Eating Disorders

Eating disorders or disordered eating habits and behaviours are signs of deep suffering. Anorexia, bulimia, and compulsive overeating are the most frequent disorders, and they often affect teenagers and young adults. Today, disordered eating habits appear to be a common phenomenon, and some people with a specific psychological profile indicate they may be at risk.

The most frequent eating disorders:

1.    Anorexia nervosa

Anorexic behaviour concerns people who voluntarily restrict eating. Anorexia nervosa is psychological, and it may start at adolescence, translating to an unreasonable fear of weight gain, but without any loss of appetite. The person refuses to eat in an attempt to lose weight quickly. This excessive focus on avoiding food can significantly lower the body mass index and put the individual at risk.

The major problem with anorexia nervosa is malnutrition. Warning signs will appear at some point.

The most effective treatment for anorexia nervosa generally requires a team approach, which may include a dietitian, psychologist and therapist.

Medical – This will address any serious health issues that may have resulted from the eating disorder behaviours, such as malnutrition, electrolyte imbalance, amenorrhoea and an unstable heartbeat.

Nutritional – This part includes weight restoration, implementation and supervision of a tailored meal plan and education about standard eating patterns.

Therapy: This helps the person identify the underlying issues associated with the eating disorder, address and heal from traumatic life events, learn healthier coping skills, and develop the capacity to express and deal with their emotions.

Anorexia nervosa can cause a range of physical problems that may require medical treatment. People with severe anorexia nervosa may require hospitalisation. It’s common for people with the condition to relapse, so ongoing follow-up and treatment for anorexia nervosa are essential.

2.    Bulimia nervosa

Bulimia nervosa is a serious psychiatric illness characterised by recurrent binge-eating episodes (consuming abnormally large amounts of food in a relatively short period of time). Binge episodes are associated with a sense of loss of control and immediately followed by feelings of guilt and shame, which then lead the person to compensatory behaviours such as self-induced vomiting, fasting, overexercising and/or the misuse of laxatives, enemas or diuretics.

Causes

Similar to anorexia nervosa, bulimia nervosa affects women more than men. Bulimia crises frequently happen with anorexic people but can also develop in other individuals and are considered significant when they take place at least once a week over three months.

Some people with bulimia nervosa also have other mental health concerns, such as anxiety and depression. Some even have suicidal thoughts or make suicide attempts. Bulimia nervosa can cause severe damage to physical health, especially if purging is involved.

Treatment

Since negative body image and poor self-esteem are often the underlying factors at the root of bulimia nervosa, therapy must be integrated into the recovery process. Firstly, it involves discontinuing the binge-purge cycle by breaking the harmful habit and restoring normal eating behaviours. Secondly, it focuses on improving negative thoughts and changing irrational beliefs about weight, body shape, and dieting. The final phase is to focus on healing from emotional issues that may have caused the eating disorder. The treatment could address interpersonal relationships and also include therapies such as cognitive behavioural therapy and dialectical behaviour therapy.

3. Binge Eating Disorder (BED)

The behaviour was first explained by the psychiatrist Albert Stunkard in 1959. His research on night eating syndromes led to the concept of binge eating disorder. It is commonly known as compulsive overeating or consuming abnormal amounts of food while feeling unable to stop. Binge eating episodes are typically classified as occurring on average a minimum of two times a week for a duration of six months.

People with this kind of behaviour do not feel satisfied. They struggle with feelings of disgust and guilt and often have a related comorbidity, such as depression or anxiety. They eat quickly and continue eating even when they are not hungry. They eat until they feel disgusted by the food, and most of the time, it is when they are stressed. They use food to cope, thus creating a vicious cycle, and after the binge eating crisis has passed, they feel guilty because of the quantity of food they have ingested. The consequences of binge eating disorder involve many physical, social and emotional difficulties, so in managing eating disorders, treatment is essential.

Causes

Although the specific causes are unknown, certain factors contribute to the development of the disorder.

First, biological abnormalities like hormonal imbalances or genetic mutations can lead to compulsive eating and food addiction. Second, it has been established that psychologically, there is a strong correlation between depression and binge eating. People may struggle to cope with their emotions. Low self-esteem and body dissatisfaction can contribute to the disorder. Lastly, there is the social and cultural context. Traumatic situations can increase the risk of binge eating. Individuals who are subject to critical comments about their body or weight, or social pressures conveyed through the media, may be more likely to experience emotional eating.

Treatment

Psychiatrists, nutritionists and therapists are professionals specialising in binge eating. They are the ideal team to address an appropriate treatment plan for a binge eating disorder. They work on the underlying issues associated with destructive eating habits and focus on the central cause of the problem. It is essential to concentrate on healing the emotional triggers that may be causing the disorder and have proper guidance for establishing healthier coping mechanisms for dealing with stress, depression, anxiety, and other difficulties.

OTHER EATING DISORDERS

Any eating behaviour linked to psychological distress or other health problems can justify medical advice and appropriate psychological support, even if it does not appear on a classification list.

Selective feeding disorder

This behavioural problem primarily affects children and teenagers. It is characterised by refusing certain foods based on their colour or texture. This behaviour will impact the natural development and growth of a child or teenager through malnutrition and a lack of essential nutrients.

Absorption of hazardous and inedible substances

This behavioural problem mainly affects children. They can habitually ingest stones, paper, soil, chalk, or other substances, which can become a serious illness. However, this type of behaviour can develop in some children with autism, others with affective disorder, or those with an intellectual deficiency.

Self-induced vomiting

This behavioural problem is known as rumination and affects mostly babies and children. The voluntary regurgitation of ingested food characterises it.

Orthorexia

This abnormal behavioural problem is characterised by the selective restriction of foods based on their nutritional values. Following a strict dietary concept, the orthorexic person refuses any unhealthy food. Acting without medical or a dietitian’s advice, they use information gained from media reports and can be at risk of malnutrition and a lack of essential nutrients.

Pathological nibbling

This abnormal behavioural problem is characterised by eating a large quantity of food outside of the regular daily meals. In the long term, this behaviour becomes uncontrollable and often appears with depression.

Eating disorders are real, treatable medical illnesses and frequently coexist with other difficulties such as depression, anxiety and stress, low self-esteem, substance misuse and other self-harming behaviour. For people struggling with eating disorders, a particularly well-suited treatment approach may increase general psychological well-being as well as physiological and emotional self-regulation.

If you have a history of trying multiple diets, difficulty with body image and self-esteem and doubt about your own judgement regarding food and eating, a mindfulness-based approach to eating and body image offers a more permanent, enduring approach.

The concept encourages the ability to observe feelings, behaviours, and experiences without judgment and with time, patience, and commitment to your own well-being, allowing for the development of a wiser and more balanced relationship with yourself, your body, and food.

If you would like to learn more about a mindfulness-based approach to eating, please make an appointment for individual counselling by calling Plaisance Counselling.