The Many Faces of Eating Disorders


At a time when over 35 percent of American adults are considered overweight — according to a statistic from the Center for Disease Control — and obesity has been implicated in heart disease, stroke and certain cancers, the current trend in American public health has been to promote weight loss.

It’s this inclination that UCSD professor and clinical therapist Danielle Beck-Ellsworth, who teaches a class on the psychology of eating disorders, says that diseases at the other end of the spectrum — anorexia nervosa, bulimia and binge eating — have escaped the limelight. 

Collectively, however, these diseases have the highest mortality rates out of any mental illness, according to statistics released by the national eating disorders association.

“It’s something that hasn’t really been on the radar,” Beck-Ellsworth said. “On a social level, we’re not really obsessed about eating disorders the way we are about obesity. But ironically, the more we stress weight loss, the more we may be encouraging unhealthy eating habits. Instead of focusing on weight, we need to be promoting a healthy lifestyle.”

Beck-Ellsworth warns individuals about drawing conclusions from eating disorder statistics, sufferers tend to share a number of personality traits. Individuals struggling with an eating disorder is often very rigid and motivated and have a very reward-dependent mindset. 

Studies have also shown that eating disorders can be triggered by traumatic events. But likely the most talked about cause of eating disorders as of late is the cultural pressure created by the concept of equating skinny with pretty.

Co-founder of the Summit Eating Disorders and Outreach Program in Sacramento Jennifer Lombardi, a survivor of anorexia nervosa, said that more research on the subject has revealed a number of trends emerging amongst college-aged sufferers of eating disorders. Lombardi said that college students may be put at particular risk because of the stress of a new environment and the cultural expectations associated with coming to college.

“Going to college is a very exciting time,” Lombardi said. “There’s a lot of emphasis put on having a wonderful time and becoming more independent, but rarely do we talk about how stressful that change may be. For someone with the acknowledged personality traits associated with eating disorders — the anxiety, in part caused by the myth of the Freshman 15 … may be enough to cause individuals to turn to that kind of behavior.” 

Characteristic of a number of psychological diseases, eating disorders are difficult to both diagnose and treat, because they’re caused by an array of issues — biological, social and cultural. 

From an anatomical standpoint, the excess or lack of specific chemical messengers, known as neurotransmitters, in the brain have been implicated. For this reason, individuals diagnosed with an eating disorder often also suffer from either obsessive-compulsive disorder or depression. A treatment option may include the prescription of antidepressants.

“There are a lot of contributing factors in the development of an eating disorder,” Lombardi said. “Biological risk factors, psychological predisposition, a family history of anxiety or obsessive-compulsive traits and temperament all sort of co-mingle.”

Lombardi regularly deals with sufferers of the disorder at her treatment center. She corroborated a study on “drunkorexia” published in 2011 by the University of Missouri. The authors of the study coined the term “drunkorexia” to describe individuals who forgo food in order to consume calories in the form of alcohol. According to the online questionnaire that they used to survey undergraduates at the University of Missouri, approximately 30 percent of female students reported restricting calories to “save them” for alcohol consumption. 

Though the conclusions from the original study did not consider the psychological effects of the “Freshman 15,” Lombardi said that the phenomenon may be a backlash to the publicity of Freshman 15, which gained traction up to a decade ago in the popular media. However, a 2011 paper published by researchers at Ohio State University found that college freshman only gain an average of 2.4 pounds for women and 3.4 pounds for men. 

Both Lombardi and Beck-Ellsworth agree that the profile for individuals with eating disorders is not nearly as narrow as formerly believed.

“It’s not just young, Caucasian girls that are affected by eating disorders,” Beck-Ellsworth said. “It can affect anyone.”

Surprisingly, studies have shown one demographic of college-aged individuals in particular to be heavily impacted by eating disorders. In 1999, a study published in the International Journal of Eating Disorders found that in a pool of 1,445 student athletes, 9.2 percent of women were diagnosed with bulimia and 10.85 percent were seen to engage in binge eating on a weekly basis. Although there is no hard and fast rule requiring it, the weight of female athletes are not listed on any NCAA roster across any sport. 

Recently, eating disorders have received more attention from the medical and academic communities. But both Beck-Ellsworth and Lombardi agree that more needs to be done. Beck-Ellsworth noted that in spite of a 10 percent mortality rate amongst the diagnosed, medical professionals still don’t have formal training in handling eating disorders. 

“I think the biggest thing that needs to change is an increase in awareness,” Beck-Ellsworth said. “People need to be aware that this is something that can affect everybody. It’s important not to just immediately rule someone out because of their appearance.”