National Eating Disorders Awareness Week

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Why I Had To Wait Years To Get My Eating Disorder Diagnosis

I’ve lived with an eating disorder for six years now, but I’ve only been in recovery for just under two years. Why is there such a discrepancy? Why did it take so long for me to receive a diagnosis? I grew up with body image struggles, but I absolutely loved food and never thought that I would end up battling an eating disorder . From an early age, I yearned to escape my body — a consequence of societal messages about disability . But I never displayed any other telltale signs of a potential eating disorder , so an ED diagnosis was never on my radar — or anyone else’s. My eating disorder developed when I was in college as I struggled to find a way to motivate myself to churn out the best grades possible. I became deeply angry with myself when I perceived that I was failing, even if my reality proved otherwise, and I allowed my feelings to affect my food portions. I was also extremely busy with extracurricular activities and leadership positions, so nourishing my body quickly became an afterthought. Still, no one — myself included — caught that I was beginning to slip into an eating disorder . My school’s counseling services were sparse, and I appeared to be eating regularly and enjoying food, so no one thought to refer me. My roommates likely noticed my eating habits were becoming peculiar and secretive, but I tried to pretend that my relationship with food was “normal.” I ate only when I knew no one else would be in the kitchen — but I ate. I stashed non-perishable snacks in my room, where no one could see them — but I didn’t fear calories. And at that point, my anxiety and depression were so pervasive that they became everyone’s primary focus — so there was no reason to look for anything else amiss. No one thought to look for signs of an eating disorder , probably because in my mind, I didn’t have one. About a year-and-a-half post-college, I read a personal account of another woman’s eating disorder recovery and realized I used many of the same behaviors she recovered from. The realization shocked me because prior to that moment, I never saw my behavior as “disordered.” My relationship with food was certainly unconventional, but it never alarmed me until that day , when I realized for years on end, I fell far behind a “normal” meal schedule. From that day forward, I acknowledged my “disordered eating,” but I never believed I had a full-fledged eating disorder . And professionals skirted the issue too, never asking about my eating habits and brushing off my low weight as fitting my weight history. It wasn’t until a chance meeting with a new psychiatrist that I was formally diagnosed with anorexia nervosa . By that time, I’d spent four years letting everyone — myself included — ignore my eating disorder symptoms that I disbelieved my own diagnosis. When the psychiatrist opened up the DSM-5 to explain the criteria for anorexia nervosa , I fought every professional interpretation he made: I wasn’t malnourished; I was naturally slender. I weighed myself, but I didn’t care about the numbers. I ate fast food, so how could I fear calories? I was completely in denial of the extent to which my eating disorder had taken over my life. It wasn’t until a few months later, when I entered eating disorder treatment for the first time, that I realized I did have anorexia — and it was serious. In treatment, I struggled every step of the way, but I gained awareness of all the latent symptoms everyone spent years mitigating. Having my symptoms validated was both comforting and terrifying because it confirmed what I’d spent years accepting, but it also proved just how much work I still had to do to reach recovery. Now, nearly two years into recovery, I’ve managed to completely eliminate some disordered habits, but I still cling to others. My continued battle with anorexia forces me to ponder the inevitable question: Would I be recovered by now if I’d been diagnosed with anorexia right when my symptoms started? Unfortunately, I’m not the only one asking that question. According to National Association of Anorexia Nervosa and Associated Disorders (ANAD), under 6% of people with eating disorders are medically underweight , even though clinicians typically rely on low BMI to diagnose eating disorders. And even though BIPOC , members of the LGBTQ+ community and people with disabilities are statistically more likely to develop eating disorders than their white, heterosexual, cisgender and able-bodied peers, they remain underdiagnosed due to the misconception that eating disorders disproportionately affect slender white, heterosexual, able-bodied women. Naturally, these dangerous beliefs put men at risk too — 10 to 15% of those diagnosed with anorexia or bulimia are male , but men are less likely to receive diagnosis and treatment than women are. But considering that eating disorders carry the highest mortality rate of any mental illness , and 26% of people with eating disorders attempt suicide , clinicians need to stop relying on tired eating disorder stereotypes so that they can provide all people with eating disorders access to early diagnosis and treatment. If you’ve spent years with an undiagnosed eating disorder , had to prove your symptoms in order to be considered “sick enough” to treat or constantly face prejudice because you don’t fit the stereotype of how a person with an eating disorder “should” look, you aren’t alone. No matter how long it took to diagnose your eating disorder , your struggles have always been valid, you deserve to have your symptoms taken seriously and you should remember that every step of your recovery, whether in treatment or in private, is worthy of celebration.

Ryan Sheldon

How Common Are Eating Disorders in Men?

Thirty million Americans will get an eating disorder at some point in their lives. Ten million of them identify as male. I remember hating my body as early as 8. As my T-shirt clung to my body in the pool, I told people I sunburned easily as an explanation for wearing it. At 13, I distinctly remember a shift in my relationship with food. I always had disordered eating habits, but in early adolescence, I realized I was binge eating. Popular narratives cast thin white women as the only victims of eating disorders . But consider this: one in three people who struggle with an eating disorder identify as male. Men oftentimes don’t seek help because of gendered stigma and rigid societal standards for masculinity. For men, the eating disorder experience can be lonely , confusing and isolating. My struggle was glossed over. My family and doctors said I was “just growing,” but I had binge eating disorder , the most common eating disorder that occurs at three times the rate of anorexia nervosa and bulimia nervosa combined. The “growing boy” narrative followed me through my teenage years. I was 16 and weighed more than what doctors deemed “healthy,” triggering a two-year restriction and dieting period. When I got to college, the “freshman 15” unraveled into something more insidious. I’d go to a friend’s place for dinner only to leave the hangout early and order more food to my own room. Nobody knew what I was doing, and I had nobody to talk to. In adulthood, I was taking sleeping pills during the day so that I would sleep instead of binge eat. It felt like the only way to stop myself from eating more. This went on for months. Exhausted and miserable, I went to get help. Though I shed weight through incredibly unhealthy and debilitating eating behaviors, my doctor congratulated me. It reminded me of the countless doctor visits I’d taken throughout my youth, where I was told I was a growing boy, which somehow meant I couldn’t possibly have an eating disorder. We need to dismantle the current model of masculinity and encourage boys and men to advocate for themselves. Just like people who identify as female, we pay attention to our bodies and what people say about them. We need to give boys the tools to be self-aware. The National Eating Disorders Association (NEDA) has a screening tool to assess whether you should seek professional help. Let’s help boys and men feel safe enough to tell someone when they’re struggling — encourage them to reach out to a helpline. And when early intervention is critical to recovery, we must help them find professional support and treatment as early as possible. To be sure, this narrative is changing, but when eating disorders have the highest mortality rate of any psychiatric diagnosis, it needs to change quicker. Now, I know I am not alone in my struggle. Of the 30 million Americans with eating disorders, 10 million are men. Nationally, there is a movement gaining momentum. The National Eating Disorders Association (NEDA) announced it would merge forces with the National Alliance of Men with Eating Disorders (NAMED), and people are realizing the dearth of resources available for men who desperately need it. It’s National Eating Disorders Awareness Week , and the theme is Come As You Are: Hindsight is 2020. We are reminded that all eating disorder stories are valid, especially from marginalized voices. No matter who you are, what you look like or how you identify, share your story. The more boys and men know about eating disorders, the more they can reach out for help. Eating disorders can affect anyone. They do not discriminate. Let’s acknowledge the barriers stopping men from speaking up and getting help early and work together to support all victims. Ryan Sheldon is a model and motivational speaker.

Rachel Clark

The Problem With the 2020 NEDA Week Theme, 'Hindsight is 2020'

National Eating Disorders Awareness (NEDA) Week kicked off on Monday, running from February 24 to March 1. Each year, the National Eating Disorders Association (NEDA) selects a focus “theme,” and this year’s theme is “Come As You Are: Hindsight is 20/20.” They posted a prompt on their Instagram page over this past weekend: If you could go back, what would you tell your younger self? Oof. A loaded question. I stopped my scrolling and initially just felt angry, and then sad. So sad. And while I am not sure I’m in a place to compose my thoughts in an entirely eloquent manner, I want to try. What would I tell the 9-year-old me, if I could go back? My mind instinctively jumps to the obvious answers: “How about let’s not go on the ‘Special K’ diet? This will ruin your entire life.” “Let’s not water the hospital plants with your tube feeds.” “How about you stop fighting all of the people who are trying to help you?” I have, especially in recent years, spent a lot of time in that place of regret and frustration towards the younger me who couldn’t “get it together,” wishing I had been someone who had been able to “make treatment work the first time,” wondering if it could have been different had I not been smearing peanut butter under the tables and sneaking out to run laps in the desert every night. But the reality is that being in that space is futile because not only can we not go back, but when I think about the younger me, and even the me just a few years ago, I was doing the best I could to survive what never should have been survivable. It couldn’t have been different, despite how much I wish it was. And I think that goes for all of us. Eating disorder treatment as a whole has come such a long way, and I’ve also often wondered if things could have been different had the providers I first worked with been more informed, had treatment not just been a feeding tube and a Bible and “the lowest possible goal weight.” And maybe it would have been. But even then, I don’t believe anyone ever had ill intent. They just didn’t know. They were doing the best they could. And the same can be said for my parents, for the things they missed, the ways in which they failed me; they were doing the best they could under impossible circumstances no parent should have to navigate. I am not someone who believes “everything happens for a reason.” That saying is actually my biggest pet peeve (coming from someone with a lot of them), but all of this is to say: I don’t think the given prompt or theme is helpful or relevant. People don’t develop mental illnesses as a poor judgment call, which is essentially, in my opinion, what “Hindsight is 20/20” implies. Of course I didn’t know what I was getting myself into back when I initially began struggling, but if I had? I still don’t know that anything would have been different. Even in my more recent relapses and in my continued struggling, I have the insight. I “know better.” And sometimes, that still doesn’t change anything because again, I am doing the best I can with what I have and where I’m at after 18-plus years of struggling with this disorder. That is all any of us can do, hindsight or not.

The Rising RN

Is My Eating Disorder Valid If I'm Not Thin?

National Eating Disorders Awareness (NEDA) Week is February 24 to March 1. The theme this year, “Come As You Are: Hindsight is 2020,” is a continuation of the 2019 theme, which sought to bring awareness to diversity in the eating disorder community. Historically, people with eating disorders have been portrayed with a certain “look.” Typically, that’s a white, young, cisgender woman in an emaciated body. Stock photos of this woman depict her frowning while eating a plain salad or standing on a scale. While there certainly are people with eating disorders who fit this look, there are also plenty of other people with eating disorders who don’t. I’ve always wanted to speak out about my eating disorder. When I was struggling, I could have used more support around me. Now I’m in a solid place in my recovery, I want to help other people find the same stability. Sometimes, I find myself still holding onto the idea that my eating disorder is less valid than the disorders of people in thin bodies, and it holds me back from speaking my truth. This week, however, I feel particularly inspired to talk about my journey. I have never been considered “thin.” The last time I was in a “normal-sized” body was in kindergarten. I spent my entire childhood feeling ashamed of my body, wanting so badly to look more like my peers. As I grew up, I frequently went on diets with little results. In college, I took my dieting behaviors to the extreme, and before I knew it, I had developed a full-blown eating disorder. I happened to be in therapy for my anxiety and depression when my eating disorder kicked into high gear. It took some time to work up the courage, but I eventually told my therapist about what had been happening outside her office. She called out my behavior for exactly what it was: bulimia nervosa. To me, it didn’t matter that I fit the diagnostic criteria for bulimia perfectly. I denied the fact I had an eating disorder for several months because I still held onto that bogus stereotype of what someone with an eating disorder looks like. When I reflect on my recovery journey, I thank my lucky stars every time I remember how my therapist saw me. She saw my struggle. She saw my pain. It didn’t matter to her at all that I was in a larger body. She heard my story and gave me the correct diagnosis. Unfortunately, I’ve heard horror stories from my fellow recovery warriors about their eating disorders being overlooked by health care providers. They were told that they weren’t “thin enough” to have an eating disorder. They were praised for their seemingly “healthy” behaviors. They were complimented for losing weight. For me, I got the diagnosis, and over the course of my recovery, I’ve had a therapist and a dietitian who truly understand eating disorders. Outside those appointments, however, the people around me complimented my weight loss. They didn’t seem to notice my exhaustion or the way in which I isolated myself. Even after some of my friends and family members knew about my eating disorder, they continued to talk about “healthy” eating, exercise and dieting around me, invalidating my experience again and again. Despite the ignorance and fat phobia that I experienced in my recovery journey, I did get better. It took several years, but every single day of recovered life is well worth the hard work. Now that I feel strong in my recovery, I can confidently say: Full recovery is possible. To anyone out there supporting a loved one with an eating disorder, I hope you know how important you are to their recovery. Please continue learning and growing with your loved one. Examine your inner bias. Challenge stereotypes when you hear them. You are one of their greatest advocates. To anyone out there struggling with an eating disorder, please know that your experience is valid, no matter your body size. You deserve full recovery. There is a professional out there who understands and can give you the help you need. Keep going. I believe in you. No matter your size, gender identity, sexuality, race, ethnicity or age, you deserve to #ComeAsYouAre. Follow this journey on the author’s blog.

Jazz K
Jazz K @jazzthefraz
contributor

Why Eating Disorder Treatment Is Wrong About 'Healthy' Food and Bodies

I honestly hate the word “healthy” in regards to anything related to eating and exercise. “Healthy” is such a subjective thing, and it is rarely actually about one’s health. It is proven to be incredibly subjective time and time again as newer research shows that the diet fads and myths we as a society once religiously worshipped (and still worship) are debunked. Our current idea of a “healthy” body and lifestyle is more often than not based on racist, classist, ableist and incredibly harmful ways of thinking. And who are our guides for this quest for healthiness? Doctors are held to be one of the most knowledgeable sources of information on health and the body, yet they aren’t even required to get any nutrition education before, during or even after medical school. Nurses, similarly, are not required to take a significant amount of nutrition education — some programs may require one basic class. Other medical professionals are equally lacking in nutrition education. What about the so-called “health gurus” who found themselves in their studies of Asia and are now the yoga champions of the Instagram influencer world? Nope. So then, why on earth do we trust these people to tell us what is healthy in regards to our diet, nutrition, weight and exercise, when they lack the appropriate knowledge to have any say in the matter? Why do we believe fads, myths and outdated research that clearly are rooted in some ridiculous and oppressive systems? This isn’t even coming from a sense of righteous anger fueled from a lifetime with an eating disorder (although yes, that’s there) — it’s from anger that so many people profit off making others not only miserable but also putting their lives in danger. Pressuring, shaming, guilt-tripping and ridiculing people to conform to an idealized and seriously warped image of “healthiness” can seriously impact a person’s actual health. These harmful ways of thinking and the normalization of these practices have killed and continue to kill people, all in the name of “healthiness.” If you want an idea of how pervasive this kind of stuff is, let me give you a real-life example. I’m in a partial hospitalization eating disorder program at a famous and reputable hospital, renowned for their treatments as well as their research. Now, right next to papers full of factoids and other helpful information on eating disorders , on a table set up for National Eating Disorders Awareness Week, sits a newsletter called “Women’s Nutrition Connection.” In bold print, it says: “Say Goodbye to Unhealthy Cold Cuts” along with other “health” tips. The newsletter had the hospital system’s logo and had medical professionals who helped contribute, yet right on the first page was an editorial piece calling for an end to cold cuts (along with a lengthy list of other “forbidden” foods). Any person who didn’t know better would trust the information coming out of this newsletter. After all, it seems to be from a reputable source; why would anyone question it? But here’s the thing: food is not some moral dilemma as these people and our society will have us believe. No one food is bad or good. Yet, people to whom we defer can’t even be sensitive and knowledgeable enough when it comes to these issues for people with eating disorders. Which then begs the question: what chance does the rest of the population have? To label foods as healthy or unhealthy, good or bad, is at best irresponsible and at worst destructive. We as a society need to recognize that healthiness has always been and still is very much subjective and not objective facts. You can’t make blanket statements about nutrition, diet, exercise and health when there are so many other variables that need to be considered. You can’t label food as inherently bad or unhealthy for everyone. Everyone’s bodies work differently. Everyone’s circumstances differ. What works for one person may not work for another. We shouldn’t be trained to fear foods or body types, nor should we feel guilted into exercise or feel guilty for eating and enjoying foods. As a doctor in the making and the third generation in my family to have an eating disorder, I’m telling you that most of my peers and people in my field don’t know enough about nutrition, diet, exercise or eating disorders to say anything about it. If they do, it’s their own personal opinion and not a scientific fact (which also is not infallible). I know too well how harmful this kind of rhetoric is; I have suffered its consequences my entire life and have witnessed people I love dearly suffer growing up. I know how normalized these things can be and how they seem so true and so objective, but “health” is not objective — it is subjective. So, in the spirit of National Eating Disorders Awareness Week, say goodbye to unhealthy food myths, diet fads, exercising and idealized body images,

Kara Conceison

Learning From My Eating Disorder and How to Recover

I’ve thought long and hard about what to post for National Eating Disorders Awareness Week, also known as NEDA Week. One thing my dietician and I have been talking about recently is viewing the eating disorder as something that was protective and actually served an important purpose in my life, rather than viewing it as the enemy. Because, throughout my long battle with an eating disorder, I have actually grown and learned more about myself than I ever would have without it. While I would not wish anorexia nervosa on my worst enemy, I am actually profoundly grateful for my struggle, because I would never be where I am today without it and without the people who have helped me through it. So, I thought for NEDA Week I’d do a list of the top 10 things I have learned from my eating disorder, and a top five things that helped me recover. I hope this is helpful to somebody out there! What my eating disorder has taught me, in no particular order: 1. It is not a sign of weakness to seek help and support. In fact, it is a sign of strength to admit you need help and to access and allow yourself that help. 2. Weight is not an indicator of the severity of an eating disorder. 3. Diet culture is pervasive, damaging and oppressive. 4. My choices about my food and well-being belong to me and me alone and have no moral weight attached. 5. Prioritizing self-care is not selfish; in fact, it helps me to be a better mother, friend, daughter, teacher and person. 6. There is goodness, light and love inside of me, even when I can’t feel it or see it. 7. My eating disorder was there for me during really hard times, especially the illness and death of my mother when I was in my late teens and early 20s. It helped me survive by releasing anxiety, giving me a sense of control, and feeling like I had a purpose. I no longer need it because I have other ways to access these feelings. 8. It is not my “fault” I developed an eating disorder. There is nothing to feel guilty or ashamed about. Biological, personality, environmental and cultural factors all came together in a perfect storm for me; I developed anorexia nervosa and sought treatment and help to recover. 9. My worth is not tied to a number. It feels like a cliché, but releasing the power of the scale, my clothing size and the number of calories eaten or burned has been absolutely essential to my recovery. 10. I am stronger than I think. Five things that helped me to recover, in random order: 1. When things get really bad, know it’s OK to seek help. Despite hating the idea of inpatient/residential treatment, I credit Walden, CEDC, Laurel Hill Inn and Beth Israel Hospital for saving my life during my darkest days. I will be forever grateful. 2. Find ways to be grateful to your body. For me, that meant becoming a mother. Watching my body change throughout pregnancy and after childbirth was one of the hardest things I’ve had to do, recovery-wise. However, knowing this body was able, after so many years of abuse, to give birth to a healthy, beautiful child makes me feel gratitude to my former enemy. My son gives me joy every day and reminds me of the importance of taking care of myself so I can be present and available for him. 3. Find a good outpatient treatment team. Not all therapists are the same, and not all nutritionists are the same. I am so lucky and thankful I have found wonderful, caring, smart, progressive therapists, dietitians and medication providers who have stood by me for years. Recovery is not over when you gain back the weight; in fact, it is just beginning. I am lucky my treatment team knows this and is there for the whole me, not just my symptoms. 4. Access your creativity. Art journaling, knitting/crocheting, paper crafts and coloring have all been crucial to my recovery. At the height of my eating disorder, I thought nothing I did was ever good enough and therefore never allowed myself to tap into my creative side. Through recovery, I have learned that art and creating things is a wonderful outlet for me and allows me a different way to express myself. 5. Open up to trusted family and friends. I could not have come so far without the help and support of family and friends — a father who is there for me unconditionally, an understanding boss who allowed me to take the time I needed to heal, friends who are always available to lend an ear or laugh with, strong and powerful women I’ve met in treatment who continue to inspire me… I could go on and on, but connection and support is key to recovery. The eating disorder wants you to restrict everything, not just food. It tells you to restrict your relationships, your friends, your family — to isolate and hide myself away. Like an abusive partner, it wants you for itself. Don’t listen. It’s important to find your tribe. So, in the words of Ariana Grande, I say to my eating disorder this NEDA Week: “thank you, next!” Onto bigger and better things.

Julia Amburgey

Post Ideas Instead of 'Before and After' Eating Disorder Photos

It’s National Eating Disorders Awareness Week, and there’s a lot of before and after photos circulating. I believe in the “before and after” when you see the light come back in your eyes, when your smile is genuine and when you can feel and give love — not when you can or can’t see weight gain or weight change. My past photos don’t matter because they only give my eating disorder credit for the years it took from me. I am the thing that survived, not anorexia nervosa. The ones who are fighting, who have survived, who are trying their best to live, — they are who deserves credit because truthfully, your eating disorder will never deem you “sick enough,” not until you’re six feet under. You are more than just a before and after. We are survivors and fighters. Here are some ideas of what to post during eating disorder awareness week instead of before and after photos: 1. Challenge a bad body image day. Post a photo on a day you weren’t comfortable, and do your best to see some beauty in it. 2. Post a before and after of your smile or face. This shows how much light recovery brings to your life. 3. Post a current photo, talking about your achievements in recovery. 4. Share facts, a motivational recovery quote or just a positive photo in general. Post about honest struggles to give awareness, and do your very best to avoid specifics and/or numbers. Your struggle can help validate instead of trigger if done the right way. 5. Post a photo associated with a positive memory. Discuss what recovery has done for your life! Talk about growth and change. Recovery isn’t about weight, shape, numbers or size. It’s about growth, change and respect for your body that carries you through life. We can fight the stigma that eating disorders only have one image.

Lily A
Lily A @lily-a
contributor

Why 'Before Photos' Are Harmful for Eating Disorder Awareness

As many may know, this week is National Eating Disorders Awareness Week. It is a powerful time because it allows us all to take a step back and acknowledge that eating disorders can affect anyone. In addition, it is so important for the general public to be educated on the truth of eating disorders. That being said, one inherent aspect of this week that I struggle to accept is the posting of “before pictures” when sharing one’s story. It is hard for me to actually put into words what I feel every time I scroll through my news feed and see a before picture, but I have been able to come up with two reasons why someone may post this type of picture: 1. To prove to others that they were sick. 2. To prove to themselves that they really were sick. I struggle to accept before pictures because anyone who has been close to an eating disorder knows weight change is only a symptom. Weight change does not prove someone has an eating disorder. Likewise, the absence of weight change does not prove someone has or is not living with an eating disorder. To be blunt, the world is highly uneducated on what eating disorders are. Eating disorders are scary. You start out feeling like you have control over this simple action and can stop at any time, but in actuality, the disorder is the one with that power. It can constantly feel like you aren’t in charge of your own life. I’m not sure if many can grasp what it actually would be like to know you should eat, know you want to eat, logically know your body needs to eat because it is starving — but something in your head is telling you this basic human need does not apply to you. It tells you that you are different than what science says and you do not deserve to eat. Eating disorders determine if you will have a good day or a bad day. They determine if you are fit to face the world, or if you will have to continue to make yourself shrink. Eating disorders are noisy, and you can quickly lose sight of who you truly are. At a certain point, you can no longer decipher which thoughts and beliefs are yours and which belong to the disorder. I am still trying to put the pieces of my life back together, and sometimes those pieces don’t fit. Some days are simply spent reworking the puzzle in pursuit of being able to function symptom-free. The notion that one has to prove they were sick is a fallacy. To anyone who is or has struggled, please know that your story is valid. Whatever way you choose to share your story is entirely up to you. Even so, regardless of whether or not a before photo gets shared, you are believed. Your story matters, and you are supported.

Jocelyn Leo

How to Get Involved With National Eating Disorders Awareness Week 2019

For the United States, this year’s National Eating Disorders Awareness Week begins on February 25 and ends on March 3. The theme is “Come As You Are,” highlighting the National Eating Disorders Association (NEDA) goal to bring more inclusive ideas to the eating disorder community, regardless of the stage of recovery you are in, the body you are in or the way that you identify. Whether you have an eating disorder yourself, you know someone who has an eating disorder or you simply support those who are living in silence, your voice matters this eating disorders awareness week. Here are five ways you can help spread awareness this coming week: 1. Utilize social media. Social media is a massive platform to spread awareness. NEDA offers various shareable graphics, ways to update your profile picture and even provides sample messages that can be copied and pasted onto social media platforms. These resources can be found here. 2. Share your story of recovery safely. If you struggle with an eating disorder yourself, or are in recovery, sharing your story can be a hopeful, inspirational message for others who may be living in silence. It can be difficult to know how much to share when it comes to writing out your story. Some things to keep in mind might be to refrain from using numbers (sizes, calories, weight) and avoid graphic details of behaviors as these could be triggering or become breeding ground for comparisons. 3. Attend a NEDA walk or recovery-focused event. On NEDA’s website, you can search for events in your location that center around eating disorder awareness. Most locations have NEDA walks throughout the year. Other locations may have support groups or recovery-focused events through NEDA or another similar eating disorder treatment or resource center. 4. Share posters and infographics with doctor’s offices, schools and local shops. Reaching people in your community is easier when posters and infographics are in spots that are easily visible and accessible. Ask your local doctor’s offices, schools and local shops if it’s OK to put up posters and infographics. This can allow for anonymity, and reach those who may be struggling in silence. NEDA offers posters and infographics here. 5. Remember to take care of yourself first. If you’re struggling with an eating disorder, it might be difficult to see all of these posts on social media and in public places about eating disorders . It’s important to remember to take care of yourself first and foremost. This National Eating Disorders Awareness Week, treat yourself to daily, consistent self-care. This could be as simple as staying off social media for the week, or as elaborate as going to the spa and getting a mani-pedi.

Katie Maylea

Why Eating Disorder Treatment Is Failing Patients in the UK

As National Eating Disorders Awareness (NEDA) Week approaches, it’s important to look at the way they are currently treated, which in my opinion has to change. Hospital admissions for eating disorders in the U.K. have doubled in the last six years – peaking at 13,885 in April 2017. The result: a terrible shortage of beds for people struggling with eating disorders, and people not getting the help they need until they reach a critically low weight and BMI. Eating disorder treatment typically has three stages: outpatient care, day patient care, followed by inpatient care (hospital admission). Day patient care is Monday to Friday, morning to evening. Inpatient care is 24 hours a day, seven days a week. Doctors, campaigners and MPs have warned that the surge in inpatient admissions tells us that outpatient treatment and daycare is not working effectively. I can relate to this personally. When I look back at my time as an outpatient, I heard things like “you have not lost enough weight to be considered anorexic, but if you carry on then you will be.” I was also told one time that I was not thin enough to be experiencing the chest pain and dizziness I had been, even though the purging behaviors I was constantly involved with would have been potentially causing this regardless of my weight in number form. These kinds of things should never be said to someone struggling with an eating disorder — it’s like holding up a red flag to a bull. I felt inadequate for not being a “good enough anorexic” and was given a new goal to hit: Admission weight. Already, there is far too much importance put on the numbers. People living with anorexia nervosa are obsessed with numbers — it’s a big part of the illness — but so too are the doctors. Numbers dictate everything relating to where someone fits within treatment and the level of help they receive. It’s easy to look at an eating disorder and believe food itself is the issue. It’s not. Eating disorders are a mental illness, the same as any other. The physical food aspect is a response to thoughts and feelings. There needs to be more help and more resources to tackle this side of things early on, with meal support alongside. As someone goes further down the path of an eating disorder, the harder it is to treat. Their brain literally becomes starved. By that time, the food behaviors have become too ingrained and they are unlikely to respond to outpatient treatment or even daycare. It’s a vicious cycle. Outpatient treatment isn’t effective and so more people need admission. The rise in admissions leads to a shortage of beds and increasing waiting times. Increased waiting times lead to outpatient treatment happening too late and more hospital admissions. The only way for this rise in admissions to fall, therefore, is to make changes to outpatient treatment. By that, I mean forgetting about these strict number guidelines against which we base someone’s illness. It’s ironic, really. This only reinforces the anorexic thoughts and behaviors — people with anorexia frequently base their self-worth on numbers. I also believe doctors need to be more aware of the words they use when treating patients. These words can be more harmful to patients with eating disorders than we perhaps realize. In short: we need to treat individuals, not numbers on a scale. There are so many stories of people having to relocate to get effective treatment and to avoid long waiting lists. Sometimes they have to go hundreds of miles away, making it difficult for patients to see their families while receiving treatment which is not going to help aid recovery. It all comes back to the same point: people living with eating disorders are not receiving the correct treatment until their weight is dangerously low or they are severely unwell. At this point, outpatient treatment is not enough and they will inevitably need inpatient treatment. Or, in some cases, by the time they receive treatment, they are already critically ill and go straight to inpatient care. Early intervention and care for people — not numbers — is essential for treating this highly complex and sensitive illness. Something needs to change.