Misconceptions can create barriers to detection and treatment
By Christine Peat
With Eating Disorders Awareness Week now upon us, it is an important time to discuss the need to broaden our understanding of who might be at risk of developing an eating disorder.
Many Americans, including healthcare professionals, imagine that a person with an eating disorder is a thin, young, white woman struggling with her body image. This stereotype has been perpetuated in movies, television shows, and other media for decades.
The reality is that women currently represent only a portion of Americans suffering from eating disorders. And the proliferation of these disorders across all demographic groups, including men, the LGBTQ+ community, and people of color, has only increased during the pandemic.
Recent research estimates that a death occurs every 52 minutes—more than 10,000 deaths annually in the U.S.—due to an eating disorder, and many of these individuals struggle for years without treatment. The cumulative impact of eating disorders on mental and physical health is staggering; however, families, educators, and the medical community can play a crucial role in developing a comprehensive approach to addressing it.
First, we must work to dismantle the stereotypes associated with eating disorders. This mental illness can affect people of all races, genders, sexual orientations, sizes, and ages.
Historically, Black Americans are underdiagnosed with eating disorders and less likely to receive treatment. People who identify as LGBTQ+ are at higher risk for eating disorders, according to experts at the School of Public Health. Nearly 2 million children alive today in our country will experience an eating disorder before the age of 20. These figures confirm the urgency and scope of this increasingly serious problem.
Eating disorders also thrive in secrecy: many go undetected because the person "appears healthy" and may be hiding their symptoms. There are also people living in larger bodies who are overlooked or, worse, sometimes praised for rapid weight loss due to extremely risky dieting behaviors.
Early detection of eating disorders
Increasing and improving the early detection of eating disorders is crucial to ensuring that those affected receive the care they need. The primary care setting is ideal for early detection of eating disorders, as these providers typically have a closer relationship of trust with their patients. Indicators of an eating disorder often include weight changes, sudden changes in diet, or changes in mood or anxiety.
Throughout my career, I have worked with numerous patients who would have benefited enormously if someone in their life had identified their illness earlier. In many cases, an early diagnosis could have meant a shorter duration of illness, lower healthcare costs, and a faster path to recovery.
These experiences led me to work with my colleagues to develop a free, easy-to-use tool that enables primary care professionals to quickly and easily perform evidence-based screening tests for adult patients, along with discussion topics and referral guidance. This tool provides clinicians with the resources they need in a practical format for today's primary care environment.
With data showing that 28.8 million Americans have had or will have an eating disorder at some point in their lives, we must improve education and understanding within the medical community. Currently, there is no requirement to teach medical students or residents about eating disorders, and many lack the knowledge, experience, and skills necessary to identify these conditions, despite wanting to help their patients. While the screening tool is a step toward bridging the knowledge gap, more robust efforts are still needed to improve the landscape of eating disorder care.
Need for funding for research and treatment of eating disorders
A final component is increased government funding for research, public education and awareness campaigns, and access to treatment. In 2016, Congress passed groundbreaking legislation allocating funds specifically to address eating disorders. This funding has led to increased education and training for thousands of healthcare professionals and the development of innovative strategies to help tackle the problem. Continued funding is needed to ensure these efforts persist and to address the growing need for eating disorder training in the wake of the pandemic.
The secrecy and shame inherent in eating disorders often mean they go undetected for years. But we can change this. With simple screening tools and other early interventions, supported by increased federal funding and public education, we can ensure that everyone with an eating disorder receives the care and support they need.
Christine Peat, PhD,opens in a new tab or window is an associate clinical professor in the Department of Psychiatry.