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• Dr. Simon B. Sherry is a clinical psychologist and an associate professor in the department of psychology and neuroscience at Dalhousie University. Ms. Cynthia Ramasubbu is the research coordinator for Dalhousie University’s personality research team.
• Bruce Bottomley

February 1 to 7 is Eating Disorders Awareness Week, an international event that encourages understanding of eating disorders. As psychologists and as scientists who study and treat eating disorders, we recognize eating disorders are often greatly misunderstood, and we want to raise awareness about these common, costly, and impairing disorders.

Eating disorders involve serious, life-threatening problems with how you eat, how you control your weight and how you view yourself. Most eating disorders involve a preoccupation with weight, shape and size. These disorders are diagnosed with reference to anorexia nervosa (low bodyweight maintained through excessive exercise, dieting or purging), bulimia nervosa (out-of-control eating followed by extreme weight loss efforts) and binge eating disorder (out-of-control eating). Many people do not fit neatly within these diagnostic categories, but still suffer greatly. Eating disorders often go along with other problems such as alcoholism, depression and anxiety.

Many people suffer from eating disorders. Peak age of onset is between 14 and 19 years of age, with eating disorders occurring in women 10 times more often than men. Eating disorders are the third most common chronic illness in adolescents (after obesity and asthma). Around the world, 9.4 million people will experience an eating disorder this year. Here in Canada, there are 100,000 people this year over 15 years of age with a diagnosed eating disorder. Many eating disorder clinics in Canada report wait lists for inpatient beds, with an average wait time of six-and-a-half weeks. A hospital stay for someone with an eating disorder costs $1,200 to $1,500 per day in Canada.

Eating disorders undermine health. These disorders contribute to tooth erosion, esophagus damage, irregular menstrual periods, miscarriages, heart problems, bone density loss and electrolyte imbalances. Eating disorders also kill. People with eating disorders are five times more likely to attempt suicide compared to the general population. And anorexia nervosa has the highest mortality rate of any mental disorder: 10 percent of people with anorexia nervosa will die within 10 years of their diagnosis.

Several different factors come together to cause an eating disorder, including biological factors (like neurotransmitter abnormalities), psychological factors (like perfectionistic traits) and sociocultural factors (like media portrayals of unrealistic thinness). Studies of twins suggest that eating disorders are highly heritable, with heritability estimates ranging between 50 percent and 83 percent. Adversity (such as abuse or bullying) also increases the odds of developing an eating disorder.

Eating disorders are treatable, but many people with eating disorders never seek or receive proper treatment. An approach targeting various aspects of an individual’s life (social, medical, nutritional and psychological) is recommended for anorexia nervosa. For bulimia nervosa and binge eating disorder, cognitive-behavioural therapy is a recommended first-line treatment option that is well-supported by scientific evidence. Without treatment, eating disorders are chronic, and much more should be done to increase funds dedicated to researching, preventing, and treating eating disorders in Nova Scotia and around the world. Lives depend on it.