Posts Tagged “For Providers”

The image that comes to mind when many people think of an “eating disorder” (ED) is a young female with anorexia or bulimia. But in reality, there is a vast spectrum of ED diagnoses, behaviors, body types, and people who “fit the bill.” The narrow view of the disease that prevails in our society can be extremely harmful, as it often results in a treatable disease going unnoticed.

What is it?

An eating disorder topic that’s been getting a lot of media attention lately is Chewing and Spitting (CHSP). It’s exactly what it sounds like— the habit of chewing food to enjoy the taste, then spitting it out to avoid unwanted calories, or the guilt of eating a “bad” or feared food. CHSP can occur on its own but is more often seen alongside other eating disorders symptoms. A cross-sectional study has shown that there is a strong association between being diagnosed with an eating disorder, like anorexia or bulimia, and lifetime CHSP behavior.¹

One of the best-known and most feared complications of eating disorders is osteoporosis. Osteoporosis is a disease in which there is a loss of bone mass, often throughout the body, and a significantly increased risk of fracture and pain. Osteoporosis is a diagnosis made through bone scans, particularly a DEXA scan. A score of -2.5 or greater on a DEXA scan is considered to be osteoporosis. A score of -1 to -2.5 is defined as osteopenia. Anyone with osteopenia is at great risk of developing osteoporosis. Statistically, 40% of people with anorexia will have osteoporosis, and as high as 90% will have osteopenia.

In the last 10 years, the notion that eating disorders are biologically based illnesses has begun to gain significant traction both inside and outside the eating disorder community.

Following “The Decade of the Brain” in the ’90s and the explosion of research in brain chemistry, anatomy, and function, we now better understand how we are susceptible to eating disorders based on a pre-existing neurological status and how our personalities, behaviors, and experiences in eating disorders are all linked.

Our physical and mental health, relationships, and day-to-day life are all affected and challenged by disordered eating habits’ pervasive nature. When someone suffers from an eating disorder, the risk of health consequences, such as brain damage, could occur. Disrupted eating behaviors negatively affect adequate nutrition absorption; thus, the brain does not get the nutrients it needs to function properly. This is especially concerning in adolescents, as brain development occurs through early adulthood – meaning that significant periods of growth could be disrupted.

Having a medical condition such as diabetes can be complicated with an eating disorder. Due to the complexity of this type of situation, The Emily Program dietitians help clients navigate and plan to mitigate problems.

There are two factors that can overwhelm people who struggle with diabetes and eating disorders. For one, it can become compensatory to overdose insulin as a means of “purging.” In addition, it can be hard to manage the diabetic diet itself because it has many guidelines that may feel like food rules to someone working on neutralizing food judgments.