Eating Disorders

This page is information on eating disorders

What are eating disorders?
Anorexia nervosa
Bulimia nervosa
Binge-eating disorder
How are eating disorders treated?
How are males affected?
What is being done to better understand and treat eating disorders?

What are eating disorders?

An eating disorder is an illness that causes serious disturbances to your everyday diet, such as eating extremely small amounts of food or severely overeating. A person with an eating disorder may have started out just eating smaller or larger amounts of food, but at some point, the urge to eat less or more spiraled out of control. Severe distress or concern about body weight or shape may also characterise an eating disorder. Eating disorders are also self perpetuating as often the brain’s need for nutrition demands and dictates the eating pattern so you can become trapped in that vicious cycle.
Eating disorders frequently appear during the teen years or young adulthood but may also develop during childhood or later in life. Common eating disorders include anorexia nervosa, bulimia nervosa, and binge-eating disorder. Eating disorders affect both men and women. It is unknown how many adults and children suffer with other serious, significant eating disorders, including one category of eating disorders. They are real, treatable medical illnesses and can coexist with other illnesses such as depression, substance abuse, or anxiety disorders.

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Anorexia nervosa

Anorexia nervosa is characterised by:
Extreme thinness (emaciation)
A relentless pursuit of thinness and unwillingness to maintain a normal or healthy weight
Intense fear of gaining weight
Distorted body image, a self-esteem that is heavily influenced by perceptions of body weight and shape, or a denial of the seriousness of low body weight
Lack of menstruation among girls and women
Extremely restricted eating.
Many people with anorexia nervosa see themselves as overweight, even when they are clearly underweight. Eating, food, and weight control become obsessions. People with anorexia nervosa typically weigh themselves repeatedly, portion food carefully, and eat very small quantities of only certain foods. Some people with anorexia nervosa may also engage in binge-eating followed by extreme dieting, excessive exercise, self-induced vomiting, and/or misuse of laxatives, diuretics, or enemas.
Some who have anorexia nervosa recover with treatment after only one episode. Others get well but have relapses. Still others have a more chronic, or long-lasting, form of anorexia nervosa, in which their health declines as they battle the illness.

Other symptoms may develop over time, including:

Thinning of the bones (osteopenia or osteoporosis)
Brittle hair and nails
Dry and yellowish skin
Growth of fine hair all over the body (lanugo)
Mild anemia and muscle wasting and weakness
Severe constipation
Low blood pressure, slowed breathing and pulse
Damage to the structure and function of the heart
Brain damage
Multiorgan failure
Drop in internal body temperature, causing a person to feel cold all the time
Lethargy, sluggishness, or feeling tired all the time

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Bulimia nervosa

Bulimia nervosa is characterised by recurrent and frequent episodes of eating unusually large amounts of food and feeling a lack of control over these episodes. This binge-eating is followed by behaviour that compensates for the overeating such as forced vomiting, excessive use of laxatives or diuretics, fasting, excessive exercise, or a combination of these behaviors.People with bulimia nervosa usually maintain what is considered a healthy or normal weight, while some are slightly overweight. But like people with anorexia nervosa, they often fear gaining weight, want desperately to lose weight, and are intensely unhappy with their body size and shape. Usually, bulimic behaviour is done secretly because it is often accompanied by feelings of disgust or shame. The binge-eating and purging cycle happens anywhere from several times a week to many times a day.

Other symptoms include:

Chronically inflamed and sore throat
Swollen salivary glands in the neck and jaw area
Worn tooth enamel, increasingly sensitive and decaying teeth as a result of exposure to stomach acid
Acid reflux disorder and other gastrointestinal problems
Intestinal distress and irritation from laxative abuse
Severe dehydration from purging of fluids
Electrolyte imbalance (too low or too high levels of sodium, calcium, potassium and other minerals) which can lead to heart attack.

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Binge-eating disorder

With binge-eating disorder a person loses control over his or her eating. Unlike bulimia nervosa, periods of binge-eating are not followed by purging, excessive exercise, or fasting. As a result, people with binge-eating disorder often are over-weight or obese. People with binge-eating disorder who are obese are at higher risk for developing cardiovascular disease and high blood pressure. They also experience guilt, shame, and distress about their binge-eating, which can lead to more binge-eating.

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How are eating disorders treated?

Adequate nutrition, reducing excessive exercise, and stopping purging behaviors are the foundations of treatment. Specific forms of psychotherapy, or talk therapy, and medication are effective for many eating disorders. We look at

Individual, group, and/or family psychotherapy
Nutritional counseling
Treating the psychological issues related to the eating disorder
Reducing or eliminating behaviors or thoughts that lead to insufficient eating and preventing relapse
Learning how to identify distorted or unhelpful thinking patterns, recognise, and change inaccurate beliefs, relate to others in more positive ways, and change behaviours accordingly.

I work in London with Weight Matters and it may be more appropriate to see you there depending on your circumstances or under that umbrella. We work with psychology, nutrition and exercise giving a unique blend of insights and skills to help you create change in your life. We work as a therapist, sometimes as a coach and often as an educator. Depending on your needs of  where you are on a particular day, and the goals you wish to achieve, will all have an affect on the way we work with someone.

It is important to start with a clear idea of what you want to achieve, so we will help you clarify your goals and objectives. Motivation and readiness to change are important factors, so we will check in with you to see if now is the right time.

If you keep doing the same things in the same way, you will get the same results. So at the end of each session we will agree some homework tasks for you to complete. Together we will explore the outcomes of the changes you have made. You will learn new things about yourself; your thinking style, your behaviours, how you deal with emotions, how changing nutrition makes you feel, how you deal with stress, and the trigger events and situations in your life that you find challenging.

Our aim is to help you build new skills and tools to help you deal with life challenges, while at the same time helping you move towards your goals. When you have new healthy ways of coping, it becomes easier to let go of distorted coping skills attached to food you don’t want, or need, anymore. Please see the link to weight matters if thats more suitable to your particular issue and if you are unsure we can advise you which is more suitable.

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How are males affected?

Like females who have eating disorders, males also have a distorted sense of body image. For some, their symptoms are similar to those seen in females. Others may have muscle dysmorphia, a type of disorder that is characterised by an extreme concern with becoming more muscular. Unlike females with eating disorders, who mostly want to lose weight, some males with muscle dysmorphia see themselves as smaller than they really are and want to gain weight or bulk up. Men and boys are more likely to use steroids or other dangerous drugs to increase muscle mass. Although males with eating disorders exhibit the same signs and symptoms as females, they are less likely to be diagnosed with what is often considered a female disorder.

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What is being done to better understand and treat eating disorders?

Researchers are finding that eating disorders are caused by a complex interaction of genetic, biological, behavioral, psychological, and social factors. But many questions still need answers. Researchers are using the latest in technology and science to better understand eating disorders. One approach involves the study of human genes. Researchers are studying various combinations of genes to determine if any DNA variations are linked to the risk of developing eating disorders. Neuroimaging studies are also providing a better understanding of eating disorders and possible treatments. One study showed different patterns of brain activity between women with bulimia nervosa and healthy women. Using functional magnetic resonance imaging researchers were able to see the differences in brain activity while the women performed a task that involved self-regulation (a task that requires overcoming an automatic or impulsive response)
Researchers are studying questions about behavior, genetics, and brain function to better understand risk factors, identify biological markers, and develop specific psychotherapies and medications that can target areas in the brain that control eating behavior. Neuroimaging and genetic studies may provide clues for how each person may respond to specific treatments for these medical illnesses.


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