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Speaker 1: Brought to you by the reinvented two thousand twelve Camray.

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Speaker 1: It's ready. Are you welcome to Stuff Mom never told you?

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Speaker 1: From House to Works dot com. Hey, welcome podcast. This

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Speaker 1: is Molly and Kristen. Kristen you know, and I'm sure

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Speaker 1: many of our listeners know, I write about health issues

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Speaker 1: for How Stuff Works, and that means that there is

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Speaker 1: one book that is on my mind a lot lately.

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Speaker 1: It's coming out, so I've got a little bit of

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Speaker 1: time to wait, but right now we're in the three

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Speaker 1: year comment period for it, so things are pretty exciting.

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Speaker 1: Think you're talking about the d s M five. Yes,

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Speaker 1: the Psychiatric Bible, as it's often called. It stands for

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Speaker 1: Diagnostic and Statistical Manual of Mental Disorders. Right now we

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Speaker 1: have the d s M four and it's going to

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Speaker 1: be updated and better than ever. Um, but it's in

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Speaker 1: the process of revising it. People are having all sorts

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Speaker 1: of questions as to, you know, what's going to be included,

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Speaker 1: How are we gonna find tune this thing because basically,

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Speaker 1: like I said, it's the Bible. If it's not in

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Speaker 1: the d s M might as well just not even exists.

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Speaker 1: And one big thing that is Uh, that's gotten some headlines.

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Speaker 1: On addition, I should say to the d s M

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Speaker 1: five is that binge eating disorder is going to be

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Speaker 1: classified along with other eating disorders such as bulimia, anorexia,

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Speaker 1: and also eating disorders not otherwise classified a K A

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Speaker 1: D nurse Right, those are the big three now or

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Speaker 1: anorexia blim in eddnurse and beinge eating is under ed

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Speaker 1: nose um. But the problem is is that ed nose

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Speaker 1: is pretty big umbrella. Yes, so that's what they're hoping

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Speaker 1: that by bringing binge eating out, it'll shine some more

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Speaker 1: light and help more people get help with the problem

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Speaker 1: of bench eating. And we thought that this would be

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Speaker 1: a good opportunity. We haven't covered eating disorders before, and

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Speaker 1: we thought that this would be a good opportunity to

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Speaker 1: not just talk about, you know, what is an eating disorder.

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Speaker 1: I think a lot of people are pretty aware of

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Speaker 1: issues like anorexia and bulimia, you know, or people will

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Speaker 1: generally like starve themselves, uh, they will go through cycles

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Speaker 1: of binging and purging. But we thought that it would

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Speaker 1: be a good opportunity to really focus on these issues

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Speaker 1: of the the eat nose, the kind of not otherwise

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Speaker 1: classified UM eating disorders, because you know, is the most

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Speaker 1: commonly diagnosed eating disorder in the United States because a

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Speaker 1: lot of times it takes a lot of different criteria

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Speaker 1: to be considered clinically anorexic or bulimic, and that's been

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Speaker 1: a big problem for for a lot of people who

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Speaker 1: are trying to seek help. UM. So, without further ado,

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Speaker 1: what constitutes need disorders, let's talk about let's talk about

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Speaker 1: eating disorders and UH, let's go to just basic definitions

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Speaker 1: of UM, the anorexia, BULIMIAM and Eve knows because I

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Speaker 1: was actually surprised for a couple of these things. I

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Speaker 1: think that we UM might not entirely understand what each

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Speaker 1: of these disorders involves. So this is coming from the

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Speaker 1: National Institute of Mental Health and UH. It defines anorexia

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Speaker 1: nervosa as UH. It's characterized by emaciation, a relentless pursuit

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Speaker 1: of thinness and unwillingness to maintain a normal or healthy weight,

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Speaker 1: a distortion of body image and intense sphere of gaining weight,

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Speaker 1: a lack of menstruation among girls and women, and extremely

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Speaker 1: disturbed eating behavior. Some people with anorexia lose weight by

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Speaker 1: dieting and exercising it excessively. Others lose weight by self

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Speaker 1: induced vomiting or misusing laxatives, diuretics, or enemies, and I

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Speaker 1: didn't realize. I think a lot of times people will

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Speaker 1: associate the vomiting with um bulimia, but um, it's more

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Speaker 1: the difference between interorexia and bulimia is really just your

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Speaker 1: food intake. A lot of times interrectis very very little food,

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Speaker 1: whereas with bolimia, UM it is characterized by recurrent and

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Speaker 1: frequent episodes of eating unusually large amounts of food you've

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Speaker 1: bene eating and feeling lack of control over the eating.

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Speaker 1: And then it is followed by something to compensate for

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Speaker 1: the bench such as purging, fasting, and or excessive exercise.

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Speaker 1: And one thing with one big difference between interorectics and

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Speaker 1: beliemics is that a lot of times you can tell

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Speaker 1: when someone is struggling with the interactually they will be

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Speaker 1: extremely thin. But um, it's not that uncommon for bliemics

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Speaker 1: to be within um a normal healthy weight range. Not

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Speaker 1: to say the behavior is healthy, but just that their

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Speaker 1: weight is Is that a normal spot? Now? I think

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Speaker 1: that just in reading those two very precise definitions of

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Speaker 1: the conditions that are recognized by the current DS, and

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Speaker 1: four you already see how hard it can be to

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Speaker 1: kind of separate out all the different issues in TEL

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Speaker 1: if you really do have a disorder eating panks. You

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Speaker 1: mentioned binge eating UM, which is now going to be

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Speaker 1: you know, possibly its own disorder u UM. So let's

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Speaker 1: talk a little bit about binge eating. Okay, Now, binge

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Speaker 1: eating is characterized by recurrent binge eating episodes, during which

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Speaker 1: a person feels a loss of control over his or

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Speaker 1: her eating. But unlike bliemia, binge eating episodes are not

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Speaker 1: followed by purging, excessive exercise, or fastening, and as a result,

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Speaker 1: a lot of binge eaters will be overweight or obese.

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Speaker 1: And one thing I think we should say about bene

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Speaker 1: eating is that while UH interex sander, and blimia tend

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Speaker 1: to affect more women than men for binge eating, it's

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Speaker 1: it's pretty split evenly. Both men and women UM suffer

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Speaker 1: equally from UH from binge eating. And this one has

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Speaker 1: been kind of tricky to classify as a mental disorder

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Speaker 1: because some people will say, well, you know, these people

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Speaker 1: just have a lack of willpower, they're just eating too much.

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Speaker 1: You know, and by calling it some kind of mental disorder,

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Speaker 1: then you're just caving to there, you know, there uh weakness.

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Speaker 1: And I think that that's sort of the heart of

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Speaker 1: the problem we're gonna get to today, is it's like

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Speaker 1: you said, it's so easy to well, not let's not

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Speaker 1: say easy, but you can recognize anorexia. It comes with

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Speaker 1: certain symptoms, um and all the other ones. People can

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Speaker 1: almost explain away there. When we were researching this podcast,

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Speaker 1: we would find articles of people who would be like,

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Speaker 1: I had a really bad relationship with food, but you know,

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Speaker 1: I go to a doctor and it's not anorexias. So

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Speaker 1: they really didn't know what to do with me. And

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Speaker 1: so people are saying, you know, oh, you just need

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Speaker 1: to eat more, you just need to stop eating as much,

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Speaker 1: and it's not considered a medical problem, whereas all these

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Speaker 1: studies that are being done um and all this revision

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Speaker 1: is attempting to show that these people do need help.

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Speaker 1: It isn't a lackable power, yeah, because the National Institutes

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Speaker 1: of Mental Health points out that, yeah, you have all

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Speaker 1: these eating behaviors, but they are a manifestation usually of

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Speaker 1: other psychiatric disorders such as depression, substance abuse. Anxiety is

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Speaker 1: for disorders, a body dysmorphic disorder when you look in

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Speaker 1: the mirror and you might be emaciated, but you still

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Speaker 1: see yourself as fat. Um. There are all these different

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Speaker 1: things that are going on, which is why it is

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Speaker 1: a hard to classify and be difficult to treat. And um,

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Speaker 1: I think when you look at the different behaviors that

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Speaker 1: are associated with or that fall under the enos umbrella, um,

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Speaker 1: you can see how it's such a huge gray area

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Speaker 1: because this will include anything from or at least formally

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Speaker 1: binge eating disorders, purging, night eating syndrome, chewing and spitting

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Speaker 1: out food, and even just extremely picky eating. Yeah. I

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Speaker 1: mean it's impossible to I mean in what woman at

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Speaker 1: some point and even men, But we're gonna kind of

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Speaker 1: focus on women since it tends to affect them a

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Speaker 1: little bit more. I mean, at what point or another

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Speaker 1: it seems like we all have preoccupation with our weight

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Speaker 1: and food. At what point does that cross into an

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Speaker 1: eating disorder? And this brings me to one pretty interesting

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Speaker 1: example that popped up recently in Time magazine, the concept

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Speaker 1: of or therexia, where you become obsessed with only eating

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Speaker 1: healthy foods and um to the point where this one

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Speaker 1: woman who was in the article way just sixty eight

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Speaker 1: pounds because she refused see anything that wasn't you know,

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Speaker 1: a raw food or organic and you know, she would

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Speaker 1: go to the doctor, they would tell her to eat healthfully.

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Speaker 1: But that in fact was her hang up. And some

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Speaker 1: experts are the Time magazine pointed out, are hesitant to

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Speaker 1: classify this idea of orthorexia as any kind of eating disorder,

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Speaker 1: but um. One doctor pointed out that such controlled eating habits,

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Speaker 1: unhealthily controlled eating habits UM are really just it's just

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Speaker 1: a step along the way to anorexia. And National Institutes

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Speaker 1: of Mental Health also points out that an eating disorder

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Speaker 1: in general is just marked by extreme. I mean, whenever

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Speaker 1: you have a serious disturbance in eating behavior, such as

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Speaker 1: extreme reduction and food intake or extreme selection of what

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Speaker 1: foods you are going to eat eat that is classified

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Speaker 1: as a disorder UM, which orthorexia would probably fall under.

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Speaker 1: So let's talk about some other different extremes because I

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Speaker 1: think that you know, we're not trying to make the

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Speaker 1: case that everyone has an eating disorder, which I think

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Speaker 1: it can sometimes sound like when you want to classify

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Speaker 1: all sorts of things and eating disorders. But I do

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Speaker 1: think that extremes can manifest themselves in ways you're not

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Speaker 1: aware of. Like, let's take athletes. Yeah, there is UM

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Speaker 1: something that I didn't. I think you and I were

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Speaker 1: both unaware of this until we started UM researching for

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Speaker 1: this podcast. There's a condition called female athlete triad, which

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Speaker 1: is basically over exercising in combination with extremely limited eating.

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Speaker 1: And I first ran across UM this term when I

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Speaker 1: was reading an article about it in Dance magazine. UM

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Speaker 1: it caught my eye because I was a I took

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Speaker 1: ballet for a while in middle and high school, got

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Speaker 1: really into it, and UM, this is something that I

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Speaker 1: definitely encountered among um the other ballerinas UM that I

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Speaker 1: would hang out with, where basically like you're you know

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Speaker 1: you're they're so image conscious and you have to be

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Speaker 1: so tiny that you will restrict what you eat. But

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Speaker 1: but if you eat even just like the tiniest amount

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Speaker 1: of something that wasn't you know on your dietary meal plan,

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Speaker 1: you will exercise like above and beyond to quote unquote

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Speaker 1: burn it off. And a lot of times this will

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Speaker 1: also be accompanied by UM, a lack of menstruation and

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Speaker 1: also osteoporosis because you're not taking in enough nutrients for

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Speaker 1: your growing body. And I think that with something like

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Speaker 1: female athletes triad, it can just be masked. Does Oh,

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Speaker 1: she's just really really healthy. But no, if you're training

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Speaker 1: four hours a day and only eating like eight calories,

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Speaker 1: no that's not. But you know, there are some sports

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Speaker 1: where that seems to be a requirement, like let's take

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Speaker 1: um sports where you have to make a certain weight.

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Speaker 1: I remember the wrestlers at my school doing extra labs

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Speaker 1: at lunch so they could make their weight class. And

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Speaker 1: I think that that sort of mentality, You know, it

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Speaker 1: can be encouraged to some extent by a coach, but

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Speaker 1: there comes a point where if it takes over your life,

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Speaker 1: even though you know the sport is a major part

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Speaker 1: of your life, but if it takes over your eating

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Speaker 1: and your exercise, that's when it becomes an extreme relationship

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Speaker 1: that would qualify some sort of disorder. Now was something

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Speaker 1: like the female athlete triad. One of those legs of

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Speaker 1: the triad is a min arehea. You stop having a period,

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Speaker 1: usually because your your body weight falls so low. But

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Speaker 1: if that doesn't happen, let's go back to these people

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Speaker 1: who have disordered relationships with food, but don't necessarily get

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Speaker 1: so skinny that you notice. I think that's again like

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Speaker 1: something to hit home that disordered eating does not necessarily

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Speaker 1: result in a really skinny person, right, because just with

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Speaker 1: the range from interrexia to boliemia to binge eating, you

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Speaker 1: have something that's marked by you know, the at one extreme,

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Speaker 1: you have interactsics you're severely underweight, beliemics who may or

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Speaker 1: may not be at a normal weight, and then benee

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Speaker 1: eaders who are at uh, you know, who are obese

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Speaker 1: or overweight. So just wait alone is not going to

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Speaker 1: be the determining factor of whether or not you haven't

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Speaker 1: eating disorder. But regardless of what way a disordered eating

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Speaker 1: pattern manifests itself being anorex here binge eating, is there

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Speaker 1: anything that all these people have in common, because that's

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Speaker 1: something that doctors are going to need to know about

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Speaker 1: so that they can develop a treatment plan. Right. I

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Speaker 1: think until recently that's been a really complicated question to

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Speaker 1: answer because you know, you do it is often accompanied

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Speaker 1: by um certain forms of anxiety disorders or depression or

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Speaker 1: what have you. But researchers have also in the past

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Speaker 1: few years found certain genetic traits that are shared among

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Speaker 1: people with eating disorders, so they're starting to think that

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Speaker 1: maybe maybe this is something that is passed along in

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Speaker 1: your d n A right specifically, it seems like they've

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Speaker 1: done a lot of work with anorexia. But that's not

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Speaker 1: to say that just you know, having a family history

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Speaker 1: of it is enough to spur your own bout with it.

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Speaker 1: It seems to be kind of a perfect storm of factors.

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Speaker 1: You know, maybe someone says the wrong thing at the

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Speaker 1: wrong time in the lunchtime cafeteria, or you know, you

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Speaker 1: get the wrong look at yourself in your genes, or

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Speaker 1: you do have something going on like a sport, you have,

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Speaker 1: you know, perfectionist tendencies, you have maybe the chaine for

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Speaker 1: it all seems to come together in just the wrong

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Speaker 1: wrong way. Yeah, And because there are so many factors

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Speaker 1: that can contribute to an eating disorder in all of

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Speaker 1: us different manifestations, it is very difficult and very costly

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Speaker 1: in severe cases to treat. I mean, some people don't

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Speaker 1: need treatment about I think with anorexia specifically, about a

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Speaker 1: third of the people will kind of recover on their

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Speaker 1: own after an episode. One third will be fine after

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Speaker 1: a round of treatment, and a third are always going

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Speaker 1: to have issues with it. It's not ever going to

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Speaker 1: go away. But you know, one of the reason that's

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Speaker 1: why this update of the d s M is so

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Speaker 1: important is because right now it's really hard to get

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Speaker 1: uh ednos that otherwise not specified disorders covered by health insurance.

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Speaker 1: And if you do need to go to some sort

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Speaker 1: of clinic, that can cost you know, maybe a thousand

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Speaker 1: dollars a day and that won't be covered by insurance.

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Speaker 1: And it seems that because each disordered eating relationship can

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Speaker 1: be so highly individual, that's a why they're hard to treat,

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Speaker 1: but be also why the d s M. You know,

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Speaker 1: it's hard to put in conditions that just affects, you know,

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Speaker 1: one person, but the d s M, the upcoming d

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Speaker 1: s M classification is very significant, especially for people who

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Speaker 1: might be struggling with bingeing, because once you get a

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Speaker 1: disorder actually listed in there, it basically validates it as

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Speaker 1: a problem, opening up the door for way more research

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Speaker 1: funding opportunities and the potential for wider insurance coverage for treatments.

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Speaker 1: Right so this is a good thing, I think. So

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Speaker 1: right now, the treatments for intrect sea and bolimia are

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Speaker 1: kind of similar. A lot of times it will involve

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Speaker 1: some kind of cognitive behavioral behavioral therapy, possibly some group therapy,

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Speaker 1: although there have been studies, um that have indicated that

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Speaker 1: antidepressants because you know, as I've mentioned a couple of times, now, UM,

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Speaker 1: there are usually some anxiety issues that are going on

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Speaker 1: as well, and so they will put people on with

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Speaker 1: eating disorders on in a depressants, but they are finding

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Speaker 1: that that might not be very effective for interorectics in particular.

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Speaker 1: It might have a little bit more of an effect

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Speaker 1: for um belimax, but in general it's all about just

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Speaker 1: kind of retraining these eating behaviors. For instance, there was

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Speaker 1: um very poignant essay in the New York Times magazine

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Speaker 1: about this woman's journey to treat her very intorectic, severely

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Speaker 1: intorectic daughter who ended up in the hospital because of

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Speaker 1: I think electrolyte and balance and dehydration and uh, you know,

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Speaker 1: just the very slow journey to teaching her that it

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Speaker 1: would be that it's okay to eat, that she doesn't

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Speaker 1: have to be scared of food. UM. And similarly with

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Speaker 1: belie mix, you know, kind of pulling the that hidden

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Speaker 1: binging behavior out into the open and teaching them how

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Speaker 1: to you know, eat normally and not having to purge

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Speaker 1: and continue this shame cycle. And because it is such

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Speaker 1: a mental thing, I think it can be very hard

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Speaker 1: to um recognize that happening to someone you know and love.

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Speaker 1: So we read one statistic that fIF of Americans know

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Speaker 1: someone with disordered eating habits. If your friend isn't eating

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Speaker 1: in the cafeteria, weill We'll give you a little bit

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Speaker 1: of advice about what to do. But again, this is

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Speaker 1: one where we'd love to hear um what people out

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Speaker 1: there have done when they had friends who were exercising

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Speaker 1: too much, eating too much, not eating enough, had some

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Speaker 1: of those relationships marked by extremes. Now, um, the Nemors Foundation,

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Speaker 1: which we've said before is great Kids self dot org

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Speaker 1: say that this was in relation to the female athlete

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Speaker 1: I add thing and basically, if you've got this friend

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Speaker 1: you it's it's almost very similar to the advice we

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Speaker 1: offered about dating violence. Kristen. Uh. You basically just have

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Speaker 1: to make your concerns known and tell them you know,

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Speaker 1: I'm worried about you. I don't think this is good

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Speaker 1: for you. And then you might need to kind of

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Speaker 1: step away a little bit just to give them time

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Speaker 1: to figure out how they're going to deal with it.

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Speaker 1: If if maybe things don't get you better, it's good

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Speaker 1: to let a coach or a teacher or parents know

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Speaker 1: about your concerns because you know, these people are pretty

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Speaker 1: good at hiding the behaviors. It's marked by shame. They'll

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Speaker 1: do all these behaviors underground. So just I think being

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Speaker 1: um open to having your friend talk about it with you,

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Speaker 1: it's a really good first step. But I don't think

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Speaker 1: that anyone out there should be able to feel like

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Speaker 1: they have to take it on themselves to force a

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Speaker 1: friend to eat or to stop a friend from exercising, right,

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Speaker 1: because I think in those kind of situations kind of

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Speaker 1: like go again. Going back to the dating violence episode,

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Speaker 1: I think that UM, because there is there's so much

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Speaker 1: hidden behaviorsociated with it, and there is a lot of

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Speaker 1: UM shame associated with it, whether or not it's you know,

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Speaker 1: the intorexic looking in the mirror and still seeing you know,

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Speaker 1: fat thighs or love handles, or the bolimic purging UM.

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Speaker 1: I think that if you go in there and try

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Speaker 1: to kind of shake it out, of them if you will,

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Speaker 1: it's only going to drive those behaviors into even more

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Speaker 1: private corners. But I mean, there are different schools of

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Speaker 1: thought on that. The the New York Times magazine article

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Speaker 1: that Kristen cited was an instance of a mother taking

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Speaker 1: the daughter and trying to shake it out of her.

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Speaker 1: So it's a hard thing for us to advise on.

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Speaker 1: I mean, no, two cases, like I think we've said,

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Speaker 1: are going to be the same. Everybody's gonna have their

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Speaker 1: own relationship with us, and clinically speaking, these are classified

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Speaker 1: as mental disorders, so it's not like you can just

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Speaker 1: snap someone out of it. I think that it's also

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Speaker 1: important for us to realize that, um, you know, it's

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Speaker 1: not just about food, it's about what's going on in

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Speaker 1: the brain. Right, So it'll be worth keeping an eye

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Speaker 1: on what happens with the d s M five, what

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Speaker 1: actually ends up in the two edition. But until we

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Speaker 1: get that, let's hear from you guys. Um, any relationships

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Speaker 1: you've had where this has been a problem for you

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Speaker 1: or someone you love, and things you did that worked

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Speaker 1: didn't work. You know, what can people do if they've

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Speaker 1: got a friend in this situation, a daughter in this situation,

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Speaker 1: and of course this does happen to guys as well,

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Speaker 1: So a daughter or a son with this problem. Yeah,

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Speaker 1: let us know. Our email is mom Stuff at how

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Speaker 1: stuff works dot com. And let's go ahead and share

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Speaker 1: a little bit of other letters that we have gotten

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Speaker 1: in recently. I've got one here from Mac and just

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Speaker 1: in response to do children need mother and a father?

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Speaker 1: And Mac was brought up by two lesbian mothers, and

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Speaker 1: he said, I thought I'd give you my two cents um.

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Speaker 1: I personally, growing up, never felt any sort of disadvantage

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Speaker 1: for not having a father, other than having a much

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Speaker 1: greater knowledge of the works of Melissa Ethridge and the

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Speaker 1: Indigo Girls and any other guy in my age. But

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Speaker 1: I seem to have turned out pretty normal. I think

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Speaker 1: there's a lot of truth to gain lesbian couples to

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Speaker 1: have children, being not usually more prepared for them in

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Speaker 1: the first place. Speaking from a biological standpoint, it's pretty

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Speaker 1: hard for gain lesbian couples to have a child by

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Speaker 1: accident or before they are ready. You have to have

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Speaker 1: your life pretty together to be able to deal with

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Speaker 1: the hasslum paperwork, and it often that it often takes

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Speaker 1: for an alternative couple to have a child. Can you

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Speaker 1: imagine how different things would be if straight children had

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Speaker 1: to jump through as many hoops to have a child. Also, uh,

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Speaker 1: if you're of the notion that takes a village to

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Speaker 1: raise a child, look no closer than a lesbian social

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Speaker 1: circle for support me. Being a child of lesbians, I

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Speaker 1: was somewhat of a rarity back in the day. Needless

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Speaker 1: to say, I had a whole army of women who

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Speaker 1: had a vested interests in my well being. My lovely

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Speaker 1: feminist girlfriend seems to think that being raised by too smart,

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Speaker 1: powerful women kept me from growing up to be some

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Speaker 1: sort of stereotypical womanizer, though I'd like to think that

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Speaker 1: wouldn't have happened anyway. So thank you Mac for sharing

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Speaker 1: all right, and I'll read one from David on the

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Speaker 1: same podcast topic you rightes, I listened to your podcast

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Speaker 1: about two gender households and wait to patiently for you

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Speaker 1: to describe my household Alas it never came. My wife

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Speaker 1: and I are married and have three boys. We both work,

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Speaker 1: But you kept referring to households with hetero married couples

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Speaker 1: as those where dad works and mom stays home. What

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Speaker 1: about both parents working, and where mom works and dad

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Speaker 1: stays home. All this talk about resources seem to be

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Speaker 1: a not so thinly veiled word for money. If the

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Speaker 1: parents have money enough to provide X, y, and z,

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Speaker 1: then the children turn out well, happycock and balderdash. I'm

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Speaker 1: a firm believer that children need at least one male

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Speaker 1: and female influence in their lives. When my boys sit

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Speaker 1: in the tub and talk about pooting, my wife doesn't

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Speaker 1: understand why that's so funny and why the four of

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Speaker 1: us are cracking up. I'm not saying it can't work

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Speaker 1: and that any other arrangement is bad, but at least

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Speaker 1: one male and one female actively involved in raising a

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Speaker 1: child as best. And I think that we should point

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Speaker 1: out that, yes, we did refer to resources a lot,

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Speaker 1: but I will say that resources can refer yes to money,

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Speaker 1: but also too emotional investment as well. Right. I don't

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Speaker 1: think we were just trying to refer to money just

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Speaker 1: as a clarification, but he makes a great point as well.

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Speaker 1: All right, So thanks folks for running in and send

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Speaker 1: us more mail mom stuff at how stuff works dot com.

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00:22:11,440 --> 00:22:13,760
Speaker 1: And also we would love for you to check out

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00:22:13,800 --> 00:22:17,680
Speaker 1: our blog during the week. It's called how to stuff

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00:22:18,160 --> 00:22:20,399
Speaker 1: and of course you can always fill your mind with

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Speaker 1: knowledge at how stuff works dot com for more on

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Speaker 1: this and thousands of other topics. Does it how stuff

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Speaker 1: works dot com. Want more how stuff works, check out

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