Mar 01, 2023 6:05 AM

Eating Disorders are a Public Health Crisis

Posted Mar 01, 2023 6:05 AM

by Michelle Russell
for The Beacon

The last week in February marks Eating Disorders Awareness Week, a national campaign to bring awareness to this common mental health condition that 30 million Americans will struggle with at some point in their life. That statistic boils down to nearly 10% of the population. While some people still hold the assumption that you can tell who has an eating disorder by their size, the truth is only 2% of those struggling are at a low body weight.

Recovery from eating disorders is near and dear to my heart, both as a Certified Eating Disorder Specialist and as a person who has experienced an eating disorder and recovered. Fifteen years ago, during Eating Disorders Awareness Week, I entered treatment. It took years of specialized treatment and unwavering support from family and friends, but I made it through. I show up for my clients every day hoping they will experience full recovery too.

Eating disorders take many forms. They can present as either one primary symptom or a mixture of the following: food restriction, binge eating, purging behaviors of several types, rigidity around the quantity, quality, or other aspects of food, preoccupation with food, compulsive eating, avoidance of foods due to sensory qualities such as texture, or avoidance for fear of adverse consequences such as choking.

Many eating disorders come with body dissatisfaction, and compulsive exercise or exercise avoidance. Eating disorders are like chameleons, shifting in presentation to hide and protect their very existence.

People who struggle with eating disorders miraculously keep behaviors hidden from their closest family and friends for months, years, or even decades. Our bodies have evolved with the ability to adapt to starvation in the form of famine, so many sufferers are incredibly ill but may have a neutral or larger body size and normal blood work and vital signs. However, eating disorders are still the second most deadly mental illness.

The assumption that people will become underweight if there is a legitimate problem fuels the suffering. This means parents, friends, even doctors and healthcare providers miss identifying this condition. Again, it’s like a chameleon: hard to see unless you’re specifically looking for it.

One interesting phenomenon about eating disorders is often the person experiencing the problem doesn’t want to change, or may not even see their very clear symptoms as a problem at all. There is actually a clinical term for this, “anosognosia,” which is the inability to recognize that one is ill.

In some ways, not seeing clear eating disorder symptoms as a problem is unsurprising, considering the rules eating disorder sufferers follow closely mimic popular diets. For people in larger bodies, healthcare guidance sometimes prescribes the very symptoms we diagnose as eating disorders in thin people!

Just this year, the American Academy of Pediatrics endorsed drastic weight loss measures for growing children, including pharmaceutical and surgical methods. The eating disorder community is in disbelief, not only because of the lack of research supporting such extreme measures, but because advising children (or anyone) to lose weight is directly correlated with contributing to the development of eating disorders.

Iowans are particularly unlucky when it comes to seeking eating disorder treatment. The University of Iowa had the one specialized inpatient unit for eating disorder patients in the state and closed last year to expand services to more general mental health beds.

There are ZERO facilities in the state of Iowa for those with eating disorders.

The statistic of 30 million Americans suffering boils down to 100,000 Iowans who have limited access to care, which flows over to the outpatient setting as well. Most folks will never need intensive medical monitoring, but they do need therapy and nutritional therapy support, usually weekly, for at least several months, sometimes years.

Unfortunately, as caring and compassionate as your standard medical provider, therapist, and nutrition professionals are, they are ill-equipped in supporting eating disorder sufferers without specialized training. They have overflowing caseloads and limited time. Treating eating disorders requires extensive time and specialized education.

Do you want to join me in doing something to support those struggling with eating disorders? If so, learn more by browsing the Eating Disorder Coalition of Iowa (EDCI) website at, where resources for families, professionals, and the public are available.

Visit the National Eating Disorder Association (NEDA) website at for even more resources and a confidential screening to see if you may benefit from support.

If you’re a professional who wants to make a difference, attend a conference or join a free online webinar to expand your knowledge to support the eating disorder sufferers you see in your practice. Please contact me directly to collaborate on providing care for our local clients!

Despite the mountain of work for both professionals and those suffering, recovery is possible. People can and do recover from eating disorders every day. The sooner they have access to specialized treatment and comprehensive support, the better their outcomes are. We must act NOW if we hope to reduce the incidence of eating disorders in the years and decades to come.

Michelle Russell, RD, LD, CEDS, is a dietitian and Certified Eating Disorder Specialist practicing in downtown Burlington. She provides nutrition therapy for individuals and families struggling with eating disorders and is one of less than ten certified specialists in the state of Iowa. Michelle’s definition of healthy eating includes eating for enjoyment and acknowledges that there are many ways our bodies are nourished. She may be reached via phone at 319-208-9038 and email