Interviewer: Thirty million Americans suffer from eating disorders at some time in their life, and those are only the reported cases. But what identifies an eating disorder and why do people suffer from them to begin with? Could you have an eating disorder and not be aware of it? Ask today on The Scope.

Announcer: Medical news and research from University Utah physicians and specialists you can use for a happier, healthier life. You're listening to The Scope.
We're with Dr. Nick Galli, Assistant Professor of Department of Health Promotions and Education. There are so many types of eating disorders; you hear it all the time, but what is it?

Dr. Nick Galli: There are actually four major types of eating disorders identified in the DSM, the Diagnostic Statistical Manual, which a new version just came out, so the standards are changing.
The two classic eating disorders that most people know about and think of are anorexia nervosa and bulimia nervosa. In either case the underlying theme is being dissatisfied with one's body weight, and making an attempt to in some way or another control the diet. Anorexia without going into every single diagnostic criteria, one of the big indicators is extremely low body weight, and intense fear of gaining weight. Those are kind of the two hallmarks, and the person may look to restrict their food intake.
Bulimia nervosa is characterized by binging, so eating a high quantity of calories and purging those calories in one way or another. So that's the characteristic of bulimia. Individuals with bulimia may be a normal weight. And then binging disorder is the binging without the purging.

Interviewer: Okay.

Dr. Nick Galli: And then there are criteria regarding the amount of time the person has been exhibiting certain symptoms.

Interviewer: So with all these different signs and symptoms of these eating disorders, it almost sounds like it's just I don't like food. And so in a way could some people have eating disorders and not know that they have an eating disorder? Or is it just an illness that you just know you have?

Dr. Nick Galli: I don't know that it's that simple. I'm sure there are people who might be diagnosed as having an eating disorder who don't know; maybe they don't have very great self awareness; or maybe they've just been living like this for awhile. There may be people who know there's something not quite right going on with the way they feel; it's possible. That's why we rely on people to help us recognize that there's something going on, because sometimes you get into a habit of how you live your life.

Interviewer: Exactly.

Dr. Nick Galli: And maybe if you're surrounding yourself with people who also have these dysfunctional eating patterns I would say it is quite possible that someone could at least be eating dysfunctionally and having disordered eating and maybe not a full blown clinical eating disorder.

Interviewer: What factors into someone developing an eating disorder? Does age play into all this, physical form?

Dr. Nick Galli: Yes, we've sort of identified different clusters of factors that contribute to an eating disorder. You mentioned age; I wouldn't say that age is a contributing factor, but we do tend to see the age of onset as around that adolescent period.

Interviewer: Someone who needs to find myself age?

Dr. Nick Galli: Exactly, but we're also seeing eating disorders linger into adulthood, and even in adults developing eating disorders it's less about age and more about sort of this inner play of the person and their environment. So personality does play into it; also who you are surrounded with. Did you have parents who modeled dysfunctional eating? Was your mom or dad always on a diet? That plays into it. Biological factors; they are still trying, and they think there might be something there, in a level of the brain.

Interviewer: So it's not just somebody just looking at a cover magazine and saying I want to look like that, the cover of the magazine?

Dr. Nick Galli: Well it's probably an interaction of where we see people who might be predisposed because of their personality and their genetics and what not. If they're exposed to these images of men and women in the media, it might be more likely to feel the urge to have to look like that. As any psychological issue it's usually not just one thing.

Interviewer: So how do you prevent then that bad eating habit into becoming an eating disorder? Is there that line, is there a gray line or is there kind of like I know this is...

Dr. Nick Galli: I'd say there's a gray line. If someone who's a typical college student is a good example, as they tend to maybe be not eat as many meals as they should, or they pack them all into one meal. We consider that disordered eating.

Interviewer: Okay. So I could have an eating disorder and wouldn't even know it.

Dr. Nick Galli: Maybe not an eating disorder but maybe you have a disordered eating pattern.

Interviewer: Bad eating habits.

Dr. Nick Galli: Yes. Maybe not developing into a full blown eating disorder, because maybe you've got some other good things going on in your life. Maybe you don't necessarily feel bad about your body, you just don't have the greatest eating patterns; the same with a lot of us are like that. We don't eat when we should, and the different nutrients that we should.

Interviewer: Do you see many cases where, like you said the typical college student, do you see that transitioning into an eating disorder?

Dr. Nick Galli: It could.

Interviewer: It could, okay.

Dr. Nick Galli: It could with some people, but not with all people.

Interviewer: Okay.

Dr. Nick Galli: They'll have multiple identities, you know, don't define yourself by how you look. So I think it's important for parents, and of course you want your parents to be on the lookout for signs, but even in the younger children you want to set the stage. You want to be proactive in helping your kids have a healthy self esteem and not define themselves based on how they look.

Announcer: We're your daily dose of science, conversation, medicine. This is the Scope; University of Utah Health Sciences Radio.