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NEDA TOOLKIT for Coaches and Trainers Common myths about eating disorders This information is intended to help dispel all-too-common misunderstandings about eating disorders and those affected by them. If your family member has an eating disorder, you may wish to share this information with others (i.e., other family members, friends, teachers, coaches, family physician) Eating disorders are not an illness. Anorexia is the only serious eating disorder. Eating disorders are actually complex medical and psychiatric illnesses. The American Psychiatric Association classifies five different types of eating disorders in the Diagnostic and Statistical Manual, 5th Edition (DSM-5): anorexia nervosa, bulimia nervosa, binge eating disorder, avoidant restrictive food intake disorder (ARFID) and other specified feeding or eating disorder (OSFED). Several decades of genetic research show that biological factors play a significant role in who develops an eating disorder. EDs can co-occur with other mental illnesses like major depression, anxiety, social phobia and obsessive-compulsive disorder. When researchers looked at the death rates of individuals with any eating disorder diagnosis who were being treated as outpatients, they found that bulimia and EDNOS (now OSFED) had the same mortality rate as anorexia nervosa. During the study, roughly 1 in 20 people with eating disorders died as a result of their illness. Individuals who abuse 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 eating disorders by increasing the amount of stress on the body. Doesn’t everyone have an eating disorder these days? Although our current culture is highly obsessed with food and weight, and disordered patterns of eating are very common, clinical eating disorders are less so. A 2007 study asked 9,282 English-speaking Americans about a variety of mental health conditions, including eating disorders. The results, published in Biological Psychiatry, found that 0.9% of women and 0.3% of men had anorexia during their life, 1.5% of women and 0.5% of men had bulimia during their life, and 3.5% of women and 2.0% of men had binge eating disorder during their life. The consequences of eating disorders can be life-threatening, and many individuals find that stigma against mental illness, and eating disorders in particular, gets in the way of timely diagnosis and adequate treatment. It’s just an eating disorder. That can’t be a big deal. Eating disorders have the highest mortality rate of any psychiatric illness. Up to 20% of individuals with chronic anorexia nervosa will die as a result of their illness. Community studies of anorexia, bulimia, and eating disorder not otherwise specified (EDNOS, now called OSFED) show that all eating disorders have similar mortality rates. Besides medical complications from binge eating, purging, starvation and over-exercise, suicide is also common among individuals with EDs because of the severe psychological distress that accompanies the disease. People who struggle with eating disorders also have a severely impacted quality of life. Strict rules about eating or fad diets aren’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, such as anemia and bone loss. Individuals dealing with serious disordered eating may benefit from intervention and treatment to address their concerns before it becomes a full- blown eating disorder. 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. As long as someone isn’t emaciated, they are not that sick. Most people with an eating disorder are not underweight. Although most people with eating disorders are portrayed by the media are emaciated, you can’t tell whether someone has an eating disorder just by looking at them. These perceptions can allow eating disorders to linger for years, and can cause distress in eating disorder sufferers for fear of not being “sick enough” or “good enough” at their disorder to deserve treatment. Just because a sufferer is no longer emaciated doesn’t mean they are recovered. Someone can experience a severe eating disorder at any weight. Page  | 11