Erase FearsmallUpwards of twenty million women and ten million men suffer from a clinically – significant eating disorder in the United States at some point in their lives, according to the National Eating Disorder Association.

And the National Association of Anorexia Nervosa and Associated Disorders reports that this statistic includes only reported incidences of the mere 10% of affected individuals who receive treatment.

The other day I visited a private school in the New England area. I visit many schools (in addition to other professionals who might come in contact with individuals impacted by eating disorders) as part of my community relations post at Walden Behavioral Care. After walking the excessively large distance from my car to the nurse’s office, across vast expanses of perfectly manicured lawns, I arrived at the pristine old mansion that was the “Health Center.” “We don’t have that problem here,” the nurse responded curtly when I asked her if the school might be interested in our FREE eating disorder prevention program. “Even if we did,” the nurse said as she shooed me out the door, “we wouldn’t want the other students to get any ideas.”

Unfortunately, this wasn’t the first time I experienced such a response.

Though we preach (validly) that blame is ineffective as a means to recovery and is not a part of treatment at Walden Behavioral Care, I find it very sad that given all of the data about prevalence, especially during transitional periods in young people’s lives, adults still deny that eating disorders affect their students, children, friends or family members and wait for it to go away on its own.

It’s not just the schools—they’re only reinforcing the opinions of the communities with which they belong to which can include parents, municipalities and, if applicable, donors.

The notion that receiving prevention education from a trained professional would plant ideas into student’s heads speaks to the misrepresentation that eating disorders have received. My opinion is that this is simply due to lack of education around the subject. If a child wishes to get a tutorial on “how to have an eating disorder” they need only do a Google search, check a box to ensure that they are over a certain age and enter any of the 251,000 results that I received in 26 seconds after searching “Pro-Anorexia Websites.”

Providing students and children with prevention education can be likened to getting your child vaccinated for polio or the measles. There is a strand of each of disease in vaccinations, but does that deter doctors from urging their patients to get these shots? Do they get polio after receiving the polio vaccination? The answer is almost always no. These vaccinations were created to prepare the body to effectively fight whatever parasite caused the infection.

Similarly, we are giving children education about body image and eating disorders when we go into schools to provide prevention education to students. We are giving them the information and the skills that will be necessary to combat any chance of developing an eating disorder. This information might include the words, “Anorexia” or “Binge Eating Disorder,” but words are just words without the power that we as a society give to them. The stigma that we have created around these words and eating disorders in general is only perpetuated by the insistence that we avoid and deny that the problem even exists.

Walden Behavioral Care treats approximately 190 patients each day in the New England area. We are one facility, in one small area of the country, one small area of the world. This problem more than exists—it thrives—especially the way our cultural climate nurtures the idea that mental health issues shouldn’t be talked about. Eating disorders haven’t gone away, and they’re not going away—especially if those needing treatment are too afraid of what others will think to seek help.

Remember when America protested the implementation of age-appropriate sexual education in public schools? Remember how many people believed that going into schools and speaking to students about sex would urge them to have sex? Well, you probably do because the fight ensues, but we have managed to reach thousands of students through various sex education programs across the country. Those students, who were able to receive comprehensive sexual education, were 60% less likely to become pregnant than those who received no sexual education according to a 2011 study by the Journal of Adolescent Health.

In the same way that you can’t expect teenagers to completely avoid negative influences, you can’t expect them not to be faced with some type of sexual encounter where education surrounding their natural feelings and urges could help them to better decide how they wish to react in these situations. This is what we hope to do with the implementation of our eating disorder prevention education program in schools. The diet culture is everywhere, and there certainly aren’t many positive influences of real bodies in the media. We can’t turn off popular culture, but we can prepare our kids to take in these messages more healthfully and help them to better navigate and critically dissect the messages that the media relays.

Walden’s three-part prevention program was designed to address students, faculty and parents in different and separate capacities. This unique approach to prevention was created as a way to generate a community of change. Although addressing only the students is better than nothing, it would be easy for them to learn and internalize all the information that we teach them, only to be contradicted later by hearing a parent make a seemingly benign comment about the “cellulite in their thighs.”

In a report published by Common Sense Media, it was found that 5-8 year olds who think their moms are unhappy with their bodies are more likely to feel dissatisfied with their own. Though we all are guilty of critiquing the parts of our bodies that we view as less than perfect, most of us don’t think about the consequences that our negative self-talk could have on the vulnerable minds of our always-listening children and adolescents.

I think that a lot of the stigma surrounding eating disorders stems from varying myths like that they are  adopted to get attention, that they are solely about  vanity or that those who struggle with an eating disorder should just be able to  snap out of their disease, as if they were a choice. In the article, “A Comparison of Stigma toward Eating Disorders versus Depression” by James Roehrig, MA and Carmen P. McLean, Ph.D., it was found that “attitudes toward individuals with eating disorders were significantly more stigmatizing than attitudes toward individuals with depression.” Respondents went on to explain why they felt more stigmatization for those with eating disorders saying they were “more fragile, more responsible for their disorder and more likely to use their disorder to gain attention than individuals with depression.”

Through my work, I have witnessed first-hand how physically and mentally debilitating these illnesses are. A walk on any eating disorder unit, where patients are receiving treatment, would start an entirely different conversation. There is one thing that these respondents said that is true, those with eating disorders are more fragile. This is true, but only because they aren’t retaining the proper nutrients to allow their body optimal strength, brain function and well-being. So I guess physically they are weaker—but that is a product of the disease, not a temperament limitation. Others in this comparison study stated that some of the qualities in eating disorder patients were enviable such as the ability to lose weight and to have enough control and motivation to skip meals.

Let me be VERY clear. Eating disorders are not desirable diseases that should be coveted or admired. Anyone who has ever been affected by an eating disorder would attest that they wouldn’t wish this illness on their worst enemy.

With that being said, it is about time for us to start a new dialogue around eating disorders and mental health. Let’s talk about prevention. Let’s talk about eating disorders without having to whisper it so as not to be heard by a neighbor or a colleague. Let’s talk about why that nurse kicked me out of her office. Was it denial? Was she afraid? I’m certain that there were students struggling at her school, but they were probably too worried about her own judgments around the disease to come to her for counsel. The National Eating Disorders Education Center says that “the first step to challenging stigma is for us to recognize how our own beliefs and talk about people with eating disorders may discourage family members and/or friends with these problems to disclose them to us.” Let’s talk about how to provide resources to people like this nurse who are too busy believing a myth to seek out the truth about eating disorders. Needless to say, something has to change.

I will leave you with some incredibly hopeful news. In providing an exit survey to students we have reached through our eating disorder prevention program, we have found that 94% of the students we have reached (in middle and high schools) found this program to be helpful. Not only did they benefit from this program, but 88% of students felt that their parents/guardians would benefit in receiving similar education and 82% of students believed their teachers/educators would benefit from receiving similar education.

Please delight in some of the comments shared by a few insightful seventh graders who recently participated in Walden’s Eating Disorder Prevention Program:

  • “This made me think about my life.”
  • “I can relate to everything she (the presenter) was saying…I was just thinking yesterday about how I felt bad about my body and was confused. Today I learned that these feelings were normal, and that it is important for me to gain weight during this time in my life so that I can develop into an adult.”
  • “I will make better decisions.”
  • “This was actually really helpful.”
  • “It was good to learn the difference between mindful and mindless eating.”

And of course, my personal favorite:

  • “You (the presenter) are really nice, cool and funny.”


About the author:

NatalieNatalie Cohen is the Senior Marketing and Community Relations Associate for Walden Behavioral Care.  She earned her Bachelor of Arts degree in Journalism from the University of Maine in Orono. Her favorite part of working at Walden is being able to act as an advocate for clients suffering with mental illnesses and interacting with other eating disorder professionals in the community.  Ms. Cohen’s passions include writing, social media and event planning. In her spare time, Natalie enjoys spending time with her dog Bella, family and friends.