Eating Disorders Awareness

This is National Eating Disorders awareness week. Perhaps you or someone you know struggles with an eating disorder. There are several different types. The ones you are most likely familiar with are Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder. I’ll give a basic description of criteria for each of them, along with how you can help, and treatment options.

Anorexia Nervosa

In order to receive a diagnosis of Anorexia Nervosa from the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM 5) one needs to have a significantly lower weight than is normal for their age or development. An intense fear of getting fat or increase in weight is a hallmark. The person bases their self worth on their weight and has a distorted body image. In addition, they don’t understand the seriousness of their low weight. They may have a restricting type which means there are no purging behaviors. Low body weight is due to lack of food intake and/or excessive exercise. The binge-eating/purging type means the person makes themself vomit, abuses laxatives, enemas or diuretics. There are different levels of seriousness based on their body mass index.

Bulimia Nervosa

Bulimia Nervosa involves periods of eating a larger amount of food than the average person, in a discrete time period (say 2 hours). There is a sense of being out of control with the eating. The person does something to purge, such as make themselves vomit, abuse laxatives, medications, exercise or fast. These behaviors need to occur on a weekly basis for 3 months to receive the diagnosis. The person’s self worth is based on their weight and body image. Again there are different levels of severity based on the number of times per week they engage in these behaviors.

Binge Eating

Binge eating disorder is characterized by eating a larger amount of food than is considered typical for a person in that time frame. They need to engage in 3 of the following 5 criteria. These include eating quickly, eat until they feel uncomfortable, eating when not hungry, or feel disgusted or shameful with oneself after the episode. The person feels a lot of distress with the situation and needs binge on a weekly basis for 3 months. Severity is based on the number of times the person engages in the behaviors.

Challenges in treatment

For those who don’t struggle with an eating disorder, it can be very difficult to understand the challenges that people with eating disorders face. One might just think, just eat more, or just control your portion size. It’s like saying to the alcoholic, just stop drinking. It’s much easier said than done. I might even argue that it’s more difficult than stopping other addictions. The reason being is that we need food to survive, so the person needs to develop a healthy relationship with food. You do not need alcohol to survive. So it would be like saying to the alcoholic, “I want you to drink 2-3 drinks daily.” No one would recommend that an alcoholic do this.

Treatment options

Eating disorders are one of the most difficult things to treat. Anorexia has the highest death rate of any of the mental disorders. There are a variety of different treatments for eating disorders based on the level of severity. We always want to allow the person to be in the least restrictive environment.

We’d want to start out with outpatient therapy. When choosing a therapist, it is important that they have experience with working with people with eating disorders. In outpatient therapy, we will also get you connected with a dietician, and be sure that you are stable medically. The next level of care is intensive outpatient therapy, which may involve a few hours of individual and group therapy daily. If that is not enough, then there is partial hospitalization, which would involve therapy all day during the week. For the most severe cases we would require residential treatment, which is overnight.

How to help

When considering eating disorders awareness, it is important to know that each person is different. They need to be evaluated on a case-by-case basis.

If someone you love has an eating disorder there are ways you can be supportive. You can express your concern for their health and recommend that they talk to someone. Don’t tell them to eat more or diet. This will not be seen as helpful. If the person tells you about it, ask them how you can support them, and then do what they say.

There are several online sources with a wealth of information on eating disorders awareness. These include the National Eating Disorders Association, Houston Eating Disorders Specialists and International Association of Eating Disorders Professionals. There are all kinds of information on treatment and ways to help.

If this is something you or someone you know struggles with, please give me a call at 7113-304-6554.

Take care,

Debbie