Treatment for Eating Disorders
Eating disorders are characterized by persistent abnormal, disturbed eating habits. People with eating disorders tend to be obsessed with food, body weight, and body image. The most common eating disorders are anorexia nervosa (anorexia), bulimia nervosa (bulimia), and binge eating disorder while lesser known disorders include rumination disorder, avoidant/restrictive food intake disorder, and pica. Any eating disorder can cause physical or psychological health problems and can be life-threatening. Those suffering with eating disorders may have accompanying anxiety, depression, and substance abuse issues. The earlier an eating disorder and co-occurring disorder is detected and treated, the greater the chance for recovery.
Different Types of Eating Disorders
Anorexia nervosa (anorexia) is an eating disorder with potentially deadly consequences. Those suffering with anorexia have an abnormally low body weight but are convinced that their body, or a part of their body, is too fat. This distorted body image manifests into an extreme fear of gaining weight and causes sufferers to avoid weight gain at all costs. Not only do those with anorexia strictly limit food intake, they may also exercise excessively, use laxatives, enemas, diuretics, appetite suppressants or weight loss supplements, or vomit after eating. Over time these actions can cause severe, even life-threatening, consequences, including starvation. Those with anorexia view even the smallest weight gain as a personal failure.
Signs and symptoms of anorexia:
Behavioral and psychological signs of anorexia may include repetitive patterns when eating, such as cutting food into tiny pieces or excluding certain food groups, constant preoccupation with dieting and calories, and depression, sometimes with suicidal thoughts.
Physical warning signs of anorexia:
- Sudden, significant weight loss (skipping meals, liquid diet, laxatives)
- Bowel problems (constipation, bloating, abdominal pain, acid reflux)
- Dry, thin skin, blemishes, rashes
- Brittle hair, nails, and bones (can develop osteoporosis)
- Infrequent or absent menstrual periods (in females who have reached puberty)
- Growth of fine, downy hair over body
- Anemia, muscle weakness, lethargy (dizziness and feeling faint can occur)
- Heart problems, may include leaking heart valves, low BP, abnormal heart rhythms, slow pulse
- Drop in internal body temperature, causing a person to feel cold all the time
Many people with eating disorders also suffer from mental disorders or physical illness. These may contribute to anxiety, obsessive behavior, substance abuse, or other serious physical issues. It is important that co-occurring disorders are part of any treatment plan.
Like anorexia, bulimia nervosa (bulimia) is an eating disorder that can cause life-threatening complications. Bulimia is characterized by eating a large amount of food at one time – bingeing – and then purging the body by inducing vomiting to get rid of unwanted calories. Excessive exercise, fasting, and use of laxatives and diuretics may also be used to expel calories. Those suffering from bulimia often restrict food intake at certain times of the day, only to binge eat and purge later. Like those with anorexia, bulimics have an intense fear of weight gain, a negative self-image, and are overly critical of themselves for perceived personal failings. While those with anorexia are abnormally thin, sufferers of bulimia are usually at or slightly above a normal weight for their age and gender.
Signs and symptoms of bulimia nervosa:
Behavioral and psychological signs of bulimia may include compulsiveness, self-harm, anxiety, sadness, fear, guilt, mood swings, depression, and low self-esteem. People with bulimia often eat in secret, attempting to hide eating behaviors that cause them to feel ashamed.
Physical warning signs of bulimia include:
- Severe dehydration
- Frequent use of bathroom after meals
- Inflamed esophagus
- Reddened fingers
- Swollen cheeks
- Irregular or absent menstruation
- Dental problems, like tooth decay, bad breath, dry mouth
- Heartburn or bloating
- Intestinal distress and irritation from laxative abuse
- Kidney problems from diuretic abuse
Binge Eating Disorder
Unlike bulimics, those suffering from binge eating disorder don’t purge or exercise excessively to rid the body of calories. They do feel a lack of control over their eating, eat rapidly, and often continue to eat even after they feel full, leading many to be overweight or obese. As with bulimia, those suffering from binge eating disorder tend to hide their behavior by binge eating in private. Depression, self-loathing and guilt are often felt after binge eating. Binge eating disorder may be diagnosed when it occurs at least once a week for six months.
This disorder is not related to anorexia, bulimia, or binge eating disorder, and is most often seen in infants or those diagnosed with an intellectual disability. Rumination disorder is defined as repeatedly bringing up, or regurgitating, food that had been swallowed, then re-chewing and re-swallowing or spitting out the food. The person exhibiting the behavior does not retch or express disgust and may not be aware they are doing it. This disorder may be diagnosed if it persists regularly for at least one month and can result in malnutrition.
Avoidant/Restrictive Food Intake Disorder (ARFID)
Individuals diagnosed with ARFID have little interest in eating, avoid foods with certain colors, textures or smells, and may be abnormally concerned with choking. Because of this, weight loss, nutritional deficiencies, and health problems can result.
Pica is characterized by the consumption of nonfood, nonnutritive items like hair, paper, soap, pebbles, chalk, and soil on a regular basis. Health complications such as bowel obstructions and infections can occur. As with rumination disorder, pica appears to be more common among people with intellectual disability. It is diagnosed when the behavior has been consistent for at least one month.
How are Eating Disorders Treated?
Eating disorders are treatable medical illnesses. Once the disorder is diagnosed, along with any co-occurring disorders such as anxiety, depression, or substance abuse, the treatment plan can be formulated.
As eating disorders usually have physical, psychological and emotional components, a multi-treatment plan is most effective. The nutritional deprivation caused by certain eating disorders often results in severe, potentially deadly, medical issues making medical oversight and nutritional counseling an essential cornerstone of the recovery plan. Psychological support is also key and may be in the form of individual or group therapy and may include family counseling. If the disorder has progressed to life-threatening levels, hospital-based care or a residential based treatment facility may be necessary.
It’s estimated that approximately half of those with eating disorders also struggle with substance abuse. Bulimia and binge eating disorder have the highest risk for co-occurring substance abuse disorder, but it can happen with any eating disorder. Dependence on laxatives and diuretics is also common with many eating disorders and can lead to addictive behavior. Eating disorders involving substance abuse or addiction to substances like laxatives are best addressed by addiction specialists.
Seeking Professional Help
At Midwest Recovery Centers we believe in our extended care treatment model. We know it works. Our multi-phasal program is staffed by addiction specialists and includes medical oversight, individual and group counseling, 12-step program, family counseling, and aftercare. We guide our clients to a deep understanding of their own addictive behavior and help them develop a personal recovery plan. Through therapy, peer and staff support, and medical and nutritional guidance, we assist our clients toward a healthy weight. At the same time, we are treating depression, low self-esteem, distorted body image, and substance abuse or other co-occurring disorders, as treating all disorders concurrently has shown to be the most effective.
Our family program provides education, counseling, and support for families as they go through the recovery process with their loved one. Our aftercare program reinforces the principles, behaviors and tools learned throughout the treatment program. The aftercare program helps minimize risk of relapse and offers continuing support to our clients.
Reviewed and Assessed by
Taylor Brown, B.A.Com., MAADC II
Tim Coleman, M. of Ed.