Eating disorders are serious mental health disorders with severe and life threatening medical and psychological consequences if untreated. They are not issues of willpower or methods of dieting but potentially deadly diseases that require professional medical and therapeutic treatment and support.
An eating disorder treatment center should offer clients everything necessary to manage the symptoms experienced due to the eating disorder as well as any and all co-occurring disorders (e.g., substance abuse, depression, anxiety, medical disorders, etc.). Treatment should offer clients access to everything they need to find stability and manage their symptoms. To that end, therapies and treatment should address all the areas of life impacted by an eating disorder, including:
Clients are encouraged to seek an eating disorder treatment program that is well-rounded in nature at the earliest signs of a disorder. Without treatment, eating disorders can be fatal. They can lead to a range of chronic and acute disorders that diminish quality of life and that can be life-threatening in some cases. Therapy, support from peers and staff, family support, and in some cases, certain medications can all contribute to the client’s ability to function without resorting to disordered eating habits, to get to and maintain a healthy weight, and to create a new life in recovery.
The signs and symptoms of an eating disorder will vary according to the specific disorder and the individual experiencing the symptoms. In general, however, those who are struggling with an eating disorder often:
Anorexia nervosa has been identified as the most lethal mental health disorder. It is defined by a fear of weight gain, and those who struggle with the disorder may believe they are fat when they are underweight, exhibit an extreme distaste for anyone who is overweight, and significantly limit their caloric intake to the point of starvation. Extreme limitation of calories can quickly result in malnutrition, chronic fatigue, mood swings, and the failure of organs that depend upon certain nutrients to function. If untreated, the disorder can be deadly; in fact, people living with the disorder have a six-fold increased chance of death over the general population.Signs and symptoms of anorexia may include:
Bulimia nervosa is a disorder characterized by binge eating followed by feelings of a loss of control and an attempt to regain that control through quickly ridding the body of the unwanted calories. People living with bulimia may attempt to purge calories and prevent weight gain caused by binge eating through such means as self-induced vomiting, use of laxatives, excessive exercise, or a combination of behaviors.
Bulimia is cyclical pattern of behavior. Some people living with the disorder may binge and purge daily while others may only do so a few times each week. Additionally, some people live with both anorexia and bulimia. They significantly limit their intake of calories for a period of time then take part in a binge session, eating a large amount of food, and then take measures to attempt to stop the absorption of those calories. Unlike people living with only anorexia, however, those struggling with bulimia may be at a normal weight for their height, underweight, or overweight.Signs of bulimia include:
Additionally, people living with bulimia may have damaged tooth enamel, swollen glands, an inflamed throat, and reflux and/or dehydration.
Binge eating disorder (BED) is the most commonly diagnosed eating disorder in the country and is defined by eating large quantities of food ” as much as 5,000-15,000 calories ” in a single sitting, then experiencing feelings of guilt and shame as a result. Binge sessions may occur after a period of stringent caloric restriction or dieting ,and they are often characterized by feelings of a loss of control.
Those who struggle with binge eating are often overweight or obese and, as a result, are likely to struggle with medical problems such as heart disease, some cancers, high blood pressure, gallbladder disease, high levels of “bad”cholesterol, and/or type II diabetes.
Some signs and symptoms of binge eating disorder include:
People who struggle with binge eating may also be living with another eating disorder or display other disordered eating habits.
When a person’s unique combination of disordered eating habits does not add up to bulimia or anorexia, the diagnosis was “Eating Disorder Not Otherwise Specified”(EDNOS) until the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was updated. Currently, EDNOS is not a valid diagnosis. Rather, the term “Other Specified Feeding or Eating Disorder”(OSFED) is used to diagnose those who are living with a feeding or eating disorder that is intrusive in their lives emotionally and/or physically, causing distress or impairment, but does not fit the diagnostic criteria of anorexia or bulimia. In some cases, the person’s experience may be similar in nature to that of someone living with anorexia or bulimia but vary just enough to be outside the diagnostic parameters for those disorders.
According to the National Association of Anorexia Nervosa and Associated Disorders (ANAD), there are five subtypes of OSFED. These include:
Additionally, other disordered eating behaviors that have been reported by patients seeking treatment that may be classified as an OSFED include exercise addiction (counting calories and obsessively exercising to ensure that more calories are burned than ingested to the point of exhaustion and despite illness or injury) and orthorexia (an unhealthy commitment to “healthy”eating that ultimately overly restricts intake of necessary nutrients or calories), among others.
Treatment for an eating disorder of any nature should focus on the specific triggers that a person faces and incorporate a range of therapeutic options and interventions, including any combination of the following:
The American Psychological Association (APA) supports a range of therapeutic treatment options for people who are living with bulimia and/or anorexia. Because the driving forces behind these disorders (e.g., poor body image, low self-esteem, depression, anxiety, and peer pressure) are often just as important as the manifestation of the disorder in terms of the direction of treatment, the focus of therapies for both conditions may be similar though the structure may be different.
In past years, treatment professionals have removed family from the equation when helping someone to learn how to manage anorexic behaviors, especially in the case of young people and their parents. In many cases, parental influence and expectations play a role in the young person’s development of anorexia, thus it was thought that by removing that influence the person in treatment would have a greater chance at making progress in recovery.
Today, however, most treatment options emphasize family support and recognize it to be one of the most important factors in a person’s ability to learn how to manage eating behaviors. One research-based, short-term treatment for anorexia is called the Maudsley approach. Essentially a family-based treatment, family members, the person living with anorexia, and therapists all get together for a picnic meal in one of the early sessions. The goal is to educate therapists on eating habits and rituals in the family and family members’ attitudes toward eating while giving therapists the opportunity to help family members better understand how they can empower their loved one to eat more healthfully.
In following sessions, family members have the chance to discuss what they have tried in the past in terms of helping their loved one to engage in healthy eating behaviors at mealtime ” what has worked and what hasn’t. This treatment approach also empowers the person’s sense of independence in self-management of eating while learning how to manage stressors in life that may contribute to the urge to limit caloric intake.
Interpersonal therapy assists people in recovery in working on the quality of their relationships with other people. With a shift toward more realistic expectations of what a relationship can and should be and improved communication skills, it may be possible to have stronger relationships that are less stressful, which in turn make it easier to avoid engaging in disordered eating habits.
Like treatment for anorexia and bulimia, treatment for binge eating disorder should include a range of treatment options. Goals for BED recovery will vary based on the needs and desires of the client, but may include:
Both inpatient and outpatient treatment options may be appropriate for the treatment of BED. Prospective clients are encouraged to talk to potential treatment centers in advance to learn more about the specific treatment options provided by each program and to determine which style and type of treatment will best suit their needs.
For example, anorexia can contribute to the development of heart palpitations, slowed heart rate, low blood pressure, and heart failure while bulimia can contribute to the development of a weakened heart muscle, low blood pressure and pulse rate, irregular heartbeat, and heart failure. Additionally, binge eating disorder can cause high blood pressure, high cholesterol, and heart disease.
According to a study published in JAMA Pediatrics, an estimated one in three young males struggle with body image and at some point in their lives engage in one or more disordered eating habits as a result.
Eating disorders take a heavy toll on the body, and it doesn’t take long for the effects of certain disordered eating habits to cause the person to need medical care and treatment. According to the National Institute of Mental Health (NIMH), typical treatment for someone in recovery from an eating disorder will include medical care that provides:
In some cases, medication may be recommended. For example, if symptoms of depression are contributing to the eating disorder, antidepressants may be recommended. This will vary from patient to patient and may not be required for the long-term. Additionally, hospitalization may be required initially in order to stabilize the patient.
After physical stabilization and management of co-occurring mental health symptoms, the goal of eating disorder treatment is often to connect the client with a range of skills that will empower the ability to avoid engaging in disordered eating habits. This means learning new coping mechanisms that are healthy and serve to satisfy the need previously met by engaging in disordered eating habits. Because each person may have a different reason for bingeing, purging, over-exercising, or engaging in disordered eating patterns, different coping skills may be appropriate and effective. Some possible examples include:
Depending upon the nature of the client’s struggle with disordered eating, fitness programs may be implemented differently and with a different focus. For example, if someone struggles with over-exercising or attempts to purge calories ingested in a binge by exercising excessively, then the focus may be on gentle fitness that promotes heart health and emotional wellness over intensive calorie burn.
On the other hand, if a client is struggling with obesity due to binge eating and does not regularly exercise at home, the focus of a fitness program in recovery may be on learning how to make a habit of safe exercise that is gentle on the joints and the heart as the person begins the process of getting to a healthy weight.
It is not uncommon for a client to struggle with both an eating disorder and a substance abuse problem. In fact, the disorders often go hand in hand. For example, someone who struggles with anorexia or bulimia may attempt to curb appetite and limit caloric intake or boost metabolism by taking stimulant prescription drugs like Adderall or stimulant street drugs like crystal meth or cocaine. On the other hand, someone attempting to micromanage body fat may binge and purge or heavily limit caloric intake while also abusing performance-enhancing drugs like steroids.
Unfortunately, the abuse of illicit substances will only exacerbate the medical issues caused by disordered eating habits and potentially add a full-blown drug or alcohol addiction into the mix. When this occurs, it is important that the client not only seeks immediate treatment but also that treatment is sought at a center that can comprehensively treat both issues simultaneously. Learning how to manage triggers for drug and alcohol abuse while also learning how to manage triggers for disordered eating behaviors can be accomplished at the same time, allowing clients to grow and progress on every level and leaving them better equipped to manage sobriety as well as a new and improved relationship with food and eating.
Absolutely. There are support groups that are specific to certain eating disorders as well as support groups designed to strengthen the community of those who struggle with disordered eating habits in general. ANAD offers a directory of local support groups searchable by state for those who would like to find out more about the meetings available to them locally or who are traveling. Additionally, there are a number of 12-Step meetings dedicated to supporting people in recovery from eating disorders, including:
Also, in addition to in-person support groups, there is a range of online support groups and forums dedicated to helping people to connect with others in recovery any time of the day or night. No matter what type of support group is chosen, regular attendance can provide a client in recovery with:
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