What are Eating Disorders?

What is an Eating Disorder?

•Include anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and eating disorders not otherwise specified (EDNOS)

•Involve extreme emotions, attitudes, and behaviors surrounding weight, food, and size.

•Are serious health conditions with both emotional and physical problems that can have life-threatening consequences for men and women of every age, race, religion, ethnicity and sexual orientation.

What Causes Eating Disorders?

•Eating disorders arise from a combination of long-standing behavioral, psychological, interpersonal, biological, genetic, and social conditions.

•While they may begin with preoccupations with food and weight, they are most often about much more than food.

•People with eating disorders often use food and the control of food in an attempt to compensate for feelings and emotions that may otherwise seem over-whelming.

•For some, dieting, bingeing, and purging may begin as a way to cope with painful emotions and to feel in control of one’s life

Factors Contributing to Eating Disorders

Psychological Factors: Low self-esteem; feelings of inadequacy or lack of control in life; depression, anxiety, anger or loneliness

Interpersonal Factors: Troubled family & personal relationships; difficulty expressing emotions & feelings; history of being teased or ridiculed based on size or weight; history of physical or sexual abuse

Social Factors: Cultural pressures that glorify “thinness” and place value on obtaining the “perfect body,” narrow definitions of beauty that include only men & women of specific body weights & shapes; cultural norms that value people on the basis of physical appearance and not inner qualities & strengths

Other Factors: Scientists are still researching possible biochemical or biological causes of eating disorders. In some individuals, certain chemicals in the brain that control hunger, appetite, and digestion have been found to be unbalanced. The exact meaning and implications of these imbalances remains under investigation.

Complex Underlying Issues

• Identity and sense of self

• Powerlessness

• Need for Control

• Acute Childhood Trauma

What are the Warning Signs?

• A marked increase or decrease in weight not related to a medical condition • Abnormal eating habits:

• Severe dieting • Preference for strange foods • Secretive bingeing • Withdrawn or ritualized behavior at mealtime

• An intense preoccupation with weight and body image • Compulsive or excessive exercising • Self-induced vomiting, fasting, or laxative, diet pill or diuretic abuse • Feelings of isolation, depression or irritability

Serious, Lethal… but Treatable

• Eating disorders are serious, potentially life-threatening

conditions that affect a person’s emotional and physical health.

• Eating disorders are not just a “fad” or a “phase.” People do not just “catch” an eating disorder for a period of time.

• They are real, complex, and devastating conditions that can have serious consequences for health, productivity, and relationships.

• People struggling with an eating disorder need to seek professional help. The earlier a person with an eating disorder seeks treatment, the greater the likelihood of physical and emotional recovery.

Some Statistics

As many as 10 million females and 1 million males are fighting a life and death battle with an eating disorder such as anorexia or bulimia.

Approximately 15 million more are struggling with binge eating disorder.

Anorexia has the highest premature mortality rate of any mental illness.

Eating Disorders vs. Disordered Eating: What is the Difference?

•If an individual doesn’t fit the clinical description of an eating disorder, they may be wrapped up in disordered eating.

•A person’s attitudes about food, weight, and body size and shape may be causing them to have very strict eating and exercise habits that jeopardize their health, happiness, and safety.

•May begin as a way to lose a few pounds or get in shape, but these behaviors can quickly spiral out of control and may even become a full-blown eating disorder.

Disordered Eating

• Body Dissatisfaction

• Weight Preoccupation

• Chronic (Normalized) Dieting

• Compulsive Overeating

• Dysfunctional Eating

• Eating Disorder Practice

Anorexia Nervosa…

… is characterized primarily by self-starvation and excessive weight loss.

Symptoms include:

• Refusal to maintain body weight at or above a minimally normal weight for height and age

• Intense fear of weight gain or being “fat” even though underweight

• Disturbance in the experience of body weight or shape

• Undue influence of weight or shape on self-evaluation,

or denial of the seriousness of low body weight

• In females, loss of menstrual periods post-puberty

Health Consequences of Anorexia

In anorexia nervosa’s cycle of self-starvation, the body is denied the essential nutrients it needs to function normally. Thus, the body is forced to slow down all of its processes to conserve energy, resulting in serious medical consequences:

• Abnormally slow heart rate and low blood pressure

• This means that the heart muscle is changing

• The risk for heart failure rises as the heart rate and blood pressure levels sink lower and lower

• Reduction of bone density (osteoporosis), which results in dry, brittle bones

• Muscle loss and weakness

• Severe dehydration, which can result in kidney failure

• Fainting, fatigue, and overall weakness

• Dry hair and skin; hair loss is common

Bulimia Nervosa…

…is characterized primarily by a cycle of binge eating and compensatory behaviors such as self-induced vomiting in an attempt to undo or compensate for the effects of binge eating.

Symptoms include:

• Regular intake of large amounts of food accompanied by a sense of loss of control over eating behaviors

• Regular use of inappropriate compensatory behaviors such as self-induced vomiting, laxative or diuretic abuse, fasting, and/or obsessive or compulsive exercise

•Extreme concern with body weight and shape

Health Consequences of Bulimia

The recurrent binge-and-purge cycles of bulimia can affect the entire digestive system and can lead to electrolyte and chemical imbalances in the body that affect the heart and other major organ functions. Some of the health consequences of bulimia nervosa include:

• Electrolyte imbalances that can lead to irregular heartbeats and possibly heart failure and death.

• Electrolyte imbalance is caused by dehydration and loss of potassium, sodium and chloride from the body as a result of purging behaviors.

• Potential for gastric rupture during periods of bingeing

• Inflammation and possible rupture of the esophagus from frequent vomiting

• Tooth decay and staining from stomach acids released during frequent vomiting

• Chronic irregular bowel movements and constipation as a result of laxative abuse

Binge Eating Disorder…

Binge

Guilt

Restrict

…is a type of eating disorder characterized by recurrent binge eating without the regular use of compensatory measures to counter the binge eating.

Symptoms include:

• Frequent episodes of eating large quantities of food in short periods of time

• Feeling out of control over eating behavior

• Eating when not hungry and eating in secret

Health Consequences of BED

Binge eating disorder often results in many of the same health risks associated with clinical obesity. Some of the potential health consequences of binge eating disorder include:

• High blood pressure

• High cholesterol levels

• Heart disease as a result of elevated triglyceride levels.

• Type II diabetes mellitus

How to Help a Friend

Do: • Learn as much as you can about EDs • Be honest • Be caring, but be firm • Compliment your friend’s inner qualities • Be a good role model • Tell someone

Don’t:

• Place shame, blame or guilt • Make rules or promises that you cannot or will not uphold • Give simple solutions

Treatment of Eating Disorders

Clinical eating disorders require the care of a trained professional with expertise in the treatment of eating disorders.

People with eating disorders need to seek professional help.

Early diagnosis and intervention significantly enhance recovery.

If not identified or treated in their early stages, eating disorders can become chronic, debilitating, and even life-threatening

conditions.

• The most effective and long-lasting treatment is some form of psychotherapy coupled with careful attention to nutritional needs and medical care – which may include medication.

• Tailored to the individual and varies according to the patient’s particular problems, needs, and strengths and the severity of the disorder.

• Psychological counseling must address both the eating disordered symptoms and the psychological, interpersonal, and cultural forces that contribute to, or maintain, the eating disorder.

• Nutritional counseling is also necessary and should incorporate education about nutritional needs and planning for and monitoring rational choices of the individual patient.

What Does Treatment Involve?

Recovery is Possible.

• Many people respond to outpatient therapy, including individual, group, or family therapy and medical management by their primary care provider.

• Support groups, nutrition counseling, and psychiatric medications under careful medical supervision have also proven helpful for some individuals.

• Inpatient care (including hospitalization and/or residential care in an eating disorders specialty unit or facility) may be necessary.

• It is necessary when an eating disorder has led to physical problems that may be life-threatening or when the eating disorder is associated with severe psychological or behavioral problems. • Inpatient stays typically require a period of outpatient follow-up and aftercare to address the underlying issues in the individual’s eating disorder.

Insurance Companies - Denials & Delays

• Huge personal, financial costs to families, patients, treatment centers

• Heavy burden on psyche of patients, families, staff • One of biggest drains on morale at centers • Major deterrent to treatment • Huge profits to insurance companies: What is the interest

earned on: – 1 day x $1000 (avg. cost/day) x 100 (low est.of #

denials/day/USA) – x 365 days/yr = $36,500,000 – x total no. of days delayed = $,$$$,$$$

• What might some do to protect that revenue?

…Various Tactics by Insurance Companies to

Avoid Appropriate Payment

•Initial barriers

–No copy of policy, “policies”--insist on them

–Any communication w/ co. is difficult

•Long waits, no direct numbers or “humans”

•Language barriers

–Outsource to reps in foreign countries

–Errors of omission/commission in transmitting member info to others in ins. co.

•Wrong ID #

•other member info

–Initial contact w/ case manager: rarely informed about EDs, treatment center options, policy on EDs

•“Not medically necessary”

•Often recommend inappropriate facilities/options

•“Out of network” provider/facility

•“Not a covered benefit”

What Can I Do Now? Mission…

• NEDA supports individuals and families affected by eating disorders, and serves as a catalyst for prevention, cures and access to quality care.

Information & Referral Helpline

• The National Eating Disorders Association (NEDA) Information and Referral Helpline was the first national toll-free resource for callers with concerns related to eating disorders.

• The Helpline is confidential and refers callers to the information that best suits their needs.

• Treatment referrals are available, as well as an interactive website with a wealth of informational handouts, resources, and links.

• Phone line workers are volunteers and do not function as counselors or medical experts, but work with active listening skills to support callers and help them see the options available to them.

• Calls to the Information and Referral Helpline are free and have steadily increased since it was launched in January 1999.

NEDAwareness Week is the largest eating disorders educational outreach effort in the nation. Educators, health professionals, eating disorders experts,

activists, media and more collaborate to raise awareness about eating disorders and body image concerns. Educational materials are distributed

and awareness activities are hosted at high schools, college campuses, treatment centers, and communities in all 50 States and 23 other countries.

National Eating Disorders Awareness Week

February 24th – March 2nd, 2013 NEDAwareness Week

Save the Date!

It’s Time to Talk about It

What happens during NEDAwareness Week?

• Annual NEDA Walks • Workshops, presentations and lectures • The Great Jeans Giveaway – “Don’t fight your genes, just

change your jeans!” • Mirrorless Monday, Fearless Friday (a day without dieting) • Film screenings and all-sizes fashion shows • Body fairs and information tables • Distributing NEDA’s Toolkits: Educator, Parent and Coach

& Athletic Trainer • And much, much more!!!

Annual NEDA Conference

…uniquely designed to bring together families and individuals affected by an eating disorder, treatment professionals, researchers, activists and educators.

Don’t Miss the 2013 NEDA Conference in

Washington D.C.

STAR Program (Solution Through Advocacy and Reform)

• The STAR Program fights for improved access to the treatment of eating disorders by speaking with state legislators, mobilizing members, and forging alliances with other groups who share NEDA’s vision.

NEDA Toolkits

NEDA Toolkits are comprehensive, easy to use resources for parents, educators, coaches, and athletic trainers that want to better understand eating disorders and how to support someone who is struggling.

Resources

Helpline: 1-800-931-2237

Website: www.NationalEatingDisorders.org

Business Line: 212-575-6200