Studies show that nine out 10 people with an eating disorder do not seek help. Not only do they fear being stigmatized and shamed, they worry about what will happen at the doctor's office. Many people are scared of what's involved in the tests and assessments. Some aren't even sure if they have an eating disorder.
Are you at risk of an eating disorder?
Health professionals use the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) to diagnose all eating disorders. Each eating disorder has different criteria that your doctor will use to determine if you or a loved one is suffering from one of these very serious, or even life-threatening, disorders. A good place to start your research is online.
The National Eating Disorder Association (NEDA) has an online screening tool you can use in the privacy of your home. They will ask you several questions regarding any preoccupation with your shape and food. They will inquire about your current height and weight along with asking you to recall your eating patterns over the last three months
If the test shows that you have an eating disorder, or at risk for one, it will be recommended that you see a doctor or mental health professional as soon as possible.
A doctor will talk to you about your exercise habits. They will see if you have muscle weakness, are dizzy, cold, or cannot concentrate. Dry hair, dental problems, yellow skin and sleeping problems also indicate to a doctor that an eating disorder is likely. Laboratory tests will be ordered if you are determined to be at risk.
Eating disorders: Assessments and tests
When your laboratory tests come back, the doctor will be look for low blood cell counts, thyroid issues, hormone problems, and anemia, as these are indications that your eating patterns are affecting your major organs. Even your immune system may be at risk. Your blood pressure and pulse will be checked as well as your breathing.
The will examine your abdominal area. Intestinal issues along with a sore throat and dry skin or hair indicates bulimia. The doctor may also order an X-ray to find out if you have bone loss, which can result from anorexia or bulimia. Your teeth may be examined for cavities and tooth decay — a result of purging.
Mental evaluation for eating disorders
If your doctor finds you have the physical symptoms of an eating disorder, they will want a psychological exam done. You will need to be open and honest with your mental health specialist to receive a correct diagnosis. They will ask you questions about how you perceive your body and how you think about food and exercise. They may explore your home life too. Many people with eating disorders try to minimize or are unaware of both the physical and mental toll their disorder is taking, on themselves and their families.
The therapist will screen you for anxiety, depression and suicidal thoughts. They will also look for signs of social isolation. Those with eating disorders will often isolate themselves from others to avoid criticism and to concentrate on eating and purging.
The American Psychiatric Association (APA) has strict criteria that determine what defines an eating disorder. Sometimes, a mental health professional will not feel you fall distinctly into one category. Instead, they might classify you as Eating Disorder Not Otherwise Specified, or EDNOS. You may have behaviors or thoughts that cross different categories, leading to an EDNOS diagnosis. Regardless of your diagnosis, you may be referred to a dietitian for further evaluation of your diet and nutrition.
How can dietitians help treat eating disorders?
Your mental health specialist will refer you to a specially trained dietitian or nutritionist that can help detect and treat disordered eating. Sometimes, patients referred to dietitians had little idea of exactly how harmful their eating patterns are for their health. It's not uncommon to see binge eaters who are actually malnourished despite being obese.
The dietitian will ask about current eating habits to assess what changes a patient will need to address regarding health issues and vitamin deficiencies. An anorexic will have different needs than a binge eater or someone with EDNOS.
Recovery from eating disorders
Sixty percent of people who seek and receive help for an eating disorder will fully recover, though it may require long-term treatment. For the best hope of success, early intervention from the medical community is a must. It's important that the medical doctor work closely with a therapist and a dietitian to treat all the symptoms. Without proper treatment, 20 percent of those diagnosed with anorexia will die prematurely.
If you suspect a loved one is suffering from an eating disorder, the best thing you can do is assure them that there are a team of compassionate professionals waiting to help. You can also be a role model by eating well and exercising in moderation. Don't talk about weight problems or make disparaging remarks about your body or theirs.