Hi, I'm Jeannie Plumb and I'm a family physician at Tahoe Forest Hospital. I'd like to talk to you a little bit about eating disorders today. Eating disorders are complex, life-threatening brain disorders that do not discriminate. They can affect people of all ages, genders, socioeconomic classes, and any size, shape, or body type. In fact, most people with eating disorders are not clearly underweight. Diet culture and weight bias can make it really difficult to identify an eating disorder. Risk factors for eating disorders are important. Personality traits can play a role in developing an eating disorder. Perfectionism, inflexibility, and high academic achievement can be risk factors for an eating disorder. Many people with eating disorders are high achievers who excel in sports and academics. Family history can also play an important role in eating disorder development. We know that there are several genes associated with eating disorders. In somebody who's genetically susceptible, a period of negative energy balance can trigger an eating disorder. Negative energy balance is when somebody fails to eat enough to sustain their metabolic needs and their activities of daily living. Things that might trigger an negative energy balance would be things like a fast for religious event, a surgery, wisdom tooth extraction, a stomach flu, or maybe exercising more than normal to prepare for a race. Other things risk factors are age. We know that children are at increased risk when they're undergoing a rapid period of growth. Also, athletes are at an increased risk for eating disorders, particularly endurance athletes or athletes that participate in a sport of a certain body type.
So, what are some signs and symptoms of an eating disorder? Often times, we see someone suddenly participate in a new diet like becoming vegan or becoming sugar-free diet. They might practice very restrictive patterns in eating or they might take up healthy eating. all of a sudden cooking for other people and not eating what they're making. Athletes might start exercising more than they normally do. They might start exercising at night or in bad weather or more than what their coach prescribes. You might see them not fueling properly for their sport or maybe not taking adequate rest days. They might develop a low heart rate. We might see people starting to wear overly baggy clothing or very restrictive clothing. They might become irritable, moody, maybe having some depression, anxiety, or self harm behaviors. They might be withdrawing from their normal activities. They might physically start complaining of stomach aches, constipation, nausea, being cold all the time, or maybe having discoloration of like bluish discoloration of their hands or feet. Girls might stop getting their periods. They might have passing out spells. We also tend to see people going to the bathroom a lot after or during meals or checking themselves in the mirror a lot called "body checking". Sudden pickiness in eating we see a lot in the younger kids. They might push food around on their plate a lot or cut their food into really tiny bites or feed the dog under the table without anybody watching. Also, secretive eating is very common. You might see someone wanting to eat and eat alone or not wanting to eat with their peers, skipping meals, or being missing from the lunchtime area at school. All of these symptoms are very commonly seen with people with eating disorders, and we should not overlook them.
So, if you're concerned about a friend, family, or loved one, I do recommend that you have them reach out to their primary care provider where the primary care provider can do an initial evaluation and a referral to Wellness at Tahoe Forest. There's also some really good online services that can be utilized if the patient doesn't feel comfortable going to the doctor. My favorite online resources are
FEAST-ed.org, the
Theprojectheal.org,
nationaleatingdisorders.org or
Equip-health.com. It is worth reaching out if you have concern for a loved one because eating disorders are treatable conditions and improved outcomes occur with earlier identification and referral. Thank you.
