Is My Relationship with Food or Exercise Disordered?

COVID-19 abruptly changed everyone’s day-to-day routines. Lives were put on hold as businesses closed, and we each weathered the uncertainty in social isolation.  Some people took to social media to make memes and jokes about gaining the “COVID 15” during this time. Fluctuations in weight are a normal part of life, and are not all that unanticipated in the setting of closed gyms, reduced activities and added stresses related to finances, health and caring for children. For some, these stressors and potential changes to their bodies were overwhelming. Along with the COVID-19 pandemic came an insurgence of mental illness. Some used food or exercise to cope with the stress. Consequently, eating disorders are at an all-time high.

Eating Disorder Epidemiology

An eating disorder is a maladaptive coping mechanism to deal with some of the stressors that life, genetics, or a pandemic has handed us. According the National Eating Disorder Association, an estimated 20 million women and 10 million men in the United States will suffer from an eating disorder throughout their lifetime.¹ If the words “eating disorder” produced a mental image of an emaciated, rich, white teenager, then you have missed the vast majority of those who suffer with an eating disorder. Less than six percent of people with eating disorders are medically diagnosed as “underweight.”² You cannot tell if someone has an eating disorder simply by looking at them. Eating disorders affect people of any race, gender, ethnicity, weight, body shape, sexual orientation and socioeconomic status.

Eating Disorder Risk Factors

There are many risk factors that can increase the likelihood of developing an eating disorder Some of them include:

• In fact, 40-60% of the risk of developing an eating disorder is due to genetic factors.³
• Comorbid mental health disorders. Mental health conditions such as anxiety, depression, and/or addiction can also run in families and can increase the risk of someone developing an eating disorder.
• History of dieting.
• Media influence. With Americans spending an average of 11 hours per day using some form of media⁴, it is no surprise that the thin ideal and 60-billion-dollar dieting industry⁵ greatly influences the way we feel about our own bodies. However, unlike a diet, an eating disorder is not a choice.

Complications of Eating Disorders

Eating disorders can be deadly, with the second highest mortality rate for any mental health condition.⁶ There are also consequential health conditions that may not be reversible or need close monitoring.

How Do I Know If I Have an Eating Disorder?

The short answer is that if your relationship with food, exercise, or body image are interfering with your day-to-day life, you should seek out a professional opinion. Most of your thought and energy should not be centered around food or the way you look. You should have the energy you need to do your everyday tasks. Your diet and exercise should not negatively impact your health. You should be able to enjoy food in social settings and be able to take a day off from your exercise routine without feeling guilt, shame or the need to make up for it.

Where Do I Go for Help?

Not all therapists, registered dietitians, or health care professionals are trained to diagnose or treat eating disorders. It is best to reach out to an individual or facility that specializes in eating disorders. Typically, an assessment is done to determine if an eating disorder is present, and if so, what level of care is most appropriate. Early intervention provides the best prognosis for recovery. If you’re not familiar with your local resources, I recommend contacting the National Eating Disorder Association who has call, text and chat options dedicated to helping individuals find care.

References

1. Wade, T. D., Keski-Rahkonen A., & Hudson J. (2011). Epidemiology of eating disorders. In M. Tsuang and M. Tohen (Eds.), Textbook in Psychiatric Epidemiology (3rd ed.) (pp. 343-360). New York: Wiley.
2. Arcelus, Jon et al. “Mortality rates in patients with anorexia nervosa and other eating disorders. A meta-analysis of 36 studies.” Archives of general psychiatry 68,7 (2011): 724-31. https://doi.org/10.1001/archgenpsychiatry.2011.74
3. Bulik CM, Blake L, Austin J. Genetics of Eating Disorders: What the Clinician Needs to Know. Psychiatr Clin North Am. 2019 Mar;42(1):59-73. doi: 10.1016/j.psc.2018.10.007. PMID: 30704640.
4. Perloff, R. M. 2014.  Social Media Effects on Young Women’s Body Image Concerns: Theoretical Perspectives and an Agenda for Research. Sex Roles,  DOI 10.1007/s11199-014-0384-6.
5. Hobbs, R., Broder, S., Pope, H., & Rowe, J. (2006). “How adolescent girls interpret weight-loss advertising.” Health Education Research, 21(5) 719-730.
6. Chesney, E., Goodwin, G. M., & Fazel, S. (2014). Risks of all-cause and suicide mortality in mental disorders: a meta-review. World Psychiatry, 13(2), 153-160.