Tag - EAT-26

Eating Disorders Among Minorities

When the term eating disorder is mentioned, there is usually a specific mental image that comes to mind. Traditionally, the stereotypical person with this type of mental health issue is a young, wealthier Caucasian female. Mass media and pop culture images usually reinforce the portrayal of hyper-thin, white women who are suffering from the effects of conditions like anorexia nervosa. However, this stereotype that eating disorders only inflect younger, white women is not correct.

Eating disorders are usually placed into four overall categories: anorexia nervosa, bulimia nervosa, binge eating disorder and Other Specified Feeding or Eating Disorder (OSFED). Other mental health issues are also commonly assisted with these eating disorders such as general anxiety, Post-Traumatic Stress Disorder (PTSD), depression, bipolar disorder and Obsessive-Compulsive Disorder (OCD).

The American Psychiatric Association defines an eating disorder as an illness where people experience severe disturbances in their eating behaviors. They also have problems related to the regulation of thoughts and emotions, usually becoming obsessed with food consumption and their body weight. The prevalence of reported eating disorders, with the exception of anorexia nervosa, is similar among Non-Hispanic Whites, Hispanics, African-Americans, and Asian Americans in the United States.

Decades ago, American societal portrayals of eating disorders were almost always shown as a white-woman problem. Shockingly, this misconception was also maintained by physicians and other healthcare professionals.

For example, behavioral health research from 2006 challenged the notion that African-American women were less likely to develop eating disorders. In this study, healthcare providers read 1 of 3 passages describing disturbed eating patterns of a fictional patient named Mary. The only differences between the passages were that the patient’s race, which was randomly changed for each provider. This meant that every fictional patient’s symptoms were identical, with only the person’s race randomly rotating between African-American, Caucasian, or Hispanic.

Healthcare professionals were then asked to diagnosis the patient’s level of depression, anxiety as well as whether an eating disorder might exist. In cases of a white racial profile, the eating behavior was considered problematic 44% of the time. For Hispanic profiles, the behavior was considered problematic in 41% of the cases. Surprisingly, when the patient was identified as African American, the eating behavior was identified as problematic in only 17% of the cases. The study’s final results suggested that healthcare clinicians appear to hold race-based stereotypes about eating disorders that could limit their detection of symptoms in African-American girls.

The results of the 2006 study reinforced earlier research from 2002 which found that the race of adolescent girls had a significant impact on the detection of disturbed eating patterns. In this study, undergraduate college students recognized the existence of an eating disorder more often when they read about a Caucasian female, rather than when they read about a minority female (Hispanic or African American) with the same behavior.

National statistics indicate that eating disorders predominantly occur in white females, but many eating disorder professionals increasingly believe that the data is skewed. Women of color have likely been alienated from personal support networks. In addition, healthcare professionals use to believe that African-American and Hispanic women were somehow more immune to eating disorders.

Until recently, people with an African American racial identify were underrepresented in treatment centers and research studies about eating disorders. Gathering quality data was more of a challenge due to societal misperceptions and prejudice. Now it is clear that perceptions of body image and disordered eating patterns are not just problems for young, white women.

Here is some additional information on eating disorders and minorities:

It is clear that eating disorders do not only occur in certain racial or socioeconomic groups. Race, ethnicity and/or socioeconomic status does not make individuals immune to these health conditions. In the past, eating disorders were primarily associated with heterosexual, young, white females. In fact, these mental health issues affect people from all demographics and ethnicities at similar rates. However, minority groups (particularly African Americans) are significantly less likely to receive help for eating disorder problems.

Regardless of one’s racial or ethnic identity, treating and recovering from an eating disorder takes time as well as professional help. An experienced mental health professional can help a person understand the origins of this behavior, whether it is an eating disorder as well as acquire coping skills.

For additional information or questions about this topic, please contact the staff at River Centre Clinic (RCC). Their Eating Disorders Programs provide a full range of treatment options for both adolescents and adults. The River Centre Clinic’s main phone number is 1.877.212.5457.

Eating Attitudes Test (EAT-26)

The EAT-26 is the most widely cited standardized self-report screening measure that may be able to help you determine if you have an eating disorder that needs professional attention. Take the EAT-26 now and get immediate and anonymous feedback.

Follow us on Twitter:  @River_Centre

Eating Disorders, Minorities

Contributor: ABCS RCM

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Two faces - River Centre Clinic

Orthorexia Nervosa versus Anorexia Nervosa?

Anorexia nervosa is a well-known eating disorder that afflicts both women and men. The disease creates an extreme fear of weight gain in people who suffer from it. Symptoms include not eating, binge eating and purging, also known as bulimia. However, there is a lesser known eating disorder that shares similarities to anorexia, but is still different. This disorder is known as orthorexia nervosa and was first described in 1998.

Orthorexia means an obsession with proper or healthy eating. Having a concern with the nutritional quality of the food is a healthy behavior, but problems occur when this concern becomes excessive, damaging and disruptive. Individuals with orthorexia become so fixated on what they perceive as healthy eating that they actually damage their own physical and emotional well-being.

Is Orthorexia Nervosa the same as Anorexia Nervosa?

Many of the symptoms and behaviors surrounding orthorexia tend to overlap with anorexia. Yet, in cases of anorexia, people tend to focus more on severely restricting the quantity of food (calorie count). There is a clear and forceful desire to not gain weight. This, in turn, creates behavior that focuses on excessive exercising in order to lose unwanted weight. However, these are separate inflictions.

Since orthorexia is a newer diagnosis, it still possesses varying levels of acceptance among eating disorder treatment professionals. Some eating disorder specialists regard orthorexia as a discrete diagnosis like anorexia nervosa or bulimia nervosa. There are reports that signs of orthorexia are perhaps increasing due to the use of social media to popularize extreme diets and other food-related behavior. Other health professionals, believe that patients with orthorexia symptoms are actually suffering from anorexia nervosa. The symptoms for orthorexia and anorexia have similarities such as:

  • A desire to maintain control of life by severely controlling daily food consumption.
  • Seeking self-esteem and fulfillment through controlling food intake.
  • Citing undiagnosed food allergies as a rationale for avoiding food.
  • Co-occurring disorders such as OCD or obsessive-compulsive personality disorder.
  • Elaborate rituals about food that may result in social isolation

What Is Orthorexia Nervosa?

There are still very few studies on the Orthorexia, but theories suggest that it is based on anxiety and/or depression much like other eating disorders. It is for this reason that the occurrence of orthorexia is typically accompanied by other eating disorders such as anorexia, bulimia, or binge eating disorder (BED). Which means a person’s orthorexia can co-exist with a bulimia disorder. This means an individual could binge on seemingly healthy foods (vegetables) and then purge the food in order to get rid of the calories.

Unlike bulimia though, people with orthorexia can hide their disease by displaying their symptoms in plain sight. At initial glance, people suffering from orthorexia appear to be simply taking care of their physical body. Individuals with orthorexia may even talk about how they are about their eating habits. But, this healthiness is an illusion. There is a difference between conscious, healthy eating and having orthorexia nervosa. Orthorexia is similar to obsessive-compulsive disorder (OCD), in the fact that people must create rules and engage in specific rituals around food.

Some trendy or extreme diets can trigger behavior that resembles orthorexia. However, simply adopting an alternative diet, whether based on science or pseudoscience, does not mean someone has orthorexia. For example, some people adopt a trendy diet that restricts certain food groups: Vegan, gluten-free, Paleo diets, etc. The adoption of these diets does not automatically create an orthorexia diagnosis.

Orthorexia turns eating into a pathological activity that becomes entangled with obsessive thinking, compulsive and ritualistic behavior and self-punishment. Individuals with orthorexia often use a diet to achieve a feeling of perfection, purity or superiority. They may feel judgmental towards people who do not follow their perfect, healthful diet. This means they often spend excessive amounts of time planning and researching “pure” foods, which interferes with participation in normal social activities and interactions. These symptoms are what turns a trendy diet into orthorexia nervosa.

How are Orthorexia Nervosa and Anorexia Nervosa Different?

Obsession with weight is one of the primary signs of anorexia, bulimia, and other eating disorders. But this is not a symptom of orthorexia. Instead, the focus for people with orthorexia is an excessive obsession with the health implications of their dietary choices.

People with anorexia will severely restrict their food intake in order to lose weight. People with orthorexia, however, strive to feel pure, healthy and natural. The focus is on quality of foods consumed instead of the quantity. In the end, it is critical that people with eating disorder signs and symptoms seek appropriate clinical advice from a professional with experience treating orthorexia, anorexia as well as other conditions. The obsessive tendencies associated with orthorexia can indicate a co-occurring disorder that should be diagnosed and treated by a psychiatrist.

There are definite similarities as well as differences between anorexia and orthorexia. Both of these eating disorders tend to provide a sense of control and stability around the consumption of food. Again, both eating disorders are dangerous mental illnesses that require professional treatment from a skilled clinician.

For additional information or questions about anorexia and orthorexia, please contact the experienced staff at River Centre Clinic (RCC). Their Eating Disorders Programs provide a full range of treatment options for both adolescents and adults. The clinic is located in a modern, spacious and tranquil setting in Sylvania, Ohio.

Eating Attitudes Test (EAT-26)

The EAT-26 is the most widely cited standardized self-report screening measure that may be able to help you determine if you have an eating disorder that needs professional attention. Take the EAT-26 now and get immediate and anonymous feedback.

Follow on Twitter:  @River_Centre

Orthorexia Nervosa, Anorexia Nervosa,

Contributor: ABCS RCM

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Child looking at partial cupcake - River Centre Clinic

Childhood Eating Problems & Adolescents Eating Disorders

Many parents are familiar with children who are picky eaters. In fact, for babies, this is often a normal eating behavior. As children age, they start to develop their own personal food preferences. However, as children grow older an overly selective eating behavior could be a sign of deeper health concerns. Many people are not aware that eating disorders are the third most common chronic illness in adolescents according to the American Academy of Pediatrics (AAP). Since the 1950s, there has been a steady increase in the incidence and prevalence of anorexia nervosa, bulimia nervosa as well as other eating disorders in both children and adolescents.

Data from the National Institute of Mental Health (NIMH) estimates that out of 800 public high school students, approximately 20-22 students will be impacted by eating disorders and even more will experience subclinical (not detectable) symptoms of the disease. Adolescents who have suffered from eating disorders are more likely to experience medical co-morbidities such as depression, anxiety, substance abuse and suicide.

During a person’s adolescence is when many of these diseases first occur. Adolescence is a time in people’s life when a great deal of change is occurring. Body changes, confusion, social anxiety only accelerate feelings of self-consciousness and low self-esteem. The onset of eating disorders often appears during this period, but these diseases can develop at a later time in a person’s life.

Not all of these eating disorders directly develop due to body image issues. Among children, they may struggle to eat certain foods because they feel physically nauseous. This can create a lack of appetite for food, which will make it more difficult to eat. A fear of vomiting or choking makes a child avoid certain foods, which can gradually become more restrictive over time. According to the National Eating Disorder Association, this restrictive eating behavior is a possible sign of what was previously identified as selective eating disorder, but is now referred to as ARFID or Avoidant Restrictive Food Intake Disorder.

ARFID is similar to anorexia in that both disorders involve limitations in the amount and/or types of food consumed, but unlike anorexia, ARFID does not involve any distress about body shape or size, or fears of fatness. Although many children go through phases of picky or selective eating, a person with ARFID does not consume enough calories to grow and develop properly. In children, this results in stalled weight gain and vertical growth. ARFID can also result in problems at school, due to difficulties eating with others and extended times needed to eat. As with all eating disorders, the risk factors for ARFID involve a range of biological, psychological, and sociocultural issues. These factors may interact differently with different people, which means two individuals with the same eating disorder can have very diverse perspectives, experiences, and symptoms.  

Eating disturbances are considered problematic when it causes the child to become upset or worry and when he or she is not eating enough to sustain proper nutrition and facilitate proper growth. Complications around eating can take many forms including but not limited to:

  • Trouble with food textures/sensory issues
  • Temper tantrums during meals
  • Refusing to eat
  • Limiting food groups
  • Choking, gagging, or vomiting after eating
  • Body image concerns
  • Anxiety/OCD

Due to the concern over the growth of eating disorders among children and adolescents, the Centers for Disease Control and Prevention (CDC) has researched this modern health concern. The CDC made the following recommendations during their 2008 national initiative. Their screening of high school students for eating disorders found that almost 15% of girls and 4% of boys scored at or above the threshold of 20 on the EAT-26, which indicated the possible existence of an eating disorder. The CDC recommended regular health screenings for high school students in order to identify at-risk students who could benefit from early intervention. Early identification and treatment of disordered eating and weight control behaviors can prevent progression of the disease and reduce the overall chronic health risk. To complicate matters, pedestrians have pointed out that some obesity prevention efforts may actually encourage the development of an eating disorder. The majority of adolescents who develop these disorders were not previously obese, but some teenagers, in a mistaken attempt to lose weight, can develop an eating disorder.

For additional information about childhood and adolescent eating disorders, please contact River Centre Clinic. Their Childhood Eating Problems Program director is Anna Lippisch, MSW, LSW. She can be reached at 419-885-8800 or by email. The EAT-26 (Eating Attitudes Test) assessment provides anonymous and instant feedback for a variety of eating-related health conditions.

Follow on Twitter:  @River_Centre

Childhood eating problems, Adolescents eating disorders, ARFID

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Muscle Dysmorphia, Eating Disorders & Males

The term eating disorder is commonly associated with younger women, even though research has shown that eating disorder symptoms and behaviors also occur in women over 50. However, this stereotype that eating disorders only appear in females is a misconception. Studies have shown that eating disorders do not discriminate, with males also suffering from this potentially lethal disease. Some studies have shown that males account for an estimated 5 to 15 percent of patients with anorexia or bulimia. Symptoms of binge-eating disorder are displayed in 35 percent of males. In males, especially boys and young men, these illnesses create a distorted sense of body image. For males, this distortion is often in the form of muscle dysmorphia, a type of disorder characterized by an extreme concern with becoming more muscular.

For boys and young men with muscle dysmorphia and related disorders, they want to lose weight or gain weight in order to “bulk up.” Young men who believe they are physically too small may actually start using anabolic steroids or other dangerous substances in an attempt to increase their body’s muscle mass. Eating disorders and muscle dysmorphia are listed separately in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders. However, the occurrence of these disorders is often seen as a collection of related behaviors. Both are the direct result of over-evaluating an idealized body type, which fuels either a drive for leanness, muscle mass or both. These eating disorders and body image distortions can give rise to disordered eating behaviors in boys, young males or even older men. Yet, in pop culture and society at large, muscular bodies are encouraged for boys. In American sports, being lean and muscular is seen as a beneficial attribute for nearly all sports. In fact, in certain athletic activities such as wrestling and gymnastics, severe weight and eating control is almost encouraged. So how do parents and loved one identify what is healthy versus unhealthy eating in boys and young men?

One question to ask is whether the person with the potential eating disorder is prone to anxiety, depression and perfectionistic tendencies. Other warning signs include people who have been bullied, felt too skinny or have struggled with their weight. These are all contributing factors for boys to develop some type of eating disorder. People should also consider their family’s personal history when considering whether or not a loved one is struggling with some form of muscle dysmorphia or related eating disorder. Risks are increased if there is a family history of eating disorder behaviors or anxiety issues. What are the family norms surrounding food and body image? Adults in a family are often the role models for their children. If discussions of weight and body shaming are frequent topics, kids will notice. From a mental health standpoint, the goal is to have a healthy sense of self and body. Excessive behaviors are usually a sign of a deeper issue. With this in mind, here are four warning signs to watch for in boys and young males:

  • Engaging in extreme dieting.
  • Quickly losing or gaining body weight.
  • Obsessing over dieting.
  • Binge eating and vomiting.

The presence of these behaviors could indicate that an eating disorder is developing. If this is the case, it is better for an individual to receive treatment as soon as possible. Earlier treatment has a better likelihood of success since these disordered behaviors will have less time to become entrenched habits. The concern is not only for the boy’s emotional health, but also for his physical health. Good physical fitness is great, but obsessive behaviors and perfectionism are not. If all signs point to a problematic body image and the existence of an eating disorder, it is beneficial to see a mental health professional who specializes in treating these conditions. Sadly, this topic is rarely talked about among young males. There is still a stigma surrounding publicly discussing mental illness. An additional stigma exists due to the fact that eating disorders are still seen as a women’s issue.

For additional questions about eating disorders in boys and young men, contact the staff at River Centre Clinic. Their programs provide a full range of treatment options for children and adults with a primary diagnosis of an eating disorder. For immediate and confidential feedback, take River Centre Clinic’s EAT-26 (Eating Attitudes Test) assessment. It is a widely cited standardized self-report screening measure that can help determine whether an individual has an eating disorder that requires professional treatment.

Follow us on Twitter:  @River_Centre

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