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NEDA TOOLKIT for Coaches and Trainers Frequently asked questions What is an eating disorder? Eating disorders are serious but treatable illnesses with medical and psychiatric aspects. The eating disorders most commonly known to the public are anorexia and bulimia. There are also other eating disorders, such as binge eating disorder. Some eating disorders combine elements of several diagnostic classifications and are known as “other specified feeding and eating disorders (OSFED).” Eating disorders often coexist with a mental illness such as depression, anxiety or obsessive- compulsive disorder. People with an eating disorder typically become obsessed with food, body image and weight. The disorders can become very serious, chronic and sometimes even life-threatening if not recognized and treated appropriately. Who gets eating disorders? Males and females may develop eating disorders as early as elementary school. While it’s true that eating disorders are more commonly diagnosed in females than in males, and more often during adolescence and early adulthood than in older ages, many cases are also being recognized in men and women in their 30s, 40s and older. Eating disorders affect people of all socioeconomic classes, although it was once believed that they disproportionately affected upper socioeconomic groups. Anorexia nervosa ranks as the third most common chronic illness among adolescent U.S. females. Recent studies suggest that up to 7% of U.S. females have had bulimia at some time in their lives. At any given time an estimated 5% of the U.S. population has undiagnosed bulimia. Current findings suggest that binge eating disorder affects 0.7% to 4% of the general population. (Smink, van Hoeken and Hoek, 2012) Can eating disorders be cured? Many people with eating disorders who are treated early and appropriately can achieve a full and long- term recovery. Some call it a “cure” and others call it “full remission” or “long-term remission.” Among patients whose symptoms improve — even if the symptoms are not totally gone (called a “partial remission”) — the burden of the illness can be greatly diminished. This can encourage increased happiness and productivity, a healthier relationship with food, and an improved quality of life. Treatment must be tailored to the individual patient and family. Controversy exists around the term “cure,” which can imply that a patient does not have to be concerned with relapse into the disorder. Many clinical experts prefer the term “remission” and look at eating disorders as a chronic condition that can be very effectively managed to achieve complete remission from signs and symptoms. Patients may, however, be at risk of a relapse in the future. Many patients in recovery agree that remission more accurately describes their recovery, because they need to continuously manage their relationship with food, concepts about body image, and any coexisting mental condition, such as depression. What if I say the wrong thing and make it worse? Family, friends, school staff and coaches often express concern about saying the wrong thing and making the eating disorder worse. Just as it is unlikely that a person can say something to make the eating disorder significantly better, it is also unlikely that someone can say something to make the disorder worse. Sometimes not saying anything can be worse than almost anything one could say. Individuals with eating disorders sometimes interpret unresponsiveness by significant others as “not caring.” See ”Tips on how to positively intervene” in this toolkit for a sample conversation with an athlete you are concerned about. I know someone who exercises for three or four hours every day. Is this considered a sign of an eating disorder? Perhaps. If the person is not training for a rigorous athletic event (like the Olympics) and the exercise has become compulsive, either to improve performance or burn calories, then yes, exercise is likely a dimension of an eating disorder. If you know the person well, talk to him/her about the reasons he or she exercises so much. If you are concerned about their weight or the rationale behind the excessive exercise regime, lead the person to information and resources that could help. Page  | 8