There are various types of eating disorders. These are usually characterised by significantly restricted eating or over-eating. One of the most common forms of eating disorders is Anorexia Nervosa, which is a rejection of maintaining a healthy body weight due to a fear of gaining weight or a distorted body image, perceiving one’s own body as significantly larger than it actually is.
Another common eating disorder is Bulimia Nervosa, which is when someone regularly engages in binge eating followed by unhealthy compensatory behaviours in order to avoid gaining weight, such as ‘purging’ (vomiting up food), excessive exercise, using laxatives and fasting for a period afterwards.
Both of these disorders are characterised by trying to maintain a thin physique by using dangerous and unhealthy methods. The disorders can be very debilitating in terms of reduced energy and nutrition, and lifestyle restrictions such as:
- Avoiding social events centred on food,
- Finding places to purge without people noticing,
- Being unable to engage in other activities due to spending so much time exercising.
In some extreme cases, hospitalisation can be necessary due to the physical effects of fasting (e.g. heart problems) and purging (e.g. teeth and oesophageal damage due to stomach acid from vomiting). The following are common signs and symptoms of Anorexia and Bulimia Nervosa:
- Dieting despite being thin
- Obsession with calories or fat content of food
- Lying and/or pretending to eat
- Constant thoughts about food
- Secretive food rituals
- Large weight loss
- Obsession with body image
- Feeling fat despite being very thin
- Denial of being too thin
- Compulsive exercising
- Purging (throwing up or taking laxatives)
- Over eating to the point of physical discomfort
- Secrecy about eating
- Eating large amounts of food in short amounts of time
- Changing from over eating to fasting
- Excessive exercise
- Fluctuations in weight
- Purging after eating
- Obsession with weight
- Obsession with body image
Binge Eating Disorder is another recently identified form of disordered eating that involves the binge eating that characterises Bulimia Nervosa, but without the associated behaviours intended to compensate for the excessive calorie intake. To meet criteria for the disorder, binges should occur at least once per week over a period of at least three months. Whilst Binge Eating Disorder is one of the most commonly found eating disorders among adults, it does not receive as much media coverage as the official diagnosis was only created in 2013 in the most recent version of the Diagnostic and Statistical Manual of Mental Disorders, the DSM-5.
How are eating disorders treated?
Often Cognitive Behavioural Therapy (CBT) is used for treating eating disorders. CBT aims to challenge and modify the internal psychological processes, behaviour patterns and negative thoughts often associated with disordered eating. Whilst this can be helpful temporarily, at times when psychological distress is very high, it can be very difficult for people to implement techniques such as thought-challenging and realistic thinking. Additionally, as eating disorders are often ‘ego-dystonic’ (i.e. the person does not recognise that their patterns of thinking are a problem), asking them to challenge their thoughts can be very difficult, as they cannot see a reason to do so.
Another ‘new-wave’ approach to managing eating disorders is Acceptance and Commitment Therapy (ACT), which aims to observe negative or painful emotions and thoughts with a different attitude involving defusion and acceptance, rather than control attempts and avoidance. These concepts aim to assist people to accept the negative thoughts they have about their weight and food, rather than trying to correct them. This process can then open a person up to engaging in meaningful, values-consistent living whilst carrying the distressing thoughts and feelings with them. Often engaging in more meaningful and values-consistent activities can inadvertently result in reduced psychological distress and reduced disordered eating; though this is not the principle aim of ACT. ACT aims to increase functioning and meaningful engagement in life, rather than symptom reduction.
At times, a person suffering extreme negative health effects of an eating disorder may be hospitalised so that health professionals can control their calorie consumption and restore their physical functioning. At these times, engaging in psychological therapy can be very challenging because the brain is negatively affected by poor nutrition and is therefore not in a fit state to engage in challenging methods of thinking and behaviour change.
Along with these therapies it can be very beneficial for sufferers to have a strong support group to help them through their treatment and aid them to regain a healthier lifestyle.
If you live in the Canberra region and you believe you may be experiencing difficulties with disordered eating, you can contact Strategic Psychology to arrange to see one of our psychologists. We can assist you in identifying the issues that are contributing to maintaining your difficulties and recommend strategies that draw on your strengths and passions in order to achieve optimal social, emotional and occupational functioning.