Body weight. We don't like to ask about it and we don't like to share our own. For nearly 30 million Americans, the taboos of body weight and shape are enough to drastically change their relationships with food and exercise.
Is there a "perfect" body type? If there is, no one agrees on what it looks like. The quest for so-called "perfection" can take a dangerous, even deadly, turn.
"Perfectionism tends to be one of those contributing factors," says Rachel Bradley, a licensed clinical social worker. "This pursuit of perfection and trying to strive for this unattainable body type and body image."
Bradley works at Cognitive Health Solutions in York County. She sees people of all ages, living with a variety of mental health disorders, including eating disorders. In some cases, weight concerns might force an individual to stop eating altogether. This is called anorexia.
"It's an intense fear of weight gain and it often leads to serious health concerns."
Eventually, the lack of nutrients forces some body systems to shut down to conserve energy. Anorexia has the most visible warning signs of all eating disorders. Extreme weight loss, dry hair and skin, fainting spells are among some examples. The pendulum, though, can also swing the other way. Bradley says she's been seeing more cases of binge eating disorder in recent years.
"So with binge eating disorder we often see people are eating more quickly, they're eating larger amounts of food, they may be eating when they don't feel physically hungry."
It's similar to bulimia; however, in cases of bulimia, individuals purge after bingeing.
"We may see excessive use of laxatives, we may see fasting, we may see excessive exercising, and those types of behaviors to counteract the binge eating," Bradley explains.
Ironically, bulimia usually results in weight gain in the long term. Bradley says most eating disorders are rooted in problems with body image, and in an age of photo manipulation, body shaming, and an overflow of technology, maintaining a positive body image is becoming more difficult.
"The rise in social media does not necessarily cause an eating disorder, but definitely has a connection to those types of things," Bradley says.
In fact, an alarming study, done in 2011, shows girls as young as six years old express concerns about their body shape and weight.
"They're seeing snapshots of people's lives. People put their best face forward, so to speak, on social media," explains Bradley. "They don't necessarily have the ability to process that that is their best picture, that their day-to-day may not look like that necessarily."
While eating disorders are more prevalent among girls and women, the male population sees a significant impact.
"We do see that about 25 percent of eating disorders are males. Generally one of the differences that we see in males and females, is females tend to focus on the weight loss, where men tend to focus on that muscular definition."
Bradley says she's also noticed a strong connection between eating disorders and sports,specifically activities with weight classes or qualifications. And that's given rise to another category of eating disorder, known as orthorexia, when diet and exercise become obsessions.
"It's one thing to say 'I'm going to go to the gym for a half hour, do some cardio, do some weights, and call it a day.' It becomes an issue when people are literally at the gym literally all day. They may be missing out on having relationships and different things because, in a sense, they're having a relationship with the gym."
So when does a change in lifestyle cross the line into dangerous territory?
"My rule of thumb," Bradley says, "has always been, if it impacts your daily functioning in some way, then it's time to start taking it seriously, and look at it from a different perspective."
Bradley says seeing a doctor for a physical health screening is an important first step on what can be a long road to recovery. From there, treatment focuses on retraining the brain.
"We look at how to have that healthy relationship with food and how to reframe your thoughts around food, food choices, and how to fuel your body appropriately."
Bradley is honest: there likely will be setbacks along the way. She makes it clear, though, setbacks are not failures.
"Setbacks can be helpful in the sense that you can learn what went wrong, you can learn how to do things differently, and that will continue to helpful propel you and move forward on your road to recovery."
All eating disorders carry a high risk of serious health consequences, including: heart problems, organ failure, and infertility. Bradley tells us there is also a high rate of suicide among people living with eating disorders. She says people can become hopeless after failing to meet an impossible standard.