By Rebecca Chasnovitz, M.D.:
Eating disorders aren't your typical dinner table conversation. However, studies suggest more people die of anorexia than any other mental health disorder.
To encourage people to open up about this important topic, Dr. Richard Besser, ABC News chief health and medical editor, hosted a Twitter chat on eating disorders Tuesday. Experts from the National Eating disorders Association, the National Association of Anorexia Nervosa and Associated Disorders, and MentorCONNECT, as well as eating disorder specialists at NYU and the Mayo Clinic and patients from all over the country tweeted out excellent advice and resources during the one-hour chat.
The chat transcript is here. And below, three main points our experts and chatters felt were essential for a frank and productive discussion.
Anorexia, Bulimia Aren't the Only Eating Disorders
While anorexia and bulimia are the most well-known eating disorders, tweeters pointed out that binge eating disorder and eating disorder not otherwise specified, or EDNOS, are actually more common. Patients with EDNOS have symptoms similar to those with anorexia and bulimia, such as distorted thoughts about their bodies and unhealthy eating behaviors, but do not fully meet the strict definitions of either.
"The exceptions are often more common than the rules," tweeted Cynthia Bulik, an eating disorder specialist at the University of North Carolina.
"People also think that EDNOS isn't a 'real eating disorder,'" tweeted Jocelyn Lebow, an eating disorder fellow at the Mayo Clinic, "but it can lead to similar long-term consequences as anorexia and bulimia."
The consequences of eating disorders discussed in the chat included other mental health disorders, such as depression, anxiety and obsessive-compulsive disorder.
It Often Takes a Family Member or Friend to Get Treatment Started
Tweeters stressed that denial is common in eating disorders. Patients fail to recognize the seriousness of low weight and do not always seek treatment on their own.
"It took my fourth hospitalization for me to accept that I had an eating disorder," tweeted Julia Kranz, a patient in recovery from anorexia. "My family were the ones to notice and get me help and they continue to be involved in my recovery."
Many patients in recovery tweeted stories of family members and friends who recognized the symptoms of an eating disorder and intervened. Warning signs discussed in the chat highlighted odd behaviors and rituals surrounding food, rather than weight loss.
"The person will start to have an intense preoccupation with food or their body," tweeted CRC Health. Bulik discussed the inward signs of hating your body, anxiety, depression, and fear, as well as the outward signs of eating small meals in public and avoiding family meals.
"Increasing isolation around meals is a red flag for eating disorders," warned NYU Langone Medical.
'Talk About It, Talk About It More'
"Talk about it, talk about it more," tweeted Dawn Matusz, a patient who currently started treatment for binge eating disorder. "Bring it into the open, and it can no longer hide."
Experts, advocates, and patients alike stressed the importance of talking about eating disorders, and the earlier, the better, as early intervention helps with recovery. "Err on the side of over-discussing," tweeted Dr. Russell Marx of NEDA.
Talking about eating disorders is not easy - even for patients. Vic Avon, a man recovering from anorexia, tweeted about how hard it is for men especially to speak about their illness. Alison Smela shared her difficulties seeking treatment as a "mid-life woman" for a diagnosis traditionally associated with teenage girls.
Tweeters also emphasized that conversations should be open, compassionate, and without judgment. "Verbalizing specific behaviors that you're concerned about lets your child know you are paying attention," tweeted ANAD.
Even once a patient starts treatment, it is important to keep talking because family and social support are essential to recovery. Lebow tweeted, "The more people involved the better-eating disorders thrive in secrecy."
Join the Conversation
Next week's Twitter chat covers colon cancer. Special guest Katie Couric will be tweeting about her experience. We'll also have experts from top organizations including the Mayo Clinic, The American Cancer Society and Colon Cancer Alliance on hand. Come share your story and get advice. To learn how to join in on the chat, click here. It's easy. You don't have to be a twitter expert to participate!