Eating Disorder Myth Busting

This week (Feb 27-Mar 5) is National Eating Disorder Awareness Week. Eating Disorders have the second highest mortality rate of all mental health disorders, surpassed only by opioid use disorder. 28.8 million Americans experience an eating disorder at some point in their lives. The National Eating Disorder Assocaition (NEDA) Help Line has experienced a 107% increase in contacts since the start of the COVID-19 pandemic, right in line with the increase in traffic of the Suicide Prevention Hotline and other mental health resources. Bottom line, it’s a problem, and the prevalence of ED in athletes is particularly high.

Spreading awareness about ED’s and mental illness of all kinds is important to me, having experienced Anorexia Nervosa and Depression/Anxiety myself. Early detection and intervention, as well as an abundance of support is key to recovery. There are so many myths and misconceptions about Eating Disorders, so I hope to dispel a few of those so that you can best support yourself or a loved one who might be struggling.

MOST COMMON EATING DISORDER MYTHS

1. People who struggle with ED’s are thin and underweight.

Similarly to other mental illnesses, ED’s don’t have a “look” and can occur at any weight, level of function, and activity level. There are several categories of ED’s, all characterized by different symptoms and behaviors. ED’s specifically reference a damaged relationship to food that interferes with one’s life and ability to function.

2. Eating Disorders are only about food.

Poor relationship with food is a symptom of ED’s, but oftentimes not the cause. The direct cause for ED’s is unknown, but likely involves biological, cultural, and psychological factors. Controlling food and weight often stems from lack of control in other aspects of an individual’s life, and can be a trauma response as well. ED’s often occur in tandem with other mental illnesses, such as depression, anxiety, Obsessive Compulsive Disorder, and PTSD.

3. Eating Disorders are a choice.

As mentioned above, ED’s are complex and are not a choice. It is a psychiatric illness that patients do not choose.

4. Eating Disorders only occur in girls/women

There is a rising number of men and nonbinary individuals who are seeking help for eating disorders. This is prevalent within sports where weight and size is a factor, such as running, wrestling, cycling, and the performing arts.

Because ED’s are so varied in their presentation and symptoms, and can be hard to know when to be concerned for a loved one. Below are examples of symptoms that may occur as a result of an Eating Disorder.

WHAT ARE THE SYMPTOMS OF AN EATING DISORDER?

Behavioral

• Preoccupation with food/weight

• Refusal to eat certain foods, elimination of an entire food category

• Mood swings or emotional instability, irritability

• Appearing uncomfortable eating around others

• Frequent checking in the mirror/assessing body

• Showering or getting dressed in the dark

• Skipping meals or eating smaller portions at meals

• Over-exercising or excessively exercising

Physical

• Fluctuations in weight, up or down

• Hair loss, brittle nails

• Menstrual irregularities

• Feeling cold all the time

• Dizziness/syncope/fainting

• Abnormal laboratory findings (anemia, low thyroid and hormone levels, low potassium, low white and red blood cell counts)

• Poor wound healing

• Sleep interruptions

• Poor work performance

RED-S may occur in tandem with an eating disorder, but the two are not mutually exclusive. Thanks to many athletes speaking out about their experiences and so many good professionals providing a voice of reason, I truly think that the culture in sport and beyond is improving around body diversity and body acceptance.

NEDA has some fantastic resources and strategies for supporting those in need at https://www.nationaleatingdisorders.org . It is so important to express concern, offer support, and nudge toward professional help.

Keep going, you got this!

Dr. Kacy Seynders, PT, DPT, OCS