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Kate Watson on the challenge of living with an eating disorder in a food-centric city
New Orleans has a reputation for decadence. Whether tailgating at a football game or indulging at a Carnival ball, locals party, drink and eat with abandon. Laissez les bon temps rouler is the unofficial motto for this culture of revelry. It’s easy to forget there is no joie de manger, or “joy of eating,” for New Orleanians struggling with eating disorders.
I know that battle personally. A nearly five-year struggle with bulimia left me sick, weak and miserable, with severe dehydration, protruding ribs and swollen salivary glands. Though now fully recovered, I understand advocacy, awareness and support are crucial in a city where eating is a religion in its own right.
The American Psychological Association defines eating disorders as “abnormal eating habits that can threaten your health or even your life.” Anorexia nervosa (excessive food restriction and an intense fear of gaining weight) and bulimia nervosa (binging and purging) are just two examples. Other types include binge-eating, restricting food intake and purging disorder. Essentially, eating disorders are mental illnesses that manifest themselves physically. According to the National Association of Anorexia Nervosa and Associated Disorders, they have the highest mortality rate of any mental illness.
Men and women of all ages, races and socioeconomic classes can be affected, but many sufferers don’t seek help due to misinformation and stigmas. J. Casey Martin, a licensed professional counselor in greater New Orleans, is familiar with the misconceptions: “Eating disorders are a choice,” he says, listing some common false impressions. “They only affect adolescent, white females. They are chronic and untreatable. Eating disorders are about the food.”
My own bout of bulimia definitely fit one stereotype — I was white, female and aged 15 to 19 when I battled it — but that doesn’t mean there aren’t sufferers of other genders, races and ages. Debunking the misconceptions around eating disorders is important, because otherwise it’s difficult for people who don’t fit the mold to find help.
Just as there are many different types of people with eating disorders, there are many approaches to treatment, including counseling and therapy, nutrition programs, addiction recovery services and support groups.
A directive, team-based approach is the heart of Martin’s method. Martin trained in Denver at one of the country’s top eating disorder treatment hospitals, and moved back to New Orleans in 2013. Martin’s private practice, Martin Mental Health, specializes in eating disorders, weight loss, anxiety disorders and stress management. Martin believes New Orleans’ overemphasis on its cuisine needs improvement.
“In a city that’s culture and heritage is so synonymous with food, I want to debunk the misconception that living a healthy lifestyle in regards to food and/or weight has to be restrictive,” he says. “It’s instead more about maintaining consistency and balance.”
Mary Munger, a licensed clinical social worker at Maple Street Counseling, uses cognitive-behavioral and dialectical-be- havioral therapy, relapse prevention models and mindfulness-based psychotherapy when treating patients. There also is a promising, though still experimental, approach which prescribes patients certain ADHD drugs to lessen binging behaviors.
Dr. Howard Wetsman of Townsend Addiction Treatment Center views eating disorders as an addiction. Townsend’s outpatient and inpatient treatment methods have similarities with rehabilitation programs for alcoholism or drug dependency.
“For us, addiction is an illness regardless of the drug or behavior the person uses,” Wetsman says. “Compulsive overeating and bulimia derived from compulsive overeating are more easily treated in this way than primary anorexia. We use the same complex medication algorithms for compulsive overeating that we do for addiction patients who are using drugs.”
Though Wetsman approaches eating disorders in a more physical way, he understands how gripping the disease can be mentally. To readers who are or who think they may be suffering from an eating disorder, Wetsman says, “You aren’t alone. You’re ill, not broken or bad or weak. Talk to someone. Get help. No one has to do this alone.”
Sufferers certainly are not alone. National studies indicate a 13 percent lifetime prevalence in women. Wetsman believes this number could be higher when “atypical” diagnoses are included. With no specific gene or standard medical test to identify eating disorders, diagnostics can be subjective.
Wetsman doesn’t believe that should dissuade patients from seeking help: “What’s really important here is that eating disorders are common — and not just in women — and need attention from a medical professional,” he says.
Patients aren’t the only ones who suffer. For people whose loved ones have eating disorders, there are often feelings of confusion, anger and powerlessness. Friends and family may look on helplessly as the physical and mental side effects wreak havoc. Corey Walsh, dietitian and founder of Real Life Nutrition Counseling, has advice for individuals who think their loved one may be at risk: “Seek support as soon as you notice a problem,” Walsh says. “Dieting and experimenting with ED (eating disorder) behaviors in teen years shows a strong relationship to developing EDs as a person gets older.”
Unhealthy eating should be nipped in the bud, since eating disorders ravage not only lives but health. When my eating disorder was at its worst, I was emaciated, tired, always cold and had heart palpitations and trouble breathing. My knuckles were constantly cut up from the forced purging. The scariest experience was when I lost consciousness at my parents’ home and hit my head on their kitchen counter. The good thing is that many of these health problems are reversible with recovery. Being proactive is key.
Because there is little to no data concerning the quantity and demographics of New Orleanians with eating disorders, the city’s influence on eating disorders is up for debate. It’s important to remember the many factors at play when someone has an eating disorder. Things are rarely black and white. While I can attest to my own struggle to be healthy in New Orleans, there is a long list of professionals ready to offer resources and support. No one has to go through an eating disorder alone — and no one should.
Types of Eating Disorders
Eating disorders can take several forms, but the three most common types are anorexia nervosa, bulimia nervosa, and binge-eating disorder.
- Anorexia Nervosa: This eating disorder is characterized by a fear of gaining weight, a distorted body image, and a refusal to maintain a healthy weight. People with anorexia may restrict their food intake severely, exercise excessively, and engage in other behaviors to lose weight.
- Bulimia Nervosa: This eating disorder involves binge eating followed by purging, such as vomiting or using laxatives. People with bulimia may also engage in fasting, excessive exercise, or other behaviors to try to compensate for their binge eating.
- Binge-Eating Disorder: This type of eating disorder involves eating large amounts of food in a short period, often feeling a loss of control over the amount of food consumed. Unlike bulimia, there is no purging behavior after binge eating.
Causes of Eating Disorders and Prevention Strategies
Eating disorders are complex mental health conditions that can arise from a combination of factors, including biological, psychological, and environmental. Genetics may play a role in the development of an eating disorder, but so can societal pressures to conform to unrealistic body standards.
In some cases, traumatic experiences such as sexual or emotional abuse can trigger an eating disorder. Low self-esteem and perfectionism are also common risk factors for developing an eating disorder.
Preventing eating disorders involves promoting healthy attitudes towards food and body image. This includes encouraging individuals to have a positive relationship with food and exercise by emphasizing balance, moderation, and variety. Education about media literacy and critical thinking skills can help individuals resist harmful messages about beauty standards promoted in the media.
Other prevention strategies include early intervention when warning signs of disordered eating emerge. Parents, caregivers, teachers, and healthcare providers should be vigilant about changes in behavior around food or weight loss/gain that could indicate an underlying issue.
Warning Signs
If you or someone you know is experiencing any of the following symptoms, it may be an indication of an eating disorder:
- Dramatic weight loss or gain
- Preoccupation with weight, food, calories, and dieting
- Refusal to eat certain foods or entire food groups
- Ritualistic eating behaviors (e.g., cutting food into small pieces, moving food around the plate)
- Excessive exercise
- Withdrawal from social activities
- Changes in mood, including depression, anxiety, or irritability
- Irregular menstrual periods
Treating Co-occurring Mental Health Conditions
It's important to note that eating disorders often co-occur with other mental health conditions, such as depression, anxiety, or substance abuse. Addressing these co-occurring conditions is critical for a successful and lasting recovery from an eating disorder.
Depression and anxiety can contribute to the development of an eating disorder, and vice versa. For example, someone who is struggling with depression may use food as a coping mechanism, leading to disordered eating behaviors. Similarly, someone with an eating disorder may experience depression as a result of their low self-esteem and distorted body image.
Effective treatment for an eating disorder must address any underlying mental health conditions that are present. This can involve therapy or medication to manage symptoms of depression or anxiety. It's essential to work with a healthcare provider who has experience treating both eating disorders and co-occurring mental health conditions.
Ignoring co-occurring mental health conditions can lead to an increased risk of relapse after treatment for an eating disorder. Addressing these issues head-on can help individuals achieve lasting recovery and improve their overall quality of life.
Coping with Triggers
Triggers are situations, feelings, or people that can lead to disordered eating behaviors. Common triggers include stress, negative emotions such as anxiety or anger, and social situations such as parties or family gatherings.
Coping with these triggers is an essential part of recovery from an eating disorder. Here are some strategies you can use to manage triggers:
- Identify your triggers: Keep a journal of when and where you experience triggers. This can help you recognize patterns and develop strategies for coping.
- Develop alternative coping mechanisms: Instead of turning to disordered eating behaviors when triggered, identify healthy ways to cope with stress or negative emotions. Exercise, mindfulness meditation, deep breathing techniques, or talking to a trusted friend or therapist are all effective ways to manage triggers.
- Create a supportive environment: Surround yourself with people who support your recovery and understand your struggles. Avoid people or situations that may trigger disordered eating behaviors.
- Practice self-care: Taking care of yourself physically and mentally can reduce the impact of triggers on your life. Eat balanced meals regularly, get enough sleep, and engage in activities that bring you joy.
- Seek professional help: If you find it challenging to manage your triggers on your own, seek out professional help from a therapist who specializes in treating eating disorders.
By developing effective coping strategies for managing triggers, individuals can reduce the risk of relapse and achieve lasting recovery from an eating disorder.
Treatment Options
The good news is that eating disorders are treatable. However, it's essential to seek out professional help from a trained mental health professional who specializes in eating disorders. Here are some treatment options available in New Orleans:
- Inpatient Treatment: For severe cases, hospitalization may be necessary to stabilize medical and psychiatric conditions. Inpatient treatment provides 24-hour care and support to help individuals regain weight and address underlying mental health issues.
- Outpatient Treatment: Outpatient treatment is often recommended for people with mild to moderate eating disorders. This type of treatment involves therapy, nutrition counseling, and medical monitoring on an outpatient basis.
- Intensive Outpatient Program (IOP): An IOP provides more intensive treatment than outpatient care but less than inpatient care. This type of treatment may be appropriate for individuals who require more support than traditional outpatient care but do not need 24-hour supervision.
- Support Groups: Support groups can be a helpful addition to traditional treatment. Groups such as Overeaters Anonymous or Eating Disorders Anonymous provide a safe space for individuals to share their experiences and receive support from others who have been through similar struggles.
The Role of Exercise in the Treatment of Eating Disorders
Exercise can play a significant role in the treatment of eating disorders, but it must be approached with caution. For individuals with anorexia nervosa, excessive exercise is often used as a way to burn calories and maintain weight loss. In these cases, exercise may need to be limited or avoided altogether until weight is restored and nutritional status improves.
However, for individuals with bulimia nervosa or binge-eating disorder, exercise can be a helpful addition to treatment. Exercise can improve mood, reduce anxiety and depression symptoms, and promote overall physical health. It's essential to work with a healthcare provider to develop an exercise plan that is safe and appropriate for each individual's needs.
In some cases, incorporating movement into daily life activities such as walking instead of driving or taking the stairs instead of the elevator can help individuals with eating disorders establish healthy relationships with physical activity without triggering compulsive behaviors.
It's crucial to remember that exercise should not be used as a way to compensate for food intake or purge after binge eating. Instead, exercise should be viewed as a supplement to other evidence-based treatments like therapy and nutrition counseling.
Overall, exercise can be beneficial for individuals recovering from eating disorders when incorporated thoughtfully and intentionally into their treatment plan.
Conclusion
Eating disorders are a serious mental health concern that can have severe physical and psychological consequences. It's essential to seek out professional help if you or someone you know is struggling with an eating disorder. In New Orleans, there are several treatment options available, including inpatient, outpatient, IOP, and support groups. Remember, recovery is possible, and seeking help is the first step towards a healthier, happier life.
