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.
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