1. Eating Disorders: The Silent Dilemma
In today’s world of medical issues
and treatment interventions there is a
primary focus on preventive health
care. Many of the issues that are
being addressed have to do with high
blood pressure, cancers, heart
attacks/strokes, diabetes, gender
health issues, and other ailments that
can cause serious risks/ and or death.
Within the last decade or so, many
healthcare professionals are shedding
light to obesity and unhealthy eating
patterns that are plaguing individuals,
and causing health risks as well. The
one thing that often does not get
diagnosed in healthcare settings is
Eating Disorders.
Some common signs and or symptoms of
eating disorders not otherwise specified
may involve,
• Underweight/normal
weight/overweight fluctuations.
• Obsessive calorie counting and
knowledge of calories in almost
all foods.
• Skipping meals or eating non
nutrient small snacks, and
pushing food around on a plate,
rather than eating it.
• Exercising excessively including
after meals.
• Ingesting food even when not
hungry.
• “Grazing” for as long as food is
available.
• Hiding Eating habits due to
shame or embarrassments.
• Obsessive- compulsive interest
in weight, body image, and
fasting.
• Switching frequently between
eating patterns. Example: Eating
normal amounts of food but,
then becoming exceedingly
obsessed with healthy eating
and categorizations of food
groups as “safe” or “off-limits
Eating disorders are often complex illnesses
with genetic components affected by
biological, environmental, social and family
variables. The obsession with food, weight,
and body image often disrupts an individual’s
health, social, family, occupational, and daily
activities (Disorders T. C., n.d.). Researchers
state that there is evidence as to an eating
disorder having predisposition to certain
genotypes, and that individuals who have had
a family member diagnosed with an ED are 7-
12 times more likely to develop them as well
(Disorders T. C., n.d.). Some genes are linked
to specific heritable personality traits such as
obsessive thinking, perfectionism, sensitivity
to reward and punishment, neuroticism
(emotional instability and hypersensitivity),
impulsivity, rigidity and excessive persistence
(Disorders T. C., n.d.).
Cycles of semi starvation will trigger these
behaviors. Individuals who suffer from eating
disorders have altered brain circuitry that
contributes as well. Their serotonin pathways
and levels become altered too. Traumatic
events such as physical/sexual abuse can
precipitate an eating disorder. The victims
often struggle with shame, guilt, body
dissatisfaction, and a feeling of lack of control,
and often times the eating disorder can be an
expression of self-harm (Disorders T. C., n.d.).
An eating disorder can be a perceived
response to emotional pain, conflict, low self-
esteem, anxiety, depression, stress, or trauma.
Experts believe that family is an integral
component in the healthy development of an
individual and can often have an importance
in the recovery process of an illness but, in the
past parents were often blamed as the sole
cause for a child’s eating disorder. While
stressful and chaotic family environments can
exacerbate this illness, they do not cause it.
Some family dynamics that were assumed to
be precursors to ED may develop as a
response to a family members ED (Disorders T.
C., n.d.). The media’s increased obsession
with the “thin-ideal” promotion of the perfect
body contributes to the unrealistic body ideals
in people with/without eating disorders with
the increase advancements of global media of
airbrushing and “photo shopping” further
skewing perceptions of the attainable and
acceptable beauty standards (Disorders T. C.,
n.d.). Individuals who are at-risk have
increased vulnerability to exposures and
societal messages
Hospitalization
Intensive Outpatient Program
Didactic and Motivational Therapy
Group Therapy
Long-term Rehabilitation
Pharmacology
Dual Diagnosis Treatment Therapy
Introduction
The following are some statistics about Eating
Disorders:
• Up to 30 million people of all ages and
genders suffer from an eating disorder.
• Currently 35.5% of adult men and 35.8%
of women are Obese.
• The most Common eating disorder in the
U.S. is binge eating disorder (BED)
• 91% of all women surveyed on a college
campus had attempted to control their
weight through dieting, with 22% dieting
“often” or “always”.
• 86% reported an onset of eating disorder
by the age of 20; 43% between the ages of
16-20.6.
• 25% of college women engage in binging
and purging as a weight management
technique
In the U.S. more than $60 billion is spent every
year on dieting and weight loss products or
solutions, which in turn makes dieting the
number one precipitating factor in the
development of an ED (Disorders T. C., n.d.).
Despite the 95-98% failure rate, people continue
to buy dangerous products and engage in
extreme measures to lose weight, and 9.5 out of
10 people usually gain back all their weight within
1-5 years (Disorders T. C., n.d.). For genetically
predisposed individuals, dieting is the catalyst for
the obsessions of weight and food.
Unfortunately due to the illusiveness,
complexity of treating, and under reporting of
Eating Disorders there is limited treatment
options or facilities that can treat the disorder. It
is nearly impossible to put a dollar sign as to the
costs of effectively treating Eating Disorders.
Inpatient treatment of ED in the U.S. can range
from $500 to $2000 per day, and it is advised that
many seek out long term patient care (preferably
dual diagnosis facilities) that includes therapy,
medical monitoring, a dietician, psychiatrist,
pharmacology can cost on an average of $60,000
-$100,000 (Farrar, 2014). This is just a basic figure
of inpatient costs that do not include the costs of
hospitalizations related to ED as discussed,
Intensive Outpatient Therapy after the
completion of long term, the psychiatric costs,
the costs of treating other illnesses that are
comorbid with ED such as physical illnesses,
substance abuse, mental health, depression,
home health care, dieticians, and possible end of
life arrangements. Societal costs are in the
billions.
Statistics
Signs and Symptoms
Signs And Symptoms
Continued
Contributing Bio psychosocial Factors
Cost of Treatments
Treatment Options
Role of Social Worker
• Educate families about the
disorder and treatment options.
• Advocate for clients and families
in getting costs of treatments
covered,
• Referrals
• Design and implement programs
to educate health professionals
and communities
• Act as a liaison and communicator
between health professionals, the
patient, and families/caregivers.
• Implement fundraising efforts to
help finance more money
towards research and
implementations of effective
treatments.
Community Resources
National Eating Disorders Association
(NEDA): 165 West 46th Street, Suite 402, New
York, New York 10036. Online national
resource guide for treatment of an eating
disorders Support groups, blogs, tool kits,
articles, current trends, education, and tool
kits/guides for professionals who treat ED.
NEDA is the leading non-profit organization in
the United States advocating on behalf of and
supporting individuals and families affected
by eating disorders. Reaching millions every
year, they campaign for prevention, improved
access to quality treatment, and increased
research funding to better understand and
treat eating disorders. NEDA works with
partners and volunteers to develop programs
and tools to help everyone who seeks
assistance. www.nationaleatingdisorders.org.
Call our toll free, confidential Help line at
(800) 931-2237. (PanCare of Florida, Inc.,
n.d.).
Conclusion
Many practitioners ignore the symptoms of
ED, or classify the symptoms into other areas
such as addictions (a person’s weight issue is a
direct result of their addiction), or mental
illness, because ED is falsely deemed as a
“social illness”. Many males go untreated,
because ED is classified as a female issue,
when in reality males are suffering from this as
well. Others feel that it is a phase that
individuals go through during their teen years,
but all ages, races, cultures, and genders are
participating in this deadly disease. The public
has received education on Anorexia and
Bulimia as an ED, but there are other disorders
not otherwise specified, and Obesity is
classified as an ED. Some feel it is a moral issue
or lack of willpower, and therefore believe that
it can be arrested through exercise, change in
diets, and self-control.
Until more awareness in communities is
shed on this disorder, ED will continue to have
high morbidity rates , and lack of treatment
options
References
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NEDA: http://www.nationaleatingdisorders.org/find-help-support
Center, L. M. (n.d.). Life Management Center of Northwest Florida
Inc. Retrieved April 14, 2015, from
http://lifemanagementcenter.org
Crow, S. &. (2014, September 25). Facts About Eating Disorders:
What The Research Shows. Retrieved September 18, 2015, from
http://www.eatingdisorderscoalition.org/
Disorders, N. A. (n.d.). Eating Disorders Statistics. Retrieved
September 14, 2015, from ANAD: http://www.anad.org/get-
information/about-eating-disorders/eating-disorders-statistics/
Disorders, T. C. (n.d.). What Causes an Eating Disorder? The Center
for Eating Disorders, Baltimore, Maryland. Retrieved September
14, 2015, from http://www.eatingdisorder.org/eating-disorder-
information/underlying-causes/
Disorders, T. N. (n.d.). Retrieved September 17, 2015, from NIMH:
http://www.nimh.nih.gov/health/topics/eating-
disorders/index.shtml
DSM-5. (2013). Diagnostic and Statistical Manual of Mental
Disorders (DSM-5) (Fifth ed.). Washington, DC: American
Psychiatric Publishing.
Farrar, T. (2014, May). Eating Disorder Statistics. Mirror Mirror.
Retrieved September 18, 2015, from http://www.mirror-
mirror.org/eating-disordres-statistics.htm
Health, A. M. (n.d.). Retrieved September 14, 2015, from Alabama
Mental Health-Find Help:
http://www.alabamamentalhealth.org/find-help/
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Eating Disorders: A Review and Application of an Integrative Ethical
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Mellace, J. (2010, July/August). Eating Disorders Not Otherwise
Specified: Real Disorders, Real Risks. Social Work Today, 10, No.4,
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http://www.socialworktoday.com/archive/071510p14.shtml
PanCare of Florida, Inc. (n.d.). Retrieved September 14, 2015, from
Resources of Bay County-Eating Disorders:
http://www.pancarefl.org/resource_directory/bay_county_directo
ry
Vanessa Almy
SWK 7722