The concept of eating disorders has become very present in our daily culture. As opposed to a few decades ago when these illnesses were overlooked and often misdiagnosed, doctors, family and friends are now very aware of these disorders and quick to jump to their own personal assumptions or conclusions, right or wrong.
In the past, I often had to explore the possibility of an overlooked eating disorder diagnosis.
These days it is much more common for eating disorders to be seen as the primary issue for people with any eating symptoms at all, despite evidence of other medical or psychiatric issues which may be the primary illness that needs to be treated.
The reasons for this about face are many. Eating disorders are a frequent topic in regular conversation and social media, which increases awareness but also dilutes the true definition of these illnesses. The rapid growth of the eating disorder treatment industry spreads education but also falsehoods to clinicians and families about these disorders and appropriate treatment. Also the decades of experience knowing about eating disorders makes clinicians and others more likely to be more aware but also makes it easier to jump to conclusions.
The ignorance and lack of access to care have reversed almost completely in recent decades and led to a transformation in how to approach eating disorders. Any sign of disordered eating has become a reason to diagnose and often send people to residential treatment without considering any other options. I see more people with other primary issues who have undergone intensive treatment before even having a thorough work up for all possible causes of their symptoms.
First and foremost, people with suspected eating disorders need to see a primary care doctor and psychiatrist to consider all the possibilities and ensure each person receives adequate and individualized care.
Eating disorders can be a misdiagnosis of many psychiatric conditions including depression, psychosis, bipolar disorder and OCD and many others as the primary issues.
Endocrine problems, inflammatory disorders, a vast number of gastrointestinal problems and neurological conditions can masquerade as eating disorders as well.
No program focused on eating disorder treatment will work through these medical options to be sure they aren’t overlooking causes for the condition. These programs have a set plan for treatment which does not include a search for other diagnoses. Many people cycle in and out of treatment and don’t get better but also don’t have any doctor looking into why they aren’t getting better. The assumption is always that the person isn’t “trying hard enough.”
I strongly advise anyone with a new diagnosis of an eating disorder to seek out a thorough medical and psychiatric assessment to rule out any underlying causes. Doing so can avoid the pain of inappropriate care and speed up the process to get well.
