The stereotypical picture of what an eating disorder looks like does not match the reality. Anyone can develop an eating disorder, and it doesn’t always appear as expected.
“We help people of any weight, shape, size or gender,” says Jessica Herrmann, a Registered Dietitian with ThedaCare Eating Disorder Care. “It’s not just what you see in the movies. In fact, atypical anorexia (when a person loses a lot of weight but is still within a ‘normal’ weight range) is more common than the ‘skinny’ stereotype.”
Answering the Call
Herrmann works alongside her colleague and fellow Registered Dietitian Carly Spreeman. They each chose to specialize in eating disorder care when they saw people become increasingly disheartened in their quests for weight loss.
“I saw people struggle against their bodies and then form negative relationships with food, and I didn’t want to perpetuate that,” Spreeman says.
In honor of National Eating Disorders Awareness Week, Herrmann and Spreeman share key facts about a group of conditions that affects more than 28 million Americans of all ages and genders.
Eating Disorder Types
Most people have heard of anorexia nervosa and bulimia nervosa, but those aren’t the only eating disorder types.
Other eating disorders include:
- Avoidant/restrictive food intake disorder (ARFID)
- Binge eating disorder
- Disordered eating patterns requiring clinical care
- Orthorexia
- Other specified feeding or eating disorders (OSFED)
Behavioral & Physical Symptoms
Someone who is living with an eating disorder may display many symptoms or few. Below is a partial list of possible signs.
Emotional and Behavioral Symptoms
- Preoccupation with weight loss, food, calories and dieting
- Eliminating whole food types from one’s diet (such as carbs, fats or dairy)
- Changes in eating pace
- Adoption of food rituals
- Frequent bathroom use after meals
Physical Signs and Symptoms
- Changes in weight (up or down)
- Poor concentration
- Often feeling cold, even in warm weather
- Dizziness, fainting or blurred vision
- Thinning hair, brittle nails
- Dental problems
- Abnormal lab results
Key Eating Disorder Tenets
Herrmann and Spreeman shed light on three important concepts in today’s understanding of eating disorders:
- Eating disorder treatment is weight-neutral. When a person begins treatment, they learn their care will extend beyond a number on the scale. Treatment also will center on a person’s behaviors, thoughts and relationships around food.
- Eating disorders are, at their heart, a mental health condition. They tend to be chronic conditions that last for an average of five years or longer. Recovery is not always a straight path. Slips are normal and expected within different phases of life.
- Eating disorders are coping mechanisms that arise due to a variety of factors. Some of these include:
- A need for control due to unpredictable life circumstances.
- A genetic predisposition to disordered eating including family history, chemical/hormonal imbalance and temperament traits.
- A person’s environment. For example, Spreeman describes how chronic food insecurity can lead to disordered eating because a person may severely restrict food intake since they cannot access enough food. They also may binge when they do have food because they are unsure of when they will be able to eat again. “This pattern of restriction and binging can remain long after food insecurity is resolved; that’s when it becomes an eating disorder,” Spreeman says. Other examples of environmental factors include involvement in demanding fitness or athletic pursuits, body-shaming and social media exposure.
Eating Disorder Treatment
ThedaCare offers two types of eating disorder treatment: behavioral health care and nutrition services. The type of care available depends on the person’s age.
Behavioral Health Care
ThedaCare Behavioral Health treats individuals 17 and older. To seek behavioral health care for an eating disorder, individuals should seek a referral from their primary care physician or advanced practice provider. Existing behavioral health patients may talk with their mental health provider about transferring their care to the ThedaCare Eating Disorder Therapy program.
Kids younger than 17 will receive a referral to Catalpa Health for behavioral health treatment of eating disorders. ThedaCare, along with other health care organizations, partners to support Catalpa Health in offering mental health care for children.
Nutrition Services
ThedaCare nutrition services are available to those 8 and older. A primary care physician or advanced practice provider can provide a referral for services.
Nutrition Care Philosophy
Herrmann says she strives to help her patients return to joy around food. Her team integrates nutritional counseling with behavioral health care and other specialized treatment to help people reclaim a healthy relationship with food.
“It’s more than a means to survive. We help people return to intuitive eating,” Herrmann says. “The goal is to tune out the societal noise about food and body shape and value our own preferences so that each of us can show up in the world in a way that aligns with our personal values.”
This may mean relearning how to perceive physical cues like hunger and fullness and honoring one’s own sensory preferences for food texture, color and flavors.
“When a person’s mind is no longer constantly occupied with thoughts about food and body shape — and has the nutrients to function well — life becomes joyful and intentional again.”
Learn more about eating disorder services through ThedaCare and how to get started.
