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Definitions
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Eating Disorders: Mental illnesses as defined by the DSM.
Overweight:
A condition in which a person has a high amount of body fat, weighs more than their projected healthy weight and has a BMI of 25-29 kg/m2
Obesity:
A condition in which a person has a high amount of body fat, weighs more than their projected healthy weight and has a BMI of 30 kg/m2 or higher.
Morbidly Obese:
A condition in which a person weighs 100 pounds or more than their normal projected weight.
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Myths About
Eating Disorders
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Myth - Eating Disorders only affect teenage girls.
Fact - Eating Disorders pervade individuals of all ages and genders. Several facilities report patients as young as eight years old diagnosed with anorexia, indicating that eating disorders affect more than adolescents. Approximately 10% of those with anorexia are males. Of those with Binge Eating Disorder, approximately 35% are males. Consider addressing this common misconception about gender and eating disorders in your production.
Myth - Eating disorders are a choice and something people do to look like celebrities.
Fact - While the decision to start eating in a different way may stem from media pressures, the development of a mental disorder is not a choice. The fact that many individuals with eating disorders must be placed in a in-patient treatment program and despite their will to improve cannot get better without help prove that the deadly nature of eating disorders is in no way a choice.
Myth- Disordered Eating is a phase.
Fact- Eating Disorder recovery is a lifelong struggle. Many of the same thoughts that pervade the mind of one with an eating disorder continue to occur after treatment. However, one's reaction to them has been altered for the better.
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Body Mass Index
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(BMI calculations do not take into account muscle mass or other circumstances. In addition, this calculation may not be directly transferable to children. Medical conditions such as obesity are diagnosed by a medical professional.
(Weight/Height˛) x 703
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Myths About Obesity
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Myth - My parents are overweight, therefore I am destined to be overweight. There is nothing I can do!
Fact- Obesity is caused in part by genetics, that is, influenced by your parents' genetic make-up. This is something we cannot control. However, the current treatment methods for obesity, including a change in diet and exercise, offer a counter to genetics. Be sure to find a supportive nutritionist or trainer to help you focus your goals.
Myth - Weight loss is based on a simple equation - eat less than what you burn.
Fact - While the basis of this equation is very true, to lose weight one needs to consume less calories than is expended in one day, many other things contribute to this equation. For example, one that has a more muscle mass has a higher metabolism. In addition, where the calories come from, whether be from fruit, alcohol, or otherwise, plays a role. Simply abiding by an equation simplifies the condition. Many other factors are at work, including what kinds of foods are eaten and the types of exercise.
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Depiction Suggestions
for Disordered Eating
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Promote the re-establishment of a healthy relationship with food.
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If possible, address the concerns of fellow characters about the person with disordered eating.
Remember that recovery from disordered eating may take years and numerous treatment attempts.
Please remember that there are no standard presentations of eating disorders.
Bear in mind that obesity is a serious condition diagnosed by medical professionals.
Be aware that the diagnosis of obesity is separate from being overweight.
Understand that obesity is a complex situation with several influences and interactions.
Remember that eating disorders are not bound to young girls.
Bear in mind that genetics play a role in the development of eating disorders and obesity.
Attempt to address the mental health situation of characters with disordered eating.
Remember that treatment is unique for each individual.
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Have a question? Planning a storyline? Want to know more?
 Feel free to contact First Draft, EIC's free service providing direct information and resources regarding health and social issues to the creative community. Visit our website at http://www.eiconline.org or call us at 818-333-5001.
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This project was made possible through:
 a
generous Community Service Fund Grant from Kaiser Foundation Hospitals,
dedicated to promoting issues of public health and social interest in local
communities.
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Spotlight on...
Disordered Eating
A news brief of the Entertainment Industries Council
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Eating is a required part of life; we need to eat to live. The act of eating should be simple; however, the staggering numbers prove otherwise.
By 2048, all of America could be overweight, ABC Health News.
Approximately, 10% of those with anorexia die from the disease...(National Library of Medicine and National Institutes of Health, MedLine Plus Medical Dictionary, March 18 2008.) Clearly, for the millions of people around the world that suffer from abnormal eating practices, eating becomes a problem.
This issue of Spotlight On...aims to shed light on the many issues relating to eating disorders, obesity, and other forms of disordered eating. Spotlight On...Disordered Eating is a resource for the entertainment community as well as for the general public interested to learn about these disorders and abnormal eating practices. We hope that you can learn more about these issues through this publication and perhaps utilize this information to create accurate storylines and depictions in your productions.
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Defining Normal
Over time, the basis of hunger has changed from moderating our energy supply to hedonics, from nutrition to pleasure. We have fad diets, liquid diets, pills...all in an endless supply. Amongst America's infatuation with food, one question remains: What exactly is normal eating?
Normal eating reflects a healthy relationship with food in which food is not viewed as threatening or as a comfort. Normally, humans eat when they feel hungry and stop upon being satiated. Any practice other than normal eating, such as eating in large binges, purposely withholding calories, or practicing restrictive diets, is considered to be disordered eating. It is helpful to define normal eating when discussing Disordered Eating and Obesity.
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Disordered Eating
"Sometimes, I only eat salad and bread for the day, with a bit of water. It makes me feel better."..."I don't feel hungry anymore. I just eat when I feel like it, which is pretty much all the time."
What do these testimonials have in common? They are all examples of disordered eating. Disordered eating practices can easily lead to the formation of an eating disorder or to the condition of obesity. Due to an individual's focus on food, weight, and body shape, an individual may adopt eating and exercise habits that compromise the individual's health, happiness, and safety.
Addressing abnormal eating early is key to preventing the development of an eating disorder or becoming overweight. While an individual's eating habits may not be defined as an eating disorder or lead entirely to obesity, all disordered eating practices are dangerous and unhealthy. If you suspect that you or someone you know is exhibiting a disordered eating pattern, please get professional assistance.
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Eating Disorders
Why, in an environment surrounded by food, do some starve? The answer lies in the definition of an eating disorder. Eating disorders are serious mental conditions diagnosed by a psychiatrist and require professional help. Eating Disorders are defined by the Diagnostic and Statistical Manual for Mental Disorders (DSM-IV). The two defined types of eating disorders are Anorexia Nervosa and Bulimia Nervosa. Several other eating disorders, such as Binge Eating Disorder, Pica, and Rumination fall under a third category in the DSM-IV: Eating Disorders Not Otherwise Specified.
Anorexia Nervosa:
An individual is classified as having Anorexia Nervosa, commonly known as Anorexia, if they weigh 85% of their projected normal body weight, demonstrate a deep fear of gaining weight despite their dangerously low weight, and hold a distorted view of their body. (American Psychological Association , Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, 1994) Additionally, females with anorexia often cease menstruation. Anorexia Nervosa manifests in two different forms: Restricting Type and Purging Type. Restricting Type Anorexia involves purposely limiting caloric intake whereas compensatory behavior such as vomiting or using diuretics is seen in Purging Type Anorexia. Due to long periods of starvation, several physical changes occur in those with anorexia. These include hair brittleness and loss, discoloration of the skin and nails, the development of fine body hair to assist with the inability to moderate body temperature, and the cessation of menstruation. Extended problems include osteoporosis and kidney failure. (National Alliance on Mental Illness, About Mental Illness: Anorexia Nervosa, 1996. Academy for Eating Disorders, 2000.)
Anorexia is a prominent eating disorder around the world, with about 8 million people suffering from the disease in the U.S. Approximately 1 million of those affected are male. Anorexia is also the deadliest mental disorder: Despite current medical programs and clinics, roughly 8-10% of those with the disorder die as a result. (National Library of Medicine and National Institutes of Health, MedLine Plus Medical Dictionary, March 18 2008.)
Bulimia Nervosa:
Those with Bulimia Nervosa display a lack of control in eating. Individuals with Bulimia Nervosa, often shortened to Bulimia, have episodes in which they consume a large portion of food and then purge through compensatory behavior. (National Library of Medicine and National Institutes of Health, MedLine Plus Medical Dictionary, March 18 2008). Compensatory behavior includes vomiting or taking laxatives or diuretics. Bulimic episodes can occur even when an individual does not feel hungry or just ate a meal. Repetitive binging and purging can cause several health problems such as severe electrolyte imbalance, eroded fingernails, and tears in the esophagus due to vomiting. (Academy for Eating Disorders, 2000. American Psychological Association Help Center, Health and Emotional Wellness, Eating Disorders, 2004.)
EDNOS - Binge Eating Disorder (BED)
Several other disorders fall under the category of EDNOS, Eating Disorders Not Otherwise Specified. One such eating disorder is Binge Eating Disorder. As its name suggests, Binge Eating Disorder is characterized by repeated and uncontrollable large binge episodes even when the person is not hungry. Individuals with Binge Eating disorder often feel guilty about their disorder, sparking a cycle of binging and guilt. Health risks associated with BED include high blood pressure and heart disease. Approximately, 1-5% of the American population suffers from the disorder. Highly contradictory to the stereotype that only females suffer from Binge Eating Disorder, approximately 35% are male. (Hogan, E.M., McReynolds, C.J., An Overview of Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorders, Journal of Applied Rehabilitation Counseling, 35(4), 26-34, Winter 2004.)
EDNOS - Pica and Rumination
Pica and Rumination are also included in Eating Disorders Not Otherwise Specified. Pica is the practice of consuming objects not considered to be food, including paint, chalk, and other items. Pica is often correlated with vitamin deficiency and often found in pregnant women. Rumination is a disorder characterized by the regurgitation of food and re-masticating after initially swallowing. Rumination often occurs in infancy and in those with mental disabilities. (National Institute of Mental Health, National Institutes of Health, The Number Count: Mental Disorders in America, April 30 2008. http://www.nimh.nih.gov/health/publications/the-numbers-count-mental-disorders-in-america.shtml. Papadopoulos, V., & Mimidis, K., The rumination syndrome in adults, Journal of Postgraduate Medicine, 53(3), pp 203-206.)
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Obesity:
Often referred to as an epidemic, the increased prevalence of obesity has prompted international action. Obesity is a condition caused by an imbalance of caloric intake and expenditure. An individual becomes overweight when their daily amount of calories is larger than the amount burned off through their metabolism and exercise. Obesity is a more severe condition than being overweight. Obesity indicates a high percentage body fat and could case severe health complications. Obesity is determined by Body Mass Index (BMI). An individual with a calculated BMI of 25-29 kg/m2 is considered to be overweight whereas an individual with a BMI of 30 kg/m2 over is considered to be obese. In the US, the problem is significant: As reported by the Centers for Disease Control and Prevention in 2008, 25.6% of adults 20 or over are obese and estimates that 72 million people are currently obese in the United States. (Centers for Disease Control and Prevention (CDC), Development of Health and Human Services (DHHS), Division of Nutrition, Physical Activity, and Obesity (DNPA), Overweight and Obesity, November 2007.)
And it's not just a problem for adults. Childhood obesity is a growing problem around the world, thanks in part to our culture's obsession with food. In the U.S., 17.1% of children are overweight and 70% of obese teenagers grow up to become obese adults! Based on these percentages, it is clear that eating habits and physical activity of youth need to be addressed early in life to prevent the development of obesity in adolescence or adulthood. (Centers for Disease Control and Prevention (CDC), Development of Health and Human Services (DHHS), Division of Nutrition, Physical Activity, and Obesity (DNPA), Overweight and Obesity, November 2007.)
Obesity is both a health and financial burden. There are several health issues associated with obesity, the most studied of which is diabetes. Both children and adults who are obese are at a very high risk of developing Type II diabetes. In addition, obese individuals can also have sleep apnea, increased blood pressure and a higher risk of developing certain cancers. Addressing obesity early in the lives of our youth can prevent both future health risks and future financial obligations. (National Heart, Lung and Blood Institute (NHLBI), National Institutes of Health (NIH), Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults, 1998.
Obesity is by no means an easy situation. Obesity is an extremely complex condition, with influences ranging from the home environment to genetics to the psyche. One may have a genetic predisposition to obesity as based on family genetics. In addition, this genetic predisposition can interact with the environment, known as genotype-environment interaction, and cause obesity, especially in a so-called "toxic environment." No, a toxic environment does not signify any scientific outbreak or deadly poison. Rather, a toxic environment can by the environment in which we live, surrounded by advertisements for food and an endless supply of quick, high-fat meals. (G.D. Foster, "Obesity: Responding to the Global Epidemic," Journal of Consulting and Clinical psychology, Volume 70, Issue 3. pp. 510-525, 2002.) Such an environment can cause certain individuals with a genetic predisposition to the condition of obesity to become overweight, and eventually obese.
So, how do we fight obesity amidst this toxic environment? The primary step in treating obesity is modifying diet and exercise to create a healthy lifestyle. This means including more fruits and vegetables in one's daily diet, drinking more water, and exercising on a regular basis. Beyond these initial changes, treatment can also include therapy, medications or surgical treatments. Surgical interventions such as gastric bypass surgery are reserved for severe cases of obesity in which previous treatment options have been exhausted. Being as obesity is a complex condition with multiple influences and often accompanied with feelings of guilt, psychotherapy is a common component of successful treatment.
Remember that a successful treatment plan is unique for each individual. A weight-loss program that worked for a friend may not work for everyone. Also, finding someone to help you through obesity, whether it is family or friends, will be extremely important along the way!
Overcoming obesity is a long-term struggle and requires lasting care and attention. In addition to the physical difficulties of obesity and being overweight, those who are obese are subject to stereotypes and discrimination. Highlighting the influence of genetics and biology can help de-stigmatize the condition of obesity.
With staggering statistics that are increasing each year, it is important that obesity is addressed both in the general public and through media outreach. A return to healthy lifestyles is imperative not just for adults but also for children. Together, through accurate depictions and sharing information, we can help focus on healthy living.
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