Eating disorders do not just affect how people interact with food — they can do permanent harm to a person’s body that will persist years after recovery. Doctors and students at the Yale Center for Eating and Weight Disorders are working to prevent these effects by providing medical services to members of the New Haven community and conducting clinical research. But how do the long- and short-term effects of eating disorders compare?
Christina Roberto GRD ’12, who is pursuing a dual doctorate in clinical psychology and public health, explains both the physical and mental trauma of living with an eating disorder. She earned a bachelors degree in psychology from Princeton University and now works as a student clinician at the center.
Q: What are the immediate/short-term physical effects felt by a person suffering from an eating disorder?
A: It varies a little bit depending on the disorder — bulimia nervous, anorexia nervosa, etc. Most often you see patients that have a lot of fatigue, they are weak and they have trouble concentrating. But there are a whole host of physical symptoms, including heart problems, the growth of soft, downy hair known as lanugo to insulate the body and brittle nails. Frequent vomiting can also cause electrolyte disturbances, but I think the most noticeable effect in the short term is the lack of energy and maybe dizziness.
Q: What are the long-term effects? What would life be like at 50 for someone who had a serious eating disorder in his or her 20s?
A: If they are able to live that long, the disease will have taken a massive toll on their body — many will have been hospitalized 10-15 times. A lot of patients develop osteoporosis and experience serious bone loss. This 50-year-old person might have multiple stress fractures, and their bones could appear to be 20 years older than they actually are. Patients suffering from eating disorders are often socially isolated and withdrawn. Some of them have financial problems, some have problems holding a job and some spend a lot of money on food for bingeing. Of course, there are those who are able to hold jobs and have families, but their day-to-day struggle is always present.
Q: Do patients have a better chance of recovery if they receive treatment sooner?
A: The quicker they can get treated, the better. Early detection can make a big difference.
Q: Is full recovery from an eating disorder possible?
A: I definitely believe that people can fully recover from their disorder. My own personal estimate is that about one-third of patients suffer from chronic illness throughout their life, another one-third essentially get better but may have a few problems here and there, and the final one-third completely recover from their disorder.
Q: Can someone “relapse” into an eating disorder? If so, is it particularly common?
A: Relapse rates can be really quite high. Various studies show 30-80 percent of people relapsing, and, of course, there are always different circumstances. Relapse can be triggered by generally stressful situations related to family, work, or relationships. It is hard to pin down one thing that would trigger a relapse for one person, but you definitely want to have follow-up care in place after being released from the hospital.
Q: How does having an eating disorder affect someone’s mental health?
A: Patients with eating and weight disorders suffer from social isolation, trouble concentrating and difficulty forming close relationships. They can be constantly preoccupied with thoughts about weight, calories, food and shape. Binge eating is also an activity generally done alone, and this can promote isolation. Disorders are often accompanied by mood and anxiety problems — having this condition takes a pretty strong emotional toll on people.
Q: Are there effective short-term treatments for eating disorders, or is it strictly a long-term process?
A: We do have evidence to suggest that Cognitive Behavioral Treatment is particularly effective for bulimia. CBT is a process of normalizing eating behavior and habits, stopping the binge/purge cycle, identifying how different thoughts relate to feelings and providing different coping strategies. Medication like Prozac is also helpful for bulimia patients, and medication in conjunction with CBT has proven successful. For anorexia, medication is not as effective, but CBT has shown good results. It really comes down to the best method of treatment for the patient.