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Today marks the first day of National Eating Disorders Awareness Week, an observance created by the National Eating Disorders Association (NEDA) in order to spread awareness about eating disorders and support for those dealing with them. According to NEDA, approximately 20 million women and 10 million men will suffer from an eating disorder at some point in their lives. Different studies show varying degrees of prevalence of what is classified as a mental illness, but the fact remains that eating disorders are common and, while not always thought to be the case, profoundly dangerous. Although they may not be considered to be one of the more “serious” mental illnesses, eating disorders have the highest mortality rate out of any mental illness, with anorexia nervosa being the deadliest among them all.
Unfortunately, like other unseen illnesses, eating disorders still have a stigma attached to them, which leads to a shortage of funding for research in the United States, says Cynthia Bulik, Ph.D., the founding director of the University of North Carolina Center of Excellence for Eating Disorders. The organization has recently been designated as the National Center of Excellence for Eating Disorders by the Substance Abuse and Mental Health Administration (SAMHSA), and will be helping to bring evidence-based information to the public and to providers. She explains that many professionals shy away from studying eating disorders because they “fail to understand how biological it is.”
In the past, eating disorders were thought to be purely psychological, but new research is starting to show that there is a physical component to them as well, and that patients with these disorders may be in much less control than originally believed. For example, research has shown that people suffering from obesity are capable of losing weight but are often unable to keep it off due to metabolic factors, and they tend to gain the weight back within a year. What researchers are seeing with patients with eating disorders who fall to unhealthy weights is that even after being nourished while in the hospital and brought back up to a healthy BMI, their bodies tend revert back to unhealthy weights again. “It’s almost like obesity and anorexia are metabolic bookends,” Bulik says.
Researchers are also seeing an interesting correlation between patients with anorexia who similarly suffer from an anxiety disorder, which is a very common overlap. Patients who suffer from both report that starvation actually brings down their anxiety levels, which is generally the opposite reaction of what starvation normally does to the body. As far as the reasons why these metabolic reactions are occurring, Bulik says more research is needed.
“The heritability of eating disorders is somewhere between 40-60 percent; meaning that around half of the liability to developing the illnesses is due to genetic factors,” Bulik says. Outside influences can and often do play a role, but more so in the sense that they could trigger an eating disorder in someone who already has a predisposition for one, and this can affect both children and adults of any gender.
Currently, the treatment of choice for adolescents with eating disorders, primarily anorexia nervosa, is family-based treatment, which involves parents “taking complete control over refeeding the child,” Bulik says. It is a very specific type of treatment and can be difficult, but as Bulik says, “the support of the family is invaluable.” Along with this, researchers are finding that treatment involving the families, and specifically the partners of adults with eating disorders, are particularly helpful as well.
Bulik wants to make sure that the message that eating disorders are treatable is out there, and that if you suspect someone you care about is suffering from one, to try and get them help, preferably by someone with experience in evaluation and treatment. NEDA has a service that can help you locate nearby treatment options, along with many other resources for both those experiencing eating disorders and their loved ones. These resources are available year-round and many will be highlighted this week.