Eating Disorders: Exposing Assumptions

Eating Disorder is defined by Google as: “Any range of psychological disorders characterized by abnormal or disturbed eating habits.” This surprised me because it is purely psychological. I have been writing about digestive disorders, and I assumed that eating and digesting were all tied up together. Not so! That’s what I get for assuming.

But here’s the problem. When people look at you, or me, they also assume. If you or I are too thin for their liking they assume we have an eating (psychological) disorder. If you or I are overweight they assume again–that we are lazy gluttons, or that we are normal–depending on their size. It seems that weight, like beauty, is in the eye of the beholder. However, this is neither fair, nor healthy. And so, I want to expose and push back against these assumptions because we are all unique!

Facts and Assumptions

Since I’ve written about digestive disorders in other posts, I will delve into eating disorders here.

General Statistics

  • Approximately 30 million adults in the U.S. have or have had an eating disorder: 20 million women and 10 million men.

  • As many as 13% of Americans under age 20 have or have had an eating disorder.

  • Approximately 13% of American women over age 50 have an eating disorder.

  • Every 62 minutes someone dies as a direct result of an eating disorder (not lack of food).

  • Eating disorders have the highest mortality rates of all mental illnesses.

  • As many as 1 in 10 adults with an eating disorders also suffers from substance abuse.

  • Eating disorders are caused by an individually unique combination of personality, environment, and levels of the brain chemicals serotonin and dopamine.

Anorexia Nervosa

This is an intense fear of gaining weight and of being overweight. It comes from a distorted view of body image, and a self-esteem that is wrapped around body shape. Sufferers struggle with intake of food: either they severely restrict intake, or they binge and purge their food. They have problems eating in public, and they have a strong desire to control their eating environment.

As one who suffers from both gluten and lactose intolerance, these struggles sound very familiar to me. I can relate! Does that make me anorexic? The two thinnest, frailest persons I’ve ever seen, outside of a nursing-care facility, both struggled greatly with eating in public. Did their eating struggles, combined with their appearance, make them anorexic? No. One suffered from advanced Crohn’s disease and the other had terrible food allergies.

Bulimia Nervosa

This disorder comes from inability to control eating, which makes the sufferer eat large amounts of food in a short time period. They do not stop until they are painfully full. Then, due to discomfort and guilt, they begin to purge this excess food. Unlike the anorexic, who obsessively controls food intake, the bulimic cannot control their intake, and so they purge in order to maintain a normal weight.

Probably the most famous bulimia sufferer was Princess Diana. I recall a fashion article on her dresses, with a photo of Diana in a kelly green, day dress, whose caption read: “This dress made eve pencil slim Diana look pudgy. It was never seen again.” I was so shocked that Princess Diana could ever be called pudgy, that the image and caption has stuck in my mind all these years. I always had the impression that Diana was anorexic, so when she revealed her struggles with bulimia, I was shocked again. My assumptions, based on appearances, were wrong.

Binge Eating Disorder (BED)

This disorder is the same as Bulimia, except without the purging. The sufferer privately eats large amounts of food in a brief time, feeling out of control while they do, and feeling intense guilt afterward, but they do not purge or try to restrict calories. This eventually leads to obesity.

I knew a woman who was short and plump, but she was energetic and fun-loving, had beautiful hair, an attractive face, and sparking eyes. I was surprised when she admitted to suffering from binge eating out of loneliness because everyone loved her! To me, she was the picture of physical, mental, and social health. She began a weight loss support group and dropped a few pounds. Then she moved away and I did not see her for several years. When I did see her again, I honestly did not recognize her at first. She was so tiny and absolutely gorgeous! A peaceful, shining joy radiated from her. And she was showing off an engagement ring! Again, I had assumed she was the picture of health, but she knew otherwise. She faced her own dark secret, and the result transformed her entire life!

ARFID Avoidant/Restrictive Food Intake Disorder

This is a newly recognized disorder, so don’t be surprised if you haven’t heard of it. It usually begins in early childhood and can persist into adulthood. In this disorder, the sufferer severely restricts food intake not due to calories and weight, but because they are either disinterested in food, or they have a strong dislike of certain smells, tastes, colors, textures, or temperatures. This is much more than picky eating! These sufferers intentionally restrict food based on their preferences to the point of malnutrition and poor development.

I knew a boy, who was the worst picky eater! He limited himself to cheese combined with bread or pasta, potatoes (mashed, fries, or chips), ice cream, and occasionally chicken nuggets. He could not be coaxed, forced, or shamed into expanding his diet by either his parents or his peers at school. At one point I suggested to a family member that psychological counseling might be appropriate, but I was told, “He’ll grow out of it.” This boy is now in his twenties and has added only an occasional taco or steak to his diet. He is tall and thin as a rail–probably with very strong bones, but no muscle on them. I think it is fair to say that he has suffered socially from his eating disorder. Not even he can say why he has such a limited range of tastes, but it certainly has affected his quality of life. In this case, the boy’s family assumed incorrectly that all was fine when an eating disorder was present, which has affected and still affects this young man’s life.

What Can You Do?

There are other eating disorders I have not addressed here, but all of them are serious illnesses and each can be deadly!

  1. Get the facts. Know the characteristics of the disorder you think you are observing.

  2. Speak to the person or family involved with great sensitivity. Ask questions instead of stating what you think.

  3. Watch and listen to what they say or do not say in response. Ask yourself: Is this an eating (psychological) disorder, or a digestive (physical) disorder, or both?

  4. Whether they realized it or not, they are already hurting for some reason. Do not add to their pain.

  5. Provide a sympathetic listening ear, instead of giving advice.

  6. Suggest places they could get help only if you are sure you are suggesting the right course of action.

  7. Know the symptoms of suicide–the leading cause of death among anorexics is suicide, and all eating disorders are mental illness which raises the possibility of suicide.

  8. An eating disorder also increases the person’s chance of stroke or heart attack, due to hormone imbalances linked to their disorder.

  9. If someone makes a wrong assumption about you, gently explain the truth to them. You will probably gain an ally in your struggle.

  10. Above all, practice the “golden rule” of doing to others what you would want them to do to you.

Have you been the victim of food assumptions? Regardless of what the assumption was, I invite you to share your story in the comments section. Your story can help and encourage others. Thank you.

4 thoughts on “Eating Disorders: Exposing Assumptions

  1. You are right. I’ve never heard of ARFID but I’m not surprised to hear that new eating disorders have been added to the list. I know people who have suffered from anorexia and can attest to the fact that it’s extremely dangerous to the individual as well as family members. Part of the problem with eating disorders is that people suffering from them tend to be very secretive. You mention that a fair amount of those suffering from eating disorders also suffer from substance abuse. While I’ve never heard this before it kind of makes sense. Another interesting finding here is that women over 50 have statistically the same rate of anorexia as those under 20. Have you heard any theories about why the rate is so high in these age groups?

    1. I also found the statistic on women over 50 being as likely to be anorexic as those under 20 very interesting, and I have no idea why it is.  My personal guess is that during the 1970’s and 80’s super-thin was so “in”, and women (me included) who are now over 50 formed their ideas of beauty during that cultural time.  Again, no evidence to back this up, just my guess.

      The link between eating disorders and substance abuse was new to me, too.  But when you think that both involve self control–either too much control or lack of control–it does make sense.

      Thanks for your comments, Lynn. It was nice chatting with you.

  2. Thank you for the insight regarding eating disorders. I am doing research for my wife, she has stage 4 ovarian cancer. The treatment she is undergoing makes it difficult (even with prescription meds, including cannabis oils) to consume even 900-1000 calories per day. Each day is a struggle, each day is a fight. We are worried that this will turn into a long term eating disorder after the chemo treatments have stopped.

    Thank you for the post, it was well received – i appreciate you.

    1. Frank, I am so very sorry about your wife! Ovarian cancer is no stranger to me as my mother died of it 16 years ago. All cancer is hell, but ovarian is a truly terrible one. I know they have much better chemo now than when my mother had it, so I’m hopeful with you that your wife will persevere through it all and regain her health. However, I’m not surprised she is having trouble eating–between the effects of the chemo and the cancer itself, eating is nearly impossible sometimes. But I really believe your wife’s appetite will return with her health. It will be gradual, but it will come back.
      Keep up the good fight along with your wife, but remember to take care of yourself, too. Your health matters as much as hers because she needs you to be there for her.
      Best wishes for your wife’s full recovery!

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