Services for Eating Disorders
Did you know?
It's common for eating disorders to occur with one or more other psychiatric disorders. This can make recovery more difficult. Among those who suffer from eating disorders:
Dieting and the Drive for Thinness
Dieting and weight control strategies reflect how dissatisfied a person is with body size and shape. They're associated with the onset of eating disorders, and in general can be dangerous to health.
Almost 50% of 1st-3rd grade girls want to be thinner.
81% of 10 year olds are afraid of being fat.
46% of 9-11 year-olds are “sometimes” or “very often” on diets, and 82% of their families are “sometimes” or “very often” on diets.
More than one-half of teenage girls and one-third of teenage boys use unhealthy weight control behaviors such as skipping meals, fasting, smoking cigarettes, vomiting, and taking laxatives.
Girls who diet frequently are 12 times as likely to binge as girls who don’t diet.
The average American woman is 5’4” tall and weighs 165 pounds. The average Miss America winner is 5’7” and weighs 121 pounds.
98% of all dieters will regain their lost weight in 1-3 years.
What are the Major Types of Eating Disorders?
We live in a society that still idealizes thinness. Almost everyone seems to have some concern about their weight, at least occasionally. People with eating disorders take such concerns to extremes, developing abnormal eating habits that threaten well-being and even their lives.
There are three major types of eating disorders:
People with Anorexia nervosa have a distorted body image that causes them to see themselves as overweight even when they’re dangerously thin. Often refusing to eat, exercising compulsively, and developing unusual habits such as refusing to eat in front of others, they lose large amounts of weight and may even starve to death.
Individuals with Bulimia nervosa eat excessive quantities, then purge their bodies of the food and calories they fear by using laxatives, enemas, or diuretics; vomiting; or exercising. Often acting in secrecy, they feel disgusted and ashamed as they binge, yet relieved of tension and negative emotions once their stomachs are empty again.
Like people with bulimia, those with Binge Eating Disorder experience frequent episodes of out-of-control eating. The difference is that binge eaters don’t purge their bodies of excess calories.
Another category of eating disorders refers to when people have eating-related problems but symptoms don’t meet official criteria for anorexia, bulimia or binge eating. The category is now called Otherwise Specified Feeding and Eating Disorder, or OSFED.
It’s important to prevent problematic behaviors from evolving into full-fledged eating disorders. Anorexia and bulimia, for example, usually are preceded by very strict dieting and weight loss. Binge eating disorder can begin with occasional bingeing. Whenever eating behaviors start having a destructive impact on someone’s functioning or self-image, it’s time to see a mental health professional, such as a licensed psychologist experienced in treating people with eating disorders.
Who Suffers From Eating Disorders?
Eating disorders aren’t just a problem for the teenage women so often depicted in the media. Men and boys can also be vulnerable. So are people who are nonbinary. In fact, the rates of eating disorders are higher among the LGBTQ population.
Binge eating disorder strikes males and females about equally. People sometimes have eating disorders without their families or friends ever suspecting that they have a problem. Aware that their behavior is abnormal, people with eating disorders may withdraw from social contact, hide their behavior, and deny that their eating patterns are problematic.
What Causes Eating Disorders?
Certain psychological factors and personality traits may predispose people. Many people with eating disorders suffer from low self-esteem, feelings of helplessness, and intense dissatisfaction with the way they look.
Specific traits are linked to each of the disorders. People with anorexia tend to be perfectionistic, for instance. People with bulimia may be more impulsive. Certain factors such as genetics also put people at risk.
A wide range of situations can precipitate eating disorders in susceptible individuals. Family members or friends may repeatedly tease people about their bodies. Individuals participating in gymnastics or other sports that emphasize low weight or a certain body image are at increased risk. Negative emotions or traumas can also trigger disorders. Even a happy event, such as giving birth, can lead to disorders because of the stressful impact of the event on an individual’s new role and body image.
Once people start engaging in abnormal eating behaviors, the problem can perpetuate itself. Bingeing can set a vicious cycle in motion, for instance, as individuals purge to rid themselves of excess calories and psychic pain, then binge again to escape problems in their day-to-day lives.
Why is it Important to Seek Treatment for these Disorders?
Eating disorders very often go untreated. About 86% of people report the onset of their eating disorder by the age of 20, making treatment and recovery more likely.
Not treating an eating disorder can have serious consequences.
People with anorexia have a mortality rate 18 times higher than peers who don’t have an eating disorder, for example. Also, eating disorders can devastate the body. Physical problems associated with anorexia, for instance, include anemia, constipation, osteoporosis, even damage to the heart and brain. Bulimia can result in a sore throat, worn-away tooth enamel, acid re-flux, and heart attacks. People with binge eating disorder may develop cardiovascular disease.
Eating disorders are also associated with other mental illnesses like depression. Researchers don’t yet know whether eating disorders are symptoms of such problems or whether the problems develop because of the isolation, stigma, and physiological changes brought by the eating disorders themselves. What is clear from research is that people with eating disorders suffer higher rates of other mental disorders – including depression, anxiety disorders, and substance abuse – than other people.
How Can a Psychologist Help Someone Recover?
Psychologists play a vital role in successful treatment of people with eating disorders. We are integral members of the multidisciplinary team often required to provide patient care. As part of this treatment, a physician may be called on to rule out medical illnesses and determine that the patient is not in immediate physical danger. A registered dietician may be asked to help assess and improve nutritional intake.
Once the psychologist has identified important issues that need attention and has developed a treatment plan, he or she helps the patient replace destructive thoughts and behaviors with more positive ones. Simply changing patients’ thoughts and behaviors is not enough, however. To ensure lasting improvement, patients and psychologists must work together to explore the psychological issues underlying the eating disorder. Psychotherapy may focus on improving patients’ personal relationships. And it may involve helping patients get beyond an event or situation that triggered the disorder in the first place.
Some patients may benefit from medication. It’s important to remember, however, that medication in most cases is best used in combination with psychotherapy, not as a replacement for it.
Does Treatment Really Work?
I EMPHASIZE TO EACH OF MY PATIENTS THAT FULL RECOVERY IS POSSIBLE!
Many people, with and without an eating disorder, believe that once a person has an eating disorder, that person will always have an eating disorder. This is not true, especially with treatment. Eating disorders can be treated successfully by appropriately trained health and mental health care professionals.
But treatments do not work instantly.
Incorporating family or marital therapy into patient care may help prevent relapses by resolving interpersonal issues. Therapists can guide family members' understanding of the patient’s disorder and learn new techniques for coping. Support groups can also help.
Remember: The sooner treatment starts, the better. The longer abnormal eating patterns continue, the more deeply ingrained they become and the more difficult they are to treat.
Eating disorders can severely impair functioning and health. But the prospect for long-term recovery is good for most people who seek help from trained professionals.
Helpful link for parents: http://www.nationaleatingdisorders.org/sites/default/files/Toolkits/ParentToolkit.pdf
Helpful link for educators: http://www.nationaleatingdisorders.org/sites/default/files/Toolkits/EducatorToolkit.pdf