5 Things I've Learned About Eating Disorders That Might Help You Understand Them, Too

I just returned from the Southeast Eating Disorder Conference (#SEED2016) in Destin, Florida which brought together a wide range of professionals who work with individuals with eating disorders (EDs) including: therapists, nutritionists, psychiatrists, primary care doctors, pediatricians, nurses and more I’m sure I am forgetting. I wanted to give a brief overview of some of the most important things from the conference I believe most may not know or understand about eating disorders.

1. Treating an eating disorder takes a village.

Treatment for any ED cannot be done in isolation or with one type of professional.

The best care for an individual with an ED must come from a multidisciplinary team, because there are number of consequences to physical, emotional, psychological and cognitive functioning.

A person with an ED, especially those in a higher risk category, should be under the care of a medical doctor for life-threatening physical aspects; a psychiatrist for psychological imbalances (which is also a result from malnutrition/physical consequences);  a nutritionist to properly re-feed or counter the effects of the physical/chemical imbalances due to malnutrition; and a trained therapist for the emotional and cognitive aspects of the illness which perpetuate the EDs functioning.

2. You may not have access to any professionals who know about EDs.

This could be due to where you live or what help is available to you. That doesn’t mean you can’t receive adequate treatment. A majority of the various professionals named above may have had little if any specific training on EDs. Understand this when seeking help and ask those clinicians to do some research and seek out consultation. There are a number of organizations out there that can point them in the right direction of a therapist, doctor, nutritionist, etc. to seek advice from and understand where to start. Don’t let inaccessibility to ED professionals stop you or a loved one from getting help, but please be sure they are procuring the knowledge needed. For example, as a therapist who treats EDs, it is a part of my practice to never discuss my client’s expected body weight or give nutritional advice. I work with a team specially trained in those fields and leave those discussions to them.

This was one of the highlights at the conference as I met a therapist and a pediatrician who were open about their “lack of training” concerning EDs, and told me it prompted them to attend the conference. So you see, it is not impossible for a clinician to learn how to work with individuals who have an ED.

3. The connection between the body and eating disorders.

It can be extremely distressing for an individual trying to recover from an ED to think they have failed or just “don’t have the willpower” to beat the disorder. That’s not the case. ED’s can be extremely difficult to overcome (but not impossible) because of a number of ways our body’s natural functioning learns to live, adapt and function with the ED.

A couple of things I learned about the body and EDs at the conference:

– The gag reflex (you know, in the back of your throat) actually sets off part of the parasympathetic nervous system that helps our body calm down and relax (this is a primitive part of the brain that lets us know we are no longer in danger). For someone who has bulimia nervosa, this means purging (vomiting) contributes to the person being able to cope or calm down from whatever has been upsetting or anxiety provoking due to our primitive brain operating system!

– It has been found that those who have anorexia nervosa may have increased
levels of serotonin in the brain. Serotonin maintains mood balance specifically anxiety, depression and happiness. It has been found that increased levels of serotonin in people with anorexia causes obsessive types of behavior and perfectionism (correlating with anxiety). So in essence, someone with anorexia who starves themselves by restricting food starts to feel better because levels of serotonin go down, decreasing anxiety levels. Again — another way our body’s functioning can be out of whack — contributing to the development of an ED!

4. Genes load the gun, environment pulls the trigger.

Eating disorders develop by what I like to refer to as the perfect storm. Everything happened “just right” for the individual to develop and maintain unhealthy or disordered eating thoughts and behaviors that perpetuate an ED. Someone may be pre-disposed to EDs from family history or genetics, but that does not necessarily mean they are pre-destined to get an ED. You know that whole “nature vs. nurture” debate? Basically, it’s a little of both for a person with an ED. It is not one person’s fault, their family’s fault or society’s fault.

In fact, there is no one place to blame or conclude why someone developed an ED, but we must think of it as many contributing factors that occurred with perfect timing (for lack of a better way to phrase it) that resulted in the eating disorder. This is important to note because eating disorders are typically a family illness — affecting all of those involved. In a perfect world, each person involved would receive their own treatment for the ways in which the ED has affected their life and the ways in which they have affected the ED (for better or worse).

5. Recovery is possible. Happiness is possible. It looks different for every person.

At the conference, I met and heard from a number of people who had “flirted” or dealt with their own ED or unhealthy relationship with food or their body. Some of these people now work as professionals (therapists, doctors, etc.) in the ED field, some are motivational speakers helping others seek treatment and some are still in the midst of battling it out with their ED. What is the saying about the battle being over but not the war?

Eating disorders are complicated and treatment and/or recovery works differently for each person. Some view their ED as a life-long recovery process, such as an addiction. Some are able to seek intensive treatment and may never have to look back being distressed about food or body image again. If you parallel EDs to cancer this could make a little more sense. Some individuals are able to cut the cancerous cells out of the body and are in remission for the rest of their lives. Others may have an inoperable tumor, but can maintain their health through monitoring and special treatments. The latter group can still be able to function daily and enjoy their lives — but yes, they will need to keep an eye out for growth of the tumor — or in this case, for the eating disordered thoughts and behaviors to grow or creep back in. It may not be perfect, but if there is one thing we know — nothing is perfect.

The conference definitely put a pep back in my step. It made me happy to see so many professionals and lay people alike able to talk and discuss treatment for eating disorders. I met some of the top treatment providers of eating disorders and learned a lot, so I thought it only responsible to pass along some of the knowledge. Eating disorders are complicated and complex — but isn’t every human being? It doesn’t mean they aren’t worth “getting to know” in terms of identifying the best ways we can help those struggling. I’ll keep working on that part if you, reading this, promise to help spread the message. Deal? Ok!

If you or someone you know is struggling with an eating disorder, you can call the National Eating Disorders Association Helpline at 1-800-931-2237.