By James D. “Buck” Runyan, MS, LMFT, LPC, CEDS, F.iaedp

When addressing disorders that severely affect one’s life, it is easy to understand when a person is found to have a problem such as diabetes, there are quick reactions from family and professionals to treat the affected person with a sense of urgency.
Diet, exercise, proper sleep, stress reduction and medications are all implemented within a short period of time with the hope of limiting the consequences of a poorly functioning or non-functioning pancreas. Though the general populace in general knows little about diabetes, the disorder tends to acquire quick attention because people are aware it is a dangerous disorder needing immediate attention.

Eating Disorders are similarly dangerous — yet the recognition of these disorders and the lack of urgency to find adequate treatment leaves those affected vulnerable to highly life altering and possibly life threatening consequences.

A Star Athlete’s Struggle 

Sara represents a common example of someone who struggles with an eating disorder. Sara was 20 years of age, a star athlete on a university scholarship, and an academic scholar with a 4.0 GPA. She had reported struggling with bulimia for more than five years. Though she did mention several of the struggles she experienced over the years, her parents dismissed the topic as being a “teenage thing.”
Based upon her parents prior responses she went silent on the progression of the disorder as well as the severity of her symptoms; until one day a collage roommate found her having fainted during a purging episode in their dorm room. This scene facilitated Sara’s entry into her first treatment.

Secrets and Shame

During the assessment phase she revealed to the medical team she had intentionally hidden the eating disorder behavior from her family. She revealed keeping them in the dark because of their previous disbelief, her potentially having to leave college as well as possibly losing her scholarships and ultimately having to address the shame she experienced on a daily basis for her behavior. She went on to provide in great detail the secretiveness, the planning, the struggles physically and emotionally of having bulimia which culminated in a deep sense of shame which brought episodes of self-directed anger and times of unstoppable sobbing. What became her solace also became her captor.
Though she admittedly is a person with physical talent, keen intellect and high potential, her emotional maturity was lacking in an age appropriate development. The lack of emotional maturity caused her severe anxiety when experiencing new social events and even kept her from developing any depth in personal relationships because she feared the rejection of others if they discovered her secret life with bulimia.

The Double Life

All eating disorders have a similar dynamic in that the sufferer not only maintains a personal secret; they protect it with an unyielding fierceness. They lead a double-life.
Family and friends will often notice their love-one’s life patterns frequently exhibit dichotomies. In one sense they present as having a focused effort to self-control or are controlling of others; having a sense of self-directedness and an unusual knack for self-destruction.

When the eating disorder becomes family and/or public knowledge, the members often speak about having noticed a variety of odd behaviors and inconsistencies within the sufferer’s life, but were neither comfortable nor free to openly hold conversations about them their observations.

The primary eating disorders that affect both men and women of all ages include Anorexia, Bulimia and Binge Eating Disorder.

Anorexia identified most often by significant weight loss due to restrictive eating behavior. Bulimia is identified by eating a large volume of food in a short period of time and making oneself vomit to remove the consumed food products. Binge Eating is identified by eating a large volume of food in a short period of time and does not include any compensating behavior such as food restriction or self-induced vomiting.

Eating Disorders are Non-Discriminatory 

Eating disorders affect both men and women of all ages. Most but, not all eating disorder behavior begins in the younger age population. The general age of onset for Anorexia is 15, Bulimia is 16 and Binge Eating is 25. Frequently there are children as young as 8 and adults in their 60’s seeking treatment services for Anorexia. The same holds true for Binge Eating Disorder. Bulimia is a bit different in that it tends to affect middle teenager up through middle aged adults.
Common traits of those affected by eating disorders include oversensitivity to change or chaos in their environments. They tend to react with extreme behavior and emotional expression when overwhelmed. Often their first reaction is out of impulse which can be presented from an odd non-reaction, excessive tearfulness, anger, yelling, or aggressive tones. Behaviorally they may withdraw from situations that are uncomfortable or attempt to “control” the circumstances in a “bullying” kind of manner. The important take-away in observing the person is that they behavior and react with extremes that are not necessarily congruent with the events at hand.
Medically, those who struggle with eating disorders will have both distinct features related to the type of eating disorder which will develop unique consequences but they will also have some similar features as well. As an example those with Anorexia will often have a lower than reasonable body weight, rapid weight loss, complain of dizziness, move or exercise continuously, maintain a slow metabolism, stress fractures, lose menses for women, lower testosterone levels for men and present somewhat fearful of various types of food. Those with Bulimia will often complain of intestinal discomfort, experience frequent headaches and experience heart palpitations. They may also experience dental problems, experience irregular menses and experience constipation.
Binge Eating is often but not always associated with obesity. For those individuals who are not obese they will experience many of the same symptoms of Bulimia with a higher focus on the intestinal track discomfort. For those who are higher in weight due to the Binge Eating, they may experience, diabetic symptoms, knee and back problems, sleep apnea, Reflux, intestinal discomfort, thyroid problems and vast weight fluctuations due to attempting various “diet” plans.

A common misconception that family members believe is that their loved one need only “make a decision” to correct their relationship with food. They put pressure on their loved one by way of allowing a “special” meal plan than the family standard meal plans. The family attempts to use a form of logical conversations to encourage the person struggling to recognize their behavior is unusual. They may even attempt to use coercion and manipulation to force change. Though well intentioned these tactics backfire more times than not. The best way to help is to seek support from a trained eating disorder specialist who can provide education on how best to approach the family member struggling with an eating disorder, but they can also provide valuable information on signs, symptoms, medical complications and they can help develop a comprehensive team of professionals to help. It will be important for a Primary Care Physician, Counselor, Psychiatrist and Registered

Dietitian be involved so that each area of the sufferer’s life is assessed and supported by a subject matter expert.

Eating disorders are the most complicated psychological disorders to treat. Sadly, when untreated they also carry the highest mortality rate of any other disorder. Much like diabetes, when a person is struggling with any one of these eating disorders, it is imperative for their health, quality of life and in some cases their life’s longevity that they receive appropriate treatment as soon as possible. The benefits to comprehensive quality care will potentially create a life of purpose and hope once the psychological, behavioral and medical concerns are resolved.

At Remuda Rach at the Meadows we believe whole heartedly that people can heal from these disorders with proper care, training and support. We encourage anyone who may be struggling with one of these disorders to take a very important step of courage to reach out for support from a treatment expert and begin a path of improving their quality of life and relationships.

About the Author
James D. “Buck” Runyan, MS, LMFT, LPC, CEDS, F.iaedp

Buck is the Executive Director for Remuda Ranch at the Meadows eating disorders Critical Care Units and In-patient/Residential programs in Wickenburg, Arizona. His prior roles have included supporting eating disorder treatment programs as a Chief Operations Officer, Clinical Director, Program Director and Therapist. 

Buck has served on the International Association of Eating Disorder Professionals Board of Directors from 2010 through 2016. He is a past President for the Board of Directors and remains an active member of the iaedp Certification Committee.  
He is credentialed as a California MFT, an Arizona LPC, IAEDP CEDS and a Fellow of iaedp. His Alma Mater is California Baptist University.

For information or inquiries visit www.remudaranch.com or call 866-390-5100.