What you may not know about eating disorders

You may think you know a lot about eating disorders — that they're caused by the social pressure to look like models, or that they're all about weight loss and excessive exercise — but there's more than meets the eye when it comes to identifying and treating these serious conditions.

In recognition of National Eating Disorder Awareness week, our team from Children's Center for the Treatment of Eating Disorders clears up some common misconceptions about anorexia nervosa, bulimia nervosa and binge-eating disorder as well as provides signs that may indicate that your child or teen is suffering from an eating disorder.

Myth No. 1: People choose to have this illness.

Eating disorders develop as a result of complex genetic, psychological, social or environmental factors. They're serious and potentially life threatening, and serious physiological (e.g., cardiac arrhythmias, kidney failure, death) and psychiatric (e.g., depression, substance abuse, suicidality) costs can accrue. In fact, among mental health diagnoses, eating disorders have the highest mortality rate. Someone doesn't choose to have an eating disorder, just as people don't choose to have cancer.

Myth No. 2: Eating disorders are caused by families.

Families do NOT cause eating disorders. This is a common myth that must be emphasized. There is no evidence showing that parenting styles or family dynamics play a role in the onset of eating disorders. Eating disorders can affect anyone.

Myth No. 3: Eating disorders are all about food.

Extreme or unhealthy dieting behaviors are associated with eating disorders, but eating disorders simply are not about food or controlling eating. In fact, people with eating disorders may either have a false sense of or complete loss of control over their eating. The core features of eating disorders are theorized to be the over-evaluation of weight and shape.

Myth No. 4: Only females are affected by eating disorders.

Eating disorders can affect anyone, males or females, across all cultural and socioeconomic backgrounds, and among all age groups ranging from young children to the elderly. However, eating disorders predominantly target females and typically strike during adolescence and young adulthood.

Myth No. 5: You have to be thin to have an eating disorder.

It is impossible to know whether a person has an eating disorder just by looking at him or her, as people with eating disorders can appear thin, normal weight or overweight. Regardless of how a person appears or how much a person weighs, he or she might have an eating disorder and be engaging in harmful eating disorder behaviors.

Myth No. 6: People with an eating disorder can change but choose not to.

Although people with eating disorders may resist treatment or push family or friends away if they try to help, this is just a symptom of his or her illness. They also cannot choose to "just eat." Eating disorders are serious mental illnesses that require professional treatment. The sooner a person with an eating disorder gets help, the better his or her chances are of recovering. Fortunately, we have effective therapies to treat eating disorders. At Children's Center for the Treatment of Eating Disorders, our clinicians are trained and have experience in delivery of these evidence-based treatments.

Myth No. 7: Once someone is treated for an eating disorder, he or she is cured for life.

Full recovery can take months or years but is possible. Many individuals go on to be free from their eating disorder, while others may have residual symptoms or remain at risk for relapse.

How to recognize an eating disorder

As illustrated above, eating disorders are complex. They may begin with a well-intended attempt to "get healthy" or "eat healthier." Eating disorders also may look different for each child or adolescent. Some of the following may be warning signs that your child or adolescent is developing or has developed an eating disorder.

Physical signs:

  • Rapid or excessive weight loss
  • Dramatic weight gain
  • Development of fine facial or body hair
  • Lack of energy
  • Dizziness or fainting
  • Feeling or complaining of being cold
  • Constipation
  • Vomiting
  • Dry skin
  • Hair loss
  • Dental erosion
  • Calluses on knuckles from self-induced vomiting
  • Decreased heart rate
  • Absent or irregular menstruation in females

Cognitive signs:

  • Belief that he or she is "fat"
  • Afraid of gaining weight or becoming fat
  • Afraid of being able to stop eating
  • Denies having a problem or an eating disorder
  • Obsesses about body image, appearance or clothing
  • Difficulty concentrating
  • Depression or withdrawal
  • Irritability
  • Self-worth appears strongly related to weight or shape
  • Obsessiveness

Behavioral signs:

  • Refuses to eat normal types or amounts of food
  • Eats large amounts of food in a short period of time (binge-eating)
  • Self-induces vomiting
  • Over-exercising
  • Takes laxatives or diet pills
  • Hoarding, hiding or throwing away food
  • Engages in food rituals or has food rules, including calorie limits, measuring food or rules about what he or she should or shouldn't eat
  • Categorizes food into "good" and "bad"
  • Refuses to eat "unhealthy" or "bad" foods
  • Eats only certain foods or only eats at specified times
  • Often says "I'm not hungry"
  • Makes excuses to avoid eating at mealtimes
  • Withdrawal from friends or activities
  • Eating in secret so that you are not aware of what he or she is eating

If you suspect that your child has an eating disorder or you have noticed some of these symptoms, it's important to seek professional help as soon as possible. Trust your instincts as parents. Don't wait until things get worse.

We encourage you to educate yourself and ask questions. We also encourage you to contact the Center for the Treatment of Eating Disorders at Children's to schedule an appointment for your child to have a thorough evaluation and to explore treatment options. Contact us at 612-813-7179.