I am honestly thrilled and inspired by the response thus far to the 1 in 20 project. I am in the process of getting a web domain for it, and I will keep you posted. One of the questions that I've frequently been asked about my little graphic is the "life-threatening" bit. Are all eating disorders life-threatening? And what does life-threatening even mean?
Here's my take. No, not everyone with an eating disorder is at immediate risk for dropping dead from physical complications or suicide. It also doesn't mean that most people with an eating disorder will die as a will die as a direct result of their disorder. Yet, when you look at the statistics, you see that someone with anorexia is 12 times more likely to diethan the girl sitting at the desk next to her in class. This girl is also about 60 times more likely to attempt suicide.
IrishUp, one of my readers who I've been lucky enough to meet twice and on whom I have a massive brain crush, said this in a comment In medical terms "Life-threatening" is applied to any diagnosis, symptom, or condition where the risk mortality is considered high - particularly if untreated mortality is high.
This should not be confused with ALTEs - apparent life threatening events. These are situations where there is sudden respiratory arrest or obstruction, or acute severe cardiac or neurological abnormalities. One of the things that qualifies EDs as "life threatening" is that someone with active ED behaviors is at SUBSTANTIAL risk for ALTEs.
And let's remember that one of the real problems with EDs is that we (medical we as well as parental we) can't really tell when an ALTE is imminent. The way the body responds to the perterbations that ED behaviors subject it to, is to keep up homeostasis on vital functions for as long as possible, by pulling required resources from non-vital functions. And it keeps doing that until the biological reserve is used up. Which often doesn't show up on labs until the ALTE is already in process.
The acute elecrolyte imbalances from vomitting that can cause siezures and sudden cardiac death are another risk. You may not even be able to detect imminent events in a patient getting monitored daily.
LT is, of course, somewhat relative and subjective. When we are talking about somewhere between 0.6 - 1% mortality per year in a population whose expected mortality is 0.012%/yr, we are talking about GREATLY increased risk of death. When 10yr survival rates are less than that of (most) childhood leukemias, I think we can safely call EDs Life Threatening.
The fact that people don't react to ED the way they do to cancer is a huge part of the problem.
That's why I used the term "life-threatening." Too many people still view EDs as a choice or a phase, and they don't really understand that EDs are deadly serious.