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Mental Health

Feb. 25, 2020

Expert clears misconceptions of eating disorders

At least 30 million people of all ages and genders suffer from eating disorders in the United States. In fact, eating disorders have the highest mortality rate of any mental illness.

Feb. 24 through March 1 marks National Eating Disorder Awareness Week 2020 – a time to raise awareness for the extensive and complex issue plaguing so many Americans.

Kelly Klump, a clinical psychologist and professor, studies the biological, genetic and psychosocial risk factors that contribute to eating disorders. She is currently working on a five-year project funded by the National Institute of Mental Health investigating the effects of oral contraceptives on binge eating risk in female twins.

Recognizing that eating disorders carry a social stigma – as well as widespread misconceptions – Klump gleaned insight to help the public get a better understanding.

Myth no. 1: Eating disorders are caused by culture alone. In the U.S., thinness is portrayed as a symbol of health and beauty in advertisements, entertainment and social media. Many people feel pressure to lose weight and be thin and some engage in unhealthy eating habits to do so. Though the pressure to be thin in our culture does play a role in the development of eating disorders, it is not the only cause of eating disorders.

Klump says that eating disorders are similar to other psychological disorders in that they are caused by the interaction of genes, biology, culture and environment.

The lack of knowledge about the biological factors behind eating disorders creates real consequences for individuals who suffer from eating disorders. For instance, past insurance carriers and regulators limited payment for psychiatric treatment to only those disorders that are considered to be “biologically-based.” Because of the myth that eating disorders are entirely cultural or environmental in origin, insurance companies were not obligated to pay for eating disorder treatment. This means that many people suffering from eating disorders were not able to receive the treatment they needed because they had to pay out of pocket for expensive treatments.

Myth no. 2: Eating disorders primarily affect middle-to-upper class white individuals. Research suggests that eating disorders are prevalent in all socioeconomic classes and individuals from all racial and ethnic backgrounds suffer from the disorders. In fact, the prevalence of some symptoms, such as binge eating, might be higher in individuals from specific racial and/or ethnic groups, like Latinx populations.

The problem with this myth is that clinicians and medical doctors who adhere to this stereotype might misdiagnose members of minority populations who do have eating disorders with other psychological disorders that are known to affect appetite and eating patterns, such as depression and anxiety. This will delay effective treatment and potentially contribute to even more negative consequences for the sufferer.

Moreover, because media often portrays only white individuals with eating disorders, individuals from other racial and ethnic groups may be less likely to recognize their symptoms as an eating disorder and less likely to seek treatment. This will again delay effective treatment for the sufferer and contribute to health disparities.

Myth no. 3: Anorexia nervosa is a more serious disorder than bulimia nervosa. One reason this myth may persist is that researchers and the media have associated anorexia nervosa with admirable traits, such as having self-control and willpower, and bulimia nervosa with less admirable traits, including a potential lack of self-control.
“Our society glamorizes thinness and anorexia nervosa in a way that it does not glamorize bulimia nervosa,” Klump said.

In reality, however, anorexia nervosa and bulimia nervosa have many similarities that are overlooked.

Though it is typically assumed that people with anorexia nervosa simply restrict their calories and food intake and resist the temptation to binge eat, past studies have shown that 50 to 70 percent of individuals with anorexia nervosa for three to five years develop binge eating during the course of their illness. Additionally, individuals with bulimia nervosa typically restrict their food intake to the same amount as those with anorexia nervosa. Ultimately, both of these eating disorders are significantly damaging and have their own set of unique consequences for individuals’ physical, mental, and emotional health.

Myth no. 4: Eating disorders are chronic conditions that do not respond well to treatment. Researchers and clinicians have worked for years to determine the most effective treatments for eating disorders and there are several that are widely used. Certain treatments are more effective for specific disorders and age groups, so an individual’s circumstances must be considered when determining treatment options.

For instance, cognitive behavioral therapy and interpersonal psychotherapy are effective for bulimia nervosa, family-based therapy has been shown to be effective for treating adolescents with anorexia nervosa and cognitive behavioral therapy is effective for binge eating disorder.

If you or someone you know is suffering from an eating disorder and would like to seek treatment, please see these websites for information and potential treatment centers: Academy for Eating Disorders (www.aedweb.org), National Eating Disorders Association (www.nationaleatingdisorders.org).

 

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Caroline Brooks, Kelly Klump
Mental HealthHealth and MedicineMental HealthFitness and Exercise

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