March 3, 2010 • 22 mins
In this episode, Molly and Cristen define and discuss the differences between well-established eating disorders like bulimia and anorexia and disordered eating patterns that aren't yet classified as a specific eating disorder.
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Speaker 1 (00:00):
Brought to you by the reinvented two thousand twelve Camray.
It's ready. Are you welcome to Stuff Mom never told you?
From House to Works dot com. Hey, welcome podcast. This
is Molly and Kristen. Kristen you know, and I'm sure
(00:22):
many of our listeners know, I write about health issues
for How Stuff Works, and that means that there is
one book that is on my mind a lot lately.
It's coming out, so I've got a little bit of
time to wait, but right now we're in the three
year comment period for it, so things are pretty exciting.
Think you're talking about the d s M five. Yes,
(00:43):
the Psychiatric Bible, as it's often called. It stands for
Diagnostic and Statistical Manual of Mental Disorders. Right now we
have the d s M four and it's going to
be updated and better than ever. Um, but it's in
the process of revising it. People are having all sorts
of questions as to, you know, what's going to be included,
How are we gonna find tune this thing because basically,
(01:06):
like I said, it's the Bible. If it's not in
the d s M might as well just not even exists.
And one big thing that is Uh, that's gotten some headlines.
On addition, I should say to the d s M
five is that binge eating disorder is going to be
classified along with other eating disorders such as bulimia, anorexia,
(01:32):
and also eating disorders not otherwise classified a K A
D nurse Right, those are the big three now or
anorexia blim in eddnurse and beinge eating is under ed
nose um. But the problem is is that ed nose
is pretty big umbrella. Yes, so that's what they're hoping
that by bringing binge eating out, it'll shine some more
(01:52):
light and help more people get help with the problem
of bench eating. And we thought that this would be
a good opportunity. We haven't covered eating disorders before, and
we thought that this would be a good opportunity to
not just talk about, you know, what is an eating disorder.
I think a lot of people are pretty aware of
issues like anorexia and bulimia, you know, or people will
generally like starve themselves, uh, they will go through cycles
(02:15):
of binging and purging. But we thought that it would
be a good opportunity to really focus on these issues
of the the eat nose, the kind of not otherwise
classified UM eating disorders, because you know, is the most
commonly diagnosed eating disorder in the United States because a
lot of times it takes a lot of different criteria
(02:37):
to be considered clinically anorexic or bulimic, and that's been
a big problem for for a lot of people who
are trying to seek help. UM. So, without further ado,
what constitutes need disorders, let's talk about let's talk about
eating disorders and UH, let's go to just basic definitions
of UM, the anorexia, BULIMIAM and Eve knows because I
(03:01):
was actually surprised for a couple of these things. I
think that we UM might not entirely understand what each
of these disorders involves. So this is coming from the
National Institute of Mental Health and UH. It defines anorexia
nervosa as UH. It's characterized by emaciation, a relentless pursuit
(03:23):
of thinness and unwillingness to maintain a normal or healthy weight,
a distortion of body image and intense sphere of gaining weight,
a lack of menstruation among girls and women, and extremely
disturbed eating behavior. Some people with anorexia lose weight by
dieting and exercising it excessively. Others lose weight by self
induced vomiting or misusing laxatives, diuretics, or enemies, and I
(03:44):
didn't realize. I think a lot of times people will
associate the vomiting with um bulimia, but um, it's more
the difference between interorexia and bulimia is really just your
food intake. A lot of times interrectis very very little food,
whereas with bolimia, UM it is characterized by recurrent and
frequent episodes of eating unusually large amounts of food you've
(04:06):
bene eating and feeling lack of control over the eating.
And then it is followed by something to compensate for
the bench such as purging, fasting, and or excessive exercise.
And one thing with one big difference between interorectics and
beliemics is that a lot of times you can tell
when someone is struggling with the interactually they will be
extremely thin. But um, it's not that uncommon for bliemics
(04:30):
to be within um a normal healthy weight range. Not
to say the behavior is healthy, but just that their
weight is Is that a normal spot? Now? I think
that just in reading those two very precise definitions of
the conditions that are recognized by the current DS, and
four you already see how hard it can be to
kind of separate out all the different issues in TEL
(04:52):
if you really do have a disorder eating panks. You
mentioned binge eating UM, which is now going to be
you know, possibly its own disorder u UM. So let's
talk a little bit about binge eating. Okay, Now, binge
eating is characterized by recurrent binge eating episodes, during which
a person feels a loss of control over his or
her eating. But unlike bliemia, binge eating episodes are not
(05:14):
followed by purging, excessive exercise, or fastening, and as a result,
a lot of binge eaters will be overweight or obese.
And one thing I think we should say about bene
eating is that while UH interex sander, and blimia tend
to affect more women than men for binge eating, it's
it's pretty split evenly. Both men and women UM suffer
(05:36):
equally from UH from binge eating. And this one has
been kind of tricky to classify as a mental disorder
because some people will say, well, you know, these people
just have a lack of willpower, they're just eating too much.
You know, and by calling it some kind of mental disorder,
then you're just caving to there, you know, there uh weakness.
(06:02):
And I think that that's sort of the heart of
the problem we're gonna get to today, is it's like
you said, it's so easy to well, not let's not
say easy, but you can recognize anorexia. It comes with
certain symptoms, um and all the other ones. People can
almost explain away there. When we were researching this podcast,
we would find articles of people who would be like,
(06:22):
I had a really bad relationship with food, but you know,
I go to a doctor and it's not anorexias. So
they really didn't know what to do with me. And
so people are saying, you know, oh, you just need
to eat more, you just need to stop eating as much,
and it's not considered a medical problem, whereas all these
studies that are being done um and all this revision
is attempting to show that these people do need help.
(06:43):
It isn't a lackable power, yeah, because the National Institutes
of Mental Health points out that, yeah, you have all
these eating behaviors, but they are a manifestation usually of
other psychiatric disorders such as depression, substance abuse. Anxiety is
for disorders, a body dysmorphic disorder when you look in
the mirror and you might be emaciated, but you still
(07:04):
see yourself as fat. Um. There are all these different
things that are going on, which is why it is
a hard to classify and be difficult to treat. And um,
I think when you look at the different behaviors that
are associated with or that fall under the enos umbrella, um,
you can see how it's such a huge gray area
(07:26):
because this will include anything from or at least formally
binge eating disorders, purging, night eating syndrome, chewing and spitting
out food, and even just extremely picky eating. Yeah. I
mean it's impossible to I mean in what woman at
some point and even men, But we're gonna kind of
focus on women since it tends to affect them a
little bit more. I mean, at what point or another
(07:47):
it seems like we all have preoccupation with our weight
and food. At what point does that cross into an
eating disorder? And this brings me to one pretty interesting
example that popped up recently in Time magazine, the concept
of or therexia, where you become obsessed with only eating
healthy foods and um to the point where this one
woman who was in the article way just sixty eight
(08:09):
pounds because she refused see anything that wasn't you know,
a raw food or organic and you know, she would
go to the doctor, they would tell her to eat healthfully.
But that in fact was her hang up. And some
experts are the Time magazine pointed out, are hesitant to
classify this idea of orthorexia as any kind of eating disorder,
(08:30):
but um. One doctor pointed out that such controlled eating habits,
unhealthily controlled eating habits UM are really just it's just
a step along the way to anorexia. And National Institutes
of Mental Health also points out that an eating disorder
in general is just marked by extreme. I mean, whenever
(08:51):
you have a serious disturbance in eating behavior, such as
extreme reduction and food intake or extreme selection of what
foods you are going to eat eat that is classified
as a disorder UM, which orthorexia would probably fall under.
So let's talk about some other different extremes because I
think that you know, we're not trying to make the
(09:12):
case that everyone has an eating disorder, which I think
it can sometimes sound like when you want to classify
all sorts of things and eating disorders. But I do
think that extremes can manifest themselves in ways you're not
aware of. Like, let's take athletes. Yeah, there is UM
something that I didn't. I think you and I were
both unaware of this until we started UM researching for
this podcast. There's a condition called female athlete triad, which
(09:35):
is basically over exercising in combination with extremely limited eating.
And I first ran across UM this term when I
was reading an article about it in Dance magazine. UM
it caught my eye because I was a I took
ballet for a while in middle and high school, got
(09:58):
really into it, and UM, this is something that I
definitely encountered among um the other ballerinas UM that I
would hang out with, where basically like you're you know
you're they're so image conscious and you have to be
so tiny that you will restrict what you eat. But
but if you eat even just like the tiniest amount
(10:18):
of something that wasn't you know on your dietary meal plan,
you will exercise like above and beyond to quote unquote
burn it off. And a lot of times this will
also be accompanied by UM, a lack of menstruation and
also osteoporosis because you're not taking in enough nutrients for
your growing body. And I think that with something like
(10:39):
female athletes triad, it can just be masked. Does Oh,
she's just really really healthy. But no, if you're training
four hours a day and only eating like eight calories,
no that's not. But you know, there are some sports
where that seems to be a requirement, like let's take
um sports where you have to make a certain weight.
I remember the wrestlers at my school doing extra labs
(11:01):
at lunch so they could make their weight class. And
I think that that sort of mentality, You know, it
can be encouraged to some extent by a coach, but
there comes a point where if it takes over your life,
even though you know the sport is a major part
of your life, but if it takes over your eating
and your exercise, that's when it becomes an extreme relationship
that would qualify some sort of disorder. Now was something
(11:22):
like the female athlete triad. One of those legs of
the triad is a min arehea. You stop having a period,
usually because your your body weight falls so low. But
if that doesn't happen, let's go back to these people
who have disordered relationships with food, but don't necessarily get
so skinny that you notice. I think that's again like
something to hit home that disordered eating does not necessarily
(11:44):
result in a really skinny person, right, because just with
the range from interrexia to boliemia to binge eating, you
have something that's marked by you know, the at one extreme,
you have interactsics you're severely underweight, beliemics who may or
may not be at a normal weight, and then benee
eaders who are at uh, you know, who are obese
(12:04):
or overweight. So just wait alone is not going to
be the determining factor of whether or not you haven't
eating disorder. But regardless of what way a disordered eating
pattern manifests itself being anorex here binge eating, is there
anything that all these people have in common, because that's
something that doctors are going to need to know about
so that they can develop a treatment plan. Right. I
(12:27):
think until recently that's been a really complicated question to
answer because you know, you do it is often accompanied
by um certain forms of anxiety disorders or depression or
what have you. But researchers have also in the past
few years found certain genetic traits that are shared among
(12:48):
people with eating disorders, so they're starting to think that
maybe maybe this is something that is passed along in
your d n A right specifically, it seems like they've
done a lot of work with anorexia. But that's not
to say that just you know, having a family history
of it is enough to spur your own bout with it.
It seems to be kind of a perfect storm of factors.
(13:09):
You know, maybe someone says the wrong thing at the
wrong time in the lunchtime cafeteria, or you know, you
get the wrong look at yourself in your genes, or
you do have something going on like a sport, you have,
you know, perfectionist tendencies, you have maybe the chaine for
it all seems to come together in just the wrong
wrong way. Yeah, And because there are so many factors
that can contribute to an eating disorder in all of
(13:32):
us different manifestations, it is very difficult and very costly
in severe cases to treat. I mean, some people don't
need treatment about I think with anorexia specifically, about a
third of the people will kind of recover on their
own after an episode. One third will be fine after
a round of treatment, and a third are always going
(13:53):
to have issues with it. It's not ever going to
go away. But you know, one of the reason that's
why this update of the d s M is so
important is because right now it's really hard to get
uh ednos that otherwise not specified disorders covered by health insurance.
And if you do need to go to some sort
of clinic, that can cost you know, maybe a thousand
(14:15):
dollars a day and that won't be covered by insurance.
And it seems that because each disordered eating relationship can
be so highly individual, that's a why they're hard to treat,
but be also why the d s M. You know,
it's hard to put in conditions that just affects, you know,
one person, but the d s M, the upcoming d
s M classification is very significant, especially for people who
(14:38):
might be struggling with bingeing, because once you get a
disorder actually listed in there, it basically validates it as
a problem, opening up the door for way more research
funding opportunities and the potential for wider insurance coverage for treatments.
Right so this is a good thing, I think. So
right now, the treatments for intrect sea and bolimia are
(15:01):
kind of similar. A lot of times it will involve
some kind of cognitive behavioral behavioral therapy, possibly some group therapy,
although there have been studies, um that have indicated that
antidepressants because you know, as I've mentioned a couple of times, now, UM,
there are usually some anxiety issues that are going on
as well, and so they will put people on with
(15:23):
eating disorders on in a depressants, but they are finding
that that might not be very effective for interorectics in particular.
It might have a little bit more of an effect
for um belimax, but in general it's all about just
kind of retraining these eating behaviors. For instance, there was
um very poignant essay in the New York Times magazine
(15:45):
about this woman's journey to treat her very intorectic, severely
intorectic daughter who ended up in the hospital because of
I think electrolyte and balance and dehydration and uh, you know,
just the very slow journey to teaching her that it
would be that it's okay to eat, that she doesn't
(16:06):
have to be scared of food. UM. And similarly with
belie mix, you know, kind of pulling the that hidden
binging behavior out into the open and teaching them how
to you know, eat normally and not having to purge
and continue this shame cycle. And because it is such
a mental thing, I think it can be very hard
(16:28):
to um recognize that happening to someone you know and love.
So we read one statistic that fIF of Americans know
someone with disordered eating habits. If your friend isn't eating
in the cafeteria, weill We'll give you a little bit
of advice about what to do. But again, this is
one where we'd love to hear um what people out
there have done when they had friends who were exercising
too much, eating too much, not eating enough, had some
(16:50):
of those relationships marked by extremes. Now, um, the Nemors Foundation,
which we've said before is great Kids self dot org
say that this was in relation to the female athlete
I add thing and basically, if you've got this friend
you it's it's almost very similar to the advice we
offered about dating violence. Kristen. Uh. You basically just have
to make your concerns known and tell them you know,
(17:11):
I'm worried about you. I don't think this is good
for you. And then you might need to kind of
step away a little bit just to give them time
to figure out how they're going to deal with it.
If if maybe things don't get you better, it's good
to let a coach or a teacher or parents know
about your concerns because you know, these people are pretty
good at hiding the behaviors. It's marked by shame. They'll
do all these behaviors underground. So just I think being
(17:35):
um open to having your friend talk about it with you,
it's a really good first step. But I don't think
that anyone out there should be able to feel like
they have to take it on themselves to force a
friend to eat or to stop a friend from exercising, right,
because I think in those kind of situations kind of
like go again. Going back to the dating violence episode,
(17:55):
I think that UM, because there is there's so much
hidden behaviorsociated with it, and there is a lot of
UM shame associated with it, whether or not it's you know,
the intorexic looking in the mirror and still seeing you know,
fat thighs or love handles, or the bolimic purging UM.
(18:16):
I think that if you go in there and try
to kind of shake it out, of them if you will,
it's only going to drive those behaviors into even more
private corners. But I mean, there are different schools of
thought on that. The the New York Times magazine article
that Kristen cited was an instance of a mother taking
the daughter and trying to shake it out of her.
(18:36):
So it's a hard thing for us to advise on.
I mean, no, two cases, like I think we've said,
are going to be the same. Everybody's gonna have their
own relationship with us, and clinically speaking, these are classified
as mental disorders, so it's not like you can just
snap someone out of it. I think that it's also
important for us to realize that, um, you know, it's
not just about food, it's about what's going on in
(18:59):
the brain. Right, So it'll be worth keeping an eye
on what happens with the d s M five, what
actually ends up in the two edition. But until we
get that, let's hear from you guys. Um, any relationships
you've had where this has been a problem for you
or someone you love, and things you did that worked
didn't work. You know, what can people do if they've
got a friend in this situation, a daughter in this situation,
(19:20):
and of course this does happen to guys as well,
So a daughter or a son with this problem. Yeah,
let us know. Our email is mom Stuff at how
stuff works dot com. And let's go ahead and share
a little bit of other letters that we have gotten
in recently. I've got one here from Mac and just
(19:40):
in response to do children need mother and a father?
And Mac was brought up by two lesbian mothers, and
he said, I thought I'd give you my two cents um.
I personally, growing up, never felt any sort of disadvantage
for not having a father, other than having a much
greater knowledge of the works of Melissa Ethridge and the
Indigo Girls and any other guy in my age. But
(20:01):
I seem to have turned out pretty normal. I think
there's a lot of truth to gain lesbian couples to
have children, being not usually more prepared for them in
the first place. Speaking from a biological standpoint, it's pretty
hard for gain lesbian couples to have a child by
accident or before they are ready. You have to have
your life pretty together to be able to deal with
the hasslum paperwork, and it often that it often takes
for an alternative couple to have a child. Can you
(20:22):
imagine how different things would be if straight children had
to jump through as many hoops to have a child. Also, uh,
if you're of the notion that takes a village to
raise a child, look no closer than a lesbian social
circle for support me. Being a child of lesbians, I
was somewhat of a rarity back in the day. Needless
to say, I had a whole army of women who
had a vested interests in my well being. My lovely
(20:43):
feminist girlfriend seems to think that being raised by too smart,
powerful women kept me from growing up to be some
sort of stereotypical womanizer, though I'd like to think that
wouldn't have happened anyway. So thank you Mac for sharing
all right, and I'll read one from David on the
same podcast topic you rightes, I listened to your podcast
about two gender households and wait to patiently for you
(21:03):
to describe my household Alas it never came. My wife
and I are married and have three boys. We both work,
But you kept referring to households with hetero married couples
as those where dad works and mom stays home. What
about both parents working, and where mom works and dad
stays home. All this talk about resources seem to be
a not so thinly veiled word for money. If the
parents have money enough to provide X, y, and z,
(21:24):
then the children turn out well, happycock and balderdash. I'm
a firm believer that children need at least one male
and female influence in their lives. When my boys sit
in the tub and talk about pooting, my wife doesn't
understand why that's so funny and why the four of
us are cracking up. I'm not saying it can't work
and that any other arrangement is bad, but at least
one male and one female actively involved in raising a
child as best. And I think that we should point
(21:45):
out that, yes, we did refer to resources a lot,
but I will say that resources can refer yes to money,
but also too emotional investment as well. Right. I don't
think we were just trying to refer to money just
as a clarification, but he makes a great point as well.
All right, So thanks folks for running in and send
(22:07):
us more mail mom stuff at how stuff works dot com.
And also we would love for you to check out
our blog during the week. It's called how to stuff
and of course you can always fill your mind with
knowledge at how stuff works dot com for more on
this and thousands of other topics. Does it how stuff
(22:29):
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It's ready, are you
Brought to you by the reinvented two thousand twelve Camray.
It's ready. Are you welcome to Stuff Mom never told you?
From House to Works dot com. Hey, welcome podcast. This
is Molly and Kristen. Kristen you know, and I'm sure
(00:22):
many of our listeners know, I write about health issues
for How Stuff Works, and that means that there is
one book that is on my mind a lot lately.
It's coming out, so I've got a little bit of
time to wait, but right now we're in the three
year comment period for it, so things are pretty exciting.
Think you're talking about the d s M five. Yes,
(00:43):
the Psychiatric Bible, as it's often called. It stands for
Diagnostic and Statistical Manual of Mental Disorders. Right now we
have the d s M four and it's going to
be updated and better than ever. Um, but it's in
the process of revising it. People are having all sorts
of questions as to, you know, what's going to be included,
How are we gonna find tune this thing because basically,
(01:06):
like I said, it's the Bible. If it's not in
the d s M might as well just not even exists.
And one big thing that is Uh, that's gotten some headlines.
On addition, I should say to the d s M
five is that binge eating disorder is going to be
classified along with other eating disorders such as bulimia, anorexia,
(01:32):
and also eating disorders not otherwise classified a K A
D nurse Right, those are the big three now or
anorexia blim in eddnurse and beinge eating is under ed
nose um. But the problem is is that ed nose
is pretty big umbrella. Yes, so that's what they're hoping
that by bringing binge eating out, it'll shine some more
(01:52):
light and help more people get help with the problem
of bench eating. And we thought that this would be
a good opportunity. We haven't covered eating disorders before, and
we thought that this would be a good opportunity to
not just talk about, you know, what is an eating disorder.
I think a lot of people are pretty aware of
issues like anorexia and bulimia, you know, or people will
generally like starve themselves, uh, they will go through cycles
(02:15):
of binging and purging. But we thought that it would
be a good opportunity to really focus on these issues
of the the eat nose, the kind of not otherwise
classified UM eating disorders, because you know, is the most
commonly diagnosed eating disorder in the United States because a
lot of times it takes a lot of different criteria
(02:37):
to be considered clinically anorexic or bulimic, and that's been
a big problem for for a lot of people who
are trying to seek help. UM. So, without further ado,
what constitutes need disorders, let's talk about let's talk about
eating disorders and UH, let's go to just basic definitions
of UM, the anorexia, BULIMIAM and Eve knows because I
(03:01):
was actually surprised for a couple of these things. I
think that we UM might not entirely understand what each
of these disorders involves. So this is coming from the
National Institute of Mental Health and UH. It defines anorexia
nervosa as UH. It's characterized by emaciation, a relentless pursuit
(03:23):
of thinness and unwillingness to maintain a normal or healthy weight,
a distortion of body image and intense sphere of gaining weight,
a lack of menstruation among girls and women, and extremely
disturbed eating behavior. Some people with anorexia lose weight by
dieting and exercising it excessively. Others lose weight by self
induced vomiting or misusing laxatives, diuretics, or enemies, and I
(03:44):
didn't realize. I think a lot of times people will
associate the vomiting with um bulimia, but um, it's more
the difference between interorexia and bulimia is really just your
food intake. A lot of times interrectis very very little food,
whereas with bolimia, UM it is characterized by recurrent and
frequent episodes of eating unusually large amounts of food you've
(04:06):
bene eating and feeling lack of control over the eating.
And then it is followed by something to compensate for
the bench such as purging, fasting, and or excessive exercise.
And one thing with one big difference between interorectics and
beliemics is that a lot of times you can tell
when someone is struggling with the interactually they will be
extremely thin. But um, it's not that uncommon for bliemics
(04:30):
to be within um a normal healthy weight range. Not
to say the behavior is healthy, but just that their
weight is Is that a normal spot? Now? I think
that just in reading those two very precise definitions of
the conditions that are recognized by the current DS, and
four you already see how hard it can be to
kind of separate out all the different issues in TEL
(04:52):
if you really do have a disorder eating panks. You
mentioned binge eating UM, which is now going to be
you know, possibly its own disorder u UM. So let's
talk a little bit about binge eating. Okay, Now, binge
eating is characterized by recurrent binge eating episodes, during which
a person feels a loss of control over his or
her eating. But unlike bliemia, binge eating episodes are not
(05:14):
followed by purging, excessive exercise, or fastening, and as a result,
a lot of binge eaters will be overweight or obese.
And one thing I think we should say about bene
eating is that while UH interex sander, and blimia tend
to affect more women than men for binge eating, it's
it's pretty split evenly. Both men and women UM suffer
(05:36):
equally from UH from binge eating. And this one has
been kind of tricky to classify as a mental disorder
because some people will say, well, you know, these people
just have a lack of willpower, they're just eating too much.
You know, and by calling it some kind of mental disorder,
then you're just caving to there, you know, there uh weakness.
(06:02):
And I think that that's sort of the heart of
the problem we're gonna get to today, is it's like
you said, it's so easy to well, not let's not
say easy, but you can recognize anorexia. It comes with
certain symptoms, um and all the other ones. People can
almost explain away there. When we were researching this podcast,
we would find articles of people who would be like,
(06:22):
I had a really bad relationship with food, but you know,
I go to a doctor and it's not anorexias. So
they really didn't know what to do with me. And
so people are saying, you know, oh, you just need
to eat more, you just need to stop eating as much,
and it's not considered a medical problem, whereas all these
studies that are being done um and all this revision
is attempting to show that these people do need help.
(06:43):
It isn't a lackable power, yeah, because the National Institutes
of Mental Health points out that, yeah, you have all
these eating behaviors, but they are a manifestation usually of
other psychiatric disorders such as depression, substance abuse. Anxiety is
for disorders, a body dysmorphic disorder when you look in
the mirror and you might be emaciated, but you still
(07:04):
see yourself as fat. Um. There are all these different
things that are going on, which is why it is
a hard to classify and be difficult to treat. And um,
I think when you look at the different behaviors that
are associated with or that fall under the enos umbrella, um,
you can see how it's such a huge gray area
(07:26):
because this will include anything from or at least formally
binge eating disorders, purging, night eating syndrome, chewing and spitting
out food, and even just extremely picky eating. Yeah. I
mean it's impossible to I mean in what woman at
some point and even men, But we're gonna kind of
focus on women since it tends to affect them a
little bit more. I mean, at what point or another
(07:47):
it seems like we all have preoccupation with our weight
and food. At what point does that cross into an
eating disorder? And this brings me to one pretty interesting
example that popped up recently in Time magazine, the concept
of or therexia, where you become obsessed with only eating
healthy foods and um to the point where this one
woman who was in the article way just sixty eight
(08:09):
pounds because she refused see anything that wasn't you know,
a raw food or organic and you know, she would
go to the doctor, they would tell her to eat healthfully.
But that in fact was her hang up. And some
experts are the Time magazine pointed out, are hesitant to
classify this idea of orthorexia as any kind of eating disorder,
(08:30):
but um. One doctor pointed out that such controlled eating habits,
unhealthily controlled eating habits UM are really just it's just
a step along the way to anorexia. And National Institutes
of Mental Health also points out that an eating disorder
in general is just marked by extreme. I mean, whenever
(08:51):
you have a serious disturbance in eating behavior, such as
extreme reduction and food intake or extreme selection of what
foods you are going to eat eat that is classified
as a disorder UM, which orthorexia would probably fall under.
So let's talk about some other different extremes because I
think that you know, we're not trying to make the
(09:12):
case that everyone has an eating disorder, which I think
it can sometimes sound like when you want to classify
all sorts of things and eating disorders. But I do
think that extremes can manifest themselves in ways you're not
aware of. Like, let's take athletes. Yeah, there is UM
something that I didn't. I think you and I were
both unaware of this until we started UM researching for
this podcast. There's a condition called female athlete triad, which
(09:35):
is basically over exercising in combination with extremely limited eating.
And I first ran across UM this term when I
was reading an article about it in Dance magazine. UM
it caught my eye because I was a I took
ballet for a while in middle and high school, got
(09:58):
really into it, and UM, this is something that I
definitely encountered among um the other ballerinas UM that I
would hang out with, where basically like you're you know
you're they're so image conscious and you have to be
so tiny that you will restrict what you eat. But
but if you eat even just like the tiniest amount
(10:18):
of something that wasn't you know on your dietary meal plan,
you will exercise like above and beyond to quote unquote
burn it off. And a lot of times this will
also be accompanied by UM, a lack of menstruation and
also osteoporosis because you're not taking in enough nutrients for
your growing body. And I think that with something like
(10:39):
female athletes triad, it can just be masked. Does Oh,
she's just really really healthy. But no, if you're training
four hours a day and only eating like eight calories,
no that's not. But you know, there are some sports
where that seems to be a requirement, like let's take
um sports where you have to make a certain weight.
I remember the wrestlers at my school doing extra labs
(11:01):
at lunch so they could make their weight class. And
I think that that sort of mentality, You know, it
can be encouraged to some extent by a coach, but
there comes a point where if it takes over your life,
even though you know the sport is a major part
of your life, but if it takes over your eating
and your exercise, that's when it becomes an extreme relationship
that would qualify some sort of disorder. Now was something
(11:22):
like the female athlete triad. One of those legs of
the triad is a min arehea. You stop having a period,
usually because your your body weight falls so low. But
if that doesn't happen, let's go back to these people
who have disordered relationships with food, but don't necessarily get
so skinny that you notice. I think that's again like
something to hit home that disordered eating does not necessarily
(11:44):
result in a really skinny person, right, because just with
the range from interrexia to boliemia to binge eating, you
have something that's marked by you know, the at one extreme,
you have interactsics you're severely underweight, beliemics who may or
may not be at a normal weight, and then benee
eaders who are at uh, you know, who are obese
(12:04):
or overweight. So just wait alone is not going to
be the determining factor of whether or not you haven't
eating disorder. But regardless of what way a disordered eating
pattern manifests itself being anorex here binge eating, is there
anything that all these people have in common, because that's
something that doctors are going to need to know about
so that they can develop a treatment plan. Right. I
(12:27):
think until recently that's been a really complicated question to
answer because you know, you do it is often accompanied
by um certain forms of anxiety disorders or depression or
what have you. But researchers have also in the past
few years found certain genetic traits that are shared among
(12:48):
people with eating disorders, so they're starting to think that
maybe maybe this is something that is passed along in
your d n A right specifically, it seems like they've
done a lot of work with anorexia. But that's not
to say that just you know, having a family history
of it is enough to spur your own bout with it.
It seems to be kind of a perfect storm of factors.
(13:09):
You know, maybe someone says the wrong thing at the
wrong time in the lunchtime cafeteria, or you know, you
get the wrong look at yourself in your genes, or
you do have something going on like a sport, you have,
you know, perfectionist tendencies, you have maybe the chaine for
it all seems to come together in just the wrong
wrong way. Yeah, And because there are so many factors
that can contribute to an eating disorder in all of
(13:32):
us different manifestations, it is very difficult and very costly
in severe cases to treat. I mean, some people don't
need treatment about I think with anorexia specifically, about a
third of the people will kind of recover on their
own after an episode. One third will be fine after
a round of treatment, and a third are always going
(13:53):
to have issues with it. It's not ever going to
go away. But you know, one of the reason that's
why this update of the d s M is so
important is because right now it's really hard to get
uh ednos that otherwise not specified disorders covered by health insurance.
And if you do need to go to some sort
of clinic, that can cost you know, maybe a thousand
(14:15):
dollars a day and that won't be covered by insurance.
And it seems that because each disordered eating relationship can
be so highly individual, that's a why they're hard to treat,
but be also why the d s M. You know,
it's hard to put in conditions that just affects, you know,
one person, but the d s M, the upcoming d
s M classification is very significant, especially for people who
(14:38):
might be struggling with bingeing, because once you get a
disorder actually listed in there, it basically validates it as
a problem, opening up the door for way more research
funding opportunities and the potential for wider insurance coverage for treatments.
Right so this is a good thing, I think. So
right now, the treatments for intrect sea and bolimia are
(15:01):
kind of similar. A lot of times it will involve
some kind of cognitive behavioral behavioral therapy, possibly some group therapy,
although there have been studies, um that have indicated that
antidepressants because you know, as I've mentioned a couple of times, now, UM,
there are usually some anxiety issues that are going on
as well, and so they will put people on with
(15:23):
eating disorders on in a depressants, but they are finding
that that might not be very effective for interorectics in particular.
It might have a little bit more of an effect
for um belimax, but in general it's all about just
kind of retraining these eating behaviors. For instance, there was
um very poignant essay in the New York Times magazine
(15:45):
about this woman's journey to treat her very intorectic, severely
intorectic daughter who ended up in the hospital because of
I think electrolyte and balance and dehydration and uh, you know,
just the very slow journey to teaching her that it
would be that it's okay to eat, that she doesn't
(16:06):
have to be scared of food. UM. And similarly with
belie mix, you know, kind of pulling the that hidden
binging behavior out into the open and teaching them how
to you know, eat normally and not having to purge
and continue this shame cycle. And because it is such
a mental thing, I think it can be very hard
(16:28):
to um recognize that happening to someone you know and love.
So we read one statistic that fIF of Americans know
someone with disordered eating habits. If your friend isn't eating
in the cafeteria, weill We'll give you a little bit
of advice about what to do. But again, this is
one where we'd love to hear um what people out
there have done when they had friends who were exercising
too much, eating too much, not eating enough, had some
(16:50):
of those relationships marked by extremes. Now, um, the Nemors Foundation,
which we've said before is great Kids self dot org
say that this was in relation to the female athlete
I add thing and basically, if you've got this friend
you it's it's almost very similar to the advice we
offered about dating violence. Kristen. Uh. You basically just have
to make your concerns known and tell them you know,
(17:11):
I'm worried about you. I don't think this is good
for you. And then you might need to kind of
step away a little bit just to give them time
to figure out how they're going to deal with it.
If if maybe things don't get you better, it's good
to let a coach or a teacher or parents know
about your concerns because you know, these people are pretty
good at hiding the behaviors. It's marked by shame. They'll
do all these behaviors underground. So just I think being
(17:35):
um open to having your friend talk about it with you,
it's a really good first step. But I don't think
that anyone out there should be able to feel like
they have to take it on themselves to force a
friend to eat or to stop a friend from exercising, right,
because I think in those kind of situations kind of
like go again. Going back to the dating violence episode,
(17:55):
I think that UM, because there is there's so much
hidden behaviorsociated with it, and there is a lot of
UM shame associated with it, whether or not it's you know,
the intorexic looking in the mirror and still seeing you know,
fat thighs or love handles, or the bolimic purging UM.
(18:16):
I think that if you go in there and try
to kind of shake it out, of them if you will,
it's only going to drive those behaviors into even more
private corners. But I mean, there are different schools of
thought on that. The the New York Times magazine article
that Kristen cited was an instance of a mother taking
the daughter and trying to shake it out of her.
(18:36):
So it's a hard thing for us to advise on.
I mean, no, two cases, like I think we've said,
are going to be the same. Everybody's gonna have their
own relationship with us, and clinically speaking, these are classified
as mental disorders, so it's not like you can just
snap someone out of it. I think that it's also
important for us to realize that, um, you know, it's
not just about food, it's about what's going on in
(18:59):
the brain. Right, So it'll be worth keeping an eye
on what happens with the d s M five, what
actually ends up in the two edition. But until we
get that, let's hear from you guys. Um, any relationships
you've had where this has been a problem for you
or someone you love, and things you did that worked
didn't work. You know, what can people do if they've
got a friend in this situation, a daughter in this situation,
(19:20):
and of course this does happen to guys as well,
So a daughter or a son with this problem. Yeah,
let us know. Our email is mom Stuff at how
stuff works dot com. And let's go ahead and share
a little bit of other letters that we have gotten
in recently. I've got one here from Mac and just
(19:40):
in response to do children need mother and a father?
And Mac was brought up by two lesbian mothers, and
he said, I thought I'd give you my two cents um.
I personally, growing up, never felt any sort of disadvantage
for not having a father, other than having a much
greater knowledge of the works of Melissa Ethridge and the
Indigo Girls and any other guy in my age. But
(20:01):
I seem to have turned out pretty normal. I think
there's a lot of truth to gain lesbian couples to
have children, being not usually more prepared for them in
the first place. Speaking from a biological standpoint, it's pretty
hard for gain lesbian couples to have a child by
accident or before they are ready. You have to have
your life pretty together to be able to deal with
the hasslum paperwork, and it often that it often takes
for an alternative couple to have a child. Can you
(20:22):
imagine how different things would be if straight children had
to jump through as many hoops to have a child. Also, uh,
if you're of the notion that takes a village to
raise a child, look no closer than a lesbian social
circle for support me. Being a child of lesbians, I
was somewhat of a rarity back in the day. Needless
to say, I had a whole army of women who
had a vested interests in my well being. My lovely
(20:43):
feminist girlfriend seems to think that being raised by too smart,
powerful women kept me from growing up to be some
sort of stereotypical womanizer, though I'd like to think that
wouldn't have happened anyway. So thank you Mac for sharing
all right, and I'll read one from David on the
same podcast topic you rightes, I listened to your podcast
about two gender households and wait to patiently for you
(21:03):
to describe my household Alas it never came. My wife
and I are married and have three boys. We both work,
But you kept referring to households with hetero married couples
as those where dad works and mom stays home. What
about both parents working, and where mom works and dad
stays home. All this talk about resources seem to be
a not so thinly veiled word for money. If the
parents have money enough to provide X, y, and z,
(21:24):
then the children turn out well, happycock and balderdash. I'm
a firm believer that children need at least one male
and female influence in their lives. When my boys sit
in the tub and talk about pooting, my wife doesn't
understand why that's so funny and why the four of
us are cracking up. I'm not saying it can't work
and that any other arrangement is bad, but at least
one male and one female actively involved in raising a
child as best. And I think that we should point
(21:45):
out that, yes, we did refer to resources a lot,
but I will say that resources can refer yes to money,
but also too emotional investment as well. Right. I don't
think we were just trying to refer to money just
as a clarification, but he makes a great point as well.
All right, So thanks folks for running in and send
(22:07):
us more mail mom stuff at how stuff works dot com.
And also we would love for you to check out
our blog during the week. It's called how to stuff
and of course you can always fill your mind with
knowledge at how stuff works dot com for more on
this and thousands of other topics. Does it how stuff
(22:29):
works dot com. Want more how stuff works, check out
our blogs on the house. Stuff works dot com home
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