The Many Faces of Eating Disorders

You cannot always tell a person has an eating disorder simply by looking at him or her.

I stressed that because one of the most common and enduring myths about eating disorders is that the person must be young, female, and extremely emaciated to have an eating disorder.

That is simply not true.People with eating disorders are both male and female, and come in every shape or size. Take the group of people pictured at the right. According to current data provided by HealthyPlace.com, up to 24 million women and men in the United States suffers from an eating disorder, such anorexia, bulimia, and binge eating. The chances are good that at least one person in the picture has an eating disorder. I don't know that, of course, and I can't surmise which person might have an eating disorder simply by looking at them.

Learning About The Many Faces of ED

I developed anorexia when I was 42. I thought I knew something about eating disorders. After all, I have a bachelor's degree in psychology, and I worked as a social worker for almost a decade. It wasn't like I had never met or worked with someone with an eating disorder. However, I also remember that eating disorders were barely touched upon when I was studying psychology and I read many books about eating disorders out of simple curiosity.

Then I entered Rogers Memorial Hospital for treatment of anorexia during the spring of 2008. I learned how little I really knew about eating disorders during my brief stay there. (I signed myself out after about an hour there, not able to resist the urge to flee because of a combination of fear and denial. Iwas discharged AMA - Against Medical Advice - twenty-four hours later.)

There were several male patients, severely emaciated and connected to feeding tubes, in treatment while I was there. Frankly, I was surprised. I never thought about males developing anorexia or any other eating disorder, and I remembered all the books I read perpetuated the eating disorder stereotype of the young female with anorexia and/or bulimia.

I thought about myself. I tried unsuccessfully to convince my family doctor that I couldn't possibly have anorexia because I was too old, and she insisted that I did have anorexia and that people of all ages develop eating disorders. Then I met a woman, also at Rogers, that was at least ten years older than me and slightly overweight. She had an eating disorder, and complications from it had required that one of her legs be amputated.

I learned a lot during that short twenty-four hour stay. I've always regretted fleeing Rogers, thinking that I might have received the help I needed then and not have spent three more years struggling with anorexia.

Emaciation Is Not The Only Symptom Of An Eating Disorder

Many people think that you must be severely emaciated to have an eating disorder. This myth is perpetuated throughout the media, with its focus on models and actresses who have anorexia and do become severely emaciated.

This is a dangerous myth. Insurance companies often buy into this myth and refuse treatment for people with eating disorders who are not severely underweight. This can cause people with anorexia to feel that they don't deserve treatment until they get to a low weight. This also can cause some insurance companies to refuse to pay for treatment once a person diagnosed with anorexia gains needed weight. But the person is kicked out of treatment just when he or she is starting to think more clearly and can more fully participate in the recovery process.

This attitude also can cause people with bulimia to have a harder time getting treatment, because people with bulimia have weights across the spectrum, and yet they can be very sick. Binging and purging is a very dangerous behavior that can throw off your electrolytes, cause severe dehydration, and a host of other problems.

Then there are those with binge eating disorder. Binge eating disorder is not yet recognized as an official eating disorder. However, the DSM-V (the diagnostic manual used by clinicians, physicians, and other people and groups to diagnose such illnesses as eating disorders) is expected to include binge eating disorder as an official diagnosis.

That is a good thing. I have several friends who struggle with binge eating, and the doors to eating disorder treatment have been mainly closed to them. One of my friends struggles with getting around and doing things because she is morbidly obese, and yet she need treatment to overcome binging. I remember when I was in a partial-hospitalization program last spring, and one woman's insurance immediately refused to pay for her treatment upon learning that she had binge eating disorder. She had to leave treatment after only four days, distraught and knowing that her insurance would not cover any type of eating disorder treatment.

I know that there are other options beside medical treatment. There are support groups, including groups held by Overeaters Anonymous and Anorexia Nervosa and Associated Disorders (ANAD). However, it can be difficult to find a support group if you live in a small town or rural area. Many support groups also require you to be in treatment with a clinician, and you are basically caught in a Catch-22. Finally, a support group simply can't replace professional eating disorders treatment, especially when you are first starting in recovery.

Education Is Key

Teaching people that there are many faces of eating disorders is very important. I believe our family, friends, and other loved ones do want to know the truths about our eating disorders. I believe that they do want to understand more, and be able to help us recover.

This includes educating clinicians and insurance companies. Both my eating disorders psychiatrist and myself have had to advocate with my insurance company that weight restoration alone does not mean I am completely recovered from my eating disorder.

It will be only when people realize that anyone can get an eating disorder that more treatment options will open for more people with eating disorders.