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9 Jul

The Fine Line Between Healthy Ambition, Pathological Dieting & Eating Disorders

The following is a guest post from Holly Peek, MD/MPH. Holly has been training with us at Cypress for over a year. Be sure to check out her blog at www.psychgumbo.com.

Whether trying to lose weight, gain muscle or simply live an overall healthy lifestyle, regular gym goers usually have a clear goal in mind. If working toward such a goal, healthy eating habits usually go hand-in-hand with regular sweat sessions. These are great habits to have in order to live a healthy and well balanced lifestyle and are something that doctors and fitness experts would certainly recommend. 
However, there does come a point when well intentioned habits straddle the line between healthy and unhealthy. When taken to an extreme, these habits can have dangerous consequences.

Do any of the following apply to you?
-checking the number on the scale is a distressful daily habit
-pushing through injuries or exhaustion to burn extra calories
-calorie counting or food restrictions have become an obsession
-avoiding friends or enjoyable social activities because of preoccupation with diet or exercise
-preoccupation with body image has become overwhelming and distressful

If so, it may be time to take a step back and reevaluate some habits and consider exactly what qualifies as an eating disorder. Although most people are generally aware of eating disorders, what many don’t realize is the often insidious progression of the disease. In fact, 35% of “normal” dieters progress to “pathological dieting,” defined as unhealthy food or calorie restriction. For instance, a refusal to eat certain foods can progress to restrictions against entire food categories (e.g., no carbohydrates). Of those pathological dieters, 20-25% will progress to a full-blown eating disorder, both a dangerous and often unintentional progression. Because of the progressive disease process, it is important for any health conscious person to learn the signs and symptoms of eating disorders, the causes and when to seek help.

In the United States, 20 million women and 10 million men suffer from an eating disorder at some point during their lifetime. This high prevalence is concerning considering eating disorders have the highest mortality rate of any mental health disorder. Two of the deadliest eating disorders are anorexia nervosa and bulimia nervosa. In general, a behavior is considered a “disorder” when it causes a great deal of emotional distress and interferes with social functioning. For instance, eating disorders involve extreme attitudes, emotions and preoccupations with weight, food and dieting. This preoccupation can lead to a withdrawal from friends and activities once enjoyed. Both anorexia and bulimia are characterized by a self-esteem that is overly influenced by body image and those with the disorder may also have a disturbance in the way they perceive their body weight or shape, also known as body dysmorphia. Excessive exercise regimens with the need to “burn off” calories taken in can also be a warning sign of both disorders. Here are the characteristics of anorexia and bulimia:

Anorexia Nervosa:
– inadequate caloric intake leading to a significantly low body weight
– intense fear of gaining weight and persistent behavior to prevent weight gain
– self-esteem overly influenced by body image and a disturbance in the way one perceives their body weight or shape (body dysmorphia)
– may or may not involve purging behaviors in order to prevent weight gain such as self-induced vomiting, misuse of laxatives or diuretics and excessive exercise

Bulimia Nervosa:
-recurrent episodes of binge eating, defined as eating a large amount of food in a short period of time with a sense of lack of control during the episode
-recurrent purging behaviors in order to prevent weight gain such as self-induced vomiting, misuse of laxative or diuretics, fasting or excessive exercise
-self esteem is overly influenced by body image
-are usually a normal body weight

The cause of eating disorders is multifactorial and include biological, psychological and social factors. Biological factors may include hormonal imbalances and genetics, as the predisposition of developing an eating disorder has been shown to run in families. Underlying psychological issues often include low self-esteem, feelings of inadequacy, a sense of lack of control in life, depression and anxiety. At the surface, eating disorders may appear to be purely a preoccupation with food and body weight. However, the process of dieting, binging and purging is often a way to cope with or distract from overwhelming and painful emotions or to feel in control of one’s life.

Perhaps the largest social factor contributing to the development of eating disorders is an unhealthy body image which is often perpetuated by the media and perceived cultural norms. Unfortunately, distorted body images often start at a young age. Although 98% of the American female population is not as thin as fashion models, 69% of elementary school females say that these media images influence their concept of their ideal body shape and 47% say the images make them want to lose weight. Unfortunately, this negative self-image persists into early adulthood, as 70% of 18- to 30-year-olds do not like their bodies. Men are certainly not immune to this effect, with perceives their body weight or shape (body dysmorphia) studies indicating up to 95% of college-aged males are dissatisfied with their appearance. Striving for this “ideal” body image often leads to unhealthy eating habits such as skipping meals, purging, excessive exercise and pathological dieting.

Although a regular exercise routine and healthy diet are part of a well balanced lifestyle, it’s important to remember how easy it can be to cross that fine line into pathological dieting or eating disorders. If you find yourself to the point where your fitness and dietary goals have become obsessive, distressful or interfering with your ability to enjoy activities, it may be time to seek help. Eating disorders are serious conditions that require professional help but are certainly treatable, especially if detected and treated early. Recognizing a problem and telling a friend, family member or health professional is a positive first step. For more information about eating disorders and how to seek treatment, visit http://www.nationaleatingdisorders.org.