Are diets and eating disorders connected? I was always taught that anorexia was just a "diet gone overboard." And while there are similarities to weight loss diets and anorexia, they're more similar biochemically than psychologically.

The "Big Fat Losers" in my office talk about food all the time. Seriously. It's annoying. I spend enough time obsessing about food- the last thing I want to do is hear my co-workers evaluating dark vs. milk chocolate. (Dark. All the way.) I don't know why it took me so long to figure it out but...

...they're HUNGRY! That's why people with anorexia talk about food all the time, and that's why dieters do, too. It's malnutrition! Perhaps on a different level, but malnutrition nonetheless.

And that's where things get tricky. I don't think diets per se cause anorexia. There is simply not enough evidence to imply causation, nor do I ever think they will be. Can anorexia start as a weight loss diet? Definitely. I've seen it. But there are other causes, such as an autoimmune reaction to a Type A Strep infection (aka, PANDAS- Pediatric AutoImmune Neurological Disorder Associated with Strep). At any rate, what I think happens is that most of the people who develop anorexia are genetically more vulnerable to the effects of malnutrition than the rest of the population. I don't think there is one gene, which certainly explains how EDs exist along a continuum. But if the conditions are right...out pops an ED.

Here's what bugs me about our diet-oriented society: it tolerates, even encourages, malnutrition as a way of life. It lets anorexia and bulimia and other eating disorders go unnoticed because the weight-loss obsession is so normal anymore. Dieting may be common, but deliberately depriving yourself of nutrients is not normal. No one bats an eyelash when a perfectly healthy adolescent or young adult wants to lose weight. For some, it may be a short lived effort, or yet another diet (followed by yet another binge), but for others, it's a whole different ballgame.

And I guess that's what really gets under my skin in my current office environment. I don't think most of these women have seen the deadly effects of malnutrition up close. I have. It's not pretty. And it doesn't just go away.