The TLC reality TV show "My 600-lb Life" Season 6 premiere airs Jan. 10 and hopes to help 17 patients to better health. Participants from past seasons are now several years out from their initial weight loss after bariatric surgery. In that time, some have backslid, while others have continued to lose weight. Some, who have taken weight loss very seriously, now face an eating disorder with another face--anorexia.

Shocking eating patterns

Patients on "My 600-lb Life" have bizarre eating habits. Every episode of the reality television show treats viewers to nauseating displays of food stuffing.

Season 6 shows patients of TLC's Dr. Younan Nowzaradan consuming super-sized meals. Their bite sizes would make the average person gag. 850-pound Steven Assanti eats entire pizzas by himself. Yet show participants say they are never full. This is clearly an eating disorder.

Disordered food relationships

At first glance, obesity seems to be the opposite of anorexia. The more that is learned about weight gain and loss, from shows like reality TV's "My 600-lb Life," the more similar they appear. Rather than 180 degrees apart, these diseases may be closer to 360 (aka next-door neighbors). Food avoidance and addiction (gluttony, overeating) are different manifestations of inappropriate food relationships.

The obese persons see food as a lover and the anorexic as an enemy. And weight loss can change the perception from one to the other.

Weight loss leads to food phobia

"My 600-lb Life" Celebrities have shed 300-500 pounds each and update on Facebook. Nikki Webster (Gray) lost 2/3 of herself. Christina Phillips dropped the equivalent of three people.

Laura Perez (now Angelika Pacheco) shaved a quarter-ton. Amber Rachdi said what spurred her to lose weight was the realization that she weighed as much as a person plus a piece of machinery. After such shocking obesity, these folks are terrified of going back. The friend that is food is now the adversary, but that relationship is just as dangerous.

Body dysmorphic disorder

After Gastric Bypass Surgery, surgeon Dr. Now helps patients put food and also body image in perspective. Grossly overweight patients don't see themselves accurately. Even after weight loss, body dysmorphic disorder makes them unable to see progress. If they are fat-shamed by people who don't get that you can be overweight and have an eating disorder, it drives them to overeat, bulimia, or starvation. Empathy and encouragement are critical to healing both obesity and anorexia.
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