Thursday, January 19, 2012

Interview: Jessica Setnick on Eating Disorders

The responses to the interview questions may not represent the views of The Echo Boom Bomb's author. These interviews are provided to inform readers of information from experts and provide these experts with a medium where they can answer questions without any content changes. You can also read other interviews at this link.

One struggle that Generation Y females and males face is eating disorders, and it seems to be a growing problem. Like with many problems, misinformation can spread and cause some people to avoid seeking the appropriate help. I recently interviewed Jessica Setnick, who is an expert on eating disorders:

Jessica Setnick introduced her compassionate and practical approach to helping individuals with eating disorders in 2003 with Eating Disorders Boot Camp. She is the author of The American Dietetic Association Pocket Guide to Eating Disorders and Director of Training and Education for Ranch 2300 Collegiate Eating Disorders Treatment Program. She is available for presentations and training workshops, and can be reached through her website, www.UnderstandingNutrition.com.

1. What is an eating disorder?

An eating disorder is the name we give to a chemical problem in the brain that causes a person to use food and eating-related behaviors in inappropriate ways. It is similar to the brain problem that causes a person to use drugs or gambling (for examples) in inappropriate ways. Since scientists/doctors have not been able to identify yet the exact brain problem, we identify eating disorders based on the visible symptoms and behaviors.

2. What factors contribute to or cause eating disorders?

The main contributing factor (as we understand it to date) is a problem with brain chemistry. This problem can be innate (something a person is born with, even if it is not revealed until a later age), or it can be something that is caused by stress, which damages the functioning of the brain, or most likely, it is a combination of the two.

Once the brain chemistry problem is in place, it makes eating disorder behaviors seem desirable, because they modulate brain chemistry. For example, binge-eating changes brain chemistry, because an overload of tryptophan (found in carbohydrates) increases the level of serotonin in the brain. Serotonin gives a feeling of calm to an anxious person. Another example is that self-induced vomiting causes a change in brain chemistry, similar to exercise. When someone with an eating disorder-prone brain is in a panic, vomiting provides them with relief. This behavior then becomes the person’s go-to ‘solution’ for managing stress.

Because the stressor in the equation often comes from the environment, society’s attitudes toward weight and eating are often mentioned as contributing factors in creating eating disorders. The pressure that individuals feel to perform, to meet societal standards of attractiveness, of success, and so on can push them to trial eating disorder behaviors, such as skipping meals, overexercising, dieting, etc. If the person has the genetic or stress-caused brain chemistry problem that makes these behaviors biochemically ‘rewarding’, then he or she will adopt the behaviors on an ongoing basis as a ‘solution’ or self-medication.

3. I've heard that people, who struggle with eating disorders, have emotional connections to food. Is this true, false, or only slightly accurate?

It depends how you interpret ‘emotional connections to food.’ To be more accurate, I would rephrase it slightly into “people with eating disorders use food and eating-related behaviors (eg overeating, undereating, vomiting, overexercising, food rules, etc.) to help manage emotional stress.” So yes, there is an emotional connection with food, and certainly an unhealthy relationship with food, but not necessarily an “I love food!” type of emotional connection.

4. How are eating disorders treated?

The gold standard of eating disorder treatment to date is a three-pronged base of:

Nutritional Counseling (with the goal of nutritional replenishment and restoration, education about the appropriate role of food, and a healthy relationship with food),

Medical Treatment (management of any conditions that have been caused or exacerbated by the eating disorder, such as osteoporosis or osteopenia, thyroid or other hormonal problems, heart conditions, and so on)

Mental Health Treatment (includes both psychiatry, to manage brain chemistry and underlying or exacerbated issues such as depression, anxiety, ADD, OCD, bipolar disorder, chemical dependency, etc. AND psychotherapy, to heal emotional wounds that prolong the eating disorder and to teach skills for more appropriate coping with stress).

Added to those, any combination of group therapy; peer-led or 12-step support groups; family therapy; inpatient, residential, or day hospital care; plus adjunct therapies such as art therapy, movement therapy, equine therapy, and so on; may be recommended on an individual basis.

5. What resources are useful for more information on eating disorders?

I have a list of resources on my website, www.UnderstandingNutrition.com, including a “How do I know if I need help” checklist.

My own book is for professionals, The American Dietetic Association Pocket Guide to Eating Disorders.

Books I would recommend for someone with an eating disorder are Life without Ed, by Jenni Schaefer; and Intuitive Eating, by Evelyn Tribole and Elyse Resch.

Gurze books, at www.bulimia.com, lists all the books about eating disorders.

The National Eating Disorders Association offers a lot of information about eating disorders and resources on their website.