Eating Disorders

In general terms, eating disorders describe a dysfunctional relationship with food. This relationship can be influenced by one’s desire to meet social norms, manage emotions, control anxiety, or even as a form of self-punishment. Binge eating is associated with a loss of control, whereas restrictive eating is correlated with a desire to increase control through self-imposed rules. Eating disorders can be accompanied by anxiety, mood, trauma or personality disorders. Therapists at Affective Counseling understand the effect eating disorders can have on daily life, health, and overall well-being. Strategies used to assist clients in improving their relationship with food are:

Dispelling negative thoughts about body image
Facing anxieties related to loss of control
Explaining the ramifications of improper diet
Learning and acquiring proper eating habits through intuitive eating (mindfulness of hunger cues)
Developing personally effective coping skills to manage mood and anxiety
Managing medications (with a collaborative psychiatrist)

Anorexia Nervosa

Anorexia is an eating disorder in which a healthy or underweight person has an over-riding fear of gaining weight, a preoccupation with being thin, or a misperception of being overweight. Extreme restriction of food, over-exercising, or an abuse of laxatives in attempts to meet unhealthy or unobtainable weight loss goals are the hallmarks of this eating disorder. Anorexia can develop from a desire to lose weight through dieting (which becomes an obsession), a history of trauma, social pressure to be thin, or as a way to manage anxiety. Although anorexia can affect both genders, it tends to be most prevalent in women in their late teens and early twenties, but can begin as early as elementary school. Symptoms of Anorexia include:

Intense fear of weight gain
Over-exercising
Abuse of laxatives
Significant weight loss or nutritional deficiency
Severe food restriction
Pre-occupation with body size
Poor self-esteem

Bulimia Nervosa

Bulimia describes a pattern of eating that vacillates between binge eating (eating large amounts of food in a short period of time) and compensatory behavior such as purging, abusing laxatives or over-exercising. A binge episode can be triggered by an emotional reaction to an external event or it can be a planned part of one’s daily routine. Additionally, feeling like one has already overeaten can compel an individual to continue to eat because of a plan to compensate through purging after the binge episode. Both binge episodes and compensatory behaviors can lead to feelings of guilt, self-disgust and loss of control. As with Anorexia, there is a preoccupation with body image and a belief that if one changes his or her relationship with food, it will lead to significant weight gain. Symptoms of Bulimia include:

Eating a large amount of food in a short period of time (two hours or less)
Feeling a loss of control while eating
Purging after a binge episode
Abusing laxatives or exercise to compensate for a binge episode
Pre-occupation with body size

Orthorexia

Orthorexia is a term used to describe someone who is obsessive about eating healthy and has little flexibility in food choice. Although orthorexia is not yet listed as a stand-alone diagnosis, it can be a precursor to an eating disorder and can have a negative impact on physical and mental health. Healthy eating is making wise choices about food and having flexibility in what one eats, whereas Orthorexia describes someone who is fearful about eating outside of his or her stringent guidelines. Convincing someone that their eating is “too healthy” can be difficult, since the advice appears to run counter to the consistent social admonition to “eat healthy”. Symptoms of Orthorexia include:

Obsession over the nutritional value of food
Reluctance/refusal to share meals with friends or family if menu cannot be controlled
Rumination over meal planning
Feelings of guilt for eating anything “unhealthy”
Identity is significantly influenced by eating only healthy foods

Eating Disorders