We now understand that people suffering from eating disorders do not have to fit the severely underweight stereotype associated with anorexia nervosa. Unfortunately, this means that it can be even more difficult to recognize and properly diagnose people who are suffering from these potentially life-threatening illnesses. One of the most insidious realities that we have come to recognize about eating disorders is that they can appear to all but the most perceptive experts to be healthy weight loss. In a society that places high value on being thin, anyone who is able to go from an above-average size and weight to that which is seen as a normal “healthy” weight is likely to generate kudos rather than concern. People are more likely to ask for your dieting secrets and congratulate you on your self-discipline than to realize that you are starving yourself.
Normal Weight Individuals Still Face Health Risks
What many people do not realize about eating disorders is that a person can be in the process of starving without ever reaching a below-average weight. People who eat practically nothing day after day and drop huge amounts of weight in a very short time are endangering their health, whether they start at an average weight or a very above-average weight. There is a widespread misconception that a person who is obese cannot starve to death because the body will begin to consume the fatty tissue until the person becomes thin. However, without food, the body does not just consume fatty tissue—it also begins to break down high-protein tissues, because these can be more easily converted into glucose than fat. These lean tissues can include tissues from the heart and other important organs, which will eventually fail. Around 5 percent of people who suffer from eating disorders will die as a result of complications from their illness. Eating disorders can result in dangerous drops in blood pressure and heart rate and in loss of electrolytes. Very low levels of electrolytes can result in heart attacks, seizures or organ failure. Approximately 20 percent of adolescents who suffer from eating disorders will be hospitalized at one time or another as a result of one of these complications. Adolescents who suffer from anorexia may face interruptions in their normal development. Eating disorders can cause teenagers to experience slow or halted growth, and while some may eventually catch up to their projected height if they recover and reestablish healthy eating, others will have permanently stunted growth. Anorexia can also delay puberty and the start of menstruation, or it can cause menstruation to be extremely irregular and an unreliable predictor of pregnancy.
Childhood Obesity Has Implications for Eating Disorders
The childhood obesity epidemic has become one of the largest threats to pediatric health in recent years, and it has also impacted eating disorders. With more and more young people reaching adolescence at weights considered to be overweight or obese, the number of cases of atypical anorexia—in which someone who is overweight starves themselves to get down to an average weight—is also rising. Unlike people who develop anorexia when they are at a healthy weight and become severely underweight, overweight or obese individuals may be facing genuine health risks at their starting weight. They may be facing pressure from peers, the media and perhaps even health professionals to lose weight. This may make them even more prone to the obsession with thinness and with losing weight that characterizes anorexia.