Putting order back in disordered eating
An estimated 80 percent of women are dissatisfied with aspects of their physical appearance. If we dig deeper, we find that a great proportion of those women partake in some form of disordered eating.— Sari Fine Shepphird, clinical psychologist
Days before your birthday, you open your front door to an explosion of confetti, singsong wishes and a table overloaded with decadent food. As you smile and utter “you shouldn’t haves,” your insides tremble with fear. Or perhaps anxiety sets in midmeal as you plot the intense workout that you hope will “undo” the calories you're ingesting. Even if you don't relate to this scenario, someone you know probably does. Anxiety, shame and an inability to reap pleasure from food are symptoms of disordered eating -- a common condition that zaps joy from life, poses physical risks and often goes untreated.
What is disordered eating?
The term "disordered eating" is used to describe a range of negative food-related thoughts and behaviors that do not meet the diagnostic criteria for a full-fledged eating disorder such as anorexia, bulimia or binge-eating disorder.
Disordered-eating traits are so common that people often deem them normal, according to licensed clinical psychologist and eating disorder specialist Sari Fine Shepphird. Characteristics include repetitive dieting, a fixation on calories, food and/or weight loss, and the belief that you won't find happiness, love, success or (fill in the blank) until you lose weight. You may have only one or two symptoms, or you may have symptoms that come and go. More serious symptoms include severe depression, laxative or diet-pill abuse, excessive exercise, and severe or long-term calorie or carbohydrate restriction.
While roughly 4.4 percent of us are diagnosed with eating disorders each year, according to the National Institute of Mental Health, far more exhibit disordered-eating thoughts and behaviors.
"An estimated 80 percent of women are dissatisfied with aspects of their physical appearance," Shepphird explained. "If we dig deeper, we find that a great proportion of those women partake in some form of disordered eating."
With male cosmetic surgery and male-specific weight-loss diets on the rise, men, too, are affected.
What are the risks?
Full-blown eating disorders carry some of the highest mortality rates of psychological disorders. And disordered eating, in severe cases, is a gateway to these diseases.
"Studies show that 35 percent of normal diets, or people who go on occasional diets, gradually progress to pathological dieting," Shepphird said. "Of those, 20 to 25 percent later progress to some form of any eating disorder."
Disordered eating is associated with emotional problems, including anxiety, poor body image and damaged interpersonal relationships, and physical problems, such as heart arrhythmia, fatigue and digestive difficulties. If the condition is left untreated, symptoms may worsen, increasing the risk for hormonal imbalances, infertility, nutrient deficiencies, osteoporosis and heart attacks. Severe eating disorders can result in death.
"But won't I get fat?"
The very fear that triggers disordered eating keeps many sufferers from seeking treatment -- the fear of "getting fat."
The goal of treatment is to achieve nutritional, physical and emotional well-being -- not fatness. "If you're underweight and you've been restricting," Shepphird explained, "treatment would include restoring a healthy weight and addressing any kind of distortion" in how you perceive your body.
This notion can be daunting. In addition to fearing weight gain, you may fear loss of control of your eating habits. Julie Duffy Dillon, a registered dietitian who specialises in eating disorders, says that when a client voices these concerns, she tells the client that "one can continue to be malnourished ... while living a life of depression, anxiety, little to no relationships, poor career outcomes ... or recognize that is the eating disorder talking and choose to do the right thing."
This philosophy applies to disordered-eating thought patterns as well as full-blown eating disorders. With the proper approach, your self-perception as well as your behaviors and attitudes about food can gradually change -- not toward excessive weight gain, but toward vibrancy and self-empowerment.
Can you make the necessary changes on your own? Quite possibly.
Many self-help books on disordered eating are available. You may also find a support group or activity-based therapy, such as art or music therapy, helpful. In some cases, merely gaining an understanding of your eating habits and their risks is enough to bring about positive changes.
The National Eating Disorders Association recommends listening to your body -- learning to detect when you're hungry and when you've had enough. Using physical cues can improve your connectedness to your physical needs and draw attention away from emotional reasons to eat or to avoid eating.
Focus on healthful foods that make you feel good, rather than on restriction, and allow for occasional indulgences. Psychologists and body-image specialists Michael Levine and Linda Smolak recommend asking yourself twice daily whether you're benefiting from your focus on what you believe to be "flaws" in your body. They also advise spending less time analysing your appearance in mirrors, and they recommend exercising for pleasure and strength rather than self-punishment or calorie compensation.
If your symptoms significantly affect your life, seek professional guidance. Shepphird recommends starting with a mental health care provider or your primary physician. A registered dietitian with expertise in disordered eating can help you establish a plan that will gradually normalise your eating habits, nutrient intake, physical activity and attitudes about food.
Regardless of which path toward healing you find most appealing, pursue it. It may be the best birthday, or any day, gift you give yourself.
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