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Food Culture vs. Appearance Pressure

Read about eating disorders from Rebecca Carrasco

As many of us try to fulfill our New Year’s resolution to reach and maintain a healthy weight, we face a food culture that makes it difficult to limit processed foods and choose appropriate portions of healthy foods. This same food obsessed culture is also obsessed with appearance; creating a perfect storm for eating disorders.

Thirty million Americans will experience an eating disorder with anorexia nervosa having the highest mortality rate of any of the mental illnesses. While the disorders do not discriminate on the basis of gender or socioeconomics, among female adolescents, the disorder is the third most common chronic illness. Between ages 16-24 persons with anorexia nervosa are 10 times more likely to die than their peers (Eating Disorders Coalition, 2016).

The Diagnostic and Statistical Manual of Mental Disorders [DSM-5] (American Psychiatric Association, 2013) identifies the following as feeding and eating disorders:

  • Pica
  • Rumination disorder
  • Avoidant/restrictive intake disorder
  • Anorexia nervosa
  • Bulimia nervosa
  • Binge eating disorder
  • Other specified feeding or eating disorders
  • Unspecified eating or feeding disorders

The diagnostic features are briefly described below (DSM-5, 2013):

Pica occurs when nonfood substances are eaten frequently. Rumination is the habitual regurgitation of food. Avoidant/restrictive intake disorder is a result of a lack of interest in food, mostly based on the sensory characteristics of food or fear of the eating process.

Anorexia nervosa results from a distorted perception of one’s own body and the fear of being fat despite having a BMI below 18. While there are 2 subtypes of the disorder, restricting or binge-eating/purging behavior may alternate within the course of the disorder.

Bulimia nervosa is diagnosed when there are at least 1-3 compensatory episodes (e.g. self-induced vomiting, misuse of laxatives or diuretics) in a week after consuming a large amount of food in a short amount of time. The weight of a person with bulimia nervosa does not vary much from the normal weight range. Binge eating disorder also results from eating a large amount of food at least once a week in a short amount of time normally without compensatory episodes.

Other specified feeding or eating disorders have characteristics of one of the other disorders, but without meeting adequate diagnostic criteria. Unspecified feeding or eating disorders present with eating disorder symptoms, but without a clear clinical picture to define the diagnosis.

Eating disorders can be successfully treated. If you or someone you know has symptoms of an eating disorder, contact your primary care provider or come into any of our UT Health East Texas facilities for an assessment and referral.

To promote awareness and hope for those recovering from eating disorders, the National Eating Disorders Association (NEDA) website offers insight and community. National Eating Disorder Awareness Week, Feb. 25 – March 3, encourages all people recovering from a variety of eating disorders to come together to share their journey, stories and to voice support of body acceptance with the theme, Come as You Are. To learn more about the week go to the NEDA website.

Blog by Rebecca Carrasco

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

Eating Disorders Coalition. (2016). Facts About Eating Disorders: What the Research Shows. Retrieved February 2, 2019, from //

National Eating Disorders Association. (2018). National Eating Disorders Awareness Week. Retrieved February 2, 2019, from