Although everyone knows eating disorders are prevalent in the United States, we often do not “see” them. Individuals with eating disorders are not obvious. Eating disorders are a brain disease caused due a combination of psychological and genetic factors.
There are many types of eating disorders.
Anorexia Nervosa
- Inadequate food intake leading to a weight that is clearly too low.
- Intense fear of weight gain, obsession with weight and persistent behavior to prevent weight gain.
- Self-esteem overly related to body image.
- Inability to appreciate the severity of the situation.
- Binge-Eating/Purging Type involves binge eating and/or purging behaviors during the last three months.
- Restricting Type does not involve binge eating or purging
Bulimia Nervosa
- Frequent episodes of consuming very large amount of food followed by behaviors to prevent weight gain, such as self-induced vomiting.
- A feeling of being out of control during the binge-eating episodes.
- Self-esteem overly related to body image.
Binge Eating Disorder
- Frequent episodes of consuming very large amounts of food but without behaviors to prevent weight gain, such as self-induced vomiting.
- A feeling of being out of control during the binge eating episodes.
- Feelings of strong shame or guilt regarding the binge eating.
- Indications that the binge eating is out of control, such as eating when not hungry, eating to the point of discomfort, or eating alone because of shame about the behavior.
There has been a recent development in new treatments for eating disorders called Enhanced Cognitive Behavioral Therapy (CBT-E). This therapy is slowly becoming the new standard in eating disorder treatment.
It is based on the transdiagnostic model which states that all eating disorders are due to an overevaluation of shape and weight and their control is central to the maintenance of all eating disorders. CBT-E is designed to treat eating disorder psychopathology rather than an eating disorder diagnosis. The therapy favors the use of strategic changes in behavior to modify thinking rather than direct cognitive restructuring. The 4 stages of the disorder are as follows:
As you can see there are many similarities between each of the eating disorders. In the past however an individual was treated based on their eating disorder diagnosis rather than their actual symptomology.
Stage 1:
Engaging the Patient in Treatment and Change
Jointly Creating the Formulation
Establishing Real-time Self-monitoring
Establishing Collaborative “Weekly Weighing”
Providing Education
Establishing “Regular Eating”
Involving Significant Others
Stage 2:
Transition period: review stage 1 and design stage 3
Stage 3:
Addressing the over-evaluation of shape and weight
Addressing Dietary Rules
Addressing Event-related changes in eating
Addressing clinical perfectionism, low self-esteem, and interpersonal problems
Stage 4:
Focus on maintaining the progress and reducing the risk of relapse. Patients start weekly weighing at home and end self-monitoring. There are also posttreatment appointments.
To minimize the risk of relapse, patients need realistic expectations regarding the future and need to understand that there will still be some eating difficulties.
It is important to realize that although not all eating disorders are the same, they have many similarities and in this way treatment should focus on the individual rather than the diagnosis. [
Sources:
http://www.nationaleatingdisorders.org/types-symptoms-eating-disorders
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2928448/
http://www.thesite.org/mental-health/eating-disorders/eating-disorders-explained-5879.html
