Samuels is the co-founder of Community Outreach for Prevention of Eating Disorders, an eating disorder prevention and support group. Each spring, members from COPE host a program in Volusia County schools to teach young girls how to have a positive body image.
“We have been going into the schools for three years and are learning that prevention really works,” Samuels said.
For more information about COPE, visit cope-ecf.org. Samuels spoke to The News-Journal about eating disorders.
What defines an eating disorder?
Eating disorders are complex conditions that arise from a combination of longstanding behavioral, psychological, interpersonal, biological and social conditions. While eating disorders usually begin with preoccupations with food and weight, they are most often about much more than food, using food and the control — or perceived control — of food to compensate for emotions that seem overwhelming.
Q: Who is at risk for getting an eating disorder?
There are a lot of biological and social environmental components. In the recently revised “American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders,” binge eating has just been included in the category of bulimia. There are a lot of patients in weight-loss programs or who are under a physician’s supervision who also have a binge-eating disorder that might not be diagnosed or addressed. What we see on college campuses is a rise of eating disorders not otherwise specified in about 25 percent of young women. I’m really passionate about educating primary care physicians because these disorders have so much secrecy, embarrassment and shame around them.
Q: What should you do if you suspect someone has an eating disorder?
I get calls all the time from people who say they feel awkward and uncomfortable and don’t know what to do. People tiptoe around asking and if they do ask, the person might get defensive and say they are fine and can handle it. Just because someone is eating doesn’t mean they don’t have an eating disorder. There is also binge eating, overeating, excessive exercising or purging. Using laxatives or diet pills is another sign. I always encourage people who want to offer support to use “I” statements when confronting someone suspected of having an eating disorder. Don’t start sentences by saying “you always” or “you never.” Tell them that you are worried or concerned and have noticed a change in behavior. Ask if there is something you can do to help, or suggest they talk to a doctor.
Q: What are some of the signs that someone might have an eating disorder?
People might have fewer and fewer foods that they are willing to eat or make excuses about why they aren’t eating. We see a lot of people who start off on a diet and don’t stop. Sometimes that can be a warning sign if they are way past their weight-loss goal but keep dieting. Another sign is excessive workouts. If you see that someone is working on a machine for hours or working out past exhaustion and can’t seem to stop, that’s a sign. Signs of binge eating and purging include foods disappearing, meals being avoided and large quantities of food going missing. Sometimes a person will excuse themselves immediately after meals and go to the bathroom.
Q: Is it true that the longer an eating disorder goes untreated, the harder is for someone to stop?
The earlier you intervene, the more likely you will have a full recovery. The longer the duration of the eating disorder, the more imbedded it becomes. It takes its toll and affects all systems of the body, including the brain and the heart. We see devastating physical effects. I treat women in their 40s, 50s and 60s who have been battling an eating disorder all their lives and say they wish they had gotten treatment earlier. There is always hope you can recover, but the longer the disease exists, the harder it is.
Q: What is the best course of treatment?
I believe strongly in multi-team treatment. We need to have a primary care physician on board to help monitor the patient’s health and make sure we aren’t overlooking anything. We also need a registered dietician on the team and a mental health professional. I work on that model so that we don’t have gaps in treatment. Even with a team, if someone is still sliding downhill, then we talk about an inpatient residential treatment program.
Q: How have eating disorders changed since you first started your career?
We are seeing an increase in eating disorders across all life spans. More women over the age of 50 are being treated. We’d hope that women feel more comfortable with their bodies as they age, but we are seeing a rise in eating disorders past midlife because of our culture of obsession with weight and shape. I am also seeing an increase in male eating disorders. Historically men have always have struggled more with binge eating or compulsive eating. Now I am seeing an increase in men and young adults with the whole range of eating disorders. I’d say that the percent of males is still low, but we are seeing it more. Because of improved treatment, more people are also coming forward to get treatment, so it’s hard to tell if these cases were always there.
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Doctor helps patients with Eating Disorders