Posts Tagged “Co-Occurring Disorders”

Eating disorders are complex illnesses for both the individuals who experience them and the professionals who seek to treat them. Among the complicating factors is that they seldom exist in isolation. Many people suffering from anorexia, bulimia, BED, and other eating disorders also experience other mental health conditions, such as anxiety, depression, substance use disorders, or a history of trauma.

The high prevalence of anxiety and depression among those with eating disorders hints at a biological connection between these conditions. Further research is needed to fully understand this relationship—to discern whether anxiety and depression are distinct diagnoses independent of eating disorders or if they are intricately intertwined outcomes of the same underlying biological factors. It’s also possible that these conditions are correlated to the change in brain chemistry that occurs with starvation, bingeing, purging, and/or other eating disorder behaviors.

Note: In this blog, we use identity-first language (e.g., “an autistic individual”) to reflect those who embrace autism as an identity category – a diverse way of perceiving and interacting with the world (Taboas et al., 2022; Bury et al., 2020).  However, we recognize that this language choice may not be suitable for everyone in the community. Whenever possible, please ask individuals about the language appropriate for them. 

Living with and treating an eating disorder may be complicated by the presence of a co-occurring condition, particularly when the condition shares characteristics with an eating disorder. One such condition that shares some psychopathology with a disordered eating mindset—and is frequently seen alongside an eating disorder diagnosis—is autism spectrum disorder.

There are a number of factors that increase the risk of disordered eating or an eating disorder in an autistic individual. By looking at the nature of both eating disorders and autism spectrum disorders, we can better understand their relationship and improve the detection, care, and treatment of both conditions.

Eating disorders impact about 30 million people in the United States. They are associated with high levels of premature mortality, including an increased risk for suicide. Without treatment, up to 20 percent of people with a serious eating disorder will die. Much like eating disorders, suicidal thoughts can affect anyone regardless of age, gender, or any other demographic categorization. 

As providers, there are certain warning signs of suicidal thinking that you should be looking out for, as well as an appropriate way to approach someone when you spot these warning signs.

Anxiety disorders are the most common mental illness in the United States, but they are still often misunderstood. As with eating disorders, the seriousness of anxiety is often dismissed. When a disorder affects so many people, the behaviors and symptoms can become normalized in our culture, but those suffering deserve help just as much as anyone else. Just like eating disorders are often misunderstood as something that people can just “get over,” many people think anxiety is something that you should be able to move past easily, which is not realistic in either case. In this article, we will cover the definition of anxiety disorder, five common myths, and how eating disorders and anxiety are intertwined. 

Episode description:

Emily Layden is a writer and former high school English teacher from upstate New York. A graduate of Stanford University, her writing has appeared in The New York Times, Marie Claire, The Billfold, and Runner’s World. She joins us in this episode of Peace Meal to discuss her debut novel All Girls. We explore the depiction of disordered eating and anxiety in the book and society more generally, using Emily’s experience with the co-occurring concerns as context along the way. 

We center our conversation on one of the characters of All Girls, Macy, who struggles with clinical anxiety and an eating disorder resembling ARFID. Emily tells us about her decision to write Macy as she did, eschewing graphic descriptions of behaviors to highlight Macy’s anxious thoughts instead. She describes what she hopes All Girls adds to the larger conversation about eating disorders and the adolescent females among whom eating disorders are particularly prevalent. Emphasizing the importance of taking both eating disorders and young women more seriously, we explore how society tends to think similarly of both.

We in the eating disorder field are generally wary of restriction. Dieting is a key risk factor in the development of eating disorders, and eliminating it and other disordered behaviors is central to healing. One of the biggest gifts of recovery is the opposite of restriction: a life where food is just food, and all foods fit.

Even so, “all foods fit” does not necessarily mean that all foods fit for all people at all times. Like any pithy “all” statement, this generalization does not represent any unique considerations. For those with special dietary restrictions, all foods quite literally do not fit. For those with allergies and intolerances, some foods are forever off-limits, and those with conditions like type 1 diabetes or celiac disease need to closely monitor ingredients to avoid triggering their physical illness.

Similarly, gastrointestinal disorders such as inflammatory bowel disease (IBD) often require dietary restriction as part of their treatment. The relationship with food is especially complicated for people in this situation. IBD symptoms can overlap and interact with eating disorder ones, and there is no one nutritional plan proven to work for all of those suffering.