1. “People with eating disorders can just get over them if they want to.”
Eating disorders are about 50% a brain disorder and about 50% other factors such as society, learning, family stress and trauma. Research in the last 10 years has revealed that there are physiological differences in the brains of individuals with eating disorders. Developing an eating disorder is at least 50% biologically/genetically determined. These vulnerabilities lead to an increase in anxiety, increased sensitivity to emotional experiences and changes in the way satiety works in the brain. “Getting over an eating disorder” will require learning specific skills to manage these differences in the brain. It will not happen just by changing one’s mind.
“Environmental factors (bullying, diet pressures, media, trauma, etc.) may then come into play with the underlying genetics in such a way that the vulnerable individual develops an eating disorder.”
— Dr. Steven F. Crawford, associate director of the Center for Eating Disorders at Sheppard Pratt
Recent studies have shown that the majority of people with AN and BN exhibit childhood perfectionism, obsessive-compulsive personality patterns and anxiety that predate the onset of AN and BN . Moreover, studies done on three continents have shown that in AN and BN individuals with a lifetime history of an anxiety disorder diagnosis, the anxiety disorder most often began in childhood before the onset of the ED. The most common premorbid childhood disorders were OCD and social phobia.
2. “People with eating disorders are just going through a phase, and it’s not really that serious.”
Actually, more people die from eating disorders (350,000) than from breast cancer (approximately 40,000) every year. Females aged 15–24 are 12 times more likely to die of an eating disorder than any other cause of death. More people die of eating disorders than any other mental/behavioral disorder including depression.
3. “Once people have developed eating disorders, they will struggle for the rest of their lives.”
Most people recover. Studies show that about 30% fully recover, about 30% continue to struggle with some symptoms but go on to live productive lives, about 30% don’t recover, and about 10% die. At ACE the outcomes are even more favorable.
4. “Someone with an eating disorder is vain.”
People who are vain think highly of themselves and believe that they are better than others. People with eating disorders are not vain. They usually have low self-esteem and regardless of their accomplishments, they cannot see themselves as good enough.
5. “People with eating disorders are selfish.”
This couldn’t be farther from the truth. Individuals who develop eating disorders are usually very sensitive. They are physiologically more sensitive from birth than the average person. They are very in tune with the feelings of others and have a strong drive to want everyone around them to be happy. This often leads to perfectionism as they try to reduce any negativity that they or others will experience. As the disorder progresses they become caught in a vicious cycle where their attempts at being the best that they can be actually does cause others negative feelings — but at that point they can’t just stop. The attempt to be perfect is primarily a way to ensure that nothing about them will cause anyone else any distress and to ensure that others will not find fault in them, something that they are very sensitive about.
6. “Developing an eating disorder is due to family problems.”
As mentioned before, developing an eating disorder is at least 50% due to genetic/biologic factors. Developing an eating disorder may involve many other factors as well such as societal pressures, environmental stressors and trauma. People with eating disorders are very sensitive to family stress, so it is often one factor in developing an eating disorder. Parents should not worry about being blamed but will need to be willing to support the individual through family therapy so that they can become part of the solution.
7. We primarily need to be concerned about childhood obesity.
Actually, one study showed that we are perhaps too concerned with obesity to the detriment of those vulnerable to other types of eating disorders. There has been an increase in the numbers of younger children developing eating disorder symptoms as a result of health classes in elementary school that are focusing on the dangers of fat and instruction on how to read food labels. Similarly, pediatricians often have a bias toward thinness and underestimate the needs of those children they see who are underweight, even after significant weight loss. At ACE we’ve seen an increase in the number of young boys aged 10 and 11 who developed restrictive eating and weight loss in response to classes at school.
8. You can tell if someone has an eating disorder by appearance.
People with eating disorders are often terrified by the possibility that someone will say to them, “Well, you don’t look like you have an eating disorder.” People with eating disorders can be any body size or shape and usually have difficulty believing that they are thin enough regardless of their size.
9. An eating disorder is a “rich, white girl” problem.
The prevalence of eating disorders is similar among Non-Hispanic Whites, Hispanics, African-Americans and Asians in the United States, with the exception that anorexia nervosa is more common among Non-Hispanic Whites (Hudson et al., 2007; Wade et al., 2011). The age range for individuals with eating disorders has greatly expanded in recent years. The latest statistics provided by The National Eating Disorders Association (2011) indicate that by the age of six, children already begin to express concerns about their own weight or shape. The American Academy of Pediatrics also reports that hospitalizations for eating disorders in children 8 to 12 years old increased 119 percent between 1999 and 2006. Recent studies have also highlighted growing numbers in women aged 40 and up. One recent study found that as many as 13% of women over the age of 50 have eating disorders.
The truth about eating disorders:
In summary, people who develop eating disorders are born with differences in their brain chemistry which increase their sensitivity to stimuli. This sensitivity develops into a heightened awareness of their own and others’ reactions which generally leads to harm-avoidant strategies such as perfectionism, obsessive-compulsive behaviors, social avoidance, shyness and ultimately eating disorders. These strategies are faulty attempts to control the level of distress they may experience. Treatment involves recognizing that their sensitivity is both a blessing and a burden and learning more effective tools for coping.
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