The Importance of Early Diagnosis and Intervention of Eating Disorders across Demographic Groups

February 25 to March 3, 2019 is National Eating Disorder Awareness Week

Social media platforms have experienced an enormous surge in popularity, especially among young adults, and diet product companies have enlisted celebrities to market their products to the masses. Using celebrities to promote weight loss products has resulted in an influx of "detox" products such as teas and shakes, as well as appetite suppressants. Many celebrities, most notably Kim Kardashian, have been under fire for promoting these products and contributing to the idealization of extremely thin body imagery. This has led to increased anxiety and poor body image in young people.

Professor Stephen Powis, National Medical Director of National Health Service England, has urged social media platforms to crack down on this type of advertising and warned that "advertising these products without a health warning is damaging; social media companies have a duty to stamp out the practice of individuals and companies using their platform to target young people with products known to risk ill health." A recent study conducted by the University of Pittsburgh has found that there is a strong and consistent association between social media use and eating concerns, and participants in the highest quartiles for social media volume and frequency had significantly greater odds of having eating concerns.

A review of nearly 50 years of research confirms that anorexia nervosa has the highest mortality rate of any mental health condition; and among those who struggle with anorexia, one in five deaths are by suicide, according to the National Eating Disorders Association. Besides anorexia nervosa, the other two most common eating disorders, binge eating and bulimia nervosa, have significant psychological and physical consequences. Binge eating disorder (BED) has strong correlations to depression, anxiety, guilt, and shame; and bulimia nervosa can cause serious electrolyte and chemical imbalances leading to heart failure. The most common eating disorder is BED, which affects three times the number of those diagnosed with anorexia and bulimia combined and is more prevalent than breast cancer, HIV, and schizophrenia, according to the Binge Eating Disorder Association. In addition, up to 50 percent of individuals with eating disorders also abuse alcohol or illicit drugs, a rate five times higher than the general population.

Straight, young, white females typically come to mind when most people think of eating disorders, but in reality, these disorders affect people from all demographics; and increasingly, people of color, men and boys, and LGBTQ+ populations. The high mortality rates, prevalence of co-occurring mental health and substance use disorders, and the reach into all demographics underscore the importance of reducing stigma and increasing awareness, prevention, diagnosis and treatment for all eating disorders.

"There is a misconception that eating disorders only affect white females, and there is a growing amount of research indicating that there are many different populations that are not receiving adequate diagnoses or treatment for eating disorders. Studies have shown that LGBTQ+ individuals are at an increased risk of developing binge eating and purging habits from the age of 12, and the transgender community has significantly higher rates of eating disorders when compared to cisgender individuals," said Debra L. Wentz, Ph.D., President and CEO of the New Jersey Association of Mental Health and Addiction Agencies (NJAMHAA).

"According to the National Eating Disorders Association, people of color, especially African Americans, are significantly less likely to receive help for their eating issues; and males are less likely to seek treatment due to stigma, but the mortality risk for males with eating disorders is higher than it is for females," Dr. Wentz added. "Early intervention is critical and we urge providers to begin screening for eating disorders, especially for individuals being treated for mental health or substance use issues. Education for the general public is important as well so that people can recognize the warning signs in themselves or their family members."

There are many treatment options available for people who suffer from eating disorders. There are multiple levels of care, including intensive outpatient and outpatient, partial hospitalization, residential treatment, and inpatient treatment. In addition, there are many evidence-based forms of therapy, including cognitive behavioral therapy. "Many NJAMHAA member organizations have the capability to treat these illnesses and have had success treating patients suffering from eating disorders," Dr. Wentz added.

It is critical for individuals and healthcare providers to be able to identify the different warning signs and symptoms of eating disorders. Common emotional and behavioral symptoms include a preoccupation with weight, food, calories and macronutrients; food rituals; skipping meals or eating very small portions; frequent dieting; extreme concern with body size and shape; extreme mood swings and withdrawal from friends and activities. Common physical symptoms include noticeable fluctuations in weight; gastrointestinal complaints; menstrual irregularities; abnormal laboratory findings, such as anemia, low thyroid and hormone levels, and low potassium; feeling cold all of the time; dizziness and fainting; impaired immune function and wound healing; dental problems such as enamel erosion, cavities and tooth sensitivity; difficulty concentrating and sleeping. A full list of symptoms, including disorder-specific symptoms, can be found on the National Eating Disorders Association website,

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