Atypical Eating Disorders Up Six-Fold
A new study just published in Pediatrics documents a nearly six-fold increase over six years in serious eating disorders (EDs) among adolescents with a normal BMI. Experts in the field have been quietly expressing concern about this trend for some time.
These patients present with serious medical signs and symptoms typical of anorexia (AN) after losing significant weight. Shorthand for this emerging diagnosis is EDNOS-Wt (Eating Disorder Not Otherwise Specified – Wt).
As public health campaigns against obesity whip up a fervor to get people moving more and eating less, eating disorder clinicians have been seeing a marked increase in EDNOS-Wt. The authors note:
In the context of the obesity epidemic, EDNOS-Wt has rapidly emerged as an ED in adolescents who have lost large amounts of weight but who are not underweight at the time they present to health services. In this study, EDNOS-Wt patients had higher premorbid weights; however, some AN cases were also premorbidly overweight or obese. It is noteworthy that some of the patients in the current study had been advised by a health professional that they should lose weight, but no advice or follow-up was provided.
Leslie Sim, clinical director of the Mayo Clinic eating disorders program, provides perspective:
These patients just fly under the radar and when they’re in that earlier stage, it’s harder for people to see it. Parents say to me every day, “I thought my daughter was doing something good and making healthy choices until it got out of control. We didn’t know it was a problem until she couldn’t eat the cake at her birthday party.”
Obesity and eating disorders are two significant health concerns that cannot be addressed in isolation. Campaigns of shame and blame (need we mention Strong4Life?) have real costs in terms of the bias and stigma that they perpetuate.
And it may be that campaigns of shame and blame can have a serious cost for people susceptible to disordered eating. Both eating disorders and obesity are serious medical conditions that deserve serious medical care — not glib, generalized advice to “get a grip” or “eat less and move more.”
Eating Disorder, photograph © Darren Tunnicliff / flickr
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