Nine Truths about Weight and Eating Disorders

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The Academy for Eating Disorders (AED) has released a new document titled Nine Truths about Weight and Eating Disorders in order to increase awareness of eating disorders in people along the full spectrum of body sizes. Despite the stereotype of patients being extremely underweight, eating disorders can occur at any weight. A companion to the “Nine Truths about Eating Disorders,” this document aims to eradicate the stereotypes and educate both medical professionals and the public about these deadly disorders.

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Eating disorders have one of the highest mortality rates among psychiatric illnesses, second only to opioid addiction. Although doctors previously believed that only patients at very low weights were at risk for fatal medical complications, recent research has shown that the risk extends the range of body weights.1 Cardiac issues due to caloric restriction, use of diet pills and laxatives, and self-induced vomiting are a leading cause of death in eating disorders, regardless of weight.2-3 Early intervention is an important factor in lowering rates of death and medical complications, but diagnosis in higher weight patients is often delayed. Instead, these patients are often given recommendations to lose weight, which can exacerbate their behavioral symptoms.

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Weight-based discrimination and bullying are prevalent in healthcare, employment, and educational settings. This stigma has been shown to affect both mental and physical health, including greater levels of depression and lowered self-esteem, with higher risk for diabetes and disordered eating behaviors.4 Individuals who have experienced weight bias from medical professionals are more likely to avoid routine healthcare, which can lead to delayed diagnoses of other medical issues.

“Weight stigma is pervasive, pernicious, and cuts to the core of our mission by both increasing the risk of eating disorders and making sustained recovery so much more difficult,” said Dr. Bryn Austin, President of the Academy for Eating Disorders. “The more a person takes the ubiquitous demeaning and dismissive messages in media and in society about fat bodies to heart, the likelier they are to develop an eating disorder and the more they will struggle with recovery, regardless of how much that person weighs. In addition, frank discrimination in healthcare against people living in larger bodies takes a direct and sometimes devastating toll on health and well-being regardless of whether or not a person believes the stigmatizing messages. With our new Nine Truths about Weight and Eating Disorders, we hope to offer our fellow health professionals — whether pediatricians or geriatricians, social workers or cardiologists – new insights on these topics, new ways of understanding patients’ and families’ experiences and, hopefully, more compassion to the care they provide.”

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Creation of the Nine Truths about Weight and Eating Disorders was led by Dasha Nicholls, MBBS, MD and Phillippa Diedrichs, PhD. Dr. Nicholls is on the Faculty of Medicine, Department of Brain Sciences at the Imperial College, London, UK. She is past president of the Academy for Eating Disorders and past chair of the Eating Disorders Faculty at the Royal College of Psychiatrists. Dr. Diedrichs is Professor of Psychology at the Centre for Appearance Research, University of the West of England in Bristol, UK. She has served as an advisor to the British Government, including the Equalities Office, the Minister for Women and Equalities, the All Party Parliamentary Group on Body Image, and the Mayor of London. Both are Fellows of the Academy for Eating Disorders.

References:

  1. Garber, A. K., Cheng, J., Accurso, E. C., Adams, S. H., Buckelew, S. M., Kapphahn, C. J., . . . Golden, N. H. (2019). Weight loss and illness severity in adolescents with atypical anorexia nervosa. Pediatrics, 144(5), e20192339.
  2. Jáuregui-Garrido, B. & Jáuregui Lobera, I. (2012). Sudden death in eating disorders. Vascular Health and Risk Management, 8, 91-98.
  3. Crow, S. J., Peterson, C. B., Swanson, S. A., Raymond, N. C., Specker, S., Eckert, E. D., & Mitchell, J. E. (2009). Increased mortality in bulimia nervosa and other eating disorders. American Journal of Psychiatry, 166(12), 1342-1346.
  4. Wu, Y.-K. & Berry, D. C. (2018). Impact of weight stigma on physiological and psychological health outcomes for overweight and obese adults: a systematic review. Journal of Advanced Nursing, 74(5), 1030-1042.
  5. DiGiacinto, D., Gildon, B., Stamile, E., & Aubrey, J. (2015). Weight-biased health professionals and the effects on overweight patients. Journal of Diagnostic Medical Sonography, 31(2), 132-135.

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ABOUT

The Academy for Eating Disorders (AED) is an international professional association committed to the leadership in eating disorders research, education, treatment, and prevention. The goal of the AED is to provide global access to knowledge, research, and best treatment practice for eating disorders. For additional information, please contact Elissa Myers at (703) 626-9087 and visit the AED website at www.aedweb.org.

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