First of all, it’s important to understand that eating disorders are both psychological and medical illnesses. That’s what Dr. Patrice Lockhart emphasized when I interviewed her for the Catching Health podcast.
Dr. Patrice Lockhart is a board-certified psychiatrist who specializes in helping people — women and men — who struggle with eating disorders. She is medical director of the New England Eating Disorders Program at Sweetser, in Saco, Maine.
This is what Dr. Lockhart said about the psychological and medical aspects of an eating disorder.
On the psychological side, there is a distortion of thinking about size, weight, and shape and a person is often distressed by this. It can increase anxiety and depression, which is another hallmark of an eating pattern gone awry. Someone may not feel that they are acceptable or adequate or even worthy to live if they’re not exercising at, say, a compulsive level or getting rid of food that they eat by either purging, vomiting, diet pill use, laxatives, or diuretics.
The medical complications are really physiologic. Every organ system is affected by the dangers of an eating disorder. Purging by vomiting can affect the electrical system in the heart by altering electrolyte balances that make the heart beat regularly. There’s also physical damage to the esophagus and to dental enamel — especially the esophagus. It’s like wearing away the inside of the esophagus with Drano because, of course, stomach acid is so damaging to surfaces and the body is not meant to throw up unless it’s getting rid of something that’s very toxic.
What should you say if you’re worried?
It’s kind of like identifying, well, I’m worried about you. I don’t know whether this is happening or it’s just my perception but I’m worried. I see you treating me differently. I see you isolating more. I see your school work going down. Being objective rather than judgmental. Letting the person know that you care about them. An eating disorder can sneak up someone and they’re plenty judgmental already, so they don’t need it pointed out that there’s something wrong with them. It’s concern, particularly about relationships, that tends to help people be willing to listen.
Providers — therapists and physicians and nurse practitioners — have an opportunity and I think an obligation to ask questions that they might not otherwise ask. What is your eating pattern in a typical week? How do you feel about your body and what are you doing to try to change it? Keeping it a fact-finding mission rather than a judgment mission can be helpful.
If you’d like to understand more about eating disorders, what they are and how they can be treated, listen to the Catching Health podcast with Dr. Patrice Lockhart.