Focus

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Focus on Eating Disorders

By Nancy Calloway, M.S.; M.A.; LPCC

Eating disorders have the highest mortality rate of any mental health diagnosis in developed world. Anorexia Nervosa and Bulimia Nervosa affect increasing numbers of Christian and non-Christian families alike throughout the United States. Societal definitions of beauty based on a thin idealized body type continue to contribute to the ever expanding numbers of young women who are dissatisfied with their bodies. Fortunately research has shown that eating disorders can be effectively treated. Recovery is possible.

Eating disorders occur for many different reasons, but almost all begin with an attempt to lose weight. Associated factors such as having low self-esteem and having one or more significant rejection experiences are also common predisposing factors. Some individuals with eating disorders have a history of abuse, but not all do. About 95% of the individuals suffering from eating disorders are female.

Eating disorders are characterized by a disordered relationship with food. Engaging in eating disorder rituals, strict calorie counting, binging on food, or throwing up food (purging) can become the central focus of life - frequently taking the place of normal activities and relationships. Eating disorder behaviors provide a sense of being in control; however, these very behaviors end up controlling the individual. Obsessive thoughts about food, weight and body image preoccupy the mind, and the constant drive for thinness becomes a main goal in life. Self-esteem is dependent on following the eating or weight plan successfully. Self-disgust, shame and guilt result from failure to successfully follow the plan.

Eating disorder thoughts and feelings are often triggered by things such as looking in the mirror, trying on clothes, eating, comparing one’s body to others, and by thoughts regarding, food, body image or weight. Although eating disorders begin for many different reasons, once established, they are maintained by fears and false beliefs. Sometimes the specific thoughts associated with these fears are below the surface of conscious awareness.

Cognitive Behavioral Therapy (CBT) is a well-researched method that has proven effective as a counseling technique for helping individuals recover from eating disorders. It involves looking at the specific underlying cognitions (unhealthy and untrue thoughts and fears) that are present and replacing them with healthy, true thoughts. Small behavioral adaptations are agreed upon between the therapist and patient. The patient experiments with these changes during the week, and keeps track of the thoughts and fears that surface. Counseling focuses on assessing the truth and healthiness of these thoughts. Gradually false thoughts and fears are replaced by true and healthy thoughts about food, body, and weight.

Because eating disorders are often accompanied by anxiety and depression, accurate identification and diagnosis of eating patterns and their associated psychological states is the first step in treatment. At our clinic, an eating disorder inventory is typically administered during or following the first therapy session to assess the frequency, duration and degree of the problem. Medication is often helpful along with therapy as the most effective course of treatment. If needed, medication can be obtained from your own physician or by making an appointment with the clinic psychiatrist or psychiatric nurse practitioner.