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Eating Disorders

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

The most frequent eating disorders:

  1.    Anorexia nervosa

Anorexic behaviour concerns people who voluntarily restrict their 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 order to lose weight quickly. This excessive focus on avoiding food lowers the body mass index significantly and puts him or her at risk.

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

Warning Signs of Anorexia Nervosa
  • Preoccupation with body shape, weight and/or appearance
  • Intense fear of gaining weight
  • Preoccupation with food or food related activities
  • Negative or distorted body image; perceiving self to be fat when at a healthy weight/underweight
  • Low self-esteem (guilt, self-criticism, worthlessness)
  • Rigid thinking (‘black and white’, ‘good and bad’ foods)
  • Feeling out of control
  • Mood swings
  • Anxiety or depression
  • Heightened anxiety around meal times
  • Heightened sensitivity to comments or criticism about body shape/weight/appearance/eating/exercise habits
  • Suicidal or self-harm thoughts or behaviours
  • Constant or repetitive dieting/restrictive or rigid eating patterns
  • Excessive or compulsive exercise
  • Changes in clothing style
  • Impaired school or work performance
  • Obsessive rituals around food
  • Changes in food preferences
  • Frequent avoidance of eating meals / excuses not to eat
  • Social withdrawal / avoidance of social situations involving food
  • Repetitive or obsessive body-checking behaviours
  • Deceptive or secretive behaviour around food

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

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

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

Therapy –This helps the person to recognise the underlying issues associated with the eating disorder, to address and heal from traumatic life events, learn healthier coping skills and developing the capacity to express and deal with his or her 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 is important.

  1.    Bulimia nervosa

Bulimia Nervosa is a serious psychiatric illness characterised by recurrent binge-eating episodes (the consumption of 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 leads the person to compensatory behaviours such as self-induced vomiting, fasting, overexercising and/or the misuse of laxatives, enemas or diuretics.

Causes

Similar to the anorexia nervosa, women are more affected than men by bulimia nervosa. Bulimia crises frequently happen with anorexic people but can also develop in other individual and are considered as major 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 serious damage to physical health, especially if purging is involved.

Physical symptoms of bulimia nervosa
  • Gastrointestinal problems
  • Severely inflamed sore throat
  • Chronic dehydration
  • Dry skin
  • Swollen face or neck due to salivary glands
  • Worn tooth enamel
  • Tooth decay
  • Intestinal problems due to laxative abuse
  • Heartburn or stomach ulcers
  • Malnutrition
  • Hair loss/hair changes
  • Intolerance to cold
  • Fainting
  • Calluses on knuckles (from trying to cause vomiting)
  • Bad breath
  • Heart failure

Treatment

Since negative body image and poor self-esteem are often the underlying factors at the root of bulimia nervosa, it is crucial that therapy is integrated into the recovery process. Firstly, it involves discontinuing the binge-purge cycle, that is, breaking the harmful habit and restoring normal eating behaviours. Secondly, improving negative thoughts and concentrating on 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 behaviours and dialectic behaviour therapy.

  1. Binge Eating Disorder (BED)

The behaviour was first explained by the psychiatrist Albert Stunkard in 1959. His research on Night Eating Syndromes lead to the concept of Binge Eating Disorder.   It is commonly known as a 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 form of behaviour do not have a feeling of satiety. They struggle with emotions of disgust and guilt and often have a related co-morbidity such as depression or anxiety. They eat quickly and eat even if 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 is 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 extremely important.

Complications from binge eating disorder
  • Cardiovascular disease
  • Type 2 Diabetes
  • Insomnia or sleep apnoea
  • Hypertension
  • Gallbladder disease
  • Muscle and/or joint pain
  • Gastrointestinal difficulties
  • Depression and/or anxiety

Causes

Even though specific causes are unknown, there are indications which influence the development of the disorder.

Firstly, people suffering from biological abnormalities such as hormonal irregularities or genetic mutations may be driven 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 have difficulty in coping with their feelings. 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. People subject to critical comments about their body or weight or social pressures through media, can trigger emotional eating.

Behavioural and emotional signs and symptoms of binge eating disorder
  • Continually eating even when full
  • Inability to stop eating or control what is eaten
  • Stockpiling food to consume secretly at a later time
  • Eating normally in the presence of others but gorging when isolated
  • Experiencing feelings of stress or anxiety that can only be relieved by eating
  • Feelings of numbness or lack of sensation while bingeing
  • Never experiencing satiation – the state of being satisfied, no matter the amount of food consumed

Treatment

Psychiatrists, nutritionists and therapists are professionals specialising in binge eating. They are the ideal team to address an appropriate treatment program 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, having proper guidance in 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 any classification list.

Selective feeding disorder

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

Absorption of hazardous and inedible substances

This behavioural problem affects mostly children. Usually through habit, they can put in their mouth and ingest stones, paper, soil, chalk or other objects and this behaviour can become an illness. However, some children with autism, others with affective disorder or with an intellectual deficiency, can be inclined to develop this kind of behaviour.

Self-induced vomiting

This behavioural problem is known as rumination and affects mostly babies and children. It is characterised by a voluntary regurgitation of ingested food.

Orthorexia

This abnormal behavioural problem is characterised by a selective restriction of food to that based on their nutritional values. Following a strict dietary concept, the orthorexia person refuses any unhealthy food. Acting without medical or 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 normal daily meals. In the long term, this behaviour becomes uncontrollable and often appears with depression.

Eating Disorder 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 disorder, a particularly well-suited treating approaches 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 judgment 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 judgement and with time, patience and commitment to your own well-being, allows for the development of a wiser and more balances relationship with yourself, your body and with food.

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

Jerome Plaisance

Ph: 0414 991 194

Call or fill out the form for your introductory session

 

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