Am I Sick Enough for help?
In honor of National Eating Disorders Awareness week and its inspiring message, "come as you are," I want to address some of the barriers to care I've noticed as an eating disorders treatment professional.
1. Eating Disorders don't have a type
If you picture in your mind's eye a thin, white, privileged female as the face of all eating disorders -- you're like the majority of us. However, what I've found in my years of work as a dietitian is that eating disorders do not care what gender, sex, or culture you identify with, or what age, race, or size you are. Feeling that you don't fit the stereotype for disordered eating/eating disorders can delay access to much needed support. If you're struggling in your relationship with food and your body, you're a good candidate for treatment. The first step I recommend you take requires making a call. Through NEDA's Helpline, you can find support, resources, and treatment options. This is a great place to start.
2. Eating Disorders don't have a size
Okay, so I know I mentioned this already. But I feel this point deserves repeating. You do not have to be wasting away in order to be in need of, or deserving of support. My ED clients come in small, medium, large -- truly all sizes. Their size often does not indicate the severity of their eating disorder. Yes, you can be living in a larger-sized body and have a full-blown, raging eating disorder. If your relationship with food or your body is causing anxiety, consuming your thoughts, or calling the shots in your life -- please know that you are deserving of help, and now is the perfect time to reach out.
3. The Diagnostic criteria for Eating Disorders doesn't always capture a person's struggle
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is in its fifth iteration at present, and still hasn't totally arrived. Major changes were made between the 4th and 5th editions, including a reduction in the number of binge episodes and compensatory behaviors 'required' to fit the criteria for Bulimia Nervosa, plus the official recognition of Binge Eating Disorder as a psychiatric disorder. Most of us who work with disordered eating and eating disorders can tell you that the client's lived experience is what truly matters. Not, for instance, whether they've binged/purged 1-3 times in the past week, or 1-3 times in the past month.
4. What signs/symptoms should I be looking for?
NEDA has a helpful screening tool. Some questions that hopefully prompt thought and exploration can be found below:
Do you have weight-related concerns? This may take the form of feeling dissatisfied with your body, fearing weight gain, or having a compelling/persistent need to be in pursuit of weight loss
Do you have a history of dieting? Has it changed the way you view or consume food?
Do you find yourself restricting foods, food groups (ie carbohydrates or fats), or calories?
Do you feel as though you've lost control around food at times, or that you're overeating to a place of uncomfortable fullness?
Have you been using laxatives, weight-loss aids, or excessive exercise in attempts to control your weight?
Do you avoid certain foods/food groups in the absence of any clear medical necessity?
Do you have strong aversions to textures, tastes, etc. that impacts your ability to enjoy a variety of foods and nutrients?
Adrienne Inger-Goss RDN, LDN is a dietitian practicing in the DC-Metro Area and is available for virtual nutrition counseling through her website.