The Oracle: Who is most likely to develop an eating disorder?

Karen Schenuer: The statistics show it is adolescents, teenagers, women more than men, boys more than girls. We see there’s a cluster of traits that people who have eating disorders have. People may have obsessive compulsive disorder, or they may have anxiety disorders or perfectionist thinking. They tend to be perfect students. They like to get straight “A”s. They excel in all that they do. Personality characteristics are low self esteem, feelings of inadequacy or lack of control. If something feels out of control at home, and if you’re a teenager, then the one thing you can control is how much food you put in your mouth and the size of your body. Other things that can be linked to genetics would be depression anxiety disorder and sometimes more benign states, feelings of anger and loneliness that can contribute to an eating disorder.

TO: What are the causes of eating disorders?

KS: The causes are complicated and multifactoral. Culture is huge. We live in a culture that glorifies thinness, so thin is something that is socially accepted and desired and it is equated to success, love, popularity: pretty much anything. In the media you see very thin pictures of women and they’re usually portraying that they’re happy. We’re constantly bombarded with women’s magazine with thin images and it’s assumed that if you don’t look like that something is wrong with you. Then we’re also bombarded with the diet industry which tells us that we shouldn’t be happy with our bodies—something’s wrong with it and we need to fix it. The message is that you’re not good enough the way you are and you’re flawed and you should always be trying to fix or make yourself better.

TO: What treatments have proven effective to cure or treat eating disorders?

KS: Treatment involves a team approach. A team approach means that the person needs to work with a doctor, psychiatrist, psychotherapist, nutritionist/dietician and they need support from all those different health professionals because each one has to specifically monitor the specific areas they need treatment for. The doctor is going to do vitals, blood pressure. The dietician is going to do eating plans, making peace with food. The psychiatrist is for medication, because many of these people have to be on medication, like antidepressants or an anxiety medication sometimes. The therapist will help unravel the causes of the eating disorders.

TO: What should you do if you suspect that a friend has an eating disorder?

KS: Basically you want to approach them and say “I notice that you seem to doing this and I’m worried and is there anything I can do to help?” You don’t want to call them out on it and say “What’s wrong with you? You don’t need to lose weight.” You wouldn’t want to say “Oh, you’re not fat,” because it really minimizes their experience. You want to focus on their inner qualities. You want to say “What’s up? What’s going on?” Try to make it not about the body, try to make it about something else that matters more, something that is distressing them.