Every time I hear a media story about “the war on __,” I automatically become suspicious. Considering America’s history of the “war on drugs” and the “war on terror,” my skepticism meter perks up, and I feel the urge to cringe.

Despite hailing from the state of “live free or die,” I am usually puzzled by any grandiose display of self-righteousness. Why must we always be fighting these nebulous enemies? How am I supposed to respond to the battle cry if I am dumbfounded by the cause?

New York City & the fight against obesity

At least I can give New York Mayor Michael Bloomberg credit for placing the culprit front and center: On various NYC Health Department advertisements and campaign videos, you can find glasses of “fat” representing the number of pounds one can gain from sugar and soda. Signs ask you if you are “pouring on the pounds” and caution you not to “drink yourself fat.” The city’s war on fat and obesity nearly resulted in a ban on super-size sodas this past month. But will such strict rules and fearless public service announcements really curb the prevalence of obesity?

Research has shown that unhealthy weight control behaviors (dieting, laxative use, purging), as well as body dissatisfaction, have been linked to weight gain, obesity and the development of an eating disorder. This data suggests that obesity and being overweight are not solely products of genetic make-up or uninhibited eating – weighing more can also be an indicator of disordered eating.

Shaming vs. condoning

Unfortunately, society tends to envision individuals with an eating disorder as extremely thin, but the truth is they present in a range of body types and sizes. A person who binges may experience as much distress as a person who restricts food intake, and both individuals are attempting to achieve a similar goal: to regulate emotions and experience a sense of control. Therefore, it is upsetting that our society shames those who are heavier and condones those who are thin, for we are only feeding the disorder. If we idealize the very thin, we are only encouraging the eating-disordered patient to accomplish thinness, be it through restriction or other compensatory strategies.

I would like to set the record straight that I am not blind to the preponderance of fast food and unhealthy food choices accessible throughout the country. Yet, before we banish the super-size cup, isn’t it important to also explore why we are so hungry for bigger portions? Yes, cravings for and consumption of sugar and fat beget additional cravings, but I speculate that we are yearning for something else. If we can look past our focus on food and how it is consumed, we may be able to identify that missing piece.

We have all known someone who is struggling with or has suffered from an eating disorder.

 Some are dealing primarily with anorexia, restricting their intake of food and fluids to the point that basic body functions are threatened, even life itself. Others find themselves driven to bulimia, bingeing on foods to excess only to purge them from their bodies by vomiting, taking laxatives, over-exercising or a combination of these. This puts their bodies at risk for dangerous fluid and electrolyte imbalances that can trigger conditions including heart attack, liver damage, kidney failure and death. Other people overeat without purging and gain unhealthy amounts of weight, increasing their risk for hyperlipidemia, cardiovascular disease, hypertension, liver disease and diabetes.

The National Eating Disorders Awareness (NEDAwareness) Week is an effort by healthcare providers and others committed to raising awareness of the dangers surrounding eating disorders and the need for early intervention and treatment. This year’s theme is “Everybody Knows Somebody” because awareness of eating disorders is crucial to recognizing the illness so that it can be treated as early as possible and treated properly.

Eating disorders contribute to altered mental states, which puts patients at increased risk for suicidality, depression, psychotic episodes, OCD and other kinds of self-harm such as cutting or burning themselves and substance abuse. The social stigma about body image compounds the stigma around mental illness.

There are so many misconceptions about eating disorders. Some people attribute these eating-disordered behaviors to vanity or social acceptance. Others think it is a personality problem in which the patient is trying to exhibit “control” over their lives or others through their illness. The real etiology usually lies in deeply felt damage from trauma at an early developmental stage, undermining the most basic of Maslow’s needs for sustenance and survival.

The good news is that increased awareness can help get those suffering from eating disorders into appropriate treatment, which to be successful requires a team approach of psychiatric, medical and nutritional care. Eating disorders are serious, life-threatening illnesses, and it is important to recognize the pressures, attitudes and behaviors that shape them.