New Orleans has a reputation for decadence. Whether tailgating at a football game or indulging at a Carnival ball, locals party, drink and eat with abandon. Laissez les bon temps rouler is the unofficial motto for this culture of revelry. It's easy to forget there is no joie de manger, or "joy of eating," for New Orleanians struggling with eating disorders.
I know that battle personally. A nearly five-year struggle with bulimia left me sick, weak and miserable, with severe dehydration, protruding ribs and swollen salivary glands. Though now fully recovered, I understand advocacy, awareness and support are crucial in a city where eating is a religion in its own right.
The American Psychological Association defines eating disorders as "abnormal eating habits that can threaten your health or even your life." Anorexia nervosa (excessive food restriction and an intense fear of gaining weight) and bulimia nervosa (binging and purging) are just two examples. Other types include binge-eating, restricting food intake and purging disorder. Essentially, eating disorders are mental illnesses that manifest themselves physically. According to the National Association of Anorexia Nervosa and Associated Disorders, they have the highest mortality rate of any mental illness.
Men and women of all ages, races and socioeconomic classes can be affected, but many sufferers don't seek help due to misinformation and stigmas. J. Casey Martin, a licensed professional counselor in greater New Orleans, is familiar with the misconceptions: "Eating disorders are a choice," he says, listing some common false impressions. "They only affect adolescent, white females. They are chronic and untreatable. Eating disorders are about the food."
My own bout of bulimia definitely fit one stereotype — I was white, female and aged 15 to 19 when I battled it — but that doesn't mean there aren't sufferers of other genders, races and ages. Debunking the misconceptions around eating disorders is important, because otherwise it's difficult for people who don't fit the mold to find help.
Just as there are many different types of people with eating disorders, there are many approaches to treatment, including counseling and therapy, nutrition programs, addiction recovery services and support groups.
A directive, team-based approach is the heart of Martin's method. Martin trained in Denver at one of the country's top eating disorder treatment hospitals, and moved back to New Orleans in 2013. Martin's private practice, Martin Mental Health, specializes in eating disorders, weight loss, anxiety disorders and stress management. Martin believes New Orleans' overemphasis on its cuisine needs improvement.
"In a city that's culture and heritage is so synonymous with food, I want to debunk the misconception that living a healthy lifestyle in regards to food and/or weight has to be restrictive," he says. "It's instead more about maintaining consistency and balance."
Mary Munger, a licensed clinical social worker at Maple Street Counseling, uses cognitive-behavioral and dialectical-be- havioral therapy, relapse prevention models and mindfulness-based psychotherapy when treating patients. There also is a promising, though still experimental, approach which prescribes patients certain ADHD drugs to lessen binging behaviors.
Dr. Howard Wetsman of Townsend Addiction Treatment Center views eating disorders as an addiction. Townsend's outpatient and inpatient treatment methods have similarities with rehabilitation programs for alcoholism or drug dependency.
"For us, addiction is an illness regardless of the drug or behavior the person uses," Wetsman says. "Compulsive overeating and bulimia derived from compulsive overeating are more easily treated in this way than primary anorexia. We use the same complex medication algorithms for compulsive overeating that we do for addiction patients who are using drugs."
Though Wetsman approaches eating disorders in a more physical way, he understands how gripping the disease can be mentally. To readers who are or who think they may be suffering from an eating disorder, Wetsman says, "You aren't alone. You're ill, not broken or bad or weak. Talk to someone. Get help. No one has to do this alone."
Sufferers certainly are not alone. National studies indicate a 13 percent lifetime prevalence in women. Wetsman believes this number could be higher when "atypical" diagnoses are included. With no specific gene or standard medical test to identify eating disorders, diagnostics can be subjective.
Wetsman doesn't believe that should dissuade patients from seeking help: "What's really important here is that eating disorders are common — and not just in women — and need attention from a medical professional," he says.
Patients aren't the only ones who suffer. For people whose loved ones have eating disorders, there are often feelings of confusion, anger and powerlessness. Friends and family may look on helplessly as the physical and mental side effects wreak havoc. Corey Walsh, dietitian and founder of Real Life Nutrition Counseling, has advice for individuals who think their loved one may be at risk: "Seek support as soon as you notice a problem," Walsh says. "Dieting and experimenting with ED (eating disorder) behaviors in teen years shows a strong relationship to developing EDs as a person gets older."
Unhealthy eating should be nipped in the bud, since eating disorders ravage not only lives but health. When my eating disorder was at its worst, I was emaciated, tired, always cold and had heart palpitations and trouble breathing. My knuckles were constantly cut up from the forced purging. The scariest experience was when I lost consciousness at my parents' home and hit my head on their kitchen counter. The good thing is that many of these health problems are reversible with recovery. Being proactive is key.
Because there is little to no data concerning the quantity and demographics of New Orleanians with eating disorders, the city's influence on eating disorders is up for debate. It's important to remember the many factors at play when someone has an eating disorder. Things are rarely black and white. While I can attest to my own struggle to be healthy in New Orleans, there is a long list of professionals ready to offer resources and support. No one has to go through an eating disorder alone — and no one should.