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How To Help Someone With An Eating Disorder

There are several different types of eating disorders listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), and each is categorized under the Disorder Class: Feeding and Eating Disorders. They are serious mental illnesses that are loosely characterized by abnormal, irregular eating habits, and an extreme concern with one’s body weight or shape. The three most common eating disorders are anorexia nervosa, bulimia nervosa, and binge-eating disorder. Eating disorders can be debilitating and can adversely affect a person’s emotions, and health, and interfere with one’s ability to adequately function in his or her daily life. According to the National Eating Disorders Association (NEDA), an estimated 30 million U.S. adults will have an eating disorder at some point in their lives. If left untreated, continued malnutrition that occurs with an untreated eating disorder can lead to severe short and long-term consequences. The best way to help someone with an eating disorder is to be able to recognize its warning signs and ultimately encourage them to pursue treatment.

Treatment

Every individual is different, and each person will require a tailored treatment plan to ensure all nuanced needs are met. The treatment plan for an individual diagnosed with an eating disorder will be directly informed by several contributing factors, such as one’s exact diagnosis, how long he or she has been actively engaging in unhealthy eating habits, his or her personal health history, and the presence of any co-morbid disorders. Depending on one’s needs, an eating disorder treatment plan could include any combination of the following components:

  • Cognitive behavioral therapy (CBT): Can be used to help an individual break unhealthy behavioral patterns associated with his or her eating disorder by identifying and replacing dysfunctional patterns.
  • Medications:
  • Anorexia nervosa: The FDA (U.S. Food and Drug Administration) has yet to approve any medication specifically for the treatment of anorexia nervosa.
      • Bulimia nervosa: The only medication that is approved by the FDA for the treatment of bulimia nervosa is the SSRI (selective serotonin reuptake inhibitors) known as Prozac (generically: fluoxetine).
      • Binge-eating disorder: The first medication the FDA approved as a treatment for the binge-eating disorder is called Vyvanse (generically: lisdexamfetamine). Antidepressants such as SSRIs (e.g., Prozac) could be prescribed to reduce the frequency of binge eating episodes. Anticonvulsant medications, such as Topiramate, could be prescribed to reduce the frequency of bingeing episodes.
  • Nutritional counseling: To facilitate weight restoration and body-weight management.
  • Medical care and/ or medical monitoring: To minimize and mitigate possible medical complications that can arise from eating disorders.
  • Dialectical behavior therapy (DBT): DBT can benefit an individual diagnosed with an eating disorder by helping to foster self-management skills, lower stress, reduce anxiety, and learn to control destructive eating behaviors. DBT promotes acceptance and teaches individuals how to live in the present moment and cope with emotional triggers that may otherwise perpetuate unhealthy symptoms and behaviors associated with eating disorders.

The goal of treatment for an individual diagnosed with an eating disorder is to help them find a healthy and sustainable relationship with food. Although eating disorders are life-long conditions, with proper treatment and support, a person can learn to effectively manage their symptoms.

 

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health. As such, please do not use any material provided above to disregard professional advice or delay seeking treatment.

The Most Serious Eating Disorder

eating disorder

Eating disorders are defined by the American Psychiatric Association as “behavioral conditions characterized by severe and persistent disturbance in eating behaviors and associated distressing thoughts and emotions.” There are several different types and each are recognized as chronic psychological conditions listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) under the Disorder Class: Feeding and Eating Disorders. The pervasive symptoms associated with any type of eating disorder can cause adverse physiological consequences and interfere with one’s ability to adequately function in daily life. Still, anorexia, formerly known as anorexia nervosa, is recognized as the most dangerous type of eating disorder because of its high mortality rate. The South Carolina Department of Mental Health assert that twenty percent of people suffering from anorexia will die prematurely due to complications related to their eating disorder.

Anorexia

Anorexia is characterized by “an abnormally low body weight, an intense fear of gaining weight and a distorted perception of weight.” Though anorexia can manifest at any age, experts suggests it most commonly develops during adolescence. The National Eating Disorder Association (NEDA) point to specific risk factors that can increase one’s propensity for developing anorexia, including, but not limited to the following:

  • Dieting and starvation: habitual dieting to the point of starvation can increase a one’s potential for developing anorexia. Studies have shown that starvation impacts one’s brain functioning and one’s ability to make rational decisions. In turn, restrictive eating behaviors are perpetuated and returning to healthy/ normal eating habits become increasingly difficult.
  • Genetics: Individuals with familial history of anorexia and/ or other eating disorders put certain people at higher risk of developing anorexia.
  • Transitions: emotional stress resulting from various life transitions (e.g., new school, move, death of a loved one, etc.) can increase the risk of anorexia.
  • Peer influence: teens going through puberty and adolescence face hormonal changes, increased peer pressure, and often internalize criticisms about appearance, which can put teenagers at a higher risk for anorexia. 

Anorexia is the third most common chronic illness among adolescents. Further, it is considered one of the most lethal psychiatric disorders, carrying a sixfold increased risk of death. 

Signs and Symptoms

Everyone is unique, and as such, an individual struggling with anorexia will present with a distinct set of signs and symptoms. The Mayo Clinic does, however, provide examples of common signs and symptoms associated with anorexia, some of which may include, but are not limited to, any combination of the following:

  • Thin appearance
  • Insomnia
  • Extreme weight loss
  • In adolescents: not making expected developmental weight gains
  • Dizziness and/ or fainting
  • Abnormal blood counts
  • Fatigue
  • Thinning, brittle hair
  • Absence of menstruation
  • Dry and/ or yellowish skin
  • Irregular heart rhythms
  • Low blood pressure
  • Dehydration

Certain behavioral warning signs may be exhibited by an individual struggling with anorexia such as skipping meals, over-exercising, obsessively reading nutritional information, constantly weighing themselves, regularly making excuses not to eat, denial of a problem despite excessive weight loss, and more. Individuals diagnosed with anorexia engage in a cycle of self-starvation that often results in severe malnutrition including a lack of essential minerals and nutrients. When an individual with anorexia becomes severely malnourished, every organ in his or her body can suffer irreparable damage, and without proper treatment anorexia can be life-threatening. 

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health. As such, please do not use any material provided above to disregard professional advice or delay seeking treatment.

What Qualifies As Having An Eating Disorder?

eating-disorder

The National Institute of Mental Health (NIH) defines eating disorders as “serious medical illnesses marked by severe disturbances to a person’s eating behavior.” There are several different types of eating disorders listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) categorized under the Disorder Class: Feeding and Eating Disorders. Eating disorders are complex psychological conditions that are broadly characterized by abnormal, irregular eating habits, and an extreme concern with one’s body weight or shape. Constantly engaging in weight loss and diets that involve severely restricting food intake to the point of continued hunger can contribute to the development of an eating disorder. This way of eating can not only cause adverse effects to one’s energy levels, but it can also impact one’s physical health as it prohibits one’s ability to extract and absorb the needed vitamins, minerals, and nutrients that are innately sourced from consuming food. The different types of eating disorders include: 

    • Anorexia nervosa: is an eating disorder characterized by weight loss and/ or lack of appropriate wait gain in growing children, an inability to maintain an appropriate body weight for one’s age, height, stature, intense fear of gaining weight and a distorted perception of body image (weight and/ or shape). People struggling with anorexia will employ extreme efforts to control their weight and/ or shape, which can significantly interfere with their ability to properly function in their daily life. 
    • Bulimia nervosa: is an eating disorder characterized by a cycle of overeating (bingeing) and compensatory behaviors (purging) in attempts to undo the effects of the binge eating episodes. Purging could include self-induced vomiting, excessively over exercising, and/ or abusing diuretics. 
    • Binge-eating disorder (BED): is an eating disorder characterized by recurrent episodes of compulsively eating abnormally large quantities of food (often quickly) to the point of physical discomfort, without engaging in compensatory behaviors. Often binge episodes are followed with emotions of embarrassment, shame, guilt, and/ or distress. 
    • Rumination disorder: is an eating disorder characterized by repeatedly and unintentionally regurgitating (spitting up) undigested or partially digested food from the stomach, chewing it again and either swallowing it or spitting it out. 
  • Avoidant/ restrictive food intake disorder (ARFID): is an eating disorder characterized by restricting food intake (e.g., eating smaller amounts) and/ or eliminating certain groups to the point of infringing on one’s exposure to and ability to absorb needed nutrients coming from food. 

Eating disorders can be debilitating and can adversely affect a person’s emotions, health, and interfere with one’s ability to adequately function in his or her daily life. 

Signs and Symptoms

Every person is unique and will exhibit a distinct set of signs and symptoms as they relate to the presence of an eating disorder. Furthermore, the type of eating disorder an individual struggles with can influence the signs and symptoms experienced. The Mayo Clinic provides a list of examples of behaviors that could be indicative of an eating disorder, some of which include the following: 

  • Obsessively focusing on healthy eating
  • Skipping meals 
  • Withdrawing from social activities
  • Making excuses for not eating
  • Adhering to an overly restrictive diet 
  • Preparing separate meals when eating in a group instead of eating what everyone else is eating
  • Excessive exercise
  • Constantly checking the mirror and/ or pointing out perceived flaws
  • Using laxatives, herbal weight loss products, and/ or dietary supplements
  • Regularly excusing oneself during meals to use the restroom
  • Eating in secret
  • Expressing disgust, shame, and/ or guilt about one’s eating habits

The combination, severity, and duration of symptoms is influenced by the type of eating disorder present as well as the individual. If left untreated, continued malnutrition that occurs with an untreated eating disorder can lead to severe short and long-term consequences. Although eating disorders are life-long conditions, with proper treatment and support, a person can learn to effectively manage its symptoms.

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health. As such, please do not use any material provided above to disregard professional advice or delay seeking treatment.

What Type Of Therapy Is Best For Eating Disorders?

woman receiving therapy for an eating disorder

Eating disorders are serious mental illnesses. They are characterized by abnormal, irregular eating habits, and an extreme concern with one’s body weight or shape. There are several different manifestations of eating disorders. The various types are listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) under the Disorder Class: Feeding and Eating Disorders. The three most common eating disorders are anorexia nervosa, bulimia nervosa and binge-eating disorder. Eating disorders can be debilitating and can adversely affect a person’s emotions, health, and interfere with one’s ability to adequately function in his or her daily life. If left untreated, eating disorders can result in severe short and long-term consequences. 

Every individual is different and will react distinctly to the array of therapeutic treatment modalities available. The treatment plan for an individual diagnosed with an eating disorder will be directly informed by several contributing factors, such as: the exact diagnosis, how long he or she has been actively engaging in unhealthy eating habits, his or her personal health history, and the presence of any co-morbid disorders. Some of the most frequently relied upon therapeutic treatment methods when treating eating disorders could include, but are not limited to cognitive behavioral therapy, dialectical behavior therapy, and interpersonal therapy.

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) works by addressing one’s thoughts. It holds the basic assumption that one’s thoughts govern one’s feelings, which in turn affects one’s behaviors. Through CBT an individual’s unhelpful cognitive distortions and behaviors are challenged and disrupted, essentially prohibiting one’s ability to maintain dysfunctional eating habits.

Dialectical Behavior Therapy

Dialectical Behavior Therapy (DBT) is recognized as an effective method of treatment for an individual diagnosed with an eating disorder. DBT can help an individual learn useful self-management skills, reduce stress, minimize anxiety, and learn to control destructive eating behaviors. DBT promotes acceptance and teaches individuals how to live in the present moment and cope with emotional triggers that may otherwise perpetuate unhealthy symptoms and behaviors associated with eating disorders. 

Interpersonal Therapy

Interpersonal therapy (IPT) a therapeutic modality that is most often used to treat individuals who suffer from psychiatric disorders such as anxiety disorders, eating disorders, depression, etc. Interpersonal therapy focuses on how a person’s communications and interactions with other people affect one’s own mental health. Through interpersonal therapy an individual will learn to resolve and adjust unhealthy interpersonal problems, resulting in a symptomatic recovery.

When posed with the question: What type of therapy is best for eating disorders? The answer is variable as there are countless factors that must be considered which make it is impossible to provide a definitive answer regarding the universal efficacy of any single type of therapy. In order to provide the most effective treatment, including a variety of different types of therapies into one’s treatment plan may be advantageous.

Disclaimer: 

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health.  As such, please do not use any material provided above as a means to disregard professional advice or delay seeking treatment.

How To Treat Bulimia Through Therapy

woman with bulimia standing on a scale with tape around her ankles

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) lists bulimia nervosa under the Disorder Class: Feeding and Eating Disorders as a complex brain disorder. Bulimia nervosa, also referred to as bulimia, is one of the three most commonly diagnosed eating disorders in America. The Mayo Clinic defines bulimia as a “serious eating disorder marked by binging, followed by methods to avoid weight gain.” Hence, bulimia is essentially characterized by episodes of uncontrolled binging (extreme overeating), typically followed by purging (making oneself vomit). An individual struggling with bulimia may also purge via the misuse of various medications related to weight loss, such as laxatives, diuretics, enemas, and/ or excessive exercise. The episodes of binging and purging is often referred to as a binge-purge cycle. Depending on the individual, eating binges can range from occurring twice a week to several times a day. Bulimia is not solely about one’s weight, but also revolves around one’s self-image. The psychological nuances and physical consequences that can arise from bulimia are what makes it such a complex disorder. The damage that occurs from prolonged malnutrition and the unhealthy cycle of binging and purging can lead to significant short and long-term physiological complications. While bulimia is a chronic disorder, with proper treatment an individual can learn the tools and skills needed to develop a healthy and sustainable relationship with food.

Treatment

Every individual is different and will require some form of customized treatment when it comes to bulimia. There are many different mental health treatment options and distinct forms of therapies used to treat bulimia. The nuanced needs of a person diagnosed with bulimia will greatly inform which psychotherapeutic methods are included in one’s treatment plan. In order to treat bulimia through therapy, a person’s treatment plan could comprise of one or more of the following types of therapy:

  • Cognitive behavioral therapy (CBT) is based off of the notion that one’s thoughts govern one’s feelings, which in turn affects one’s behaviors. According to the Society of Clinical Psychology, “In CBT, the therapist works collaboratively with the patient to disrupt the factors maintaining the binge-purge cycle with the goal to achieve abstinence from these behaviors.”
  • Interpersonal therapy (IPT) is a therapeutic modality that is most often used to treat individuals who suffer from anxiety disorders, eating disorders, depression, as well as other psychiatric disorders, including bulimia nervosa. Interpersonal therapy focuses on how a person’s communications and interactions with other people affect his or her own mental health. Through interpersonal therapy an individual will learn to resolve and adjust unhealthy interpersonal complications, resulting in a symptomatic recovery.
  • Dialectical behavior therapy (DBT) is a type of cognitive behavioral therapy that places greater emphasis on the psychosocial aspect of therapy. DBT can benefit an individual diagnosed with bulimia by helping to foster self-management skills, lower stress, reduce anxiety, and learn to control destructive eating behaviors. The goals of DBT are to help an individual learn to establish healthy coping mechanisms that can be applied to environments that would have otherwise provoke destructive eating behaviors. It helps individuals learn how to reduce emotional reactivity and improve their interactions with others. DBT promotes acceptance and teaches skills to enable an individual to live in the moment and cope with emotional triggers that may otherwise perpetuate the binge-purge cycle and other unhealthy symptoms and behaviors associated with bulimia. 

A treatment plan for bulimia will be carefully tailored so as to effectively accommodate all of the individual’s mental health needs. 

Disclaimer: 

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health.  As such, please do not use any material provided above as a means to disregard professional advice or delay seeking treatment. 

How To Treat Anorexia

anorexia spelled out

Anorexia nervosa, often referred to as anorexia, is listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as an eating disorder. According to the Mayo Clinic, anorexia is “characterized by an abnormally low body weight, an intense fear of gaining weight and a distorted perception of weight.” Though anorexia can manifest at any age, research suggests it most commonly develops during adolescence. Individuals that struggle with anorexia engage in a cycle of self-starvation that often results in malnutrition including a lack of essential minerals and nutrients. The list of adverse short and long-term effects of anorexia is extensive, and without proper treatment anorexia can lead to life-threatening consequences. 

Diagnostic Criteria

Obtaining an accurate diagnosis is essential to the recovery process for any mental health illness. Though the symptoms of anorexia can become visibly evident, a diagnosis of anorexia nervosa is reached through a thorough physical and psychological exam. Further, the evaluating provider considers the diagnostic criteria for anorexia, provided by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). To be diagnosed with anorexia nervosa, according to the DSM-5, the following criteria must be met:

  • Restriction of energy intake relative to requirements, leading to a significantly low body weight in the context of age, sex, developmental trajectory, and physical health. Significantly low body weight is defined as a weight that is less than minimally normal, or for children and adolescents, less than that minimally expected. 
  • Intense fear of gaining weight or of becoming fat, or persistent behavior that interferes with weight gain, even though at a significantly low weight.
  • Disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or persistent lack of recognition of the seriousness of the current low body weight. 

Atypical anorexia is diagnosed when an individual meets the above criteria but despite significant weight loss, is not medically considered underweight. It is important to note that an individual may still be struggling with a serious eating disorder even if all of the DSM-5 criteria for anorexia are unmet. 

Treatment

Every individual is different and will require a tailored treatment plan when it comes to recovering from anorexia. Treatment plans often include a multidisciplinary approach. According to the Mayo Clinic a clinical treatment team for an individual diagnosed with anorexia could include doctors, mental health professionals and dietitians. Depending on the nuanced needs of the individual, the treatment process could include any combination of the following components:

  • Inpatient treatment: intensive, inpatient treatment can help address severe malnutrition and other physical health complications that have developed from one’s eating disorder, settings could include:
    • Hospitalization
    • Inpatient facility
  • Psychotherapy: there are a variety of therapeutic modalities used to help treat individuals with anorexia, such as cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), interpersonal psychotherapy, psychodynamic psychotherapy, creative arts therapies, and more. 
  • Medications: certain medications (e.g. antipsychotic: Zyprexa) can be prescribed to help with weight gain
  • Nutrition counseling: used to help individuals learn how to restore normal eating patterns and teach a healthy approach to weight and food

The Mayo Clinic asserts, “One of the biggest challenges in treating anorexia is that people may not want treatment.” Although anorexia is a considered to be a chronic disorder, with proper treatment an individual can learn how to effectively manage its symptoms and go to on lead a healthy and fulfilling life. 

Disclaimer: 

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health.  As such, please do not use any material provided above as a means to disregard professional advice or delay seeking treatment.