Treatment for Eating Disorders


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What is an Eating Disorder?


Eating disorders are a group of disorders characterized by a change in a persons relationship to food and/or body image. In my experience, I find they can be challenging for patients to deal with in that unlike other activities that patients can avoid, (such as alcohol consumption or gambling), food intake is necessary for survival. Therefore, especially at the beginning of treatment, there can be a lot of struggle with changing behaviors.


Symptoms of Eating Disorders


Anorexia, nervosa- the primary feature is a less than ideal body weight. Patients may do this by either restricting food intake, or by purging via vomiting, excessive exercise, and use of laxatives or diuretics. They have an intense fear of gaining weight or looking obese.  This is a potentially lethal condition (as in the case of singer Karen Carpenter, as severe electrolyte abnormalities, low blood pressure and low heart rate may develop. There are many other physical sequelae as well, including bad breath, development of fine body hair, abdominal distention, muscle aches, fatigue, and cessation of menstruation in women.

Bulimia nervosa- the primary feature of this is binging and compensation. The bingeing is such that patients consume excessive amounts of food over 2 hours, and feel out of control. Like anorexia, the purging occurs purging via vomiting, or nonpurgeing via excessive exercise, fasting or use of laxatives.  When vomiting occurs, dental abnormalities can be found, and electrolyte abnormalities are found in use of laxatives or diuretics. We also can see esophageal tears, reflux, swollen salivary glands,

Binge eating- excessive eating, without compensatory purging. Patients will eating excessive amounts of food over 2 hours, often  faster than usual and feeling out of control, and associated with feelings of shame.


How to Treat Eating Disorders


In terms of treatment, anorexia is different from the others. For patients with anorexia, medical stabilization is of the utmost importance, and sometimes will even occur in an inpatient setting to make sure that vital signs and electrolytes are monitored appropriately. Psychotherapy is also extremely important, as medications do not seem to help with this condition (likely related to the brains functioning in the starvation state). Patients with bulimia nervosa and binge eating disorder often benefit from antidepressants such as prozac and zoloft, and stimulant medications are FDA approved for patients with binge eating disorder as well.


Frequently Asked Questions About Eating Disorders


What qualifies as an eating disorder?


Eating disorders are psychological conditions that cause unhealthy eating patterns. These conditions may start with an obsession with body weight, food, or body shape. Severe eating disorders can have serious health consequences, including death, if left untreated.


Who is most likely to have an eating disorder?


There are many reasons you may struggle with eating. Often, the root of an eating disorder is a history of physical, emotional, sexual, or family trauma, but this isn’t the case for everyone.


Why do I struggle with eating?


Eating disorders are more common in women and girls than in men and boys. Teen girls are most likely to develop eating disorders, but that doesn’t mean boys and men aren’t affected too. One in four children diagnosed with anorexia nervosa is a boy.


Does social media cause eating disorders?


We don’t believe that social media causes eating disorders, but with the amount of time teens spend on social media, it’s easy to see how it can contribute to the development of body image issues. These issues can lay the foundation for an eating disorder.


How do people with eating disorders feel about their bodies?


People with eating disorders place a high value on their body weight and shape when determining their self-worth, while also having negative body image. This combination is a common symptom of many eating disorders.


What is orthorexia?


Orthorexia is an unhealthy fixation on eating healthy foods or adhering to an especially restrictive diet. People with orthorexia obsess about food in a way that interferes with their overall well-being.


Can you choose to have an eating disorder?


Like any other mental illness, an eating disorder is not a choice.


What mental illness has the highest mortality rate?


Anorexia nervosa has the highest mortality rate of any mental disorder due to the physical toll it takes on the body and its chronic nature. Many patients progress through treatment, but relapse into periods of malnutrition, which can cause life-threatening complications.


What is an emotional eater?


An emotional eater is someone who eats as a way to soothe or suppress negative emotions, including sadness, stress, fear, anger, boredom, and loneliness. Daily life stressors and major events can trigger emotions that cause emotional eating. Emotional eating is not the same as an eating disorder, but it can be addressed with psychotherapy.


Are you an emotional eater?


Signs that you may be an emotional eater include having difficulty listening to your body’s natural hunger and fullness signals, eating more than you want or need, having trouble making healthy food choices, and an inability to maintain a healthy weight.