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Come as you are

Eating disorders.


People know they are out there, but like other mental health issues, its easier and more socially acceptable to downplay the signs and symptoms, avoid a serious sounding label, and pretend everything is under control.


The occasional heart-warming recovery story on the local news and positive body image hashtags on social media give us the peace of mind that people are advocating for self-love and healthy relationships with food. So it's easier to think that true eating disorders are few and far between.


But sadly, they are still very much a presence.


In fact, increasing types of eating disorders and body image dysmorphia are taking form as social media, online communities, technology and imagery filters, as well as general access to information continues to grow exponentially.


When people hear the term eating disorder their mind jumps to the skin and bones look of a shy young girl refusing to eat at dinner and pinching at her body in a mirror.


Ah, the quintessential image of anorexia...


Though this image is very real and these cases exist, the list of symptoms, behaviors, and demographics that encapsulate who and how eating disorders affect people vary tremendously.


So, to broaden your view of eating disorders, lets imagine...


... A potentially "healthy looking" African American college freshman who eats normally while in public. There is virtually no sign that anything is wrong with her eating. But that's because everything wrong is happening in secrecy. She eats larger than normal amounts of food alone in her dorm room, followed by vomiting, diet pill, laxatives, or excessive exercise ....

... A potentially overweight white male in his 30s. While on a work lunch break, you encourage him to join a gym and talk about the benefits of a healthy diet. He orders a salad with you and signs up for a gym that afternoon. But when alone, he eats large amounts uncontrollably and battles shame, guilt, and distress soon after. He compensates by restricting himself back to only salads for a few days paired with 3 hours on the treadmill...until another uncontrollable binge strikes at night. Six months later you notice he has only gained weight since starting the gym. . .

... A strong and tan 28 year old Hispanic "fitness model" whose dedication to the gym and clean eating motivates you to meal prep, and let's be honest, it also makes you a little jealous that they have it all together. In reality, her motivation for clean eating is driven by a legitimate fear that certain foods could harm her body. And her "dedication" is coupled with spending hours reading nutrition facts, counting how many grams of sugar she ate that day, and bringing a protein shake to "girls night" because she can't trust the food that will be there. . .

... A 17 year old Caucasian lacrosse player who is focused on writing college essays, being in after school groups, making the team. Suddenly, he has started loosing weight and muscle. He tries to eat more, but he's full after just a few bites. He starts to feel self-conscious compared to all the other boys on the team who are putting on muscle and growing beards. He plugs his nose to down another protein shake, even though he has lost all interest in eating, and he begins researching what testosterone boosting supplements could help him put on weight. . .

... A 16-year-old inter-racial cross-country runner who is slaying records and getting noticed on the state level. People don't question her thin frame because they see her eating with the team, drinking plenty of water, and assume that good runners are skinny. Her parents think she just hasn't hit her growth spurt yet and her hormones will kick in with time. She passes out after her final 400m interval at practice this week. Teammates are amazed at her ability to push her body to the limits. Coach tells her to take tomorrow off to recover, but she still goes out for a light jog on her own and skips breakfast since she's not practicing later that day. . .

So no, eating disorders are not just anorexia, and they don't just happen to "one type" of person.


Eating disorders do not discriminate. I made a point to list various races, ages, genders, occupations because they can happen to anybody!


And they can begin for any reason.... from insecurities, to lack of knowledge about nutrition, to trying to obtain a certain image, to athletic drive, to a past traumatic event, or even what is seemingly health-conscious reasons.


And they can take form in many ways... from anorexia, orthorexia, bulimia, binge eating, body dysmorphic disorder, or something that seems like an odd blend of them all. . . or perhaps only one or two symptoms that might not even classify as a full-blown "disorder", but is still affecting somebody's physical and mental health.

For all these reasons, I love the National Eating Disorder Awareness Week campaign theme this year, "Come as you Are" because it welcomes anybody and everybody to their organization.


No matter who it happens to, or how an eating disorder begins or manifests, the most important thing to know is that there is help for everybody.


So, ask for help, if its happening to you or if you see it happening to others.


Talk about it.


Refer people to a website (National Eating Disorder Association is a great place to start), a counselor or a dietitian (Health Professionals Search).


Be a friend and listen and support.


Talk to your friends about what you are struggling with!


. . .Even if you don't know anybody that has it, and even if you don't fully understand it yourself!


You never know who is listening, and a simple comment recognizing its existence or impact is a relief to many.



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© 2019 by Lindsey Elizabeth Pfau MS RD CSSD LD/N