It’s an upsetting question posed by a New York Times piece, which delves into the proliferation of for-profit, specialty eating disorder clinics—posh rehab centers and chains that offer yoga and spa retreat amenities while tackling a health issue that is notoriously difficult to cure. At the crux of the investigation is the question of whether the focus of treatment goes by the wayside when money is a more prominent focus.
In a lot of ways, eating disorder (ED) treatment is where addiction treatment was a generation or two ago. A deep lack of understanding as to both the physiological and psychological causes of the disease, plus the manifold variety of ways in which it manifests in individual cases, makes for incredibly scattershot and ineffective treatment. The only ED treatment facility I’d be okay with sending a loved on to is one that says, “Look, we know fuck-all about this right now because no one can figure out how to design a treatment study that doesn’t break all the rules of medical ethics. But we have, at least, some pretty good basic knowledge about the human psyche, addictive behaviors, and our nutritional requirements. So, we’re going to do our best to find and deal with the root causes of this disease, using the things we do know, always being guided by compassion and the well-being of the whole person. If and when we learn something new that suggests we should change our approach, we’re 100% open to that.” If anyone suggests religion as an answer, or punitive models of behavior modification, run the fuck away.
When Nate Nahmias was 16, he decided that he wanted to get fit.
A math- and science-oriented kid, he applied his analytical know-how to his workout regimen and diet. He meticulously planned each lift and run, and ensured every single calorie he consumed was accounted for. But he had a hard time keeping track of it all himself, so he asked his mother to set up an appointment with a dietitian. “I thought that maybe the dietitian would have some tools to help me stay on track with what I wanted,” Nahmias, now 25, tells Yahoo Health. “I thought she would applaud me for all of my hard work and strict diet.
I have a very clear distaste for the thinking that things are distinct to a particular gender.
I’ve certainly known proactive guys with body issues who got into weights to attain the physique they idealize. I figure that some likely would meet the criteria of having an eating disorder, but the behaviour got addressed as they came to learn about nutrition. For me, before nutrition it was the fact I’d “reward” myself and eat back all the gains I’d made. Similar goals, it’s about finding what works best for ourselves in order to make progress.
It’s long been known that eating disorders such as anorexia and bulimia are associated with other challenging health issues. Heart problems, osteoporosis, tooth decay, esophageal damage, pancreatitis and kidney failure, among many things, have been linked with eating disorders.
But now a new study has associated the conditions with long-term negative economic consequences, including lower earnings.
While I worry some will get self conscious, I hope this news reinforces the severity of eating disorders and that pursuing treatment is in a sufferers best interest.
If you read into the study, they discuss a bit about how people with eating disorders tend to be much higher on the “perfectionist” type spectrum than most. Some of what may account for the difference between men and women is that because of society, etc, that perfectionism manifests differently in men versus women. Still, it’d have been nice if the sample had the same number of men as women.
Low-calorie, low-fat, sure. But food-restrictive eating, like Jess’s, can be signs of orthorexia, an increasingly common form of disordered eating. Unlike anorexia, which addresses how much you eat, orthorexia is about what you eat. And nutritionists and psychologists say that they’re seeing it more often, especially in the face of restrictive food trends, like gluten-free, and growing information about where food comes from, and how it’s grown and processed.
…That’s the sticking point, where healthy eating ticks over into compulsion.
To date, this has been lumped in with ED-NOS. ED-NOS is basically just a catch-all for anyone with food issues that isn’t bulimic or clinically anorexic. This is why it’s the most commonly diagnosed eating disorder.