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By Diane Atwood
The first thing you should understand about eating disorders is they are both psychological and medical illnesses.
That’s what Dr. Patrice Lockhart tries to emphasize to her patients and their families. She’s a board-certified psychiatrist specializing in helping people — women and men — struggleing with eating disorders.
She is medical director of the New England Eating Disorders Program at Sweetser in Saco. Dr. Lockhart explains the difference and also what to say if you’re worried about someone.
Psychological side of eating disorders
On the psychological side, there is a distortion of thinking about size, weight and shape, and a person is often distressed by this. It can increase anxiety and depression — another hallmark of an eating pattern gone awry. Someone may not feel they are acceptable or adequate or even worthy to live if they’re not exercising at, say, a compulsive level or getting rid of food they eat by either purging, vomiting, diet pill use, laxatives or diuretics.
The medical complications are really physiologic. Every organ system is affected by the dangers of an eating disorder. Purging by vomiting can affect the electrical system in the heart by altering electrolyte balances that make the heart beat regularly. There’s also physical damage to the esophagus and to dental enamel — especially the esophagus. It’s like wearing away the inside of the esophagus with Drano because, of course, stomach acid is so damaging to surfaces and the body is not meant to throw up unless it’s getting rid of something that’s very toxic.
What should you say if you’re worried?
Acknowledge the problem with words like “I’m worried about you.” “I don’t know whether this is happening or it’s just my perception but I’m worried.” “I see you treating me differently.” “I see you isolating more.” “I see your schoolwork going down.”
Be objective rather than judgmental. Let the person know you care about them. An eating disorder can sneak up someone, who is already self-judgmental, so they don’t need you to point out there’s something wrong with them. It’s concern, particularly about relationships, that tends to help people be willing to listen.
Providers — therapists, physicians and nurse practitioners — have an opportunity and, I think, an obligation to ask questions they might not otherwise ask. What is your eating pattern in a typical week? How do you feel about your body, and what are you doing to try to change it? Keeping it a fact-finding mission rather than a judgment mission can be helpful.
Diane Atwood was the health reporter on WCSH6 for many years. Now she is a blogger and podcaster at Catching Health with Diane Atwood, dianeatwood.com.
