In the United States, 20 million women and 10 million men suffer from a clinically significant eating disorder at some time in their lives, and unfortunately here in the Midlands, the national statistics are accurately reflected. Among girls in their teens and 20s, the prevalence of eating disorders may be as high as 15 percent, and anorexia ranks as the third most common chronic illness among adolescent U.S. females. The average age for the onset of anorexia nervosa is 17, but as young as the age of 6, girls can start to express concerns about their own weight or shape, and eating disorders have been diagnosed as early as age 7. Studies also reflect that 40 to 60 percent of elementary school girls are concerned about their weight or about becoming too fat.
According to the National Eating Disorders Association, “Eating disorders are complex medical/psychiatric illnesses. Eating disorders are classified as mental illnesses in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Health Disorders (DSM-IV), are often considered to have a biologic basis and co-occur with other mental illness such as major depression, anxiety or obsessive-compulsive disorder.”
NEDA also explains that, while the “thin ideal” portrayed through media and other sociocultural pressures can trigger or contribute to eating disorders, research has shown that the causes are multifactorial and incredibly complex. Eating disorders have been documented in medical literature since the 1800s, when social concepts of an ideal body shape for women and men differed significantly from today and long before mass media promoted thin body images for women or lean muscular body images for men.
Indicated by the fact that they extend long after a person has reached his or her initial “target” weight, eating disorders are mental illnesses and fundamentally have little to do with food, eating, appearance or beauty. Eating disorders are usually related to emotional issues such as control and low self-esteem and often exist as part of a dual diagnosis of major depression, anxiety or obsessive-compulsive disorder.
Ashley King, currently a personal trainer and owner of an Anytime Fitness gym in Columbia, experienced the horrors of eating disorders firsthand.
“When I was 13, my best friend’s dad, who was very close to my family, died of cancer, and it really scared me. I found myself worrying about my parents dying and the obsession and fear of it got worse as time passed. I think this, combined with the pressure from friends and models to be thinner, started my eating disorder,” she reflects.
“Several of my girlfriends would talk about dieting, and I would see them having very small meals with diet soda – and it stuck with me. Also, I had been told to lose five pounds by a modeling agency to be at my ideal weight. I think the combination really caused me to take the dieting too far.”
After about six months, Ashley’s parents became concerned with her weight loss and took her to their pediatrician, who referred them to a psychiatrist, Richard Harding. “At first, we started with counseling sessions, but then he decided to admit me to the hospital when I continued to drop weight. I remember being terrified and angry at my parents for letting him put me in the hospital. I was in complete denial,” she confesses.
Ashley spent three weeks in the hospital before being released. However, as is common for those battling eating disorders, Ashley relapsed.
“I relapsed three times, and my total hospitalization lasted for a year and a half. During my time in the hospital, I attended daily counseling sessions, met with a dietician and was able to visit with my family once a week. If I had a good week and put on weight, they would let me have a day visit outside of the hospital with my family,” Ashley says. These types of goals were put in place to encourage her not only to succeed, but to want to overcome the unhealthy outlook she had regarding food.
“It took a long time for me to want to get well. The turning point for me was when I got to an all-time low of 74 pounds and was put in the hospital for the third time because I passed out. Dr. Harding told my family if things didn’t change, I would die. They put a feeding tube in and made me stay on bed rest. Over the next few weeks, I gained weight and got stronger. When I was able to go home that time, I never wanted to go back. I didn’t want to face death again. Every day was a struggle, but I felt determined. I had such supportive friends and family who wouldn’t give up on me, so that helped.”
Another key factor in Ashley’s recovery was turning her attention to physical fitness. Ashley’s parents, Linda and Glen Mosser, met Paul Lomas, now the director of Doctors Wellness Center in Forest Acres, who introduced a new combat strategy to Ashley for her recovery.
“I was scared to gain weight,” says Ashley, “but I didn’t want to be sick anymore. Paul offered to train me so that I could add muscle and get stronger the right way. He would only let me train with him if I wasn’t losing weight, so that motivated me to stay on track.”
Due to demanding training schedules, young athletes struggling with anorexia are in a risky position. Fuel is an obvious requirement for the energy that exercise requires. Once the motivation is in place to balance nutrition with the desire to exercise, baby steps toward success are made.
“It took years to feel like I had control over my mind and to be able to go through the day without constantly fighting the urge to starve myself or binge. Working out gave me a feeling of control over the eating disorder and made me feel like I could beat it. As part of the training I did with Paul, I also took an interest in learning about nutrition so that I could actually build some muscle and get shape back to my rail-thin frame,” Ashley says. “As I got stronger physically it healed me mentally. My parents were a big part of my recovery because they never gave up on me and got me the help I needed. Instead of keeping me away from the gym, they allowed it and trusted Paul’s expertise.”
Once Ashley reached her freshman year in college, she decided to start competing in fitness competitions for fun. “Once I stepped on stage I was hooked,” she says. “The girls I saw compete were athletic, strong and feminine. It was the first time I realized I didn’t want to be skinny, but fit.”
Today, Ashley and Bryan, her husband, have two daughters, Abigayle, 9, and Addison, 5. Even though they are still quite young, Ashley explains that she makes deliberate efforts to foster both health and a healthy body image in the minds of her girls.
“I prepare healthy meals and always make sure they know that fueling their bodies with good things helps them stay healthy. We also stay very active as a family. Bryan and I own an Anytime Fitness gym, so the kids know a lot about working out and how important it is. Abigayle takes Taekwondo and is about to test for her orange belt. Addison loves dance and swimming.”
For all the young girls and teenagers out there, Ashley has some solid personal advice: “Treat your body well. I think the most important thing you can do as a teenager is to stay active and take time to learn how to be fit instead of starving yourself. I have worked with a lot of girls, and I am amazed at how many are on diets. I want to teach them how to eat healthy so the ‘diet’ word never has to come up. And don’t give into peer pressure — love the body you have and take care of it. Fit is beautiful! If you want to get in better shape, talk with a trainer or someone educated on this to get guidance.”
With eating disorders on the rise, many Midlands families are finding the need to go out of state to find professional help for their children. Margaret Yeakel, whose own daughter successfully overcame anorexia, has been heavily involved in establishing a local resource for individuals who battle these issues. The Hearth Center for Healing is South Carolina’s first specialized eating disorder treatment facility to offer residential treatment for children and adolescents. Located on the Carolina Children’s Home campus, The Hearth opened in the spring of 2013 and is accredited by the Joint Commission. The non-profit eating disorder program follows an evidence-based model, and its comprehensive plan is delivered by a team of psychiatrists, therapists, a dietician and others. Its mission is to offer all levels of care for the treatment of eating disorders, including outpatient, intensive outpatient, partial hospitalization and residential.
“The program was originally envisioned for pediatric patients,” says Margaret, “but young adults are now included because the local colleges and universities expressed interest in having these services available for this age group as well.”
Another local resource is the South Carolina Eating Disorders Association, which meets monthly to provide education, advocacy and support regarding eating disorders.
“It is open to anyone affected by an eating disorder, but it has evolved into a group of primarily parents and clinicians,” says Margaret. “We network across the state through a Google Member Hub site. This group, in its second year, is becoming more active and involved. The National Eating Disorder Association holds walks across the country to raise awareness and funds for eating disorder support, and a member coordinated the first NEDA Walk in South Carolina in March of this year.”
Margaret explains that the role of a parent is critical in a child’s success in defeating an eating disorder. “Early detection and prompt treatment of eating disorders enhances the chances for a quick and complete recovery and the opportunity for a full and productive life. In the area of mental health, resources are limited, so parents’ willingness to proactively pursue treatment may be beneficial and necessary for their child. The mortality rate for anorexia is higher than that for childhood leukemia. While childhood obesity will take years off a person’s life, anorexia, if left untreated, can take a life in months,” Margaret says.
Many adolescent girls can experiment with dieting without developing an eating disorder, but it’s certainly a serious issue to monitor. “An eating disorder is much more than a diet gone too far,” Margaret says. “Parents can know there are red flags when there are extreme emotions, attitudes and behaviors surrounding weight and food issues.” And they can also realize that they are not alone. Other parents in the Midlands can offer wise advice, and as Ashley King shows, there is exciting encouragement that eating disorders can be overcome and survivors can live healthy, fit lives.
Additional information on care for the treatment of eating disorders is available at thehearthheals.com.