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NEDA TOOLKIT for Educators Anorexia is the only serious eating disorder. When researchers looked at the death rates of individuals with any eating disorder diagnosis who were being treated as outpatients, they found that individuals with bulimia and OSFED were just as likely to die as those with anorexia. During the study, roughly 1 in 20 people with eating disorders died as a result of their illness. Individuals who take laxatives or diuretics or force themselves to vomit are at significantly higher risk of sudden death from heart attacks due to electrolyte imbalances. Excessive exercise also can increase the risk of death in individuals with bulimia. The psychological and social consequences of eating disorders, including isolation, stigma, and shame, can also be extremely dangerous to the sufferer’s mental health and social wellbeing. If my student insists they are fine, I should believe them. One of the symptoms of an eating disorder can include a difficulty understanding the presence or severity of the eating disorder. Thus, your student may genuinely believe they are fine when they are acutely ill. The effect of malnutrition on the brain can make it difficult for the sufferer to think rationally and perceive the seriousness of the behavior. Other people may insist they are fine even when they know they are not because they are afraid of treatment. And in many instances the child is terrified to surrender the one coping skill they have found to be effective for them. Regardless of the reason, it is important to insist on regular medical follow-up with a physician who is well- versed in eating disorders. Keep in mind that medical tests do not always reveal a need for treatment, but it is important for anyone struggling with disordered eating to have their health monitored by a professional. Strict dieting or fad eating isn’t a problem. What appears to be a strict diet on the surface may actually be an eating disorder in disguise, or the beginnings of one. Even if it isn’t a clinical eating disorder, disordered eating can nonetheless have serious medical consequences. Individuals dealing with serious disordered eating (eating behaviors that negatively impact one’s life but do not meet the criteria for an eating disorder) may benefit from intervention and treatment to address their concerns. Chronic dieting has been associated with the later development of an eating disorder, so addressing these issues right away may prevent a full-blown eating disorder; early intervention for disordered eaters has been shown to dramatically improve outcomes. As long as someone isn’t emaciated, they are not that sick. You can’t diagnose an eating disorder just by looking at someone. Although most people with eating disorders are portrayed by the media are emaciated, they don’t represent the vast majority of eating disorder sufferers, most of whom are not underweight. These perceptions can allow eating disorders to remain untreated for years, and can cause distress in eating disorder sufferers, who may feel that they are not “sick enough” to deserve treatment. The main eating disorder symptom I have to worry about in my student is weight loss. Although anorexia nervosa and other restrictive eating disorders are characterized by weight loss, many people with eating disorders don’t lose weight and may even gain weight as a result of their disorder; weight is not always an identifying factor for having or not having an eating disorder. There are many physical and behavioral symptoms of an eating disorder; weight change is one of many possible effects. Eating disorder behaviors only focus on food. Individuals with eating disorders generally have an unhealthy focus on food and weight, but the symptoms of an eating disorder can extend far beyond food. Genetic research has shown links between eating disorders, perfectionism, and obsessionality, which can lead to a fixation on grades or sports performance. As well, the malnutrition caused by eating disorder behaviors has been shown to increase depressed mood and anxiety that can affect all aspects of life. My student doesn’t claim to feel fat. Can they still have an eating disorder? Absolutely. While body image and weight concern are common in eating disorders, some individuals develop eating disorders without concern about weight. Younger children are less likely to indicate concerns about weight or shape in spite of engaging in disordered eating behaviors, and some teens and adults also do not report weight concern as a symptom. Body image issues are not required for an eating disorder diagnosis. Page  | 9