While public perception tells us eating disorders are limited to extreme dieting, the reality is much different. In truth, eating disorders affect all genders and ages, and the causes and warning signs are not always visible.
Being sensitive to symptoms and understanding that help is out there are important steps in the right direction.
Sanford Health providers like Leah Bryan, M.D., M.Sc., a family medicine physician at Sanford Wheaton Clinic in Minnesota, can offer expertise in helping people sort out causes and shape effective treatment plans for a disorder that can involve underlying complexities.
“Some people don’t realize eating disorders are psychological disorders that medication and therapy can help,” Dr. Bryan said. “They view these disorders as a personal failing. This often prevents them from seeking help.”
Eating disorders are complex health conditions
In general, eating disorders fall into two types, though people with disordered eating do not always fall rigidly into one group. Someone with an eating disorder may display behaviors from both of these categories:
- Anorexia nervosa. People with anorexia severely restrict calories to the point of starvation. They have an intense fear of gaining weight and lack the capacity to recognize the seriousness of their low body weight. They may refuse to eat at all. Or they may only eat tiny amounts of food that has few calories, or only a certain food.
- Bulimia nervosa. People with bulimia nervosa binge on huge amounts of food. They then force themselves to vomit, exercise compulsively or take laxatives. They continue this cycle of binging and purging. They may also diet excessively in between binges. People with bulimia nervosa may often seem to be of normal weight.
Primary care providers can help
In regard to eating disorders, your primary care provider is often the first to notice symptoms, sometimes even before patients themselves understand they have a problem they need to address. Communication is a huge piece of regaining control of your relationship with food.
“It’s incredibly important to talk to your doctor,” Dr. Bryan said.
Dr. Bryan has made it a cause to overcome those conversational barriers with her patients. The result can be that they know more about why they feel the way they do, and they understand it’s not a lack of character keeping them from better health. For doctors, these conversations can provide a pathway to successful treatment.
“We really have to break the stigma,” Dr. Bryan said. “When people come to the doctor and bring up issues – and we start talking about weight and eating patterns – they should not be topics that cause us to cut the conversations short.”
Early recognition leads to better health
Dysmorphia is a condition where a person is preoccupied with their appearance. As it applies to bulimia and anorexia, it can distort how people see themselves and can make effective treatment more difficult.
“Their brain is literally telling them that they weigh differently than what they truly weigh,” Dr. Bryan said. “They’re not going to view what they weigh as a concern.”
They may come in to see a family provider like Dr. Bryan with other health concerns and leave having a much more accurate view of their health.
“Sometimes, it’s only after we ask them a lot of questions about their stress, their mood and their habits throughout the day that they realize that, ‘OK, maybe a disordered eating issue is one of my concerns,’” Dr. Bryan said.
Eating disorders that persist can do lasting damage. Binge-eating, bulimia, and in particular anorexia, can disrupt a body’s chemical reactions and result in severe health issues.
“You can end up with metabolic derangement involving your electrolytes that can lead to death,” Dr. Bryan said. “It can cause heart failure – and no 20-year-old should be walking around with heart failure. The earlier we can identify an eating disorder, the better it will be. We can make sure you avoid long-term consequences.”
Earlier diagnosis of an eating disorder can also identify trauma that, left untreated, can cause long-term problems.
“Eating disorders have a wide variety of causes – things like physical abuse or sexual abuse or even environmental disasters like hurricanes that destroy homes,” Dr. Bryan said. “The disorders can be a response to trying to take control of something. We’d really like to find out as early as possible what is causing mental anguish.”
You can start the conversation
Lately, for providers who often talk to patients about the role eating plays in health, conversations about GLP-1s have been unavoidable. Patients’ questions about GLP-1s can provide a gateway to valuable conversations about nutrition, however, so it’s not a bad thing.
After explaining how GLP-1 weight loss medications work, Dr. Bryan will often review what has to take place after you quit taking them.
“Once you get off these medications, the eating pattern you had while you were on it has to continue,” she said. “I’ve been able to identify overeating, binge-eating disorders in patients who came in because they wanted to talk about GLP-1s.”
Patients will tell her they have tried everything to lose weight and none of it is working. As is so often the case, they attribute it to their own lack of willpower. This kind of thinking can bring on other problems, like anxiety and depression.
In a sense, bulimia and anorexia issues are personal attempts at restricting the amount of food they eat. GLP-1s are chemicals taking on that same assignment.
“Either way it’s an attempt to treat an eating disorder without actually treating the disorder itself,” Dr. Bryan said. “You’re telling yourself, ‘Hey, here’s another way you can restrict how much you eat at one time.’”
Find help for eating disorders nearby
Eating disorder treatment starts with a conversation. Regardless of where you live, care options exist via virtual care or clinic visits that will give you access to the medical expertise people like Dr. Bryan can supply.
“Sanford Health has a lot of satellite locations, a lot of rural locations like in Wheaton where we can reach people,” Dr. Bryan said. “You don’t have to live in a big city to get the treatment that you need. You don’t have to live in a big city to have somebody actually talk to you about eating disorders. It can happen right here in your hometown.”
Sanford Health can help you get back on the path to physical and emotional well-being. You can find a provider who offers support and expertise when you need it most.
Learn more
- Think someone has an eating disorder? Here’s what to do
- Eating disorders vs disordered eating: Differences & dangers
- Patient shares eating disorder journey: ‘I was so afraid’
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Posted In Behavioral Health, Family Medicine, Healthy Living, Internal Medicine
