As National Eating Disorder Awareness Week is recognized across the United States, Jessie Newell, personal trainer and owner of AbSolution in Turlock, says she believes eating disorders are on the rise.

“As a trainer, I assess eating habits of clients to ensure safe workouts and assist fitness goals,” Newell said. “From my viewpoint, very few individuals have a healthy perspective on food.”

Held annually from Feb. 24 to March 2, the week serves to educate and support those suffering from potentially life-threatening eating disorders. In the U.S. alone, an estimated 20 million women and 10 million men suffer from an eating disorder at some point in their lives, according to the non-profit National Eating Disorders Awareness.

The National Association of Anorexia Nervosa and Associated Disorders, Inc. says that eating disorders have the highest mortality rate of any mental disorder.

“Body dissatisfaction among girls and women [is] the best known contributor to the development of anorexia nervous and bulimia nervosa,” according to NEDA’s website. “And, it starts early."

Early as in 1st through 3rd grade, meaning children as young as six years old.

Eating disorders are believed to be triggered by many causes, including, but not limited to genetics, media pressure and psychological factors such as low self-esteem and perfectionism. Additionally, ANAD finds that nearly half of individuals with eating disorders meet the criteria for depression. Newell says some utilize eating disorders to control stress.

ANAD defines an eating disorder as: “an unhealthy relationship with food and weight that interferes with many areas of a person’s life. A person who struggles with an eating disorder can have unrealistic self-critical thoughts about body image, and his or her eating habits may begin to disrupt normal body functions and affect daily activities.”

Three main eating disorders are generally identified: anorexia nervosa, bulimia nervosa and binge eating disorder. Individuals with anorexia typically have an intense fear of gaining weight and practice behaviors such as frequently skipping meals, only eating certain foods and/or resisting calories. Losing weight can also be achieved through the same forms of purging as those with bulimia.

“I have had both obese and normal body weight clients suffer from anorexia,” Newell said. “They view food as the enemy. Anorexia burns off the body's luxury items, like muscle, first. If a client is not eating, he will not have the energy to work out, burn muscle instead of fat and decrease the metabolism into a starvation mode.”

Those with bulimia also have an intense fear of gaining weight but instead of resisting food, binge – eat large portions of food in a short amount of time – and purge – eliminate food. Purging can be done by vomiting, excessive exercise, laxative abuse, and/or use of diuretics or diet pills.

Individuals who binge eat very large portions of food rapidly and frequently. Eating occurs to the point of feeling sick or uncomfortable and the individual often feels as though they cannot control consumption.

Newell says that both bulimia and binge eating can lead to severe health risks and have detrimental effects on the metabolism and energy level.

Though a smaller percentage of men suffer from eating disorders, they are far less likely than women to seek help. Homosexual males and athletes rank at the top of the list.

Athletes of both genders in aesthetic and judged, rather than refereed, sports have higher rates of eating disorders. These include, but are not limited to: ballet and other dance, figure skating, gymnastics, running, swimming, rowing and wrestling.

Experts urge those who believe friends or family members may be suffering from an eating disorder to speak to them, expressing concern and offering support. “I statements” such as “I am worried that you won’t eat lunch” or “I am worried you are taking too many diuretics” work better better than “you statements” such as “you need to eat more,” which can inflict feelings of blame or attack on the other, according to experts.

Offering support with treatment can be helpful as neglecting and continuing any eating disorder can result in major health issues and fatal consequences.

Recommended treatments are conducted through a collaborative, multidisciplinary team usually including a psychologist, psychiatrist, social worker, nutritionist and/or primary care physician.

From a trainer’s perspective, Newell stresses the importance of changing the mindset towards food, by viewing food as fuel and being conscious of food choices.

“I advise my clients to improve nutrition by planning food options, slowing down during meals and taking smaller portions,” Newell said. “Keeping a food journal can also be useful in changing the mindset of food from control, punishment, or comfort into nutrition and fuel for the body.”

For confidential assistance, various hotlines are available. The NEDA offers a confidential and free hotline from 9:00 a.m. to 5:00 p.m., Eastern Standard Time, Monday through Friday, by calling (800) 931-2237.

Disorder warning signs as listed by ANAD:

Anorexia nervosa:
• Deliberate self-starvation with weight loss
• Intense, persistent fear of gaining weight
• Refusal to eat or highly restrictive eating
• Continuous dieting
• Excessive facial/body hair because of inadequate protein in the diet
• Compulsive exercise
• Abnormal weight loss
• Sensitivity to cold
• Absent or irregular menstruation
• Hair loss

*Note: Being underweight does not solely indicate an eating disorder or anorexia. Anorexia is classified as someone who refuses to maintain a normal weight by restricting weight gain.

Bulimia:
• Preoccupation with food
• Binge eating, usually in secret
• Vomiting after binging
• Abuse of laxatives, diuretics, diet pills
• Denial of hunger or drugs to induce vomiting
• Compulsive exercise
• Swollen salivary glands
• Broken blood vessels in the eyes

Binge Eating, criteria for diagnosis:
• Loss of control over amount of eating
• Marked distress over binge episode
• Occurs at least 1 time per week for 3 months
— And, 3 or more of the following:
• Eating more rapidly than normal (e.g. 2 hour period)
• Eating until feeling uncomfortably full
• Eating large amounts of food when not feeling physically hungry
• Eating alone because of being embarrassed by how much one is eating
• Feeling disgusted with oneself, depressed or very guilty over after overeating