Eating Disorder Counseling
What is an Eating Disorder (ED)?
Eating disorders are unique in comparison to some other mental illnesses, as they manifest physically as well as mentally. There are numerous eating disorders with varying symptoms and diagnostic criteria, however each have a complicated relationship with food and the body, often involving dangerous behaviors. Eating disorders do not discriminate and affect people of all sizes, ages, genders, sexualities, ethnicities, religions, and socioeconomic status.
Types of EDs:
- Anorexia Nervosa (AN)
- Bulimia Nervosa (BN)
- Binge Eating Disorder (BED)
- Rumination disorder
- Avoidant/Restrictive Food Intake Disorder (ARFID)
- Other Specified Feeding or Eating Disorder (OSFED)
- Unspecified Feeding or Eating Disorder (UFED)
What are some common emotional/behavioral symptoms of an ED?
Each individual and each ED is different and may or may not have all of these symptoms present, but below are some of the more common presenting symptoms of EDs:
- Focus on weight loss/dieting/skipping meals/calorie counting
- Abnormal or unusual eating patterns/food rules; eating very quickly/slowly, not allowing foods to touch on plate, cutting food in specific ways, etc.
- Hiding food and/or eating alone
- Compensatory behaviors after eating; purging, over-exercising, abuse of caffeine/diuretics/laxatives, etc.
- Focus on body composition/shape
- Body checking; body pinching, checking mirrors often, covering specific areas of body, etc.
- Distorted view of body
- Mood swings
- Cognitive dysfunction; difficulty concentrating, impulsivity, etc.
What are some physical symptoms of an ED?
Aside from emotional and behavioral symptoms, EDs often also have physical components that result from some level of malnourishment. These symptoms can include:
- Rapid weight fluctuations
- GI disruptions/issues with regular bowel movements
- Dry skin and/or skin discoloration
- Brittle hair and nails/hair loss
- Lanugo growth (soft body hair growth; as a means to keep body warm)
- Impaired immune system
- Blood pressure issues
- Breathing complications
- Amenorrhea (loss of menstrual cycle)
- Muscle weakness/fatigue
- Often feeling cold
What causes eating disorders?
EDs are incredibly complicated and multifaceted illnesses, and therefore don’t have a simple answer to what causes them. Instead, EDs develop due to a combination of biological, psychological, and environmental factors. Each individual has a unique history of what contributed to the development of their ED.
How are EDs treated?
Before digging into the treatment modalities of EDs, it is crucial that treatment is completely body liberation focused, Health at Every Size (HAES) and Intuitive Eating (IE) based. Briefly, this means that there is a “no-diet” and “all foods fit” approach. Weight loss is not prescribed or a part of the treatment plan, and only perpetuates diet culture. Diet culture has permeated many areas of our lives, and ultimately is not the antidote but the toxin that contributes to body distrust/hate, body dysmorphia, disordered eating, and EDs.
Regarding treatments and interventions, Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), and Family-Based Treatment (FBT) are the most recognized and evidence-based treatments utilized in ED treatment. However, ED treatment is not limited to or only effective if using these modalities. Internal Family Systems (IFS), Compassion Focused Therapy (CFT), Acceptance and Commitment Therapy (ACT), and Mindfulness-Based Cognitive Therapy (MBCT) are additional effective and supportive treatment modalities for EDs. It is important to mention that treatments are often utilized in some combination that is ideal for each individual.
Again, EDs can vary drastically case to case, and diagnosis to diagnosis, there is not only one way or environment to treat them. Depending on the level of severity of the ED, there may be a need for a higher level of care such as inpatient hospitalization or residential. Slightly lower levels of care include partial-hospitalization programs (PHP) and intensive outpatient programs (IOP). And finally, when appropriate, there is outpatient care for those who are physically and mentally stable enough to engage in therapeutic treatments without more consistent immediate support.
More details on Health at Every Size (HAES) & Intuitive Eating (IE)
Articles related to body liberation:
Further details regarding each ED diagnosis:
If you think you may be struggling with an eating disorder, try this screening tool:
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