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Eating disorders: confronting an epidemic

March 6, 2014

While attention to eating disorders has increased in recent years, the illness remains one of the most common, dangerous and least understood in the United States. The numbers are truly staggering: An estimated 25 million Americans, many of them adolescents, suffer from eating disorders. Ninety percent of them are women between the ages of 12 and 25, though eating disorders do not discriminate by gender, age or ethnic background. More than one-half of teenage girls and nearly one-third of teenage boys use such unhealthy weight control behaviors as skipping meals, fasting, vomiting, and taking laxatives.

If those numbers were linked to cancer or other well-documented medical condition, alarm bells would be ringing. But eating disorders are complicated, easy to hide, and difficult to diagnose or treat. And while scattered media coverage has helped raise public consciousness in recent years, awareness of the depth and scope of eating disorders remains relatively low. Ironically, few people are aware that the last week in February marks National Eating Disorders Awareness Week, an annual event that draws attention to this sweeping problem.

Eating disorders can be lethal. So lethal, in fact, that anorexia nervosa has a higher mortality rate among young women than any other cause of death, and eating disorders account for more fatalities in the U.S. than any other mental illness. And those statistics obscure a more dramatic number, as many deaths resulting from eating disorders are officially attributed to suicide, organ failure and other fatal complications that stem directly from destructive eating behaviors.

The physical and emotional damage from eating disorders extends well beyond a fatal outcome, however. Physical debilitation, depression, anxiety, low self-esteem, and social withdrawal can last for years and have devastating personal and professional consequences. This is especially true for young people whose bodies and minds are still in their formative stages. Early intervention and treatment – before a person becomes sick enough to be hospitalized – is therefore crucial to gain control of an eating disorder and limiting its long-term harm.

That may sound simple, but it’s not. Identifying eating disorders poses multiple challenges, and their causes differ from person to person. Genetic, biological, behavioral, psychological, and social factors can all contribute to the development of an eating disorder, which in turn can manifest in various ways that include both restrictive and binge eating. Young men and women are constantly bombarded with messages about dieting, maintaining low weight and unrealistic body size in order to be successful, and peer pressure contributes to this perception. Resisting these messages is hardest for teenagers trying to find their place in the world.

Because symptoms cross both medical and psychological lines, few high schools or universities can employ the cumulative expertise needed to deal with the many cases that cross their paths, and many go unrecognized. Even when a medical professional is able to diagnose an eating disorder, limitations in the health-care system pose further obstacles to recovery. Very few treatment centers specifically geared to young people with eating disorders exist in the U.S. Effective treatment requires time and is best achieved with a multi-disciplinary, team approach, but insurance coverage is often inadequate to cover the costs. In fact, studies have found that only one in ten women and men with eating disorders receive treatment.

In this context, increased public awareness offers the only immediate answer. Parents, teachers, coaches, and peers must become more knowledgeable about eating disorders as well as how and when to intervene. Recognizing the early warning signs and debunking myths about eating disorders will lessen the fear and stigma associated with them. Online resources produced by the National Eating Disorders Association and other advocacy groups provide readily accessible information that can serve as a foundation for action. We must all work together to stem the tide of this national affliction.

Stacie McEntyre, MSW, LCSW, CEDS

Veritas Collaborative is a comprehensive treatment facility in Durham, NC, specializing in the treatment of eating disorders for adolescents.