The Great Debate: ED’s as a Brain Disorder?

I’ve seen it so often in my practice. Young men and women being brought to treatment several months after the behaviors have been in effect. Starts off with “healthy” eating. Wanting to improve performance in athletics or just “feel better.” Parents hopeful that it is a “phase” that will pass, sometimes reinforcing of “eating well.” Friends make compliments on what appears to be an improved appearance. All of it very innocent.

Then a few months pass, the behaviors get more solidified and ritualistic. They feel comfortable and safe, and there is an obsessive quality to them. Not wanting the compliments to stop, or fearing they are going to become “fat,” the person tries harder at cutting back calories, or experiments with purging behaviors to get rid of excess calories. Is their brain working improperly when it is not being fed?

There has been an ongoing debate in the eating disorder community about whether eating disorders should be classified as “brain disorders.” Certainly, it can be argued that when a brain is not nourished enough, it will not work at its optimal capacity. Re-feeding the brain through consistent, reliable nutritional support is an integral piece of treatment that often makes people not only feel better, but think more clearly. It’s still a complicated issue that is exacerbated by factors such as anxiety, environmental factors (i.e. media, peers, coaches), family influences and genetic heritability, and sometimes medical factors (illnesses). It’s important that when treatment begins, a full assessment can be completed to understand what factors contributed to the behaviors, and how to create a team (i.e. dietician, physician) to be most helpful to get the brain and body working more effectively to combat the disordered issues.

Starving in Silence: Men have Eating Disorders Too

Brought on by bullying, criticisms from others, dieting behaviors and biological influences, men are just as susceptible to disordered eating issues as women. A 2007 study out of Harvard University shows that one in four of those diagnosed with anorexia/bulimia are male. Here is a wonderful article describing the journey of several men who struggled with eating disorders. If you have a son, this is well worth the read.

http://shoeleathermagazine.com/2011/feuer.shtml

The Scary Trend of Tweens with Anorexia

An excellent article on how food issues start out so innocently, but create potentially deadly and lifelong physical/emotional effects at such an early age.

http://www.cnn.com/2011/HEALTH/08/08/tweens.anorexia.parenting/index.html

Back to School and After Summer Comparisons

It’s back to school time, and soon your kid will be sharing the “who did what over summer” comparisons. A lot of this will be fun, informative conversation, and some of it will be filled with comparison and disappointment. Because we know that the majority of eating issues develop in the teenage or college years, it’s also a time where those more vulnerable may fall victim to food and body image issues.

People generally notice when others lose and gain weight. Because there is so much social referencing that occurs in the adolescent/teenage/early adult years, this generation is astute to these changes.  Particularly after a break (i.e. a few months of summer vacation) where changes are more noticeable, the comparisons can start. You may hear you child say, “oh my gosh….did you see so and so” or “I can’t believe how so and so.” These are cues that you should pay attention to, and opportunities to understand how they are processing such comparisons.

In our culture (and driven by the media), thinness equates to being more attractive and popular. For someone who is unclear on what their social status is, they may go to food or their body to gain attention or cope with their feelings. It gives them the illusion of control over their appearance, and a sense of purpose. The dieting behaviors may start up, or become worsened by these interactions. Some emotionally eat for comfort. Others alleviate stress through bingeing and purging.  Regardless of the “type” of behavior, without adequate support, these behaviors can cause more stress on the individual and worsen over time.

So, what to do? Best case scenario is that you build as much confidence in your child so that when these comparisons arise, they are resilient against trying to change themselves to gain social acceptance. Developing an ongoing dialogue about how to cope with peer pressures and disengage from negative talk about other people’s appearances. If you notice that your kid is starting to struggle, arm yourself with education and resources in effort to help it from spiraling out of control. If your child is at college, those campuses should offer counseling services (often, for free!) as well as have organizations devoted to food and body image issues.