Choosing to Be Part of the Solution: National Eating Disorders Awareness Week

Choosing to Be Part of the Solution: National Eating Disorders Awareness Week

Eating disorders occur in children and adults of all sizes and weights. When the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) replaced the DSM-IV this past year, there were some significant changes made to the Feeding and Eating Disorders chapter. Notable was the fact that amenorrhea (loss of menstrual cycle associated with low body weight) was no longer required criteria for Anorexia Nervosa, subsequently opening the diagnosis to those women who do not reach dangerously low weight and making the criteria more behavioral-based.  Additionally, the addition of Binge Eating Disorder to the DSM-V opened the diagnosis of an eating disorder to those who previously fell under the “not specified” criteria; the hope being that diagnosis will lead to more affective treatment.   (http://www.dsm5.org/Documents/Eating%20Disorders%20Fact%20Sheet.pdf)

In honor of February 23- March 1st 2014 being National Eating Disorders Awareness Week, I was reminded of an insightful post by Hope Reeves in The New York Times “Motherlode Blog” which was posted the beginning of this past school year (September 17, 2013).   The post, “When Obese Children Develop Eating Disorders, Doctors Often Don’t Notice”, sheds light on the fact that doctors are not accurately diagnosing eating disorders in overweight children, even after they have lost weight due to unsafe or obsessive behaviors indicative of pathology.

Last week, a friend of mine posted a photograph of an overweight eight-year-old girl (face not shown) on her Facebook page, with the caption “sad”.  The photo was taken as she was boarding a flight. She did not know this little girl.  My friend stated that she wanted to raise a discussion on the childhood obesity epidemic in our country, but some of the comments that she received in response to the photograph were so distasteful that I suggested she remove the photograph.  These comments were biting, cruel, inappropriate, and were coming from adults.

As a clinician, but also as a formerly overweight child, I experienced many emotions when seeing this, mostly anger and sadness at the ignorance and behaviors of adults, but also at how social media is perpetuating such behavior. First and foremost, I think this speaks to issues regarding this child’s anonymity and privacy, despite there being no face in the photograph.  It speaks to how easily it is in our society to become a victim of online bullying. The photograph and its comments reminded me that online bullying is not limited to youth bullying youth, that adults can bully just as much, and that this bullying can- and is- occurring within my very own social network.  And much of this bullying has to do with weight and body size.

In my choice to engage in what I hoped was a psycho-educational conversation it was revealed that my friend pinpointed the cause of this young girl’s excess weight to be poor eating habits and the fault of the parents.  This absolutely could be; yet, I reminded the friend there are many causes of childhood obesity and that the lollipop this child was sucking on may or may not be the root of this child’s issues, or tell the whole story.

The truth is, weight and food issues and eating disorders go way beyond food and physical appearance. If only it was as simple as following a simple recipe of “eating less” and “exercising more”, then we wouldn’t be a country with so many people struggling with their weight.   But it isn’t that simple, and that speaks to the complexities of weight and eating problems.

This little girl, no matter what the cause of her obesity might be: eating disorder, poor parenting, steroids for a medical problem such as cancer, a thyroid issue, a response to emotional or physical trauma (the list goes on…) has most definitely experienced emotional pain, teasing, guilt and shame as a result of her body composition.

As Ms. Reeves blog post points out, this little girl is at tremendous risk of an eating disorder if she doesn’t yet have one already.

As a society, we are so fixed on looking at things in the black and white, which is largely in part due to what we are fed in the media.  Online bullying is not something that just happens between youth, even though we hear mostly about it in that capacity in the media. Eating disorders are not just about starvation and low weights, even though we mostly hear about it in that capacity in the media. Obesity is not just about overeating and lack of exercise, even though we hear mostly about it in that capacity in the media.

The moral here: there is always more to the story.  There is always an opportunity to educate yourself and someone else. This is called raising awareness, and this is what National Eating Disorders Awareness Week is about.

Acknowledge the beauty in someone: regardless of his or her weight.  Smile at a child, regardless of weight.

Kindness always trumps judgment.

Let’s celebrate National Eating Disorders Awareness Week by being part of the solution, not part of the problem.

For more information:  http://nedawareness.org

-Jaime Gleicher, MSW