The Truth About Eating Disorders: Common Myths Debunked

The Truth About Eating Disorders: Common Myths Debunked

by Julie Holland, MHS, CEDS

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Because most eating disorders (approximately 95 percent) surface between the ages of 12 and 25, parents are often a first line of defense against the development of these illnesses in their children.* Despite increased prevalence of eating disorders in the United States, widespread misconceptions about eating disorders remain that challenge identification, diagnosis and early intervention. To truly protect and advocate for their children, it is important that parents understand the truth behind common eating disorder myths.

Myth: Eating disorders aren’t serious illnesses.

Truth: Anorexia nervosa, bulimia nervosa, binge eating disorder and eating disorder not otherwise specified (EDNOS) are very real and very serious mental illnesses. Each disorder has clear diagnostic criteria in the Diagnostic and Statistical Manual, the go-to diagnostic reference for mental healthcare professionals. Another reason to take eating disorders seriously is that they can be deadly. Anorexia nervosa has the highest mortality rate of any psychiatric disorder. In fact, women ages 15 to 24 years of age who suffer from anorexia nervosa are 12 times more likely to die from the illness than any other cause of death.**

Myth: Eating disorders are just about food.

Truth: While eating disorders generally involve obsession with calories, weight or shape, these illnesses are rooted in biological, psychological and sociocultural aspects. Restriction, bingeing, purging or over-exercise behaviors usually signify an attempt to control something of substance in the individual’s life. Because friends and family mistakenly believe that eating disorders are just about food, they will often encourage their loved ones to “just eat more,” “just eat less,” or “just eat healthier” to be “cured” of this illness. In reality, eating disorders often require some combination of medical, psychiatric, therapeutic and dietary intervention to achieve full recovery.

Myth: Eating disorders are a women’s illness.

Truth: While research shows that eating disorders affect significantly more women than men, these illnesses occur in men and boys as well. While males used to represent about 10 percent of individuals with eating disorders, a recent Harvard study found that closer to 25 percent of individuals presenting for eating disorder treatment are male. The widespread belief that eating disorders only affect women and girls can prevent accurate diagnosis of an eating disorder in a man or boy, even among healthcare experts.

Myth: Eating disorders don’t develop until the teenage years.

Truth: Consider this—research found that up to 60 percent of girls between the ages of 6 and 12 are concerned about their weight or about becoming too fat, and that this concern endures through life.*** Not surprisingly, the incidence of eating disorders in children is on the rise. Between 1999 and 2006, hospitalizations for eating disorders in children 12 and younger rose 119 percent, according to a 2010 study by the American Academy of Pediatrics.

Myth: Only very thin people have an eating disorder.

Truth: While anorexia is characterized by extreme low weight, many individuals struggling with bulimia, binge eating disorder and EDNOS are normal-weighted. The misconception that an eating disorder can only occur if someone is very thin contributes to misdiagnosis or delayed diagnosis in many cases, even among those patients seeking support from medical and mental healthcare professionals. Unfortunately, many healthcare experts lack eating disorder exposure and training, which highlights the important role of eating disorder specialists to ensure effective diagnosis and early intervention.

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In addition to educating themselves about basic eating disorder information and understanding myth from fact, parents should also trust their instincts when it comes to eating disorders in their children. Eating disorders can thrive in secrecy, but parents often intuitively know if something is wrong with their children. While parents may feel terrified of saying the wrong thing, but also not want to stay silent, they are an important champion for diagnosis and effective treatment. If concern arises, consult with an eating disorder specialist sooner rather than later—early intervention is critical to lasting eating disorder recovery.

 

*Substance Abuse and Mental Health Services Administration (SAMHSA), The Center for Mental Health Services (CMHS), offices of the U.S. Department of Health and Human Services.

**American Journal of Psychiatry, Vol. 152 (7), July 1995, p. 1073-1074, Sullivan, Patrick F.

***T.F. Cash & L. Smolak (Eds.), Body Image: A Handbook of Science, Practice, and Prevention. New York: Guilford Press. 2011.

It Takes a Village – And Then Some!

It Takes a Village – And Then Some!

by Erica Leon, MS, RDN, CDN

While not easy, I somehow launched my children into college and beyond. With fellow empty-nester friends who are also health professionals and moms—one a nurse, one a psychologist—I took a walk down memory lane. We reflected on teaching children good self-care, particularly when they have health concerns related to food.

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Peanut Allergy:

Carpooling was challenging enough, but when I thought three-year-old Thomas had shared my son’s peanut rice cakes, I panicked! Thomas was severely allergic to peanuts as well as tree nuts. Still parked at the nursery school, I hoisted Thomas like a football, screamed for the teachers, and rinsed his mouth, hoping I did not have to administer his EpiPen. He never ate any of the rice cakes, but I learned a valuable lesson on scrutinizing food items when you have or care for a child with allergies!

According to Hildie Kalish, RN, an elementary school nurse whose child has a severe nut allergy, “Keep your child safe by constantly checking and then rechecking ingredients in food products. Never assume an item is safe as it is not uncommon for food manufacturers to change ingredients or processing techniques. As soon as children are old enough to understand, teach them to read labels and avoid sharing food with other kids. When they are responsible enough, have them carry Benadryl and their own Epi-pen or Auvi-Q, and make sure they know how to use them.”

Dehydration:

My nutritional skills were put to the test when I rescued ten-year-old Luke, my son’s friend, who was dizzy from playing baseball in the summer heat. Driving up with hydrating sports beverages and a mom’s wisdom, I remembered that Luke had an endocrine condition that made dehydration particularly dangerous. When a child exercises, their muscles generate heat, which in turn raises body temperature. The body cools itself through sweating, which must be replaced by fluid or the body will overheat.

Dehydration is more common in children, and young athletes are particularly prone to dehydration. Encourage your young athlete to drink fluids before, during, and after sports to prevent heat-related illnesses. Recommend fluid-rich foods such as fruits and vegetables and have your youngster carry a water bottle and drink a sports beverage when his/her physical activity level exceeds one hour.

Celiac:

I became a celiac expert when Rachel, a good friend of my daughter’s, was diagnosed. From that day forward, I stocked my cabinets with gluten-free items and helped her mom educate other parents about which foods to keep on hand for play dates.

 Merle Keitel, Ph.D, counseling psychologist and parent of a child with celiac, says,

“It is important to establish a support system that is aware of your child’s dietary restrictions and has food on hand that your child can eat if at their homes for an extended period of time.  In the case of celiac, fruits and vegetables work but if other children are having sweets, it is helpful for there to be chocolate or other gluten-free sweets so the child does not feel cheated and self conscious about being ‘different.’ Friends and extended family who are educated and willing to help can be a gift to the child with special dietary needs.”

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These real-life scenarios portray what can happen when a child has a chronic health condition. Says Kalish, “At school I work with families of kids newly diagnosed with Type 1 diabetes. I always say that education is key. I see parents overcompensating with extra treats for fear that their child will feel deprived. Diabetic children do not need extra treats. It is important to treat them like any other child and learn the merits of a healthy balanced diet with plenty of ‘everyday’ foods and occasional ‘sometimes’ foods.”

While we can try to protect our children from all types of threats, educating your child, caregivers, schools, and trusted friends about a chronic health condition is essential. Allow your child to take the reigns and manage his/her own health as soon as he/she are emotionally and intellectually ready. We want our kids to remember the lessons that we teach them at home, as they will eventually leave the nest.

Color Me Red

Color Me Red

by Christie Caggiani, RDN, LDN, CEDRD 

 

As we enter February, we’re seeing Red around every corner.  Valentine’s Day and American Heart Month highlight the color, and give us a burst as the sometimes-drab days of winter continue to swirl around us.   Not only can our moods become a little blah this time of year, our food choices may become more monotonous as well.  By creating a theme, however, we can add a fun, proactive twist to eating, and bring more variety to our plates. What a great way to jazz up your kids lunchboxes, snacks or meals at home by picking a color theme– and what better color this month than RED!

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Our role as parent or provider is not to make sure our kids love everything they eat, but rather to present them with opportunities to explore food, develop their preferences, expand their comfort level around a variety of choices, and therefore become confident, competent eaters.  A color theme is one way that children can participate in the process, as they identify colors in the grocery store, find them in your fridge, and add them to their plate palate.  It also provides an opportunity for them to learn about the function of many foods.   For example, as you will notice below, many red fruits and veggies help promote heart health, so children can begin to connect the ways that foods work for them and support their bodies and brains.   If you are introducing a new food, make it fun and don’t be discouraged if they don’t enjoy it the first time around (or the first many times!). 

So roll out the red carpet and enjoy acquainting your family with some of these bright beauties: 

Acai: This berry from Central and South America is shown to have excellent antioxidant value, which may assist in heart health, decreased inflammation and decreased risk of some cancers.  Mix frozen acai in your blender with a splash of milk and banana, then top with granola, fresh fruit and shredded coconut for a colorful and satiating breakfast or snack. 

Cherries:  These succulent rubies give us great fiber, immune-helping vitamin C, and heart-happy potassium.  Slice up fresh or frozen cherries for a fun ice cream topping or substitute berries in your favorite recipe with equal parts (pitted) cherries. 

Cranberries:  Not only are they super for our urinary tract system, they may also help keep our digestive system protected from unhealthy bacteria and ulcers.   Pour a glass of cranberry juice, add some canned cranberries into a smoothie or mix some dried cranberries into your kids’ trail mix.

Raspberries:  Rich in vitamins C and K, and many antioxidants such as alpha and beta-carotene, lutein, zeaxanthin, and choline,  these berries can help protect our heart and prevent certain types of cancers.  Fold some fresh berries into your favorite muffin or pancake mix, or keep frozen raspberries on hand to toss into a smoothie or oatmeal

Strawberries:  They are a good source of heart-helping folate, which decreases the risk of certain birth defects, and are a powerhouse of the antioxidant vitamin C, giving a boost to our immune system.   Sprinkle some strawberries on cereal or blend up some frozen strawberries in a milk and yogurt smoothie.  Or dip into some melted chocolate for a super satisfying snack!

 

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Watermelon:  Despite popular belief that watermelon is made up of only water and sugar, it is actually considered a nutrient dense food, one that provides a high amount of vitamins, particularly A and C, mineralssuch as magnesium, potassium and zinc, and antioxidants, including high levels of lycopene.  Because it does contain 92% water, it’s also a wonderful way to help keep your kids hydrated.  Insert a popsicle stick into watermelon chunks for a fun snack, or freeze some watermelon balls to add to your kids’ water bottles. 

Beets:  With an earthy flavor that gets supersweet when cooked, beets are very nutrient-loaded, giving us 19 percent of the daily value for folate, necessary for the growth of healthy new cells.  Their rich color comes from the phytochemical betanin, which helps bolster immunity. Roast them, pickle them or shred them raw and dress them with citrus for a refreshing salad. 

Red peppers:  For the love of your eyes and your skin, include these vitamin A-packed foods.  Add a little crunch to your child’s favorite deli sandwich or have them taste test with peanut butter or hummus. 

Tomatoes:  These red beauties are heart protective and provide a great defense against prostate and potentially breast cancers.  Include a little more marinara sauce on your pasta or add some grape tomatoes into the lunchbox.  

This Mom's Early Path to Nutrition

Many of my clients often wonder what attracted me to the field of nutrition. In truth, there’s no single response, and the reason can be traced back to a progression of events throughout my life that affected the way I view health and wellness today. Here is my honest answer.

My journey began with the family in which I was raised. I come from an Italian and German household. I have one sister. My mother, who is 100% German, was fantastic about providing balanced, home-cooked meals. She made us oatmeal and pancakes, packed our lunches, and prepared dinner menus that included stuffed peppers, roasted chicken, veggies and grains. Our lunches typically had 2 cookies as a side (I distinctly remember envying my friends with bags and bags of snacks.), and we ate dessert nightly.

I remember observing my father’s eating habits along with those of my extended family, including aunts, uncles and cousins. My family is not on the lighter side; rather, many relatives weigh on the upside of 300. Holidays and celebrations were centered on food. If we had 30 people, then we had 30 pounds of mashed potatoes. Portions were without limits. However, my sister and I ate intuitively. I never thought about portions or my health until 8th grade, when I was diagnosed with high cholesterol.

The doctors told me that I had “inherited” high cholesterol, but before they would consider medication, I was instructed to change my diet. Physically, I was still very petite, and though I ran track and stayed in shape, I also consumed a ton of high-fat dairy products like cheese and drank whole milk like it was going out of style.

The doctor’s prognosis made me much more aware of my diet, and so my mother and I began to educate ourselves. I eventually learned to lower my consumption of high saturated fat foods, eating less cheese and switching to skim milk. I ate plain pasta. Within a month, my cholesterol dropped from 236 to 180. Wow! If observing my family’s eating habits signified the first time I’d recognize differences in dietary behaviors, then this was the first time I realized the power of those behaviors and what we put into our bodies.

When I hit middle school and high school, specifically between 7th and 10th grade, my habits changed significantly, mainly because I started eating outside of my home on a regular basis. I ate a lot more pizza, Chinese take–out, and tons of muffins while working at DePiero’s Farm, which had a bakery I absolutely loved.

I specifically remember people telling me I would gain weight if I kept eating those foods—especially the muffins. Well, they were right. The next time I’d have a revelation of this magnitude was when I couldn’t fit into my clothes—the result of eating endless baked goods daily for lunch while working one summer. Puberty and growth may have been partially to blame too, but the weight gain was largely caused by an increase in calories.

Another piece to the puzzle was when I quickly lost weight as a freshman in high school—the result of playing sports all 3 seasons. The weight loss was unintentional, and when my friends and family noticed, they brought it to my attention. In an effort to re-gain the weight, I began to eat even when I wasn’t hungry. This helped me put the weight back on, but this routine of eating for no reason and at any time stuck around.

Sophomore year was challenging for me. I could no longer run due to an injury and I was eating for behavioral reasons, as mentioned above. Fortunately, I began to learn about health and nutrition in biology class. I became fascinated, and before long, I was hooked.

It was also around that time that my uncle Gene was diagnosed with diabetes and started seeing a registered dietitian. Kindly, he was open to me joining his sessions.

Inspired by what I was learning, I knew I waned to become an RD and began apprenticing for my uncle’s nutritionist, Nancy. Just like that, my career path was set.

So like I said, my decision to become an RD can’t be pinpointed to any single moment in time. In the same way many others discover their passions in life, my desire to learn about nutrition and to teach others about its importance is the result of a confluence of experiences—from my childhood on. It was through all of these lessons that I personally found empowerment, balance and my ideal health. Today, as an RD and a mother, I can only hope to pass on my knowledge and enthusiasm for the field to others.