Eating disorders are way more common than one may think. Its signs, based on the type of disorder, can be extremely evident or incredibly discrete, but their consequences are similar in how damaging they can be to a person’s mental and physical health. There are many reasons why people suffer from eating disorders and statistics[1] show that “70 million people internationally live with eating disorders” and that number continues to increase.
This makes eating disorders a serious issue that need medical and psychological intervention in order to be treated.
These disorders can also be indicators of other health conditions that have gone undiagnosed or that haven’t been given sufficient attention by either the patient or their health providers. Some of the reasons why people develop eating disorders or are prone to disordered eating include differences in brain structure and biology[2], as well as certain personality traits like perfectionism and impulsivity[3].
Our relationship with food can be very complex and it may vary drastically from one person to another. Although food is our main energy source and a well-balanced diet allows us to lead a healthy lifestyle, the mere idea of eating can have different connotations and the association it has with negative feelings or behaviors is way more common than we may think.
Coming to terms with having an eating disorder can be a very difficult process for those who are suffering from it because its causes go beyond superficial assumptions. Our team at LIMARP®, led by Dr. Liza María Pompa González, is equipped with mental health professionals in order to help our patients reach their health goals and guide them throughout their journey. There are several types of eating disorders and all of them are complex, meaning that their root cause may vary from patient to patient; in order to identify and treat them, we recommend you speak with licensed professionals to avoid self-diagnosis.
In this article, we’ll take a look at the different types of therapy designed to treat eating disorders.
As always, we’d like to remind you that every case or situation is different, and if you’re struggling with any type of disorder, we encourage you to seek professional help or to talk to your doctor so that they can help you find the therapy that’s right for you.
Understanding Eating Disorders
First, it’s important to know how to identify an eating disorder. According to the National Alliance on Mental Illness[4], eating disorders are illnesses that affect or impact a person’s relationship with food and body image, which makes them have excessive thoughts of food, body weight or shape, and how to control their food intake. Some of the causes for eating disorders include the effects of another mental illness, genetics, unhealthy exposure to media, negative body image, and trauma; it’s safe to say that society’s standard for beauty has also played a huge role in the development of eating disorders, since thinness is often encouraged and sought, regardless on how unhealthy the methods to achieve this may be.
There are several types of eating disorders, like anorexia nervosa, bulimia nervosa, and binge eating disorder, among others. The symptoms for each eating disorder vary according to the type a person may present, but what they do have in common is the dangers that they pose to their overall health. If an eating disorder goes untreated, it can result in death; in fact, studies have concluded that these disorders are some of the most dangerous mental illnesses[5].
Signs and Symptoms of Eating Disorders
Before diving into the available therapy for eating disorders, we’d like to provide more information about the signs and symptoms[6] of different eating disorders, such as anorexia nervosa, bulimia nervosa, binge eating disorder, and avoidant restrictive food intake disorder.
Anorexia Nervosa
Anorexia nervosa is a condition where people avoid food, severely restrict food, or eat very small quantities of only certain foods. They also may weigh themselves repeatedly and even when they’re dangerously underweight, they may see themselves as overweight.
There are two types of anorexia nervosa: restrictive and binge-purge. When it comes to the restrictive type of this eating disorder, people severely limit the amount and type of food they consume; while in the binge-purge type, people also greatly restrict the amount and type of food they consume.
In addition, they may have binge-eating and purging episodes, which means that they eat large amounts of food in a short time, followed by vomiting or using laxatives or diuretics to get rid of what was consumed.
Anorexia nervosa can be fatal. It has an extremely high death rate compared with other mental disorders. People with anorexia are at risk of dying from medical complications associated with starvation and suicide is the second leading cause of death for people diagnosed with it.
Symptoms for this type of eating disorder include:
- Extremely restricted eating
- Extreme thinness
- Intense fear of gaining weight
- Distorted body image
- Thinning of the bones (osteopenia or osteoporosis)
- Mild anemia and muscle wasting and weakness
- Brittle hair and nails
- Dry and yellowish skin
- Growth of fine hair all over the body (lanugo)
- Severe constipation
- Low blood pressure
- Slowed breathing and pulse
- Damage to the structure and function of the heart
- Brain damage
- Multi-organ failure
- Drop in internal body temperature, causing a person to feel cold all the time
- Lethargy, sluggishness, or feeling tired all the time
- Infertility
Bulimia Nervosa
Bulimia nervosa is a condition where people have recurrent and frequent episodes of eating unusually large amounts of food, while feeling a lack of control over them. This is followed by behavior 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 this eating disorder may be slightly underweight, normal weight, or over overweight.
Symptoms for this eating disorder may include:
- Chronically inflamed and sore throat
- Swollen salivary glands in the neck and jaw area
- Worn tooth enamel, as well as increasingly sensitive and decaying teeth
- Acid reflux disorder and other gastrointestinal problems
- Intestinal distress and irritation from laxative abuse
- Severe dehydration from purging of fluids
- Electrolyte imbalance, which can lead to stroke or heart attack
Binge Eating Disorder
This eating disorder consists of eating unusually large amounts of food in short periods of time without control, meaning that people dealing with this disorder tend to eat when they’re not hungry or when they have grown uncomfortably full. Unlike other eating disorders, like anorexia or bulimia, people with binge eating disorder don’t restrict calories, resort to purging, or overexercise to compensate for the excess consumption of food. Because of this, many of them may be overweight or obese and they become more at risk of heart diseases, type 2 diabetes, or having a stroke.
Some symptoms of binge eating disorder include:
- Eating fast during binge episodes
- Eating alone or in secret to avoid embarrassment
- Feeling distressed, ashamed, or guilty about your eating
- Frequently dieting, possibly without weight loss
Avoidant restrictive food intake disorder
Avoidant restrictive food intake disorder (ARFID) is an eating disorder where people limit the amount or type of food eaten. Unlike anorexia nervosa, people with ARFID do not have a distorted body image or extreme fear of gaining weight. Many children go through phases of picky eating, but a child with ARFID does not eat enough calories to grow and develop properly, and an adult with ARFID does not eat enough calories to maintain basic body function.
Symptoms for this type of eating disorder include:
- Dramatic restriction of types or amount of food
- Lack of appetite or interest in food
- Dramatic weight loss
- Upset stomach, abdominal pain, or other gastrointestinal issues
- Picky eating that gets progressively worse
Therapy for Eating Disorders
In order to treat any of the eating disorders we covered in this article, there are different types of therapy that can help patients overcome their disorders and lead a healthier lifestyle. It’s important to talk to a mental health professional to ensure that the patient is receiving the right therapy, as well as to make sure that it’s working and carried out properly.
Here are some of the therapy available options to treat eating disorders[7]:
Cognitive behavioral therapy
Cognitive behavioral therapy (CBT) and enhanced cognitive behavioral therapy (CBT-E) aims to identify the thought patterns and beliefs that contribute to an eating disorder.
These could include thoughts or beliefs that are associated with things such as food, weight, body shape, and appearance. Once these thoughts and beliefs are identified, the patient is taught strategies to modify and help manage them.
CBT is used for a variety of mental health conditions, and people receiving CBT for eating disorders experience improvements in other related symptoms like depression and anxiety. CBT-E is a type of enhanced therapy that’s intended for use in all types of eating disorders.
Interpersonal psychotherapy (IPT)
IPT is a type of therapy that’s used to treat eating disorders like binge eating disorder or bulimia. In IPT, an eating disorder is explored in the context of social and interpersonal relationships.
This type of therapy identifies four problem areas to treat an eating disorder, such as:
Interpersonal deficits: This often includes feelings of isolation or a lack of close, fulfilling relationships. The relationships in question don’t have to be romantic, but can also be related to those with friends or family.
Role disputes: This often involves a difference in expectations between yourself and one or more important people in your life, such as parents, friends, or employers.
Role transitions: This is typically concerned with big life changes, such as being on your own for the first time, starting a new job, or being in a new relationship.
Grief: This can include feelings of loss due to the death of a loved one or the end of a relationship.
A mental health professional works with the patient to explore how issues in each of these problem areas contribute to their eating disorder. They’ll then help develop strategies to improve their communication and interpersonal skills to help reduce their symptoms.
Family-based treatment (FBT)
This type of therapy is also referred to as the Maudsley Method because it’s often used for children or adolescents that have an eating disorder.
In FBT, family members are vital parts of the recovery process. They’re involved in helping you do things like maintaining healthy eating patterns, restoring and maintaining a healthy weight, and interrupting unhealthy behaviors, such as binge eating or purging.
Dialectal behavior therapy (DBT)
DBT focuses on managing difficult emotions and encourages the patient to learn skills to change the behaviors associated with their eating disorder.
Some specific skills that this type of therapy aims to build include interpersonal skills, emotional expression, flexibility and openness, coping with feelings of distress, and encouraging mindfulness.
DBT has been studied in the treatment of binge eating disorder, anorexia nervosa, and bulimia nervosa.
Acceptance and commitment therapy (ACT)
ACT asks you to focus on changing actions as opposed to thoughts or feelings. A principle of this therapy is that the behaviors associated with mental health conditions come from responses to unpleasant feelings like anxiety or pain.
Patients undergoing this therapy are asked to examine for themselves what their core values are. They’re then asked to develop goals that help them better satisfy these values. The aim is to accept all feelings and to commit to changing their actions so they better align with their values.
While this therapy is a viable treatment for eating disorders, more research is needed to see if it’s effective as a standalone therapy. If you’re interested, talk with your doctor to see if they recommend it.
Cognitive remediation therapy (CRT)
This type of therapy focuses on promoting “big-picture thinking and mental flexibility”. It’s usually used in the treatment of anorexia nervosa.
In CRT, a variety of exercises and tasks are used to help address the rigid thinking patterns that are often associated with anorexia nervosa. Some examples of such tasks include drawing shapes or performing motions with the dominant and nondominant hand; asking the patient to repeatedly switch their attention between two topics; reading and summarizing increasingly difficult passages; finding different ways to navigate a map; and asking them to come up with alternative ways to use everyday objects.
Psychodynamic psychotherapy
The overall goal of psychodynamic psychotherapy is to help the patient understand the underlying cause of their eating disorder. This involves diving deep into things such as internal conflicts and motives.
Mental health professionals of this type of therapy believe that the symptoms are the result of unresolved wants and needs. As such, understanding the root cause of the disorder can address the symptoms and reduce the risk of relapse.
Contact Us to Learn More
If you want more information about therapy for eating disorders, schedule an appointment with one of our doctors. We can help determine the right treatment for you. Contact us online anytime or give us a call at (619) 373-0229.
References
[1] “Eating disorder statistics 2023”. https://www.singlecare.com/blog/news/eating-disorder-statistics/. (Accessed April 20, 2023).
[2] Riva G (2016) Neurobiology of Anorexia Nervosa: Serotonin Dysfunctions Link Self-Starvation with Body Image Disturbances through an Impaired Body Memory. Front. Hum. Neurosci. 10:600. doi: 10.3389/fnhum.2016.00600
[3] Culbert KM, Racine SE, Klump KL. Research Review: What we have learned about the causes of eating disorders – a synthesis of sociocultural, psychological, and biological research. J Child Psychol Psychiatry. 2015 Nov;56(11):1141-64. doi: 10.1111/jcpp.12441. Epub 2015 Jun 19. PMID: 26095891.
[4] “Eating Disorders”. https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Eating-Disorders. (Accessed April 20, 2023).
[5] Arcelus J, Mitchell AJ, Wales J, Nielsen S. Mortality Rates in Patients With Anorexia Nervosa and Other Eating Disorders: A Meta-analysis of 36 Studies. Arch Gen Psychiatry. 2011;68(7):724–731. doi:10.1001/archgenpsychiatry.2011.74
[6] “Eating Disorders”. https://www.nimh.nih.gov/health/topics/eating-disorders. (Accessed April 20, 2023).
[7] “Is Therapy an Effective Treatment for Eating Disorders?”. https://www.healthline.com/health/eating-disorder/therapy-for-eating-disorders. (Accessed April 20, 2023).