Myths About Eating Disorders: Sufferers are "Vain" and "Superficial"

This weekend my post about "pregorexia" and pregnancy weight gain guidelines ran on the homepage of Shine, prompting a steady stream of comments that reinforced how much confusion still swirls around the topic eating disorders. A few commenters dared to admit that their issues are serious enough that they don't want to get pregnant and face inevitable body changes. Responses to these confessions were filled with anger:

"Get off your high horse and start valuing what really matters in life--and it's not your looks!" wrote one commenter.

"Wow these shallow snotty little brats with no concept of reality or any sort of decency...They would rather pass up the miracle of motherhood than risk any damage to their young bodies(that I am sure have flaws but we wont mention those)last laughs on you! Your going to get OLD LOL have fun with that nutcases! Maybe you will miss out on being a mother you dont deserve to have a gentle spirit in your care anyway" another chimed in.

There was talk about self-centered skinny bitches, too.

Oy. Those who live with an intense fear of weight gain are not shallow nutcases. They are our friends, our family members, our colleagues. They did not choose to be trapped by thoughts that they will never be thin enough or good enough. And the reasons they have arrived at those skewed beliefs are complex, varied, and deeply rooted. They can't just "shake it off" or "come to their senses," but they can seek help and begin the process of getting healthier.

It is true that people who are obsessed with food and weight often say and do exasperating things (believe me, I've said and done my share in the past). As hard as it can be, we have to remember that their words and actions come from a place of illness. Judgment and harsh reprimands won't encourage anyone toward a place of health. Compassion and persistence will.

More:
National Eating Disorders Association: Information for Family and Friends

From "Pregorexia" to Pregnancy Weight Guidelines: Let's Talk About What Women REALLY Need

In a MomLogic story that has been burning up the blogs, mother Maggie Baumann discusses her bout with the media-invented term "pregorexia" (we've taken issue with all these "-exias" and "-mias" before). This is not to say that what Baumann experienced wasn't very real. She struggled throughout her pregnancy to gain weight and faced deep and damaging insecurities. She writes:

[F]or me, pregnancy was a nine-month battle in which I lived in a dissociated state from my body -- horrified by my expanding "self" that protested every ounce of weight I gained. I did not experience the freedom to eat for two; rather, I experienced the restriction of starving for two.

While this article stresses the dangers of not gaining enough weight during pregnancy, the newly released guidelines from the Institute of Medicine and the National Research Council (the first revision since 1990) recommend that very overweight and obese women gain less weight during pregnancy than what was previously advised.

Yes, it's unhealthy to gain too little weight during pregnancy and it's unhealthy to gain too much. But an obsessive focus on pounds is not the solution when you're trying to grow a baby, especially because so many women who struggle with unhealthy eating are already caught up in a dangerous relationship with the scale. Doctors should be helping their patients get to the root of what is causing them to overeat or undereat. Women should feel safe enough to communicate honestly with their healthcare providers about past and current body image issues or disordered eating. Sadly, this is rarely happening.

Of the pregnant women and mothers we surveyed for Does This Pregnancy Make Me Look Fat?, seventy-six percent of those who said they had suffered with poor body image, disordered eating or full-blown eating disorders admitted that they had not discussed these issues with their OB or midwife. If we really want to ensure the health of mothers and babies, we need to start addressing this very heavy silence.

"Pregorexia: Starving for Two" [Mom Logic]
"Pregorexia: What Happens When Moms Aren't Eating Enough?"
"Drunkorexia, Stressorexia, Orthorexia, Diabulimia: Is Healthy Eating Extinct?"
"Less Weight Gain for Pregnant Women" [New York Times]

Pregorexia: What Happens When Moms-to-Be Aren't Eating Enough?

We have written before about the insane amount of pressure pregnant women and new moms face in our "get your pre-baby body back" culture. We've also talked about the fact that we now need a new dictionary to define all the terms that are popping up to describe disordered eating behavior, a surefire sign that our collective attitudes about food and weight have gone off the deep end. Now we've officially arrived at the intersection of these two observations: Pregorexia.

"Pregorexia" is another media-coined term used to refer to mothers who are so terrified of gaining weight during their pregnancies that they diet and put their own health and the babies health at risk. Those health risks include anemia, low birth weight, heart palpitations, and rickets. Of course, women are warned not to gain too much weight either, because that comes with a whole other set of health risks. No pressure or anything. Just get it perfect, okay?

We're hearing a lot of accusations of women putting vanity before the health of their babies. We'd like to slow down the judgment train for a second. It's a pretty widely accepted fact that many women have serious body image issues, weight concerns (and yes, eating disorders) before they get pregnant, right? So why are we all so quick to assume that those issues will magically melt away as soon as women decide to become moms? What resources are available to help us cope with the body changes and body pressures that come with pregnancy and motherhood? The fact is that we're surrounded by "Celebrity Moms' Diet Tricks!" magazine covers (sometimes in the OB/GYN's office, thanks very much), but the voices of reason are few and far between.

Our recommendations? Women need doctors who are sensitive to and knowledgeable about body image issues, and we need to talk honestly with each other about how we're coping with these pressures instead of quizzing each other on how much weight we've gained or lost during and after pregnancy. What do you think? [Daily Mail] via [Shine]

Drunkorexia, Stressorexia, Orthorexia, Diabulima. Is Healthy Eating Extinct?

Does it seem like every week there's a "new" eating disorder making headlines? Let's see, we've got diabulimia for diabetics, drunkorexia for college girls, stressorexia for working moms and orthorexia for eccentric celebrities. Meanwhile, more eating disorders are affecting younger children and record numbers of middle-aged women are being treated for anorexia. The media can slice and dice disordered eating behaviors to come up with endless sensational stories and clever buzzwords. But let's just step back for a minute and call this situation what it is: one steaming hot mess of food and weight issues.

Eating habits and body image are reflections of our emotional health. And all of these disorders, whether official diagnoses or not, point to the pretty obvious fact that our culture is not in the best place. But you know what? We're bumming ourselves out with all this bad news, so next week we're going to focus our energies on spreading some good cheer. Got some positive news or projects to share? Send them our way. Look for sunshine and rainbows starting Monday.

"Stressorexia" Affects Working Moms

"Stressorexia" is the latest media-invented term to describe disordered eating behavior (remember drunkorexia and diabulimia?). Experts say that stressorexics are mostly working moms who might skip lunch one day to meet a deadline, but self-starvation quickly becomes a way of coping with the stress of juggling work and home life. And of course once the pounds drop off, the MILF talk starts--whether it's compliments about losing baby weight or praise for juggling so much and managing to look so good.

"They are trying to be sexy, fashionable and slim, have a career and be perfect mothers and wives, says Dr. Adrian Lord, a psychiatrist. "Some neglect to eat because they are too busy and others are just totally stressed-out, which suppresses the appetite. Fifty years ago, women just had to be a good mother. Now they have to do everything and they can't abdicate."

Unfortunately, Dr. Lord goes on to blame this pressure on the "blurred roles of men and women," which seems to suggest that if we all went back to being June Cleavers and let the men bring home the bacon, there would be no mommies with eating disorders. Um, ever heard of The Feminine Mystique? That scenario didn't really result in optimum mental health for a lot of women. There's nothing wrong with staying home with your kids if you can afford it, but being a SAHM certainly doesn't protect you from being over-stressed and developing an eating disorder. The truth is that all moms would benefit from a definition of success and beauty that is more in balance with reality, not Us Weekly. [Daily Mail]

Drunkorexia: Starving and Boozing

First there was diabulimia. Now there is drunkorexia--another new and buzzworthy term for some not-so-new behavior. According to this report on The Morning Show (featuring our friend Sondra Kronberg, an eating disorders specialist from the National Eating Disorders Association of Long Island), 30% of women ages 18-23 restrict food calories so they can drink more and not gain weight from their alcohol consumption.

All of the women interviewed for the piece (as well as the studio audience) fell into the "Well, duh. Of course I've done that before!" category, which makes us think that "drunkorexia" isn't always just a college phase that girls grow out of. Millions of women are willing to subject themselves to dangerous fad diets, plastic surgery, and speed-laced weight loss pills; we can't say we were surprised to learn that the health consequences of letting large amounts of alcohol absorb directly into the bloodstream seem to be of little concern when compared to the calorie-saving "benefits." As one aspiring model and self-identified drunkorexic put it, "You want to stay skinny but you want to go out and look good and have fun." And what about the known health risks? "You just try to block it out," she says. Actually, black out is probably more accurate.

Eating Disorder + Diabetes = Diabulimia

Remember when everyone was talking about how Halle Berry claimed to have cured herself of Type 1 diabetes? Then doctors chimed in to say she must be mistaken because it could be life-threatening for a Type 1 diabetic to stop taking insulin. Well, there are thousands of girls and young women with diabetes who are willing to take that risk. The reason? Weight loss.

Salon reports on an eating disorder called diabulimia. Sufferers are Type 1 diabetics who willingly skip their insulin shots because of the effects it has on their weight. If they take insulin, they plump up and have to carefully regulate everything they eat. If they skip the insulin, they can binge all they want and watch the pounds melt off. But this miracle diet also results in hair loss, extreme fatigue, confusion, and tingling extremities. And that's just in the short term. In the long term, sufferers will likely go blind, lose a limb or suffer a heart attack. Size 2 today and dialysis down the road? Because a high percentage of diabulimics are teenagers, the future dangers may be harder to grasp than the present benefits.

Diabulimia is not a new disorder. I worked at an eating disorders organization ten years ago and we got several calls a week about diabetes and eating disorders. The connection between diabetes and eating disorders makes sense when you consider how carefully diabetics must structure their lives around food and weight management. What is relatively new, say doctors, is the ease with which diabulimics can find each other online and trade tips and tricks. Yep, there are pro-diabulimics online, too.

In a recent study conducted by the Eating Disorders Institute, of 87 patients diagnosed with diabetes in childhood, 36 percent admitted to misusing insulin in order to control their weight -- but only when they were asked a decade later. Patients with diabulimia have a mortality rate of 34.8 percent per year. It is the die in diabulimia that is the harshest wake up call. [Salon]

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?