National Eating Disorders Awareness Week: Eating disorders defined + explained

Previously: Introduction

The first, most basic thing I want to discuss is what eating disorders are and then highlight the different types that exist. The majority of this information is coming from the National Eating Disorders website, with information from other resources thrown in.

“Eating disorders — such as anorexia, bulimia, and binge eating disorder – include extreme emotions, attitudes, and behaviors surrounding weight and food issues.” They are known for their “serious emotional and physical problems that can have life-threatening consequences for females and males.”

Anorexia Nervosa

Anorexia is defined as “a serious, potentially life-threatening eating disorder characterized by self-starvation and excessive weight loss” and is characterized by a fear of gaining weight, a resistance to or refusal to maintain an appropriate weight for one’s age and height, and debilitating thoughts of feeling “fat” or overweight (when in fact they are most often the direct opposite). In women, losing your period (amenorrhea) can be a sign and/or symptom of anorexia. At the very least, it’s a sign you’re not eating enough, regardless of whether or not an eating disorder is a factor.

While the specific causes of anorexia aren’t known, it is thought that one can be predisposed to it if you suffer from anxiety, poor self-image, etc.

Bulimia Nervosa

Bulimia is defined as “a serious, potentially life-threatening eating disorder characterized by a cycle of binging and compensatory behaviors such as self-induced vomiting designed to undo or compensate for the effects of binge eating”. Those who suffer from it tend to ingest larger than normal quantities of food before feeling a sense of loss-of-control, which results in their use of laxatives, water pills, self-induced vomiting, etc. to purge what they ate.

“Larger than normal” quantities of food doesn’t mean eating an extra 1000 calories at dinner – for some people, it could mean eating an extra 10,000 calories in one sitting. Most often, people will hoard their food and then secretly indulge in it later when no one else is around to witness their behavior. That secretive behavior can be one of the main giveaways for someone suffering from bulimia. Their weight tends to be fairly normal since they’re not usually losing any weight, which is why it’s easier to hide bulimia. The only person who might be able to easily spot someone suffering from it is your dentist, since cavities, gingivitis, and worn enamel on the teeth (thanks to the stomach acid) are all trademark signs of bulimia.

One compensatory behavior of bulimia that we often forget about is obsessive and/or compulsive exercise. As athletes, our workout regimens are pretty regimented to begin with so hiding this behavior can be pretty easy. Sometimes this is classified as it’s own disorder known as “exercise bulimia“.

Binge Eating

Binge eating, while not as commonly recognized as anorexia or bulimia (despite being more common than both), is an eating disorder that is “characterized by recurrent binge eating without the regular use of compensatory measures to counter the binge eating.” Similarly to bulimia, it involves consuming large quantities of food in short periods of time. They differ in that binge eating isn’t accompanied by the purging behaviors that bulimia is associated with.

Like other eating disorders the causes aren’t known but it’s thought to be linked with dieting, since after a period of dieting some people “reward” themselves by eating large quantities of food but then end up taking it too far by experiencing a loss of control in how much they consume, which leads to them eating to the point where they are uncomfortably full. This leads to strong feelings of guilt and depression which can come full circle and start the process of binging all over again. Stress, boredom, etc. are all emotions that can lead to binging.

Unlike anorexia and bulimia, at this time binge eating doesn’t fall under the DSM-IV‘s definition of mental illnesses but it has been studied and treated for well over 50 years.

Eating Disorders Not Otherwise Specified (ED-NOS)

Anorexia and bulimia are both known and classified as the two “main” eating disorders but there is another classification known as ED-NOS for those who are “struggling with eating disordered thoughts, feelings or behaviors, but does not have all the symptoms of anorexia or bulimia”. If you fall under the criteria for suffering from anorexia but you still get your period or your weight is still relatively normal, you would be classified under ED-NOS.

Men and women may also fall under the ED-NOS classification if they indulge in behaviors of multiple eating disorders (“crossing over” is how it’s defined). Of all the EDs though ED-NOS has a higher death rate than all of them so it’s just as serious, if not more, than anorexia and bulimia.

Orthorexia

While not technically considered an eating disorder per se, orthorexia displays compulsions similar to those seen in anorexia and bulimia. The focus is not on losing weight or being thin but instead on eating healthy. It was considered an eating disorder in the 90s but due to society’s sudden fascination with organic food it’s become too “mainstream” to be considered one anymore.

Diabulimia

This is a really interesting one and not something I had heard of until I started doing research for this post. It affects those who suffer from Type 1 diabetes and “is the reduction of insulin intake to lose weight.” Although those with diabetes can suffer from other eating disorders as well, diabulimia is specifically related to diabetes because instead of cutting calories through starvation (as in anorexia) or purging (as in bulimia), they’ll “eliminate” calories by restricting their insulin intake. If you know even the basics of diabetes you know how imperative it is for diabetics to follow a strict insulin regime so in addition to the negative health effects the would suffer from the eating disorder, they are  also seriously comprising their health by ignoring the dangers of not taking their insulin.

Because there are two diseases that make up diabulimia, it is considered a “dual-diagnosis” disorder. The mortality rate of diabetes jumps to 35% when combined with an eating disorder but despite this it’s probably the least discussed disorder of all the ones listed so far. All of the usual diabetic symptoms would be experienced, in addition to a severe drop in energy, higher than normal levels of glucose, organ damage, etc.

As I mentioned yesterday, I’m going to finish this series with a post that highlights the experiences of rowers and coxswains who read the blog. Everything will be kept anonymous so if you’re interested in participating, send me an email.

Video of the Week: University of Washington vs. Cambridge University Boat Club

Last weekend, while those of us in USA were prepping for CRASH-Bs, the University of Washington Huskies headed across the pond to race Cambridge University on the Tideway. Matthew Pinsent served as the official umpire of the race, which saw Washington come away with a 3 length victory over CUBC.

Question of the Day

I’m currently a novice high school rower but I haven’t been feeling really into rowing lately. I’ve wanted to cox since I started in September, but I’m too big to cox for the women. I’m 120ish and really want to cox for the men next season. However, I’m really nervous to talk to my coach about it because she considers me one of her better lightweight rowers. I know I still have a while to think about it since the season doesn’t end for a few months but how should I talk to her about this?

If you’re leaning more towards coxing than rowing, just tell your coach that. Explain to her why you feel like that and just say that even though you know she considers you an asset to the lightweight boat, you think you’d be more effective to the team as a coxswain. Then explain why, of course. Always have reasons that you can explain and/or back up. It makes for a much more effective argument. Don’t be nervous to talk to her – coaches are there for a reason and one of them is to help their athletes when they’re having problems. If you think she’s going to react poorly or punish you in some way, you’ve got bigger problems on your hands. Ask to talk to her privately and then just have an honest discussion about where you are mentally with crew. If your heart isn’t in rowing but something about coxing excites you, tell her that. I’d rather have an enthusiastic rower-turned-coxswain than a rower with a perpetual “meh” attitude.

Related: Is it unusual to change from rowing to coxing? I’m nearing the end of my novice season and feel like I could be a good cox in the future. I love rowing and am getting decent results but at 5’4 (shorter than one of my coxswains) and 120lbs (female) I have to work crazy hard to keep up with all the bigger girls. I’ll be sticking with the sport either way but it just seems like such a cool component of the boat to be.

I’d also think about why you’re not feeling into rowing lately and ask yourself if coxing is going to make you feel any differently if you’re able to make the switch. I’ve had friends try and do this before and I always end up equating it to people who are really unhappy about things and think that losing 20lbs will suddenly make all their problems go away. For the short term, maybe, but in the long term there’s a good chance you’re probably still going to be unhappy because you never dealt with the root issue. Before you make any decisions, figure out why rowing isn’t doing anything for you right now and what you could do to fix that. If whatever you try doesn’t seem to make things better, then try coxing. Don’t look at coxing as the be all, end all solution though.

Question of the Day

I just read your post about intimidating your opponents, which is perhaps one of the greatest things I’ve seen, but I wanted to ask what are some of your favorite/most effective calls?

If we’re under a bridge or something, I love to say “attack now” because I think the echoing of my voice just heightens the intensity of the call. I borrowed “Do not sit, do not quit” from Pete Cipollone and use it during pieces or races to remind my boat that we can’t take a single stroke off. I also like quick, monosyllabic calls like “pop”, “BOOM”, “sharp”, etc. basically because I can say so much without actually having to say anything. I also like directly calling out people in my boat so doing bursts for or with each pair is a good way to do that.

Related: One of the varsity rowers told me about a certain race move/call-10 for pairs? Like having all 8 take a 10, but emphasis for specific pairs. I’m not sure how to call that, can you help me out? I was thinking maybe ” Alright, we’re all 8 we’re going to take a 10 by pairs.. in two… in ONE.. on THIS one, stern pair let’s see what you got! That’s one… two… 5 and 6 right here 3… 4..” and so on..” I don’t know if that’s how you call it…

I think the effectiveness of your calls lies not within the call itself though but in how you say it. It’s like when your parents tell you to do something in their normal voice and it’s like “yea ok, gonna get right on that” and then there’s the times when they tell you to do it and you can actually sense Satan in their voice. That’s one of the reasons why I try and constantly reiterate that it’s not what you say, it’s how you say it that makes the difference. If there’s no passion or intensity behind your voice, how and why would you expect the rowers to respond with intensity in their rowing? In the posts I’ve done on coxswain recordings I’ve tried to point out good and bad examples of this so check those out if you need some inspiration on what an effective tone sounds like.

Related: Coxswain recordings

The way to really make a call do something for your crew is to match your tone of voice to what you want to get out of the rowers. If you want the rowers to relax, your voice has to be relaxed. If you want them walking on a crew, the intensity of your voice should be increasing with each stroke that you get closer to or walk away from them. Your tone of voice is by far the biggest asset to your crew and how effective you are at utilizing it is what in turn makes your calls effective.