Breaking the Silence During National Eating Disorders Awareness Week 

This week (February 26 to March 3) marks National Eating Disorders Awareness Week, an annual campaign to educate the public about eating disorders and promote early intervention, treatment, and recovery support. This year’s theme is “Healing in Community.” 

Eating disorders are serious mental illnesses that impact people of all ages, genders, ethnicities, body shapes, and weights. They are complex conditions that affect both psychological and physical health. The most common eating disorders are anorexia nervosa, bulimia nervosa, and binge eating disorder. However, many people struggle with other unspecified eating disorders as well. 

Understanding Eating Disorders 

Eating disorders are characterized by extreme emotions, attitudes, and behaviors regarding weight and food[1][2]. They are often related to low self-esteem, body image issues, and a desire for control. People with eating disorders tend to be perfectionists and place unrealistic standards on themselves. 

Anorexia nervosa involves restrictive eating and extreme thinness. People with anorexia severely limit their food intake and have an intense fear of gaining weight[1][3]. They often have a distorted body image and see themselves as overweight even when severely underweight. Anorexia has the highest mortality rate of any mental illness. 

Bulimia nervosa involves cycles of binging and purging[3]. People with bulimia go through periods of eating large amounts of food rapidly and then purging through forced vomiting, over-exercising, or using laxatives. Like those with anorexia, they place too much emphasis on body shape and weight as part of their self-image. 

Binge eating disorder involves recurring episodes of compulsive overeating. People with binge eating disorder consume very large amounts of food in short periods of time and feel unable to control their behavior[1][3][4]. They often eat when not hungry and continue eating past the point of fullness. Unlike bulimia, binge eating episodes are not followed by purging behaviors. People with binge eating disorder are often overweight or obese. 

Other eating disorders include avoidant/restrictive food intake disorder, pica, and rumination disorder[1][3][4]. People with these disorders have significant disturbances related to eating behaviors and food consumption. Treatment is aimed at addressing medical complications, nutritional rehabilitation, and underlying psychological issues.

Anorexia sufferers resort to severe weight-control methods, such as food restriction, and excessive exercise, leading to various health problems and complications.

Warning Signs and Symptoms 

Eating disorders do not discriminate. They affect people across age groups, gender identities, ethnic and cultural backgrounds, and socioeconomic levels. However, they often first appear during the teen years or early adulthood. 

It’s important to recognize the warning signs of eating disorders early and seek help. Potential physical, behavioral, and emotional red flags include[1][2][3][4]: 

• Significant weight loss or weight fluctuations 
• Intense fear of gaining weight 
• Distorted body image or denial of thinness/weight problem 
• Severe food restriction, calorie counting, elimination of food groups 
• Binge eating, purging, over-exercising 
• Social withdrawal, irritability 
• Frequent trips to the bathroom after meals 
• Calluses or scars on the hands and knuckles from self-induced vomiting 
• Discoloration or staining of teeth from stomach acids 
• Lightheadedness, fainting 
• Menstrual disorders or loss of menstruation 
• Stomach issues like bloating, constipation, acid reflux 
• Difficulty concentrating and making decisions 
• Depression, anxiety, self-harm behaviors 

Co-occurring conditions like depression, anxiety, obsessive-compulsive disorder, and substance abuse are also common. It’s not unusual for someone with an eating disorder to also struggle with other mental health issues. 

If someone is exhibiting a combination of physical, behavioral, and psychological warning signs, it warrants further screening and evaluation by a medical doctor and mental health professional. Getting assessed early is key, as eating disorders can be fatal if left untreated. 

Causes and Risk Factors 

The exact causes of eating disorders are still being researched, but are believed to be multifaceted. Contributing factors may include[1][3][4][5]: 

• Genetics and family history: People with first-degree relatives who have had an eating disorder are more likely to develop one. 
• Psychological health: Trauma, poor coping mechanisms, low self-esteem, and feelings of inadequacy can contribute to disordered eating thoughts and behaviors. 
• Environmental influences: Cultural attitudes and social pressures that glorify thinness and narrowly define beauty can promote problematic eating behaviors, especially among young people.
• Life transitions or stressful events: Times of change or high stress may trigger eating disorder symptoms in vulnerable individuals. 

Certain characteristics put some people at higher risk than others for developing an eating disorder, such as[5]: 

• Gender: Women are more likely to have eating disorders. Men account for approximately one in four cases. 
• Age: Eating disorders typically begin during adolescence and early adulthood, between the ages of 15 and 24. 
• Dieting: Chronic dieting and fasting can pave the way to an eating disorder.
• Activities: Athletes, dancers, models, actors, and performers in sports or activities that emphasize body shape are at increased risk, especially if they’re lean to begin with. 
• Psychiatric disorders: People with conditions like depression, anxiety, and OCD have higher rates of eating disorders. 

However, those presumed to be at “low risk” can also develop eating disorders. Dangerous weight control behaviors should never be ignored, regardless of gender, age, weight, or other factors. 

Getting Help and Treatment 

Seeking professional help is critical for addressing eating disorders. The earlier treatment begins, the better the outcomes typically are. Many different healthcare providers may be involved in treatment including psychologists, psychiatrists, dietitians, medical doctors, counselors, and others. 

A comprehensive treatment plan will address medical, nutritional, and mental health needs. Common components include[2][3]: 

• Medical care and monitoring: To stabilize any life-threatening issues and address physical consequences of malnutrition, purging, or related behaviors. 
• Nutritional counseling and support: To promote adequate calorie consumption and correct nutritional deficiencies. Meal planning guidance is often provided. 
• Therapy and counseling: Such as cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), and family-based therapy to address disordered thoughts about food and body image as well as underlying emotional issues. 
• Medications: Such as antidepressants and anti-anxiety medications that may support mental health treatment and recovery. 
• Support groups: Peer support provides needed encouragement throughout the recovery journey. Groups like Eating Disorders Anonymous model the 12-step principles of Alcoholics Anonymous. 

Treatment settings range from outpatient to residential options, depending on illness severity, health status, self-sufficiency, and program availability. Someone severely medically

compromised from their eating disorder may require hospitalization to stabilize their health. But less intensive treatment can be effective for those in earlier stages of illness. 

A patient’s nutritional status must improve significantly before other therapies can be fully effective. Weight normalization alone does not constitute full recovery, but it is an important step. Other goals include reduced eating disorder behaviors, healthier attitudes about food and body image, distress tolerance skills, and relapse prevention planning. 

Ongoing support and continued vigilance are vital, as relapse is common. About 30-50% of anorexia patients relapse, over half of bulimia patients relapse, and nearly two-thirds with binge eating disorder relapse. Having resources in place is key for maintaining recovery wins over the long run. 

Impact on Loved Ones 

Eating disorders affect not just those suffering but also loved ones around them. Witnessing the toll of an eating disorder is extremely distressing for parents, spouses, children, and close friends. 

Loved ones often feel confused, frustrated, and powerless. A key message of this year’s awareness campaign theme “Healing in Community” is that friends, family, and community can play an important role in recovery. Steps they can take include[6]: 

• Learning about eating disorders – their signs, symptoms, dangers, and treatment options – to know what they’re dealing with 
• Speaking up sensitively to express concerns about observed eating disorder behaviors 
• Encouraging professional help if health deterioration, physical safety, or relationships are severely compromised – while eating disorders thrive on secrecy, secrecy also enables them to progress 
• Exploring their own support options like educational resources or private counseling to process their feelings in a healthy way 
• Collaborating in recovery efforts once the individual accepts treatment – this can mean attending sessions, meal planning, or discouraging harmful behaviors 
• Celebrating recovery milestones, no matter how small – positive reinforcement goes a long way 

Taking an active role requires understanding, patience, and emotional strength from loved ones contending with someone’s eating disorder. But it can have a significant influence on motivating positive change. 

Bulimia nervosa is an eating disorder involving eating a large amount of food in a short amount of time followed by vomiting or the use of laxatives

Reducing Stigma 

Eating disorders are often profoundly misunderstood. Negative stereotypes and judgments about these conditions persist throughout society. As a result, stigma surrounding eating

disorders creates barriers not only for speaking out about the problem but also for seeking support. 

It’s paramount to challenge assumptions and clarify facts in order to break down stigma. Helpful starting points include[7][8]: 

Eating Disorders Are Not Choices 

• Eating disorders are serious bio-psycho-social illnesses – they significantly impair physical health and emotional functioning. They require compassionate medical treatment, not punishment or blame. 

Recovery is Possible 

• Like other mental illnesses, eating disorders can be treated and managed successfully over time. With professional help and social support, many people fully regain health and go on to thrive. 

Eating Disorders Affect Everyone 

• While certain risk factors exist, eating disorders do not discriminate. People of all body sizes, ages, ethnic groups, genders, and income levels develop these complex conditions. 

Continuing education and open conversations are imperative for improving attitudes, early intervention efforts, treatment accessibility, and recovery outcomes. There is no place for shame or stereotypes around potentially deadly illnesses. Silence simply allows problems to grow worse. 

Progress in dismantling stigma has occurred, but further change is still needed. Challenging bias starts with each of us – and the more voices speaking out, the better. 

Spreading Community Awareness 

We all have a role to play in spreading compassion and support around eating disorders. Here are some tips for getting involved: 

Share posts and graphics on social media – Follow hashtags like #NEDAwareness to find content to share or create your own infographics. Help get the word out about signs, statistics, and stories to educate others. 

Organize an awareness event – Host a community talk, screening, art exhibit, memorial walk, or fundraiser. Partner with advocacy groups or treatment facilities to tap into resources. Provide learning opportunities and chances for people to honor those affected.

Write letters to the editor – Share how this cause connects to your local community. Push for change around eating disorder treatment access, school curriculum additions, public awareness campaigns, or policy improvements. 

Volunteer your time or make donations – Get involved with non-profits helping those in need. Look into camps, peer support groups, recovery home projects, or advocacy programs making an impact and see how you can contribute. 

Guide conversations with empathy – If someone confides an eating disorder struggle, respond with compassion, not criticism. Be a trustworthy ear, help them find resources, and continue to check in on their wellbeing. Or gently voice concern if you suspect a loved one needs support. 

We all play a role in fostering a healthier culture, spreading understanding, and supporting loved ones around body image and eating struggles. National Eating Disorders Awareness Week reminds us we have the power to make a difference through our voices, actions, communities, and connections. 

References: 

[1] “Eating Disorders.” National Institute of Mental Health (NIMH), 2024, 

www.nimh.nih.gov/health/topics/eating-disorders. 

[2] “Eating Disorders.” Nyc.gov, 2024, 

www.nyc.gov/site/doh/health/health-topics/eating-disorders.page. 

[3] “Eating Disorders: About More than Food.” National Institute of Mental Health (NIMH), 2021, www.nimh.nih.gov/health/publications/eating-disorders. 

[4] “Eating Disorders.” Samhsa.gov, 2023, www.samhsa.gov/mental-health/eating-disorders. 

[5] Barakat, Sarah, et al. “Risk Factors for Eating Disorders: Findings from a Rapid Review.” Journal of Eating Disorders, vol. 11, no. 1, BioMed Central, Jan. 2023, 

https://doi.org/10.1186/s40337-022-00717-4.

[6] Gilbert, A A et al. “The impact of eating disorders on family relationships.” Eating disorders vol. 8,4 (2000): 331-45. doi:10.1080/10640260008251240 

[7] Doley, Joanna R et al. “Interventions to reduce the stigma of eating disorders: A systematic review and meta-analysis.” The International journal of eating disorders vol. 50,3 (2017): 210-230. doi:10.1002/eat.22691 

[8] “Stigma and Eating Disorders.” Nedc.com.au, 2020, 

nedc.com.au/eating-disorders/eating-disorders-explained/stigma.