Like so many other mental disorders, eating disorders project people who are really “out of balance.” I don’t think anyone would be an obesity advocate… after all; obesity presents as many or more health problems as being overly thin. In the end, it’s all about balance.
1 in 5 women have an eating disorder. Kids start dieting as early as 4th grade. I can actually see this, I see a bit of it in my daughter… she is age 8 (2nd grade) and has shown concerns about “being too heavy.” We have turned the focus onto “being healthy” not “being thin.” 80% of 13 year olds have tried to lose weight… this doesn’t surprise me, considering the “ideal image” that western culture projects to children. 1 in 5 anorexics die? Our text indicates it was closer to 1-10, that’s nearly double NHW’s estimate. I know it’s a real problem, but having good epidemiological data would be a good start to “justifying” expending resources to extinguish it.
With regard to what a clinican should know or ask about eating disorders, the following questions are at the top of my list.
1) Clinicians should know your subtypes of Anorexia Nervosa (AN):
- Restricting Type describes presentations in which weight loss is accomomplished primarily through dieting, fasting, or excessive exercise.
- Binge-Eating/Purging Type describes presentations where the individual engages in binge eating, purging, or both. They may employ self induced vomiting, misuse of laxative, diuretics, or enemas. (American Psychiatric Association, Diagnostic and statistical manual of mental disorders, 2000, p. 585)
2) Probe for comorbid disorders and associated features, especially depression, anxiety disorders, dissociative disorders, substance abuse, and personality disorders (particularly borderline personality disorder). (Netherton, Holmes, & Walker, 1999, p. 401)
3) Clinicians should know that, while these disorders predominantly effect females, males can also suffer from either AN or BN. “There is some evidence that ED prevalences are recently increasing in males.” (Blaney & Millon, 2009, p. 433)
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.
Blaney, P. H., & Millon, T. (2009). Oxford textbook of psychopathology (2nd ed.). New York, New York: Oxford University Press.
Netherton, S. D., Holmes, D., & Walker, C. E. (1999). Child and adolescent psychological disorders: A comprehensive textbook. Oxford, NY: Oxford University Press.