There’s no doubt the pandemic has caused a rise in many issues relating to our health, both mentally and physically, and one of those issues is the prevalence of eating disorders, particularly in teens. In fact, the National Eating Disorders Association reported a 40% increase in calls to their helpline in the first year of the pandemic. And perhaps the most alarming part is this—a loved one could be suffering from an eating disorder without you or anyone knowing. To gain more insight, we spoke with Darlene Osipuk, MD, a psychiatrist at Robert Wood Johnson University Hospital Somerset’s Eating Disorders Program, on what to look for and how to treat it if you suspect someone you know is suffering. (featured photo credit: istock/Motortion)
What are the types of eating disorders, and who is at risk?
Anorexia nervosa and bulimia nervosa are the most common types of eating disorders. Anorexia nervosa is known as being obsessed with becoming thin, restricting food intake, and enhancing physical activity to keep body weight dangerously low. Bulimia nervosa is seen when individuals binge and purge—excessive eating and vomiting episodes. A person who suffers from bulimia can also be abusing laxatives or diuretics. When these disorders are not recognized and appropriately treated, they can lead to severe health issues, including cardiovascular disease, osteoporosis, anemia, kidney dysfunction, and in some cases, death. Because those who suffer from eating disorders do not always appear to be overly thin, it can be hard to detect that a loved one is suffering from the illness. Like many other disorders and diseases, this illness is extremely difficult for one person to handle and overcome alone.
Eating disorders affect both males and females and any age group. Onset most commonly begins in young adulthood. Adults diagnosed with eating disorders typically have struggled with it throughout their lives, but it wasn’t severe enough to require medical attention. Between 10 to 30% of eating disorders patients are males. Men can struggle with body image just as females do, but their focus may be more on building muscle and getting stronger. Men have more difficulty asking for help if they are anxious or depressed and may turn to eating disorders to feel better about themselves.
We know the pandemic has affected everything, especially mental health. How has the pandemic played a role in the rise of eating disorders?
During the height of the pandemic, schools went virtual, many people worked from home, and in-person gatherings were limited to prevent the spread of COVID-19. Social isolation is very triggering for anxiety and gives us more time to focus on our bodies and weight. People, especially teens, spend even more time on social media, where they constantly see images of the ideal perfect body. They became determined to achieve that ideal at all costs, contributing to increased eating disorders.
What are the treatments? How do you know when a patient needs hospital care?
Eating disorders are commonly known to stem from an underlying problem such as a major or traumatic life event, family or social problems, or emotional issues including anxiety, obsessive-compulsive disorder, low self-esteem, and stress. Individuals will use the disorder to cope with these issues and feel that they are taking control. The need to resolve the physical illness and the biological, psychological, and sociological problems typically results in a long and complex treatment process. Treatment options vary depending on the case but usually include therapy/counseling, support groups, nutrition education, and, if necessary, medication management and education. While it can be difficult, the appropriate treatment allows individuals to develop more effective coping skills and ultimately facilitates a happier and healthier life. A medical evaluation will determine if hospital care is needed. Hospital care may be recommended when a patient has lost a significant amount of weight quickly and the patient’s weight is less than 85% of their ideal body weight.
You just finished the first phase of renovations at the Somerset facility. Can you tell us about the Somerset Eating Disorders Program at Robert Wood Johnson University Hospital and the dedicated inpatient units for eating disorders? What is new?
Robert Wood Johnson University Hospital Somerset’s Eating Disorders Program is one of only two inpatient eating disorders programs in New Jersey. The unit has undergone a major renovation, creating a state-of-the-art facility that promotes healing, wellness, and recovery. The renovation expands the number of patient rooms from 14 to 20, and many rooms are private. When renovations are completed, it will be the only inpatient eating disorders program in New Jersey that separates adults and adolescents into distinct areas. One of the highlights of the space is nature-based lighting—indoor lighting changes to correspond with the brightening and dimming of natural sunlight throughout the day. It is more conducive to healing when you can attune people to circadian or daily, natural rhythms in behavioral health settings.
Throughout the facility, structural and decorative lines are designed to be soft and calm-inducing, often by incorporating curves, which are more common in nature than straight lines or hard angles. Spaces such as the reception area feature natural images and colors to evoke the relaxing quality of living environments. The unit’s design concept also calls for direct patient access to dedicated garden spaces. What’s more, the spaces are flexible and can accommodate a mix of uses such as active or quiet, open or private. The unit provides ample space for group activities that are key to the program’s recovery-based treatment, which helps patients develop resilience and coping skills through mindfulness and cognitive behavioral therapy.
In addition to inpatient care, Robert Wood Johnson University Hospital Somerset also offers partial hospitalization and outpatient services for eating disorders patients ages 14 and older.
Please share some tips moms should look for in their kids and teens. What should they do when they suspect an eating disorder?
It’s not always easy to detect, but the important signs to look for indicating a loved one may be suffering from an eating disorder can include:
- Rapid weight loss – A thin appearance or a weight loss of more than 15 percent usually signifies there might be an issue. Continual dieting is also a red flag.
- Intolerance to the cold – People with anorexia or bulimia typically have difficulty tolerating colder weather.
- Cessation of menstrual periods – Females suffering from an eating disorder may stop getting their period.
- Tiredness – People with eating disorders are often extremely fatigued and may also suffer from insomnia. It is also common for people to feel dizzy and faint.
- Physical changes – Hair thinning or falling out, a bluish discoloration of the fingers, and dry skin are all warning signs of a potential eating disorder. Swelling of the arms and legs is also common.
Emotional and Behavioral Signs
- Unusual food behaviors – These behaviors can include but are not limited to irregular eating, hiding food, refusing to eat in public or with family and friends, or lying about how much food has been eaten.
- Excessive exercise – Many eating disorder patients have periods of compulsive exercising to either counteract the effects of eating or attempt at weight loss. Patients may experience intense anxiety if they cannot engage in exercise and may reduce their social, school, and work activities to fit in their exercise routine.
- Emotional changes and social withdrawal – The social signs that may arise in someone who has an eating disorder include a lack of emotion, irritability, depression, rapid mood changes, and a reduced interest in sex. The presence of extremely low self-esteem is also an emotional state that can often be a sign of eating disorders.
If you believe that you or a loved one may have an eating disorder, visit your family physician to discuss any concerns, questions, and options. For immediate evaluation and treatment options, contact your local hospital or call Robert Wood Johnson University Hospital Somerset’s Assessment Center at 1-800-300-0628. Services offered at Robert Wood Johnson University Hospital Somerset’s Eating Disorders Program include an inpatient treatment center, partial hospitalization, intensive outpatient services, and weekly support groups. For more information on eating disorders and treatment services, visit www.rwjbh.org/somerset.