Battling a mental health condition of any form can be an isolating challenge. However, with some illnesses in particular there is more stigma and myth surrounding the illness than kindness and compassion. I was firmly reminded of this whilst on the night bus home the other week.
My friend and I met through our mental health difficulties. Our paths crossed in support groups and forums alike. Over time, we managed to build a healthy friendship from the foundations of having ill mental health: in particular an experience of bulimia in common.
It feels like a very positive friendship for me as we have both recovered from our eating disorders. Within our relationship though, there is a friendship within which it is perfectly fine and comfortable to talk about one of the most taboo aspects of our lives: my mental health.
However, I realised when we were talking on the bus how rife mental health stigma is. During our conversation the two men behind us found something hilarious in us talking about our mental health, whilst another two women took it upon themselves to shout negative remarks and something along the lines of, “the fucking anorexic at the back of the bus”. As if having had eating disorders touch our lives in one form or another was something to be ashamed of, and derogatory. I can firmly say: it is not.
So here is a continuation from my previous post about eating disorder myths, for the second third of my ‘Myths Debunked’ series:
11. Only teenagers get eating disorders
It is commonly believed that an eating disorder is mainly an illness of the adolescents and early adulthood years. Although it is the third most common chronic illness amongst teenagers, they are not the only ones that can be affected my eating disorders.
Many men and women in their 50s are suffering from eating disorders, however we don’t seem to recognise them as easily. “You have a neighbor in her 50s who’s slim and running all the time, and you don’t know she’s purging and exercising four to five hours a day. She falls over dead, and it gets charted as sudden cardiac death when the real problem was an eating disorder,” says Kathryn Zerbe, professor of psychiatry at Oregon Health & Science University. Kathryn Zerbe (2012)
There are many factors that can lead to post mid-life eating disorders developing such as grief, divorce, an awareness of ageing, or physical illnesses could trigger someone into unhealthy eating behaviours and patterns such as fasting, bingeing and purging.
There is also a pressure to age gracefully if one cannot quite manage to be forever youthful. The media and societal messages of being a perfect beauty in perfect shape to not only target the younger generations, but as studies suggest, older generations of people are affected also. “In a 2010 study at the Oregon Health & Science University, women ages 65 to 80 were just as likely as young adult women to feel fat or concerned about their body shape.” Harvard Women’s Health Watch (2012)
12. Boys and Men don’t get eating disorders
There is a stigma around men getting eating disorders, even within treatment communities. However, many studies have illustrated that an estimated 10% of sufferers are male. “The National Institute of Health and Clinical Excellence (NICE) guidelines on eating disorders showed that 1.6million people in the UK were affected by eating disorders in 2004 and 180,000 (11 per cent) of them were men.” Mengetedstoo.co.uk (2014)
There is now more understanding within health organisations and healthcare reducing the stigma around males getting eating disorders. Some celebrity figures have disclosed about their weight difficulties: Dr. Christian Jessen and Gok Wan, for example. You are equally worthy of care and treatment. Here are some helpful links:
13. It is an illness reserved for the white people of a higher socioeconomic status.
Just as mental illnesses don’t discriminate, nor do eating disorders. Either gender of any race are vulnerable to developing an eating disorder. Providing the environmental, emotional and mental circumstances permit, people of any race can experience an eating disorder. That is not to say that cultural differences don’t play a role, but a black woman, Asian woman, white man, Hispanic teen may all well develop an eating disorder. We all have mental health.
“While more research is needed in this area, we do know that the prevalence of eating disorders is similar among Non-Hispanic Whites, Hispanics, African-Americans, and Asians in the United States.” National Eating Disorders (2014)
14. An eating disorder is a cry for attention and is just a phase that will pass.
Many of those who develop an eating disorder do so by their teens or early twenties. However, an eating disorder is never just a “cry for help”, it is a serious illness. Eating disorders are the most fatal of all mental illnesses and cannot be palmed off as a phase.
“Anorexia has the highest mortality rate of any psychiatric disorder, from medical complications associated with the illness as well as suicide.”[reference citation from: http://www.b-eat.co.uk/about-beat/media-centre/facts-and-figures/] However, “Reviews of the research into recovery suggest that around 46% of anorexia nervosa patients fully recover, with a third improving, and 20% remaining chronically ill (Steinhausen, 2002). Similar research into bulimia suggests that around 45% of sufferers make a full recovery, 27% improve considerably, and 23% suffer chronically (Steinhausen & Weber, 2009).” B-eat (n.d.)
It is never a good idea to “see how severe it will get”. Prognosis for full recovery is highest if an eating disorder is treated earlier into development. As if stopping it in its tracks so’s to speak.
“The longer an eating disorder remains undiagnosed and untreated, the harder it is on the body and the more difficult to overcome, so urge your loved one to see a doctor right away.” Smith (2014)
The truth is that eating disorders often fester in secrecy; “People with eating disorders are not seeking attention. In fact, due to the nature of an eating disorder a person may go to great lengths to hide, disguise or deny their behaviour, or may not recognise that there is anything wrong.” National Eating Disorder Collaboration (2014)
15. Eating disorders are entirely about vanity and wanting to be pretty.
Yes, poor body image plays a role in eating disorders, but this is not to be taken at face value. Alongside poor body image lies a dwindling self-esteem at a deeper level in regards to many aspects of the self: self-doubt and a lagging confidence that leave many sufferers questioning many aspects of their selves, and enduring a very harsh self-critic. “Eating disorder patients are often very critical about themselves. This self-criticism already starts in the period before they start to diet, but increases when they have developed an eating disorder. Noordenbos (2013)
16. It is not possible to recover from an eating disorder.
Recovery is most definitely possible. It is a hard, long, winding road. From personal experience I have met many people who have managed to overcome, contain or recover fully from their eating disorders. I, myself am an example of how recovery is possible. As with male sufferers coming forward to talk about their experiences with eating disorders, there have also been many more celebrities who have spoken out: K$sha, Demi Lovato, Mel B, Gok Wan, Dr Christian Jessen, Portia de Rossi.
It isn’t easy, but it is possible. Keep fighting. You can win.
17. Anorexia is the only eating disorder that can be life threatening, so others aren’t so serious.
Although Anorexia is the eating disorder most commonly related to fatality, that is not to disregard the effects of eating disorders such as Bulimia and Binge Eating Disorder. Each, in their own right, can incur an individual set of long-term medically complications, some of which can be life threatening. In those who purge for example, electrolyte imbalances can prove fatal. “In the case of bulimia nervosa, electrolyte disturbances are the main origin of sudden death by means of purging behaviours.” Jàuregui-Garrido and Jàuregui-Garrido (2012)
“Bulimia is also associated with severe medical complications, and binge eating disorder sufferers often experience the medical complications associated with obesity.” B-eat (n.d.)
18. Purging is an effective weight loss method.
There have been a number of studies concluding that purging is an ineffective method of removing calories from the body. Initially, there is likely to be some weight loss. However, once the binge purge cycle gains momentum alongside the body’s survival mechanisms in times of perceived famine then many people with bulimia gain weight – often times getting to their highest weights whilst in the woes of bulimia.
From personal experience I can conclude that this is true. At the time of my highest weight I was very bulimic. Only once I was into recovery from my bulimia did I lose that extra weight, and finally returning my natural weight.
19. Eating disorders are a result of heavy Photoshop use in the fashion and media industries.
Although these pressures do nothing to help with developing a culturally healthy perspective upon health, weight, shape and size: imagery does not cause an eating disorder. Eating disorders are a complex psychological illness.
The underlying factors that contribute to the development of an eating disorder are low self-esteem, a lack of control in one’s life, a perfectionistic personality, and an inability to cope with life’s current circumstances. After all, an eating disorder is a coping mechanism. There are many, many more factors that affect the development of an eating disorder, and although media imagery is not necessarily helpful and can add fuel to the fire, they do not directly cause eating disorders.
“While these unfortunate elements of our society CAN contribute to widespread negative body image and promote an internalization of the “thin ideal”, they cannot be blamed outright for the development of the serious and complex illnesses such as anorexia, bulimia, binge eating disorder and EDNOS or OSFED.” The Centre For Eating Disorders (2014)
20. You have to be underweight to have an eating disorder.
Eating disorders come in all shapes and sizes. In order to be diagnosed with Anorexia then there is a weight measurement aspect in the DSM, however, a sufferer of bulimia can be underweight or overweight. Each is as likely as the other. Someone suffering from binge eating disorder is most likely to be overweight, where as someone suffering from eating disorder – not otherwise specified may also be at a size or shape. It is not a clothes size in the shop. It is not the number on the scale. It is not a certain number of inches around the waist, hips and thighs. An eating disorder is a pervasive pattern of disordered eating. It is a psychological disorder.
The Body Betrayed: A Deeper Understanding of Women, Eating Disorders, and Treatment , by Kathryn J. Zerbe, M.D. (G�rze Books, 1993)
Disordered Eating in Midlife and Beyond, by Harvard Women’s Health Watch, February 2012
Men Get Eating Disorders Too. n.d. The Facts. [Online]. [Accessed 14th November 2014] Available from: http://mengetedstoo.co.uk/information/the-facts
National Eating Disorders. n.d. Race Ethnicity and Culture. [Online]. [Accessed 14th November 2014] Available from: http://www.nationaleatingdisorders.org/race-ethnicity-and-culture
B-eat. n.d. Facts and Figures. [Online]. [Accessed 14th November 2014] Available from: http://www.b-eat.co.uk/about-beat/media-centre/facts-and-figures/
Smith, M. 2014. Helping Someone with an Eating Disorder. [Online]. [Accessed 14th November 2014] Available from: http://www.helpguide.org/articles/eating-disorders/helping-someone-with-an-eating-disorder.htm
National Eating Disorder Collaboration. 2014. Common Myths About Eating Disorders. [Online]. [Accessed 14th November 2014] Available from: http://www.nedc.com.au/myths
Noordenbos, G. 2013. Recovery From Eating Disorders: A Guide for Clinicians and their Clients. West Sussex: John Wiley & Sons, Ltd
Jàuregui-Garrido, B and Jàuregui-Garrido, I. 2012. Sudden Death in Eating Disorders. Vascular Health and Risk Management. 8, pp. 91-98
Clemmer, K. 2014. Photoshop Does Not Cause Eating Disorders – Media & Body Image. [Online]. [Accessed 14th November 2014] Available from: http://eatingdisorder.org/blog/2014/02/photoshop-does-not-cause-eating-disorders-media-body-image/