It's National Eating Disorder Awareness Week. And no one knows better than the staff at Rogers Memorial Hospital in Oconomowoc how important it is to promote education about eating disorders.
Statistics show that eating disorders including anorexia and bulimia have the highest mortality rate of any mental illness - but only 10% of those affected by it seek treatment. Only 35% receive treatment at a specialized facility. For adolescent females aged 15 to 24, anorexia's death rate is 12 times higher than any other cause of death.
Dr. Tracey Cornella-Carlson, MD, CEDS is the medical director of the child and adolescent eating disorder programs at Rogers Memorial Hospital, which was the first facility in the nation to offer specialized treatment to men and boys suffering from eating disorders.
She sat down with OnMilwaukee.com to weigh in on common misconceptions about the disease that 24 million Americans suffer from.
OnMilwaukee.com: Many people point the finger at the media for drilling the ideals of "perfection" into the population. Do you agree or disagree with that?
Tracey Cornella-Carlson: I would say I disagree and agree. I think that many teenage patients that I deal with tell me that they are bothered by the media and those messages that are sent. However, we do know that all of us are exposed to the media and not everyone develops an eating disorder. So I would say that it takes a predisposition to have an eating disorder, in conjunction with many different triggers, in order to produce an eating disorder. People themselves are likely perfectionists who develop an eating disorder. But the media doesn’t cause eating disorders.
OMC: Is an eating disorder more about self-image or more about control?
TCC: An eating disorder is about both self-image and control. Many teenagers will start dieting in an attempt to improve their self esteem or feel better about themselves. They may have been teased or bullied about being overweight, and that’s one way they take charge of that. And they temporarily feel better, because then they’ll start getting compliments - "Oh you’re losing weight you look great." And then, all of a sudden, the eating disorder takes on a life of its own. It becomes very much out of control and they continue to lose weight or engage in other unhealthy eating behaviors far beyond what is normal. In terms of control people do attempt to take control of their eating when they feel very out of control of certain stressors. For example, teenagers might talk about a parents' divorce or making a geographic move with their family. Many of these things are out of their control and an easy answer to them seems like focusing on dieting and weight.
OMC: There is a perception that only young, white women suffer from eating disorders. Do you treat many male patients as well? Do many non-white patients present with an eating disorder?
TCC: We treat a good percentage of males at Rogers Memorial. The statistic is probably for every ten females there is one male suffering. Oftentimes the triggers are similar, such as bullying, but sometimes males are different in that they want to have a very muscular physique whereas females want to be skinny. So that’s a difference, but I think the triggers are similar, whether it’s bullying or an anxiety or mood problems or perfectionism, males and females are both at risk. We treat Asian patients, African-American patients...so it’s an illness that does not discriminate.
OMC: What's the difference between having an eating disorder and simply dieting, or having a tumultuous relationship with food?
TCC: Many people are in denial of having disordered eating or an eating disorder. Typically, if other people are concerned about your behaviors, you need to take a step back and look more objectively at it. Individuals themselves will be able to identify an eating disorder by increased obsessional thinking about body size, weight and shape, increased planning of meals, increased avoidance of social events because there’s food there. My favorite line is: eating disorders are not about body size, weight and shape, they are about what’s going on in the mind. Anorexia is pretty classic - you can see (people who suffer) by someone’s low weight. But how do they get to that low weight? Because their mind was telling them they weren’t good enough, they needed to be thinner, they needed to lose one more pound and it got them to the low point that they couldn’t reverse.
OMC: Can even a minor eating disorder have long-lasting effects on the body?
TCC: Yes. With adolescent patients that I treat they are very in denial that even a minor eating problem could affect their overall health. Women have only until the age of 30 to make their bones as strong and as dense as they can be and then they start to lose bone density for the rest of their life, so not having proper nutrients such as calcium, Vitamin D, can lead to osteopenia. And infertility experts will tell us that many of their patients are actually eating disorder patients that are at too low of a weight or too low of a body fat to become pregnant, to ovulate and have regular menses. In terms of heart health, restrictive eating can lead to wasting of heart muscle and low heart rate, bradycardia. Purging every so often can lead to electrolyte abnormalities, which can lead to heart arrhythmia and sudden death. Even purging very infrequently can actually lead to death. People don’t acknowledge that. There’s so much denial.
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