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How to identify, treat eating disorders

Judy Clifford, far left, Nancy Albus, Laura Huff and David Bachman talk to 'St. Louis on the Air' host Don Marsh about eating disorders on Feb. 19, 2015, at St. Louis Public Radio in St. Louis.
Alex Heuer
St. Louis Public Radio
Judy Clifford, far left, Nancy Albus, Laura Huff and David Bachman talk to 'St. Louis on the Air' host Don Marsh about eating disorders on Thursday at St. Louis Public Radio in St. Louis.

Several sterotypes are associated with eating disorders. Among them, that the disease only affects teenage women.

Nancy Albus, CEO of Castlewood Treatment Center, told “St. Louis on the Air” host Don Marsh on Thursday that her facility is seeing more and more men. Because only about one in 10 people affected by an eating disorder seek treatment, there are probably a lot more men (and women) who need treatment, she said.

And it’s not just teens: Eating disorders can manifest at any age, said Laura Huff, director of the St. Louis Behavioral Health Medicine Institute.

There’s also more than one kind of eating disorder.

“The anorexic often is able to be seen within the culture because it is significantly below ideal body weight, so oftentimes people think that that’s the only type eating disorder,” Albus said. “Bulimia sometimes is more of like a silent disorder, where people — families, friends, loved ones — are unaware of the behaviors that are occurring because they’re occurring not during the mealtime, oftentimes in secret after a meal.”

But binge eating disorder is the most common, Huff said. It can affect those who are at an ideal weight or overweight and is often done in secret as well.

“People can fully recover from an eating disorder,” Huff said. “It certainly depends on quite a few variables. There’s different levels of severity; it depends on how long they’ve had the eating disorder; as well as co-occurring disorders, such as depression, history of trauma, anxiety and things like that.”

Eating disorders are “brain-based diseases,” Huff said, but genetics also contribute significantly, she said.

“What we like to say is that genetics loads the gun, and culture pulls the trigger,” said Judy Clifford, whose daughter is in recovery from anorexia nervosa. “It doesn’t necessarily have to be about body image. It can be about achieving, being perfectionistic — personality traits that can turn against you.”

External factors also can contribute to eating disorders, Huff said.

“Certainly we know there’s a role in society of this thin ideal, that we overvalue being thin,” she said. “When you buy into that, it can really lead to aggressive dieting, which is the leading behavior that leads to eating disorders. Research does show that obesity programs in our schools and kind of this war on obesity is a contributor to the development of eating disorders.”

Many signs of eating disorders show up during adolescence, which can make them difficult for parents to identify, Huff said.

“For parents, they’re going to look for isolating behavior and mood changes,” she said. “Typically you’re seeing some personality changes. There’s really a lot more time spent alone, and this is not, by any means, pleasant time. They’re avoiding eating, and it’s easy to miss because we’re not having family meals. Parents aren’t always seeing what kids are eating. It helps to have some regular family meals so you really can observe your child eating, and really take seriously the mood changes that you might be seeing. You may see weight changes; you may not. You may see food missing. You may find evidence of certainly purging or hoarding in kids’ rooms.”

David Bachman’s son was 12 when Bachman and his wife began noticing what they dubbed “behaviors.” His son is now in recovery for anorexia nervosa, which became much more apparent during a family vacation, Bachman said.

“The research says that the average recovery really takes about six years to really cement itself,” Albus said. “So you need professional care, like psychiatric care, seeing a nutritionist, seeing a therapist in an outpatient setting.”

Some, like Bachman’s son and Clifford’s daughter, also require hospitalization.

“If the family can find the proper treatment early-on, and get the proper treatment for the proper amount of time, you really cut out a lot of this chronicity down the road,” Clifford said. Her daughter has been in recovery for more than six years; Bachman’s son is two years into recovery.

National Eating Disorders Awareness Week is Feb. 22-28. The Missouri Eating Disorders Association estimates that more than 200,000 Missourians suffer from an eating disorder.

Related Event

"I Had No Idea" panel discussion

  • When: 7 p.m. Feb. 26, 2015
  • Where: Donius Auditorium at Maryville University. 13550 Conway Road, Chesterfield
  • More information

“St. Louis on the Air” discusses issues and concerns facing the St. Louis area. The show is produced by Mary Edwards and Alex Heuer and hosted by veteran journalist Don Marsh. Follow us on Twitter: @STLonAir.

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