Trigger Warning: If frank discussion of eating disorders and disordered eating may be triggering to you, this would be a good time to move along. Your well-being is way too important to ignore.
I well remember the first time I ran across the term anorexia nervosa. I was twelve years old and eagerly devouring the latest issue of American Girl magazine. It’s not the same magazine as American Girl is today. This was a magazine for Girl Scouts, not a line of dolls and books. The content ran the gamut from scouting-related news, games, and puzzles to feature articles on girls and women doing interesting things to campfire recipes to stories about girls’ health.
As I recall, I read and re-read the article about anorexia half a dozen times that week. I would have looked for more information, but I didn’t know where to start. My parents didn’t have a lot of health manuals around the house, and most of what they did have on the subject covered things like very basic anatomy or tips in my mother’s ladymags about getting your family through cold and flu season with minimum mucous. There wasn’t a peep about young girls becoming so obsessed with being thin that they starve themselves literally to death.
In fact, I wouldn’t find any more information than that one article for another three years… and when I did, it was a novel. I devoured it as ravenously as that article. And between the two, I learned quite a bit of misinformation.
You see, the American Girl article assumed that eating disorders are all about food and such pop culture images as Scarlett O’Hara. The novel placed the blame squarely on the family, particularly good old Mom, eternal doormat of psychiatric theory. Both suggested that once the cause had been identified, recovery was – while hardly pleasant – pretty much an assured thing. Oh, and it was a couple more years before I heard about bulimia at all, let alone binge eating disorder or EDNOS (eating disorder not otherwise specified).
Then a funny thing happened: someone I knew developed an eating disorder. A high school friend became bulimic during her first year at college. I knew this girl. I knew her family. She’d never been obsessed with pop culture, let alone that of the thirties. Her family was one of the kindest, closest-knit, most supportive ones I’ve ever known. She’d always had attention, love, plenty of friends. Clearly something wasn’t right about what little I knew about eating disorders.
In point of fact there is no one sure way of telling who will and who won’t develop an eating disorder, or which one they will develop. The risk factors include such varied elements as: genetics, a history of infant feeding problems, fad dieting, family pressure to be thin, childhood obesity or extreme thinness (Hmmm… I wonder if that might be related in any way to the three previous indicators), or a severe stressor involving friends or family in the year before the disorder begins. The word that seems to come up the most when I’m reading the life experiences of people who are in recovery from eating disorders is ‘control.’ My guess is that’s a pretty major key.
Once identified and diagnosed, the horror is far from over. Treatments are wildly expensive, and according to the National Association of Anorexia Nervosa and Associated Disorders (ANAD), permanently effective a whopping 50% of the time. Inpatient programs can cost $30,00o and up a month. Not year, month. ANAD estimates the cost of outpatient care at $100,000 and up, but does not specify what time frame that covers. In the end, some 6% of people with eating disorders will die of complications related to their disorders. The causes of those deaths range from malnutrition to heart disease to serious liver and kidney damage.
Eating disorders have the highest death rate of any psychiatric illness. Just let that sink in for a minute.
Another myth I got from the first two sources of information I had on eating disorders was that only upper middle class teenaged white girls get them. This is patently untrue. The fact is that while it is most often diagnosed among girls, a growing number of boys are being identified, too. And yes, most people who develop anorexia and bulimia do so during adolescence, but there are outliers on both ends of the age scale who do so, too. As for race and socio-economic level, these are even worse predictors. Black or white, rich or poor, it neither dooms nor protects you.
On top of that, a growing number of related disorders are being identified. Orthorexia, pregorexia, and diabulimia may not be officially recognized, but the research and literature are showing some shocking trends.
So how do we turn the mass of misinformation around? We educate ourselves. We learn what the latest research has to say and listen to the voices of recovery. We keep our ears, eyes, minds, and hearts open. And once we have educated ourselves, we talk.
Here are some good sources of factual information on eating disorders: