Thursday, September 20, 2007

The Spectrum of Disordered Eating

Iowa researcher Pamela Kessl is exploring a "new" eating disorder called purging disorder. Purging has long been associated with bulimia, but for the women in Kessl's study there is no bingeing--just purging after regular-sized meals or even a small snacks.

Patients with purging disorder face many of the same health risks of those suffering from bulimia. The illness is also linked to psychological problems and poor body image. Unfortunately, because purging disorder has not yet been quantified and codified (i.e. it falls outside of the criteria outlined in the Diagnostic Statistical Manual for Mental Disorders), it is difficult for doctors to screen and treat suffering patients. And forget about getting health insurance to cover treatment if your eating disorder happens to fall into a gray area. It's hard enough to get insurance companies to pay up when an eating disorder diagnosis is spelled out in black and white.

The bottom line is that we live in a culture of disordered eating. Pictures of emaciated actresses on the red carpet are quickly tagged with "Have these Stars Gone Too Far?" headlines. But the truth is that millions of us have gone too far, even if we don't have a doctor's diagnosis or a skeletal frame to prove it. Disordered eating comes in all shapes, sizes, and behaviors. Unhealthy obsessions and self-destructive rituals go unnoticed and untreated every day (or worse yet, they are validated and praised).

The epidemic of disordered eating or "eating disorders not otherwise specified" is being passed along to future generations of women, too:

A 2007 study of 70,000 schoolchildren in the U.K. shows that forty per cent of 14 and 15-year-old girls had either nothing or just a drink for breakfast. Many also went without lunch. Half of 12-15-year-old girls named their physical appearance as their biggest worry in life.

On a 2006 episode of Oprah, Oprah interviewed the mothers of a three-year-old who was obsessed with her looks and a 4-year-old who was terrified of gaining weight. It became quickly and painfully obvious that these women were battling their own body image demons.

This new research about purging disorder has sparked some important conversations and debate, but it also draws attention to a larger issue. How do we effectively diagnose and treat disordered eating when our culture's disordered attitudes about food and weight have become the norm?

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