Eating Disorders 101

Hi All,

In honor of mental illness awareness week, I want to include a blog post that focuses on one of my specialities that I address in my Danville counseling practice, eating disorders. I hope this post helps to shed some light on these often misunderstood disorders.

Disordered eating is prevalent in our culture, and if you are struggling with an eating disorder and/or body image issues you are not alone:

  1. Up to 24 million people of all ages and genders suffer from an eating disorder in the US
  2. Eating Disorders have the highest mortality rate of any mental health disorder
  3. 90% of American women (and girls are dissatisfied with their appearance)
  4. 81% of 10 year olds are afraid of getting fat

With any mental health disorder, symptoms can range between mild to severe. When we talk about something being a disorder, it means that these symptoms are significantly getting in the way of someone's school life, family life, work life, friend life, and/or posing safety risks. And just to be sure, because someone demonstrates “red flag” signs of disordered eating does not mean they have an eating disorder. To get an accurate diagnosis you need to see a medical or mental health professional who can accurately diagnose you.

There are 3 types of eating disorders

Anorexia Nervosa: (restricting type/binge-purge type): Restriction of food leading to a significantly low body weight // Intense fear of gaining weight or becoming fat, even though they are underweight //They often have a distorted perception about their size (thinking they are fat when they are clearly underweight)

  • If any of you have seen Netflix's movie "To the Bone" the main character Ellen would be diagnosed with Anorexia. Despite being severely underweight, she continues to restrict her food intake and overexercise because she is afraid of getting fat. 

Bulimia Nervosa: Eating a large amount of food in a short period of time // Experiencing a lack of control // Recurrent compensatory behaviors to prevent weight gain (fasting, purging, laxatives, excessive exercise) // Occurs 1x per week for 3 months // Self evaluation significantly influenced by body shape/size

  • Someone who is struggling with bulimia has a pattern of binging-eating large quantities of food in a short span (around a couple of hours) and then tries to compensate for the binge by expelling the food in some manner whether it be by throwing up, overexercising, or taking laxatives or diuretics. The binge is started usually to cope or numb out uncomfortable negative emotions, but after the binge, guilt and regret are often felt so they expel  in some way, but this also creates feelings of shame because these compensatory behaviors are looked down upon as well.

Binge Eating Disorder: Eating a large amount of food in a short period of time // Lack of control over eating // At least 3 of the following: eating rapidly, overly full, eating when not hungry, guilty/ depressed afterwards, marked distress regarding the behavior // 1x per week for 3 months 

  • Binge eating disorder is similar to Bulimia except that there is no purging involved. Again someone binge-eats often to cope or numb out from strong negative emotions and then experiences a strong sense of guilt, shame, or regret afterwards. In a binge, there is a sense of not being able to control the consumption. 

There is another disorder called Other Specified Feeding or Eating Disorder, and this diagnosis is a catch all for any eating disorder characteristics that cause significant impairment in someone's life, but does not meet full criteria for the other 3 diagnoses. For example, someone who has experienced significant weight loss, but weight is within normal range or someone who displays Bulimia traits of binging and purging but only does it 1x per month.

So I described a lot of what disordered eating is, but you may ask: What is “ordered eating” or “non disordered eating”? 

The philosophy that I along with many other eating disorder professional subscribe to is:

All foods fit, everything in moderation, balance and variety. The goal is to eat intuitively, meaning that you trust you body and it’s needs rather than sticking to eating a certain amount of calories, labeling foods as good and bad, or eat whatever is in sight just because it is there. This can often be very difficult for a lot of us because we are bombarded with messages about foods being labeled as "good foods" or "bad foods".

Eating disorders are caused and maintained by a multitude of factors and it not just about eating and weight. Yes, eating disorders can be triggered by someone trying to meet a pressure to be a certain weight or look like society’s ideal body type or to avoid teasing/bullying about their weight/body size, but they are often maintained or get stronger because they help the person numb out from or manage emotional pain. If our mind/bodies are focused on food, then we do not have to focus on our loneliness, anxiety, or shame. The eating disorder continues because at least in the short term, the pain is decreased, but in the long-term cause bigger problems. So telling someone to "just eat" or "stop eating so much" does not work. Yes, the eating patterns need to be monitored, but treatment for someone with an eating disorder also has to get to the underlying causes and pain and that is driving the disorder, and help the person find new ways to handle and manage the emotional pain. 

In addition to giving you all some information about eating disorders and a little bit about the way that I treat them, I wanted to list some resources and recommendations if you believe you might be struggling with disordered eating or may have someone you care about that is struggling:

  • Find someone you trust (maybe a close friend or family member, or school counselor) and reach out: you do not have struggle alone. 
  • Get connected with a trusted medical professional (pediatrician, doctor, nurse) as well as mental health professional to address both the physical and emotional symptoms
  • Be there for a friend or family member who may be struggling with disordered eating. You don’t have to fix them. Listening to them and not jumping to conclusions or assumptions goes far in supporting them. Be curious, asking questions like how are you doing? What are you experiencing? How can I support you? Demonstrate that it is okay to talk about their struggles and that you are not going to judge them
  • Help them get connected with a professional who has knowledge about treating eating disorders. A pediatrician, doctor, nurse or a counselor specializing in disordered is a good place to start

 Resources:

Free, confidential eating disorder screening or www.eatingdisorderevaluation.com

NEDA (National Eating Disorders Association)

Helpline: 1-800-931-2237 (M-Th 9am-9pm, F 9am-5pm)

Crisis Line: Text NEDA to 741741

*Shylah Blatt MA, LMFT is a licensed Marriage and Family Therapist and owner of Whole Family Counseling, located in Danville, CA, serving Danville, San Ramon, Dublin, Pleasanton, Castro Valley, Walnut Creek and surrounding areas. In her Danville counseling practice, Shylah specializes in providing counseling and therapy services for children, teens, families, and adults experiencing issues related to depression, anxiety, stress, life transitions, and disordered eating.

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