Posts Tagged ‘Education’

For many people, college is a time of tremendous transition and change. It provides new freedom and responsibility and offers lessons in life far beyond the classroom.

It is a milestone time—and one far too often hijacked by eating disorders.

All types of eating disorders can develop, return, or worsen in young people during their college years. Though these illnesses occur across the lifespan, they are particularly prevalent between the ages of 18 and 21. Research has found that the median age of onset is 18 for anorexia and bulimia and 21 for binge eating disorder, both findings within the age range of the traditional college student.

This article examines eating disorders in college students, including potential risk factors, warning signs, and tools for screening and intervention. Learn what makes college students particularly vulnerable to these complex mental illnesses as well as ways to identify and support those affected by them during college and beyond.

Eating disorders are complex illnesses. Diverse and multifaceted, they are associated with biological, psychological, and social factors that themselves are complex and interact with one another in complex ways.

One factor often overlooked in conversations about eating disorder development, illness, and recovery is food insecurity. Research about the link between food insecurity and eating disorders has emerged in recent years, as food insecurity has likewise seeped into the public consciousness more generally.  

This article describes what we know about food insecurity and eating disorders to date, how to screen for food insecurity, and how to integrate food insecurity support into eating disorder treatment and recovery. By addressing food insecurity in patients with eating disorders (and eating disorders in patients experiencing food insecurity), providers can play a critical role in intervening and supporting those dually affected.

What is food insecurity?

Food insecurity, as defined by the USDA, is the “limited or uncertain availability of nutritionally adequate and safe food” or the “limited or uncertain ability to acquire acceptable foods in socially acceptable ways.” Assessed on a household level, food insecurity is influenced by multiple factors and occurs at different levels of severity.  

We all live in diet culture, a society obsessed with thinness and dieting. Weight and food biases permeate the air we breathe, tingeing our thoughts and actions in ways sometimes hard to notice. Providers, patients—none of us—are immune to these biases. They’re often subtle and deeply embedded, and left unexamined and unchecked, they can manifest in interactions between patients and even the most capable, well-intentioned providers.

In this article, we define and discuss weight and food bias, including its perpetuating factors and health consequences. Learn the impact of weight stigma and how to recognize and counter implicit and explicit bias in yourself, your practice, and in our larger society.

What are weight bias and stigma?

Weight bias refers to negative attitudes, beliefs, or assumptions about others based on body weight or size. Internalized weight bias occurs when these negative weight-related beliefs are absorbed and held about oneself.

Weight bias can lead to weight stigma, or the disapproval of someone based on their weight. Stigma is seeing someone negatively because of their weight, which can in turn lead to treating someone negatively because of it. Stigma manifests in stereotyping, bullying, and discrimination on the basis of weight, as well as exclusion and marginalization in media, professional, health care, and other settings. While weight bias harms people of all sizes, those who live in bodies that do not conform to “normal” body size expectations experience the greatest weight stigmatization.

March is National Nutrition Month. For those of us who are dietitians and nutritionists, National Nutrition Month is typically a time to ask folks to think a bit more about food, nutrition, healthy eating, etc. So, it might be a little odd that I am choosing to write about the possible dangers of paying too much attention to the food you eat! 

Don’t get me wrong, I absolutely believe that what you eat—when, how, and with whom you eat—can make a tremendous difference in your physical and mental health, as well as your overall enjoyment of life. However, we are seeing a disturbing trend, particularly online, that promotes strict adherence to a rigid set of food rules as the path to health and moral purity. This is the world of “clean eating.” 

The concept of “eating clean” has its origins in the early days of alternative medicine. People would become obsessed with obtaining health and curing disease through the strident adherence to various dietary strategies. Dr. Steven Bratman, an alternative medicine physician at the time, noted that many of his more diet-focused patients were “inadvertently harming themselves psychologically through excessive focus on food.” Also, their “exuberant pursuit of physical health had spawned a rigid, fearful and self-punishing lifestyle that caused more harm than good.” He created a name for this hyperfocus on food and obsession with eating the “right” food—“Orthorexia Nervosa” (1).

You’re invited!

Whether in-person or virtually, you’re invited to assess, assess, assess! In school, we clinicians are taught to ask questions—so many questions. We are taught to ask about our patients’ history, about their current happenings, and about their future hopes and dreams. We are taught to ask about easy things and hard things. We are taught to ask about things that aren’t socially appropriate, things that are extremely uncomfortable outside the confines of medical and mental health settings. We are trained to ask questions about substance use, depression, anxiety, suicide, sexual behaviors, and peculiarities of the human body and its functioning.

Yet, so often, we forget to ask questions about one of the things that sustains life: FOOD! We know that to survive we need to eat. From the moment of conception to the moment of death, we are required to consume, in some way, calories that feed and nourish the systems within the body. Why, then, do we shy away from asking questions about this life-giving, life-sustaining human behavior?

Anecdotally, I hear medical and mental health providers say, “We have never had training,” “I don’t know what to ask,” and “I’m not sure what to do if it seems as though there might be a problem.” However, in the same way that we all learned how to ask and how to respond or intervene following questions about suicidal ideation or even substance use, we all can become more comfortable with integrating questions about eating disorders into our assessments of 100% of our patients.

The Emily Program’s Peace Meal podcast is officially in its third year of production! To celebrate the milestone, we listened back to our first two years of episodes and rounded up our choice picks for healthcare providers. Tune in to this sampling to hear eating disorder experts and people in recovery provide education by way of clinical experience, research, and personal stories. You’ll learn how to better understand, identify, and address eating disorders in your everyday interactions with patients.

Episode 2: Eating Disorders 101

For a basic introduction to eating disorders, this 101 primer is the place to start. Therapist Jennifer Nelson lays out general eating disorder facts, including the primary types and diagnoses, risk factors, and warning signs.

Rejecting the myth that eating disorders are always visible, Jennifer explains that the illnesses are in fact often missed by both providers and clients themselves. Eating disorders don’t have a look, size, or shape, she says, and many symptoms are easily dismissed or hard to see. They often develop slowly and subtly over time. Emphasizing the importance of close, careful examination and early intervention, Jennifer also offers advice to providers concerned about their patients.

Listen to the episode here.