If you click on the TV, scroll through Facebook or watch YouTube videos, the commercials and ads that pop up feature more diverse body types than what we've seen in the past. The media world seems to finally get that most people are not perfect and would rather see images of people who look like they do -- jiggly thighs and all -- than unattainable body images. So you'd think that maybe the incidence of eating disorders would be declining. Not so, says Dr. Leslie Sim, a Mayo Clinic pediatric psychologist.
"For so long we saw eating disorders as a product of our media, social and cultural influences, and all about body image issues, food, weight and shape," says Sim. "Now we're seeing that they are more than that. Eating disorders are a neurobiological condition, as are other mental health issues."
Yes, media images of perfect people can greatly and unhealthily exacerbate a teenager's (or anyone's) feelings of inadequacy. And Sim says the issue is absolutely part of the equation. But instead of relying on the traditional theory that people develop eating disorders because they have a genetic vulnerability that's triggered by an environmental stressor and obsession about being thin, she uses what's called the "orchid hypothesis" to describe who might develop the condition.
The orchid hypothesis, as described in a book by Dr. W. Thomas Boyce, uses flower analogies to describe how kids respond to their environments (and as a University of Minnesota Olmsted County Master Gardener Volunteer, I appreciate the analogy). Most kids are "dandelions" that can manage in just about any environment. Some kids are "orchids" and require special care or else they will wither on the vine. "Orchids" are sensitive, but that's not a bad thing. Sim and fellow psychologist Dr. Carol Peterson published a paper about how the orchid theory applies to people with eating disorders in the International Journal of Eating Disorders.
"Most of us are dandelions and we do just fine no matter what the environment," says Sim. "Orchids are a unique subset. These individuals have a specific gift that makes them more sensitive to the environment. Under high-stress conditions they might become overwhelmed and develop an eating disorder. But under the right circumstances, this gift allows them to thrive and be more creative, open and compassionate. Orchids may do better in treatment than dandelions because they are more sensitive and responsive to both positive and negative situations. They are more malleable."
This idea is changing aspects of eating disorder prevention and treatment, putting more emphasis on creating supportive environments for orchids and building on their strengths, such as creativity and compassion. To push the flower analogy a bit more, once orchids are planted in properly amended soil with the right growing conditions, they can thrive.
Dr. Sim says people do not choose to have eating disorders because they're obsessed with being thin. The condition is a serious, potentially deadly illness that can affect every organ system in the body. And because people who are orchids may be more vulnerable when in high stress environments, they need to be treated with the right care in supportive environments. Examples of positive environments include positive parent-child relationships, high quality friendships and opportunities for academic and artistic enrichment.
"I want people to know that eating disorders are very treatable," says Sim. "People with eating disorders have incredible potential and can live rich, meaningful and happy lives after recovery."
Types of eating disorders include restrictive eating, binge eating and extremely picky eating. Anorexia nervosa and bulimia nervosa may be the terms with which most people are familiar. Eating disorders affect people of all ages, genders and ethnicities.
If you suspect an eating disorder, contact your health care provider. The resources below are links to websites that can provide more information and even help you find providers.
Vivien Williams is a video content producer for NewsMD and the host of "Health Fusion." She can be reached at firstname.lastname@example.org.