Posts Tagged ‘For Providers’

Disordered Eating vs. Eating Disorders: What’s the Tipping Point?

Male teen looking out of a window

Eating disorders are hard to spot, especially when disordered eating behaviors are extremely common. From the prevalence of dieting to the glorification of excessive exercise, it can be tricky to understand when disordered behaviors spiral into a full-blown eating disorder.

What is Disordered Eating?

Disordered eating includes unhealthy food and body behaviors, usually undertaken for the purpose of weight loss or health promotion, but that may put the person at risk for significant harm.  Disordered eating is serious and can lead to severe complications in one’s life, so it is important to stay vigilant of the warning signs and symptoms. Unfortunately, disordered eating is extremely common due to the normalization of many disordered behaviors in primarily Western cultures. Common examples of disordered eating include:

  • Fad diets
  • Cleanses
  • Heightened focus on appearance
  • Skipping meals
  • Supplement misuse
  • Diet pills
  • Extreme social media focused on appearance or food
  • Undereating or overeating

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Fostering Open, Judgment-Free Communication with Patients about Eating Disorders

As a medical provider, you may be the first person to recognize that a patient has an eating disorder. That’s because eating disorder behaviors often occur in secret, and those struggling are typically very good at keeping their eating disorder a secret from the people in their lives.

Eating disorders are often apparent in a medical setting because we check weight, assess vital signs, and spend time discussing physical symptoms with patients. Signs of eating disorders that could be recognized even in a routine check-up may include dramatic changes in weight, menstrual irregularity, dizziness, dry skin, leg cramps, hair loss, and bruising. If you’re lucky, your patient may view an appointment as a natural time to share that they are experiencing eating disorder thoughts and behaviors. However, many patients are not forthcoming and the medical system is very poorly designed to talk to people about food and body issues.

Usually, the first thing that happens when a patient walks into a provider’s office is that they are asked to step on the scale. Patients are usually told their weight or it is written on a piece of paper.  After that, patients are taken into an office and asked several questions about medications, habits and health concerns. The patient may see one or two providers before seeing their primary medical provider.

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How do Eating Disorders Present in Males?

Doctor writing on clipboard

As a field, we are beginning to understand that males are at a high-risk for eating disorders and that it is crucial to understand how males present with eating disorders and how we can treat them. Realizing that men have eating disorders is extraordinarily important. Eating disorders are serious and potentially life-threatening and unfortunately, they are often overlooked and trivialized.

The reality of the eating disorder world is that the diagnoses of eating disorders have historically been based on women. Studies to define what eating disorders are have been done primarily with women. The criteria used to describe eating disorders has been normed to women. The professional field is primarily women and treatment is often designed with a gender bias.  However, we are very aware that men can get eating disorders and that more men are presenting with symptoms and entering treatment. As a result, we have a lot of work to do to truly understand how males present with eating disorders.

To give an example of how eating disorder treatment is normed to women, we can look at current eating disorder screening tests. Typically, there are statements such as these where a client can answer yes or no.

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Eating Disorders: The Brain-Gut Connection

Tea leaves in tea cup

Eating disorders are biologically-based brain illnesses that are noted by changes in food behaviors, eating, and self-perception. Eating disorders are complex illnesses that often become increasingly severe.

Over the last decade, we have seen a new area of research take shape as investigators have studied the brain, personality traits that are mediated by how the brain is wired, and how the brain processes reward. Recently, fMRI studies have demonstrated differences in the experiences of reward in individuals with eating disorders compared to controls who have never had eating disorders as well as people who had an eating disorder but are now recovered.

These studies found that people with Anorexia Nervosa experience less stimulation of the reward pathways of the brain, while people with bulimia seem to experience more active reward pathways. Early research examining reward processing in individuals with binge eating disorders shows data similar to those with bulimia. Additionally, there is emerging research on the gut’s connection to mood and brain function that may illuminate our understanding of eating disorders.

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