In a recent release from the state’s Department of Health, the number of youth dealing with eating disorders in Pennsylvania continues to climb.
“Eating disorders are serious health conditions that can affect individuals of any gender, age, race, ethnicity or lifestyle,” Health Secretary Dr. Rachel Levine said. “The prevalence of eating disorders has continued to increase and is one of the top five most common illnesses among American teens. It is essential that everyone, especially parents, know the signs and symptoms of eating disorders so we can help connect those who are suffering with the support they need.”
Types of eating disorders
Family doctor, Richard Conn, who has a practice in Connellsville, said there are three major types of eating disorders, although there are several other types and subtypes.
The most known is probably Anorexia Nervosa, which is a condition where the patient has a distorted body image, even to the point where they will feel that they are overweight when in fact they are dangerously underweight. It’s also coupled with a morbid fear of gaining weight.
“Anorexia is estimated to affect 0.4 percent of women with a 10:1 female to male ratio,” Conn said. “Patients with anorexia will typically restrict their food intake in order to not gain weight. Usually, patients with anorexia will have a weight loss of up to 15% or more below their ideal body weight.”
He added that anorexia is often a chronic condition, and about 10 percent of these patients will die from complications of it.
“This is typically due to organ failure from severe calorie malnutrition or overwhelming infection because their immune system cannot mount an adequate response,” said Conn. “Anorexia is typically not very responsive to treatment with medication and is instead treated primarily with psychotherapy.”
The second most common type of eating disorder is Bulimia Nervosa where the patient has an episodic intake of large amounts of food followed by ritualized purging through vomiting or the abuse of laxatives.
“Patients with bulimia can be a normal weight or overweight but are rarely as underweight as patients with anorexia,” Conn said.
Bulimia is estimated to affect one to one and a half percent of women, again with a 10:1 female to male ratio.
“The primary health risk with bulimia is from the electrolyte disturbances associated with induced vomiting or diarrhea,” said Conn. “Particularly, severe changes in potassium levels can result in dangerous heart arrhythmias.”
He added that abusing substances such as ipecac to induce vomiting can cause irreversible cardiomyopathy (damage to the heart muscle), congestive heart failure and death.
While bulimia is more responsive to treatment with medication, psychotherapy is still an important component of treatment.
A third category of eating disorders is the binge/purge subtype of anorexia.
Conn said in this eating disorder, patients at baseline will restrict food intake and will have weight loss similar to other patients with anorexia.
“However, unlike classic Anorexia Nervosa, the patients with the binge/purge subtype will also have intermittent episodes of binging and ritualized purging that resembles patients with bulimia,” he said. “At times, it can be difficult to distinguish between this Anorexia Nervosa subtype and Bulimia Nervosa. However, the distinction is important, since this disorder is treated in a manner more similar to the treatment for anorexia, with treatments for bulimia being less effective.”
Effects of eating disorders
Levine said eating disorders can affect every organ system in the body, including the cardiovascular system, gastrointestinal system, neurological system and endocrine system.
“One person dies every 62 minutes as a direct result of an eating disorder, which is why it is so important that those struggling with an eating disorder get professional help,” she said. “The earlier a person with an eating disorder seeks treatment, the greater the chances of recovery.”
The warning signs of eating disorders, which are physical, emotional and behavioral in nature, can vary depending on the disorder. Generally, behaviors and attitudes that are fixated on weight loss, dieting or control of food are warning signs.
The Department of Health said stereotypes usually link eating disorders to young women; however, about one in three people struggling with an eating disorder is a man.
Treatment of eating disorders
Getting diagnosed is the first step towards recovering from an eating disorder and involves a combination of psychological and nutritional counseling in addition to medical and psychiatric monitoring.
Dr. Krista Boyer, a psychologist with Connellsville Counseling Services, said there is a heavy genetic component to having an eating disorder.
“If there is someone in your family who has suffered from an eating disorder, you are at a heightened risk,” she said. “Also, those with an obsessive personality character can be at greater risk.”
Usually those with an eating disorder obsess over their weight or their food and have intense feelings of guilt after they eat, said Boyer.
“They also have intense feelings about being a perfectionist with everything from grades to work to their appearance,” she added. “It’s usually difficult for them to manage their emotions and they have problems with impulse control.”
An individual with a traumatic history might also be at high risk for an eating disorder because when a traumatic event threatens their sense of control, the individual then uses extreme control in the few things they have control over, such as eating.
Add these characteristics to the way women’s bodies are portrayed in the media and the false way it can be portrayed with social media picture filters and Boyer said it can be hard for some not to struggle with eating disorders.
“Not everyone that I see comes because they have an eating disorder, but usually when discussing issues that a young girl might be having, it often comes up where they say they’re not happy with their body,” Boyer said. “This is something that is at the forefront of their mind, and they think a lot about it.”
Therapy that helps with some eating disorders include education on how to regulate and manage emotions, working with cognitive behavioral therapy where the individual is taught to self-monitor their thoughts and to identify thought patterns.
“Usually the patient is also treated with visits to a psychiatrist or the prescription of anti-depressants,” Boyer said. “Also, seeing a nutritionist is part of the treatment process.”
The American Dietetic Association said that “nutrition intervention, including nutritional counseling by a registered dietitian (RD), is an essential component of team treatment of patients with anorexia nervosa, bulimia nervosa, and other eating disorders during assessment and treatment across the continuum of care.”
Heidi McClain, registered dietitian and Director of Dietary at Highlands Hospital, said that she has found that in order to achieve success in terms of recovery, a registered dietitian must establish a personal relationship with a patient suffering from an eating disorder more so than any other type of patient.
“I have found it helpful to share more personal details about my own life in order to facilitate an open, comfortable environment,” she said. “Gaining his/her trust, and having him/her see you as a person aiding in their recovery more so than a practitioner, has been successful.
“Often, an appointment with an eating disorder patient will include discussion on other areas of his/her life such as relationships with friends, family or partners, school or work challenges, financial struggles, even a sick pet - the patient’s ability to focus on recovery can easily be disrupted by other stressors, so it is important to discuss these things as well,” McClain added.
Anyone looking for support, information, referrals and guidance about eating disorders, either for themselves or a loved one, can contact the National Eating Disorders Association Helpline at 1-800-931-2237.
For more information on eating disorders, and other health issues, visit the Department of Health website at www.health.pa.gov