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.
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