.
She's in a transitional period that's likely stressful, and she's also experimenting with dieting.
Emotional Signs
Because the behaviors are often done in secret, you might not know a friend has an eating disorder; but if you know the signs to look for, you're more likely to be able to help them.
You might recognize signs of an eating disorder by observing these emotional signs...
A change in attitude and/or performance Body image complaints or concern The person appears sad, depressed, or anxious or expresses feelings of worthlessness The person spends increasing amounts of time alone.
Physical Signs
There are several physical signs of an eating disorder, including...
Sudden weight loss or gain in a short time Abdominal pain Feeling full or bloated Feeling faint, cold, or tired Dry hair or skin Dehydration Blue hands or feet Lanugo, which is a soft, downy, white hair that grows over the arms, face, back, and chest of someone who's extremely emaciated.
Lanugo is actually the body's attempt to keep itself warm by creating a blanket of sorts out of hair.
Loss of menstrual period in a woman who previously was menstruating Swollen salivary glands Broken blood vessels in eyes Eroded teeth enamel, all as a result of frequency vomiting.
Behavioral Signs
There are several signs that indicate that someone is engaging in binging and/or purging or has an eating disorder...
Dieting or chaotic food intake Pretending to eat Throwing away food or skipping meals might all be signs of an eating disorder.
Exercising for long periods of time or excessively...for example, long intense workouts without having a goal, like training for a marathon.
Making frequent trips to the bathroom, especially immediately after eating, might be a sign that they are purging.
Wearing very bagging clothes, which could be a result of just how much weight they've lost or intentionally wearing baggy clothes to hide their emaciated body Avoiding the cafeteria or eating in public because much eating disorder behavior occurs in secret Showing compulsive behavior in other areas of their lives. In my experience, I've observed several students who were perfectionistic about their academic work; and they later self-disclosed that they were being treated for an eating disorder.
Treatment Barriers (Study Of Faculty & Staff)
One study asked higher education professionals what they believed were the barriers to treatment for college students.
Their responses were varied.
They believed the barriers were...
Students are unwilling to seek treatment.
Students don't know that they have an eating disorder.
Students have a lack of awareness of their school's treatment resources.
Students are embarrassed to seek treatment.
The campus lacks on-campus treatment resources.
A perceived lack of anonymity in treatment.
Lack of knowledge by staff ab where to refer students.
Students don't need to seek treatment.
Now, keep in mind that these are the perceptions of faculty and staff; and actual barriers may be different.
Nonetheless, the need to remove barriers of any kind is critical.
How You Can Help
Eating disorders have a high fatality rate; they cause serious distress; and they interfere with success.
If you recognize some of the emotional, behavioral, or physical signs that we've reviewed, here are a few ways that you can help...
Don't ignore the signs that you see.
Talk openly and honestly.
Be specific with the person about what behaviors you see that concern you.
Be gentle but firm.
Take time to listen and hear them out, but don't try to force the issue.
Encourage them to get help from a professional who specializes in eating disorders.
If you feel comfortable, offer to help make an appointment or accompany your friend on their first visit.
You can also help by providing the person with resource information for on-campus or off-campus help or walk them to the appropriate on-campus office if possible.
Express your love and support at each stage of the conversation.
Don't try to force them to eat; and don't shame, blame, or guilt them.
Talking with someone about an eating disorder can be uncomfortable or upsetting for you.
Be sure to contact the appropriate campus office or department yourself to ask questions or get help...even if, or especially if, the person refuses to go get help for themselves.
Resources & Referrals
Once you've persuaded the person to get help, there are several resources you can refer them to...
Counseling Office or Student Health Services if they're available on your campus Your college BIT or behavioral intervention team.
BITs also go by different names such as CARE teams, [TAT], or CAT.
Accessibility or disability services, or Off-campus community mental health center.
Would This Statement Be Helpful To Someone With An Eating Disorder?
Would this statement be helpful to someone with an eating disorder?
"I'm concerned about your eating habits and what seems to me to be excessive exercising. I've also noticed that you always go to the bathroom right after you eat and when you come out, your eyes look bloodshot. I think these things indicate a problem that might need professional attention."
This statement is helpful because it expresses concern using specific examples and directly expresses your belief that the person needs professional assistance.
"If you'd just stop throwing up, then everything would be fine. You just need to start eating normally."
This statement would not be very helpful because it's too simple a solution that tries to force them to eat.
"You're going to disappoint the whole team and your family if you keep doing what you're doing. How do you think they'll all feel if you just collapse and die one day at a match?"
This is not a helpful statement because it shames, blames, and guilts the person.
"Would you be willing to explore these behavior patterns with a professional - maybe a nutritionist or counselor who is knowledgeable about eating disorders?"
This statement is helpful because it encourages the person to get help from a professional who specializes in eating disorders.
"I'd be willing to help you make an appointment or go with you to your first meeting."
This statement shows support by offering to help make an appointment or accompany the person on their first visit.
"I'm going to keep nagging you until you go see a doctor so you might as well just go and get it over with."
This statement is not helpful because it doesn't convey understanding or that you're taking time to listen, and it seems to just force the issue.
"Well, when you're ready to talk or get help, know that I'm here for you. I care about you and will always support you."
This is a helpful statement that conveys your concern and support and that you will still be there to help if they change their mind.
Eating Disorder Screening
Take this eating disorder screening test or share it with a friend that you're concerned about.
Depending on your results, it may provide you with a recommendation to seek professional help.
Conclusion
This concludes this very important video.
If any of the information you've learned today resonates with you or seems to apply to a friend, please reach out and get assistance.
Your campus has many resources to help you.