Steve Bryson, a registered nurse and licensed therapist, specializes in treating people with eating disorders at Bryson Counseling and Consulting in Whitefish. He said these disorders afflict people around the world, including the Flathead Valley.

“There’s an alarming number of people with eating disorders in this valley,” Bryson said.

According to statistics from National Association of Anorexia Nervosa and Associated Disorders, up to 24 million Americans suffer from disorders such as anorexia nervosa, bulimia nervosa and binge eating.

Sufferers include pre-adolescents, teenagers, young women and an increasing number of middle-aged women. Men make up 10 to 15 percent of patients.

“We have to be careful that we don’t include disordered eating as eating disorders,” he said. “Disordered eating is when you go to Thanksgiving dinner at your mother’s and you have an extra piece of pie that you don’t need nutritionally.”

People with anorexia severely restrict the type and amount of food they eat to avoid gaining weight. Those with bulimia eat normal amounts of food but compensate with behaviors such as self-induced vomiting (purging), laxatives, diuretics, excessive exercise and fasting.

Binge eating involves excessive overeating without the compensating behaviors employed by people with bulimia.

Bryson said each patient needs a careful work-up for a diagnosis and to find the underlying drivers.

“The most common trigger right now is fashion or body image,” he said, adding that other triggers include family stresses and a history of abuse.

He said sufferers often include the brightest individuals. Bryson described them as very social, bright and engaging people who are caring and compassionate as well.

According to Bryson, the latest duplicated research has found genetics as a factor. He also cited research by Shan Guisinger, a professor affiliated with the University of Montana.

Guisinger defined a “flee famine hypothesis” to explain a subset of young women who become energetic when their bodes go below their set point.

“They were the ones who said ‘we’ve got to go find food’ and she was the one who would go off and find food and then come back and lead the tribe to where that was,” Bryson said. “In fact, Charlie Russell has four paintings called ‘moving camp.’ All of them depict a young woman leading the tribe.”

Although some people carry a gene of vulnerability, Bryson said it doesn’t mean the person will ever develop a disorder.

Therapist Carrie Thiel agreed. She said the latest information points to a biological component that may never surface or may kick in with the right trigger .

“There’s some kind of emotional trigger or sometimes several that happen within a close period of time,” she said. “A person’s normal, healthy coping strategies are overwhelmed.”

During therapy sessions, Thiel said she works with the person to determine where the behavior started. She said she and the patient don’t linger in the past, but gain insight for the patient, then quickly move forward.

Thiel does individualized “solutions-focused” counseling with patients which varies depending on a person’s age and place in life.

She said some people, although not the majority, respond to anti-depressants. Thiel said professionals don’t know why, but it may relate to the biological component.

Thiel recommends The Summit’s Body Balance program as a resource. Dietitian Linda Fredenberg and mentor Barbi Webber, an eating disorder survivor, provide a program of support and guidance to help people build a healthy relationship with food.

Both Thiel and Bryson said much remains unknown about eating disorders, but new brain research with advanced imaging techniques may uncover more clues for expanded treatment options in the future.

Bryson said early identification and treatment helps people successfully overcome eating disorders with individual, group or family psychotherapy and medication for co-existing disorders such as depression and anxiety. However, only one in 10 seeks treatment and one in five with the disorder dies from anorexia.

If the behaviors become chronic, Bryson said most require placement in a residential facility dedicated to eating disorders to avoid relapse. He said the Northwest has no such facilities yet.

“It’s a real problem,” he said.

Bryson stressed that people need to first see their physician because of the life-threatening complications of eating disorders. Even though a person may appear very fit, he said some young women have died suddenly from electrolyte loss or heart failure.

He said he has one very important message for the public about eating disorders: “It’s not vanity. It’s a mental/emotional disorder.”

Reporter Candace Chase may be reached at 758-4436 or by email at cchase@dailyinterlake.com.