Tuesday, November 29, 2022

Are Eating Disorders On The Rise

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Shrinking Ideal Body Shapes

Eating disorders on the rise during the pandemic

Some experts trace the rise in anorexia back to a significant shift in ideal body shapes that took place in the 1960s. This is when super-skinny models such as Twiggy were seen as the epitome of beauty for the first time. Their waif-like frames marked a big departure from traditional ideals of beauty, such as curvy Rubin-esque figures or voluptuous hourglass pin-ups like Marilyn Monroe. And it proved a decisive cultural break.

From the late 1960s onwards, both female models and celebrities continued to shrink, from the heroin chic of the Nineties to the size-zero controversy in the Noughties, and beyond.

Why Are The Numbers Rising

Therapists across the UK have all noticed a rise in their caseload since the height of the pandemic in 2020, and are still seeing the effects of lockdown in their practices today. For therapists working with those who suffer with eating disorders, there is no exception.

The isolation of the pandemic, the limit of movement and social activity are factors in many cases of deterioration in mental health, but testimony from Dr Richards highlights an important aspect of lockdown that may have caused eating disorders to thrive while we have been stuck inside: a lack of control in daily life.

While many cannot control where they go, who they see or what they do, the one thing they can control is the amount that they eat, or perhaps more concerning, what they look like.

There has also been widespread concern about lack of physical activity, and about weight gain during periods of lockdown, which has seen the nation both dieting and exercising, en masse She tells The Guardian, Eating disorders have thrived in this environment, as the focus on eating and weight control becomes a way of coping.

Dr Ayton also raises a great point that the sudden rise in cases could also be due in part to the lack of people feeling as though they can seek help in the midst of lockdown. Ayton says,

Some people dont want to see their GP or they dont feel they deserve to come forward as they think that other people with Covid are more deserving. There is a lot of shame related to eating disorders.

Uptick In Eating Disorders Outweighing Resource Capacity In Saskatoon: Experts

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Experts say theyre struggling to keep up with a pandemic-induced surge in eating disorders, which feed on secrecy and isolation.

It keeps us up at night sometimes, knowing that we are struggling to try and meet the need, said Dr. Ayisha Kurji, a pediatrician at the Jim Pattison Childrens Hospital in Saskatoon.

Read more: Why the coronavirus pandemic is triggering those with eating disorders

A concerning number of youth are getting sick, Kurji said, with up to six patients staying at the childrens hospital and Dubé Centre for Mental Health for months at a time. Inpatient and outpatient referrals have almost doubled during the pandemic, she said.

We try to do our very, very best to make sure that everyone is seen in as timely of a fashion as we can, she said. But our resources are limited.

The faster people are connected to treatment, the more likely they are to have positive long-term health outcomes, she said.

The Saskatchewan Health Authority said the pandemic has put stress on several health care services, including those for eating disorders.

We continue to do our best to balance these necessary health care services with the response and pressures related to the COVID-19 pandemic, the SHA said in an emailed statement.

Read more: Men suffer from eating disorders, too so why do we ignore them?

Theres going to be potential gaps in care when that person is unavailable, she said.

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How Common Are Eating Disorders

  • Approximately 30 million Americans live with an eating disorder.
  • Eating disorders are the third most common chronic illness among adolescent females in the United States.
  • 10 million men in the U.S. will suffer from an eating disorder in their lifetime.
  • The lifetime prevalence of eating disorders is highest among those with a binge eating disorder .

The Rise In Eating Disorders Among Adolescents Due To Covid

Anorexia in America: an Illness on the Rise

Contributor: Staff at Timberline Knolls Residential Treatment Center

To some extent, almost everyones world has been turned upside down by COVID-19.

Even if the only real effects youve felt have been related to a shift in work environment, fewer dinners out, and the need to remember your mask, the pandemic has played at least some role in the way we live our lives.

The new reality has been especially hard to swallow for adolescents, whose formative years have suddenly been absent of the sleepovers, sporting events, school dances, and graduation parties theyve come to expect. Remote learning wasnt easy on anyone, whether you were missing the in-person adjustment to your first year of school or the eager anticipation of your last.

With such considerable change comes significant hardship. Teens have experienced a major uptick in physical and mental health consequences, including eating disorders.

That has been particularly true for adolescent girls. New data from the Epic Health Research Network shows that there has been a 30% spike in eating disorder-related hospital admissions among girls ages 12-18 during the pandemic . Overall, eating disorder diagnoses increased by 25% for that same age range compared with pre-pandemic trends.

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Eating Disorder Statistics By Age

  • Globally, 13% of women older than 50 experience disordered eating behaviors.
  • The median age of eating disorder onset was 21 years old for binge eating disorder and 18 years old for anorexia and bulimia nervosa.
  • The lifetime prevalence of eating disorders in the U.S. was 2.7% among adolescents as of 2001-2004.
  • Of adolescents with eating disorders, the 17- to 18-year-old age group had the highest prevalence .

Researchers followed a group of 496 adolescent girls in a U.S. city over a span of eight years and found that by the age of 20:

  • More than 5% of the girls met the criteria for anorexia, bulimia, or binge eating disorder.
  • More than 13% of the girls had experienced an eating disorder when including non-specific eating disorder symptoms.

The Path To Disordered Eating Is As Unique As The Person Affected

Because disordered eating originates from a combination of genetic, environmental, and individual factors, the path to developing such a disorder is complex, and is likely as unique as each person affected. The presentation of disordered eating is also extremely individualized. For example, some people may appear to eat in a healthy manner, but their extreme exercise habits negatively impact their health and their relationships, as the preoccupation around exercise for weight loss or maintenance becomes the biggest priority in their life. Others may eat very little during the day but eat throughout the evening. Some people may try to compensate for binge eating with strategies such as self-induced vomiting or laxatives, while others compensate for the caloric intake by restricting for days following a binge.

Myths surrounding eating disorders often lead to shame and secretive behaviors that could destroy relationships or lives. KNOW THE FACTS:

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‘children Reaching Out Themselves’

Ms Ogle told MLAs that during the pandemic the age of children contacting the charity was “much lower than we previously experienced, with several children as young as 13 or 14”.

“Usually it’s parents getting in touch to discuss their children but sometimes we actually have the children reaching out themselves,” she said.

“The people who are contacting us at the moment are a lot more unwell than we have previously experienced.”

Ms Ogle said that anorexia-type symptoms were the most common presentation to EDANI, but since the summer of 2021, more children were coming forward with bulimia or binge-eating disorders.

She said EDANI had 2,000 requests for support in the past year alone, but it was difficult to get overall data on the prevalence of eating disorders in Northern Ireland.

“The data only captures people that are within the trust’s care system, they don’t capture people at a primary care level,” she said.

“I can tell you who reaches out to us but that is obviously only the tip of the iceberg of who is actually out there.”

Adolescent Boys And Young Men

Eating disorders on the rise during the pandemic

Historical research on diagnosing eating disorders has focused on females. This has made it harder for doctors, families and patients to recognize eating disorders in males. For example, adolescent boys may be more prone to focus on muscle strength and steroid use indicators that are not captured in traditional, female-focused screening tools and diagnostic criteria.

However, newer research suggests that males may account for up to half of all cases of eating disorders. While males have likely been underdiagnosed in all categories of eating disorders, male adolescents seem to be more prone to avoidant restrictive food intake disorder. This is a relatively new eating disorder that involves inadequate food intake but not distress about body shape or size.

Disordered eating a pattern of problematic eating behaviors that include dieting, skipping meals and feelings of shame but does not meet formal criteria for an eating disorder diagnosis is increasingly being self-reported by male athletes. This means high school coaches and athletic trainers are a potential source for increased awareness and recognition of problematic relationships with food or exercise in young males.

Read Also: The Most Important Predictor Of An Eating Disorder Is

Study Findings: Eating Disorders In Men On The Rise

According to the National Eating Disorders Association , about one in three people struggling with an eating disorder is male.

Theres a range of eating disorders in existence, with some of the most common types being:

  • orthorexia, or a preoccupation with eating only clean foods
  • anorexia, focused on restrictive eating and severe calorie deprivation
  • bulimia, which involves purging foods via vomiting, laxative use or excessive exercise
  • binge eating disorder, in which people consume large quantities of food in a brief period

What do males with eating disorders tend to focus on?

A 2021 study published in Current Opinions in Pediatrics found that eating disorders usually affect boys and men a bit differently than they do girls and women, specifically by being focused more on muscularity and muscle-enhancing goals.

While women with eating disorders tend to want to make their bodies smaller, men with eating disorders typically want to appear more defined, lean, muscular and strong. Case in point: NEDA reports that 25% of normal weight males perceive themselves to be underweight and 90% of teenage boys exercise with the goal of bulking up.

A 2019 study even found that about 22% of young men turn to dangerous means to bulk up, suggesting that almost one in four young men displays disordered eating behaviors.

Which eating disorder is most commonly found in males?

Yale Power Program Is Studying The Best Ways To Help

POWER offers a variety of clinical trials for children and adults focusing on such areas as the use of medications to treat binge-eating, plus such treatments as cognitive behavioral therapy . A new treatment trial is examining behavioral and/or medication treatments for adults with loss-of-control eatingthe central feature of binge-eatingfollowing bariatric surgery.

One approach the program is studying is CBT for teens. The trial provides treatment over four months, first focusing on the eating pattern. To do this, they ask participants to write down everything they eat, what time they eat, how they were feeling, and what they were thinking at the time they ate. We look for patterns with the teen and help them to eat meals and snacks on a regular, predictable schedule, Lydecker says. Parents attend the sessions once a month as well, which is helpful for a discussion of such practical issues as how to buy groceries for a child who may insist on only eating certain foods.

Thinking about weight loss as a solution to problems in a childs life is like saying that weight is a problem, which is a message the child will likely internalize.Janet Lydecker, PhD, director of child eating and weight initiatives for Yales POWER Program

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Subtle Signs That Someone May Have An Eating Disorder

Showing a large amount of interest in food and excessively talking about food

When someone is struggling with an eating disorder, they may become preoccupied with food, explains Longsdale. They may start to watch more cooking programmes, read more recipes or prepare a lot of food without consuming it.

While its true your friend could just be a foodie, or maybe they want to start a new hobby, one study found that following a period of starvation, people can become heavily preoccupied by cooking and food, despite having no prior interest in it.

Regimented eating habits

The compulsive nature of many eating disorders can lead to a person developing rigid eating habits, where they become particularly meticulous in their eating routine says Longsdale.

This could be something like only eating at very specific times of the day, and refusing to eat before or after a certain time: inflexibility around mealtimes may point to someone wanting to control their eating habits meticulously.

Another sign could be, as Longsdale points out, someone only uses certain plates and bowls.

Adding lots of condiments to food

Again, condiments in and of themselves arent always associated with eating disorders.

But, Longsdale says, A person may choose to use condiments that have flavour but few calories, such as vinegar, hot sauce, salsa, chilli, gravy, tabasco, salt and pepper.

Wearing clothes that dont fit

Eating food in a particular way

Fidgeting

Chewing gum

Generally eating the same foods

The Pandemic Rise In Eating Disorders

Anorexia in America: an Illness on the Rise

To folks who concern themselves with eating disorders, this is not news. Rather, it is confirmation. The pandemic has brought a sharp rise in eating disorders. A new report yesterday in the MMWR provides solid documentation. In fact, the proportion of emergency department visits with eating disorders doubled for teenage girls during the pandemic. Emily Pluhar is a pediatric psychologist at Boston Childrens Hospital. She described the findings as unsurprising:

You take a very vulnerable group and put on a global pandemic. The eating disorders are out of control.

The report also found a tripling of emergency visits for tic disorders for adolescent girls. The authors of the MMWR report describe these observations as an indication of a rise in distress for these teens:

Increases in weekly visits for eating and tic disorders for females, and particularly among adolescent females aged 1217 years during 2020, 2021, and in January 2022, could represent an overall increase in distress among females during the pandemic. Both eating and tic disorders can co-occur with anxiety, depression, and OCD.

A Hidden Burden?

Thats the irony of health stigma. Inevitably, it magnifies the harm of a health problem.

An Urgent Crisis in the Spotlight

Debra Katzman describes the urgency of this problem:

Click here for the MMWR report and here for further perspective on it. For more on the crisis in mental health affecting our youth, click here and here.

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Unique Insights From 2500+ Contributors In 90+ Countries

It is imperative that parents and loved ones have this issue on their radar screen, as treating disordered eating patterns often requires clinical intervention. Keeping an eye out for warning signs can be life-saving. If someone you care about starts avoiding eating with family and friends, along with noticing changes in weight , these should be considered concerning, Allison points out. Using a bathroom directly after a meal could be a red flag for vomiting or laxative use. Other warning signs include hoarding food, a preoccupation with body weight, food or calories, wearing baggy clothes to hide weight loss, frequent checking in the mirror, skipping meals, etc.

Regardless of the reason, the pandemic has driven a rise in eating disorders and, like with COVID-19, a lot depends on everyone doing their bit to make sure those at risk are protected.

The views expressed in this article are the authors own and do not necessarily reflect Fair Observers editorial policy.

Why Eating Disorders Increased During The Pandemic

Recommendations such as social distancing helped protect us from COVID-19. However, it was emotionally taxing being separated from friends and family. During the pandemic, there were higher levels of depression, anxiety and stress, and a real appreciation that periods of isolation and disconnection are tough on mental health, says Dr. Albers.

Isolation provides the right environment for eating disorders to thrive, she adds: When you are alone you can eat or not eat in any way that you choose. Weve experienced some extreme levels of isolation with the pandemic.

In non-pandemic times, isolation can also be an eating disorder warning sign. If you find that a friend or family member is canceling dinner reservations or not eating meals with family, these are significant signs they are struggling with their eating, Dr. Albers says.

Disordered eating habits are easier to spot during in-person interactions. When you are going out to dinner with people, eating with others, eating with family members, they notice what youre eating or not eating, says Dr. Albers. Its also easier to compare what youre eating with others at communal meals.

Being separated from loved ones and, by extension, a strong support system can also hide eating disorder relapses.

Dr. Albers adds that changes to habits and routines may have also been a factor.

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Eating Disorders: Increase In Young Teenagers Seeking Support

BBC News NI Education Correspondent

An increasing number of younger teenagers are seeking support for eating disorders, assembly members have been told.

Eating Disorders Association Northern Ireland’s Sian Ogle gave evidence to Stormont’s Education Committee.

She said in one case a child deemed an emergency had to wait 26 weeks before being seen by specialists.

According to a BBC investigation, waiting lists for treatment in England have trebled since the pandemic started, while those that are being seen are having to wait longer for care.

In 2019-20, there were 9,969 review appointments for eating disorder services in health and social care trusts, but that rose to 13,792 in 2020-21.

Those figures include both adults and children.

However, Eating Disorders Association Northern Ireland suggested that this number could be significantly higher as it does not include individuals who have not been hospitalised – such as those seeking help in community-based settings or those who choose not to seek help.

The Youth Wellbeing NI Survey in 2019 found that “one in six children and young people in Northern Ireland engaged in a pattern of disordered eating and associated behaviours that might indicate the need for further clinical assessment,” for example.

EDANI is a charity which offers support and services for families affected by eating disorders such as anorexia or bulimia.

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