Can You Spot the Person with Anorexia?
An individual who appears to be of average size, or with a larger body, can also suffer from anorexia.
When we think about anorexia, many of us might envision an emaciated individual, typically a young woman with clothes hanging off a skeletal frame. However, it’s important to recognize that serious eating disorders can affect individuals of all body sizes, genders, and ethnic groups. In fact, only 7% of individuals with eating disorders are underweight and it is not possible to “guess” whether they have anorexia nervosa or not.
What is Anorexia Nervosa?
Anorexia Nervosa Is the refusal of food/nutrition, along with an obsessional fear of gaining weight or โbecoming fatโ. This results in a disturbance in the way body image is seen and experienced. In other words, the individual with anorexia not onlyย believesย their body is larger than it is, but they alsoย experienceย it to feel bigger โ as if they are taking up more space then they actually are. At Sanford Comprehensive Treatment for Eating Disorders (SCTED) we treat anorexia nervosa inย residentialย andย outpatientย modalities.
Anorexia results in a loss of weight, or a failure to gain weight at the rate expected along the developmental trajectory for a child or adolescent. Some individuals will also engage in compensatory behaviors โ vomiting, laxative abuse, or excessive exercise โ in a desperate attempt to rid the body of unwanted calories.
Sanford Behavioral Health Comprehensive Treatment for Eating Disorders
At Sanford Behavioral Health, our eating disorder programming has shaped the way the entire organization looks at body image, eating, and meals. We know that body dissatisfaction is a risk factor in the development of an eating disorder. But it also plays a role in other mental health conditions. In that regard, Sanford endorses and practices a Health at Every Size approach.
Weight alone is not an indication of health in any of our practice areas. We also recognize that individuals in larger bodies have often experienced discrimination and trauma due to their weight. Sadly, studies show that healthcare providers are responsible for 10% of this trauma. Our trauma-informed treatment is respectful of all body sizes and shapes.
Sanford Comprehensive Treatment for Eating Disorders endorses and practices a Health at Every Size approach.
Anorexia in Larger Bodies
Anorexia, where restriction of food leads to severe weight loss, is the condition most people think of when they picture someone with an eating disorder. However, an individual who appears to be of average size, or with a larger body, can also suffer from anorexia. Eating disorders are mental health issues with physical symptoms and changes. In fact, an eating disorder is largely an internalized set of obsessional thoughts and rigid beliefs that drive dangerous behaviors.
Often the serious consequences of eating disorders are not obvious to the naked eye. Not understanding this can lead to a lack of recognition regarding the development of an eating disorder, causing treatment to be delayed or even denied. Furthermore, because there is a stigma associated with being in a larger body in our society, many individuals avoid routine medical care out of fear of being shamed. The biggest medical consequence of being in a larger body can be substandard medical care, where routine screenings for cancer, high blood pressure, and heart problems are missed along with mental health issues. At Sanford we are on a mission to educate and collaborate with medical practices.
Overweight and Underweight – Where do These Terms Come From?
What do the terms โoverweightโ and โunderweightโ even mean? In general, these are terms used to compare an individual to the “norms” of BMI charts. Itโs important to understand that BMI was developed as a concept to normalize weight trends in whole societies. BMI was not intended to be applied to individuals. BMI does not take into consideration race, gender, or muscle mass. Consequently, even elite athletes can fall into the โobeseโ category.
We reward thinness and consider restrictive dieting normal in today’s society. Even MDs can be susceptible to bias, overlooking significant weight loss as potentially dangerous behavior. Physicians may not screen for binge eating or purging behaviors due to a lack of knowledge. This delay in receiving the proper diagnoses allows the condition to become more entrenched and makes recovery much more difficult. With education and collaboration, we intend to help improve diagnosis and early intervention.
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For more information on eating disorders:
You Don’t Look Anorexic – The New York Times
Anorexia – When is it Time for Residential Treatment? – Sanford Behavioral Health
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Stigma and Trauma – Larger Bodies
We also need to recognize that the term โobesityโ is more of a societal construct than a true health condition. There is no medical term for โoverly tallโ or โunusually shortโ which flags individuals for special treatment considerations. We donโt devise federal programs for a โtallness epidemicโ. We must develop a broader concept of health including metabolic health, flexibility, strength, and stamina rather than the narrow concept of weight alone.
If you or a loved one is struggling with an eating disorder, taking action promptly is crucial. At Sanford Behavioral Health, we provide a variety of outpatient and inpatient treatment options for individuals of all ages. Our dedicated team will collaborate with you to create a customized plan tailored to your specific needs. When youโre ready to take that first step towards recovery, reach out to us.ย We will support you every step of the way and can help you recognize the signs of an eating disorder.ย
