What do eating disorders and cancer treatments have in common?
In my experience – a lot.
For 15 years, I worked as a physician at St. Jude Children’s Research Hospital treating young people with cancer. Now, in my role at Veritas Collaborative, I provide medical care for children and young adults with eating disorders. And while there are obvious differences in my day to day practice, there are a surprising number of similarities.
Chemotherapy works by destroying all cells that are dividing in the body. Cancer cells divide extremely quickly, so the hope is that chemotherapy will destroy these rapidly dividing cells. However, chemotherapy also prevents all healthy cells in the body from dividing. The cells that turn over the most quickly, like hair cells, nail cells, and infection fighting white blood cells, are typically the most effected. This is why cancer patients often lose their hair and wear masks to lessen the risk of overwhelming infection.
Poor nutrition, not surprisingly, also prevents healthy cells from dividing. So, it makes sense that many of the physical manifestations seen in cancer patients are also seen in eating disorder patients. Many patients have hair loss, weakened hearts, depressed immune systems, and some even have osteoporosis.
In addition to their physical similarities, the psychosocial state of oncology and eating disorder patients are remarkably similar. Healthy teens and young adults have so many conflicting demands in life – exploring romantic relationships, sifting through mixed feelings about emerging independence, and developing college and career plans. Imagine exploring these day to day challenges and battling a chronic illness. I have seen time and time again the importance that community can have in healing. Support from others who, unlike most at home and at school, know “just what I’m going through” can be invaluable.
When I sit back and listen to some of my current patients speak with each other, in therapeutic groups or during mealtimes, many of the conversations are almost exact replications of those I heard amongst my cancer patients:
“No one understands me at home.”
“Should I tell my employer about my illness?”
“How will I tell a person I date about my struggles?”
Psychiatric illnesses are no less severe and no less common than non-psychiatric illnesses. In fact, eating disorders are the most lethal of all psychiatric illnesses. They should be taken seriously by families, by friends, by schools, by physicians, and by insurance companies. Early intervention and treatment – before a person becomes sick enough to be hospitalized – is crucial to mitigating its long-term harm.
My transition from oncology to eating disorder care has caused me to recognize this urgency and made me realize we have a long way to go to further public and professional education.
Written by Stuart Kaplan, MD, FAAP