Posts tagged #eatingdisorders

Understanding Eating Disorders

As warm weather rolls in, so do the commercials for diet plans, liposuction, fat freezing, gym memberships, fat shedding supplements, and on and on. An overwhelming number of advertisements identify aspects of our appearance as flaws and encourage expensive steps to improve those flaws in order to achieve happiness. This message of striving (and starving) for an unrealistic physical appearance is sometimes as blatant as “stop letting that stubborn fat keep you from being happy”. Other times it is the more subtle advertisements and entertainment with portrayals of the happy human with an unrealistic body. The body, they don’t tell the audience, has been enhanced and altered through airbrushing, lighting, and make up (both body and facial).

All of this exposure and how often does the message “these are altered and unrealistic body images” come up in daily life? Look around and we find it is no where near the hundreds of thousands of negative images which are seen over the course of a day or week. Some of these are so subliminal we don’t even realize we are seeing them, they are just running in the background like barely noticeable music played in a mall.

So why is this concerning? These images can contribute to dangerous eating disorders. The Diagnostic and Statistical Manual, the guide to identifying mental health related disorders, even states that the culture of valuing body image is one of the factors which contributes to the development of eating disorders. Such disorders can lead to malnutrition, dehydration, irreversible bone mineral loss, organ damage and other ill effects on health. Mental health related concerns are the continued diminish of self-esteem, neglect of prosocial areas of life due to progressive obsession over food and weight, ongoing negative self-image, increased depression and anxiety, isolation due to fear of being overweight, lack of enjoyment in life, and a number of other mental health related issues. The most common age group in which eating disorders occur is teenage years through the 20’s. This is a critical time related to the development of a healthy body and the development of the brain. Lack of necessary nutrition can negatively impact this process.

One positive aspect is that parental involvement still vey much exists within the age group most afflicted. This offers the opportunity for support in prevention and recovery. Empowering parents with education regarding the signs, and ways to reduce the risk of eating disorders, hopefully, will reduce the rate of these disorders and make for healthier adults.

The following educational piece starts with understanding that each disorder has their own unique distinguishing behaviors. The two main weight related disorders are Anorexia and Bulimia.

Anorexia is the most commonly acknowledged eating disorder. This may be do the shock of the rapid weight loss and sickly appearance of Anorexia. Anorexia has multiple root causes. The most common roots can be an attempt to establish a sense of control, a response to distressing events, or exposure to body shaming or unrealistic expectations of how an attractive body is defined. At first, Anorexia can appear as healthier eating or superficial focus on appearance, which may come with the increased self-awareness accompanying puberty and teenage years. The distinction can be made when:

  • There is rapid and extreme weight loss

  • Inability to see weight loss

  • Obsessive focus on weight (e.g., complaining about body image, pinching of areas to measure how much fat they can grab, constant criticism of body shape)

  • Extreme reduction of food intake

  • Obsessive calorie counting

  • Overuse of laxatives, diuretics, or exercise (differs from Bulimia in there is no binging and are used despite low calorie intake)

  • Detailed food diary

  • Use of diet pills or engagement in fad diets when at a low weight

  • Somatic issues such as stomach pains, constipation, dizziness, headaches, fatigue on a regular basis

  • Lack of engagement of activities, such as swimming, where body shape is more easily observed by others

  • Justification of weight loss due to extracurricular activities (dance, wrestling, gymnastics)

  • Stunted puberty (girls show delayed menstruation or discontinuation of menstruation)

  • Hanging posters (or following on social media) of idealized body types rather than their talent or attraction to the person

  • Struggle to or hiding eating due to shame

  • Consistent use of the bathroom following a meal (indicative of self-induced vomiting)

  • Daily weighing, sometimes multiple times in a day

  • Extreme intolerance to cold

Bulimia is known, but less common. Bulimia is more about not gaining weight than losing weight. It also comes with a fear of being overweight. The distinguishing factor of Bulimia vs Anorexia is that there are bouts of uncontrolled eating of an extreme quantity of food in a short period of time followed by some type of purging to avoid weight gain. This usually does not come with an extreme loss of weight or noticeable change in weight. The lack of change in body shape makes it less noticeable that Bulimia is present. The signs to look for:

  • Times of extreme eating within approximately 2 hours or less, sometimes consuming food they normally would not eat or to the point of being ill

  • Consistent use of the bathroom following a large meal (indicative of vomiting)

  • Excessive use of laxatives, diuretics, diet pills or stimulants

  • Diary of food consumed vs what is purged (extreme versions include weighing what was purged such as vomit, urine and feces excreted)

  • Development of “chipmunk cheeks”, which is due to the swelling of salivary glands

  • Referred to as Exercise Bulimia, obsessive exercise as a form of purging noted by longer than reasonable engagement in one exercise session (e.g., running up and down stairs for hours rather than sets or the use of exercise equipment beyond the standard hour session)

  • Erosion of the esophagus

  • Tooth erosion

  • Constant irritation of the lips

  • Severe acid reflux

Additional tips:

  • In some cases, the use of vomiting can lead to uncontrolled reflexive vomiting upon eating without the intention of purging.

  • There is a trend among those who support the engagement in Eating Disorders to don red beaded bracelets in order to identify themselves to others with eating disorders.

  • Another clear sign is involvement in ProAna or ProMia websites. ProAna are sites dedicated to providing tips and support on how to maintain anorexia. ProMia are sites encouraging Bulimia. Both of these sites maintain the position that eating disorders are a lifestyle choice rather than a disorder. ProAna sites label those with an eating disorder as a “Rexie” or an “Anorexie”. A “Rexie” is someone who defines their Anorexia as achieving success in developing a high level of self-control, power over self, and strength. An “Anorexie” is someone who uses Anorexia for sympathy rather than manifesting the strengths of a “Rexie”.

If you have concerns, exploring your child’s search history may be eye opening regarding these sites and other weight loss sites they have been exploring.

Just like addiction, Eating Disorders can be a lifelong recovery process with the risk of some relapses in the process. Just like addiction, Eating Disorders come with a high level of denial, manipulative behaviors to maintain the disorder, and justification of their behaviors.

There are inpatient and outpatient clinics specific to the treatment of eating disorders. There are support groups, unlike ProAna and ProMia groups, focused on recovery. Eating Disorders can be difficult to watch in the people we care about. It can bring about anger and fears in the loved ones of those struggling with this condition. There is significant information to help understand Anorexia and Bulimia.

This article was broken up into two separate articles; Understanding Eating Disorders and Prevention of Eating Disorders. Click here to read about Prevention

Some quick tips to remember when dealing with the dynamics of an eating disorder:

  • Don’t engage in a power and control struggle as it may increase the severity

  • Remember, the desire for control is one facet feeding their behaviors. Don’t increase their resistance by constantly insisting that they eat.

  • Discussing food with someone who is food obsessed is not the best approach

  • Don’t express anger at them or withdraw; they already carry enough shame

  • Do try to express understanding of how they are feeling, identify the pressure our society unfairly places on them, and work together to find ways to improve their health and begin recovery.

PCOS and Mental Health

For the nearly thirty percent of American women who struggle with Polycystic Ovarian Syndrome (PCOS), one of the largest sources of frustration can come from feeling as though the only symptom being treated is the absence of periods. In fact, many women complain that only the physical symptoms of PCOS are the focus of treatment while mental health is often ignored. These frustrations are validated by a growing body of research examining the correlation between PCOS and mental health.


For women with PCOS, anxiety is one common mental health concern. Studies suggest that abnormally high levels of testosterone production in the body can result in anxiety. Women with PCOS can also develop anxiety as a result of some of the symptoms associated with PCOS such as hair loss and hirtuism (excessive body hair).


In a manner similar to anxiety, PCOS can also lead to depression due to the distress caused by many of the symptoms of PCOS. Some studies have revealed that women with PCOS report feeling hopelessness, despair, and feelings of having a poorer quality of life compared to their counterparts who do not have PCOS. Women with PCOS are also at a much higher risk for suicide than women without PCOS.

Eating Disorders

Research suggests that there is indeed a correlation between PCOS and eating disorders, but there is often a disagreement as to whether PCOS is the cause of eating disorders or if those who struggle with eating disorders will go on to develop PCOS later in life. With weight gain being one of the most common symptoms, it is not unusual for a woman with PCOS to develop low-self-esteem or an unhealthy body image. For women with PCOS, it is especially important to find body-positive role models to help promote a healthier body image.

For many women, knowing that treating fertility issues does not need to be the focus of PCOS treatment can be sobering news. Studies show that a healthy, balanced diet and exercise can drastically relieve many of the physical emotional symptoms associated with PCOS. While a healthy lifestyle is by no means a magic pill or a universal answer, making healthy choices can go a long way in reducing stressful emotional symptoms associated with PCOS.

For more information, or to seek out additional support, please visit


Anthony Rivas, Medical Daily

Columbia University

By Becky Ruhter

Posted on November 9, 2015 and filed under awareness.

Eating Disorder Resources by Becky Ruhter


Getting help recovering from an eating disorder is a difficult process. In addition to professional treatment, some people recovering from an eating disorder may wish to seek additional support. Other times, the family members or friends of someone recovering from an eating disorder may feel confused and unsure of how to help their loved one. There is a plethora of information on eating disorders that exists both in print and online. Unfortunately, some of that information may be triggering, misguided, or simply unhelpful. Fortunately, not all of the information on eating disorders consists of glamorizing symptoms or boasting about dangerously low weights. Many helpful resources exist for people suffering from eating disorders and their loved ones to help them better navigate the world of recovery. 

Physical Services: 

The Eating Disorder Center of Denver

The Eating Disorder Center of Denver is a treatment center that focuses on empowering the client and helping them discover their identity beyond their eating disorder. They not only offer treatment to individuals with eating disorders, but they also provide resources for families as well. The organization’s blog also contains informative articles on eating disorders.

The Eating Disorder Foundation

The Eating Disorder Foundation is a nonprofit organization that aims to eliminate eating disorders through education, advocacy, and support. They also assist those who may be struggling with an eating disorder and provide services such as drop-in support, support groups, and directories for professional treatment. Their website includes information about eating disorders as well as links to helpful resources.


National Eating Disorders Association

NEDA is a non-profit organization created with the mission of educating communities about eating disorders as well as providing support to eating disorder patients and their families. The organization’s helpline operates five days a week to assist those seeking treatment resources. The website’s blog lists local and national NEDA events as well as advice to those in recovery and family members who wish to help a loved one with an eating disorder.

We Bite Back

Some people may prefer the anonymity of an online support group. Founded in 2006, We Bite Back was created with the intention of offering online support to people with any eating disorder at any stage of recovery.

Recovery Warriors

Recovery Warriors initially began with the development of the Rise Up + Recover app as a tracking tool to be used by anyone in the early stages of recovery. With the app, the user can track their food intake and record any thoughts they may be having. They can also make a record of any time they perform a behavior associated with eating disorders and record the thoughts and feelings that may have triggered the behavior. Due to the success of the app, the developer, Jessica Raymond, created a podcast and website devoted to educating people about eating disorders and providing inspiration and resources to those in recovery.


Goodbye ED, Hello Me by Jenni Schaefer

In this memoir, Jenni Schaefer details her journey to finding freedom from her eating disorder (referred by her as “Ed”) by providing not only a personal account of her recovery success, but by also imparting practical advice for those looking to begin their own journey. Schaefer’s advice and encouragement inspires readers to set themselves free from destructive behaviors with food and to fall in love again with life.  

Don’t Diet, Live It by Andrea Wachter and Marsea Marcus

This workbook, created by two licensed therapists who have also recovered from their own struggles with food and weight, is designed to help those in the early stages of recovery challenge maladaptive beliefs about food and weight. Each chapter focuses on a specific lesson that is important to recovery (for example, learning how to think in multiple options as opposed to black and white, learning how to set healthy boundaries whether they happen to be with food or with other people, and challenging the notion that happiness can be obtained with outer solutions rather than looking inward). At the end of each chapter, the reader is encouraged to answer thought-provoking questions that can help inspire the reader to develop new behaviors and thought patterns. 


Posted on October 5, 2015 and filed under awareness.