Eating Disorders: What is the treatment?
Eating Disorders are widely noted for being one of the most fatal mental health issues. They can affect people of every age, race, size, sexual orientation, gender, and background. It is estimated that globally, 15% of women will suffer from an eating disorder before the age of 40. Globally, at least 9% of the population suffers from eating disorders. However, despite this, only 27% of people will receive any treatment. This is one of the things that makes eating disorders so fatal as many people do not receive the help they need.
There are many myths surrounding eating disorders which perpetuate this mortality rate. In general, people with Anorexia Nervosa are 18 times more likely to die by suicide. Additionally, Black, Indigenous, and People of Color (BIPOC) are affected by eating disorders at similar rates however they are half as likely to be diagnosed. People with larger bodies are at the highest risk of having developed an eating disorder during their lives. It appears the higher the BMI, the higher the risk of developing an eating disorder.
A common misconception about eating disorders is that it only includes people who are underweight however a study found that among post-secondary students, just 2% of those who met the criteria for an eating disorder were underweight. This misconception could lead to people not getting diagnosed and prolonging the treatment process.
Moreover, people in the 2SLGBTQIA+ community are three times more likely to have an eating disorder. A shocking 75% of transgender college students with eating disorders attempt suicide. Finally, over 70% of people with eating disorders are diagnosed with other conditions including anxiety and mood disorders1.
With such alarming statistics, it is crucial that we know the warning signs and what to look for as well as know some common myths surrounding eating disorders. This way, if our loved one or ourselves are in need, we will be better equipped to seek out treatment.
They can affect anyone and the term "eating disorder" encompasses a variety of diagnoses including...
Anorexia Nervosa
Bulimia Nervosa
Binge Eating Disorder (the most common eating disorder)
Pica
Orthorexia Nervosa
Other Specified Feeding and Eating Disorders (OSFED)
Avoidant Restrictive Food Intake Disorder (ARFID)
Rumination Disorder
Unspecified Feeding or eating disorder (UFED)
What causes Eating Disorders?
There can be many genetic and social determinants of an eating disorder. For people who have a sibling or a parent with an eating disorder, they can be at an increased risk. Additionally, personality traits such as perfectionism, impulsivity, and neuroticism are often linked with a higher risk. Moreover, the perceived pressure to be thin or the Western ideal for thinness, in addition to, the media promoting these images can put a person at an increased risk. In a society that tends to value thinness seeing images on social media that perpetuate this standard can lead to decreased body image. However, it is important to note this list is not exhaustive and there are many reasons why someone might be at an increased likelihood for developing an eating disorder2.
Signs and Symptoms
Depending on the different types of eating disorders symptoms may manifest differently. Regardless, each disorder involves an extreme focus on food and eating, some in addition involve an extreme focus on weight.
Signs and Symptoms MAY include...
dramatic weight loss
concern about eating in front of others
preoccupation with weight, food, calories, fat grams, or dieting
excuses to avoid mealtime
immense fear of weight gain or being "fat"
dressing in layers to hide weight loss
severely limiting the amount and types of food consumed
repeatedly weighing themselves
hiding or tampering with food
excessively exercising
binge eating and/or purging
dizziness
fainting
feeling cold all the time
thinning hair
poor wound healing
Myths about Eating Disorders
There are many myths surrounding eating disorders which exacerbates the lack of treatment reaching everyone in need. Often people can make the mistake of focusing solely on anorexia when talking about disordered eating - although anorexia is extremely important and needs attention - many more eating disorders can manifest differently and only being aware of one disorders symptoms may make us more likely to miss someone else in need.
Other myths include...
Myth: Eating Disorders are not serious illnesses
Fact: they are very real and serious mental illnesses that can be deadly
Myth: Eating Disorders are just about food
Fact: While they involve these things they are rooted in many different biological, psychological, and sociocultural aspects
Myth: Eating Disorders solely affect women
Fact: eating disorders can affect any gender, race, or culture. Males represent close to 25% of the people in eating disorder treatment.
Myth: Only very thin people have eating disorders
Fact: many individuals struggling is normal weight. This misconception can lead to a delay in diagnosis and can contribute to the mortality rate and lack of treatment we are seeing3.
Getting Diagnosed
Getting a proper diagnosis can be challenging for many, especially because of the misconception surrounding weight. Generally, a family doctor may not feel comfortable with providing a diagnosis, however, can refer you to a professional who can, such as a psychiatrist or psychologist. In most cases, to get a diagnosis you may need a physical exam, a mental health evaluation, and other exams to check for complications related to the eating disorder.
Treatment Options
Dialectical Behaviour Therapy (DBT) is a widely used treatment for symptoms of eating disorders. DBT Therapy was originally developed for people with borderline personality disorder however can be a helpful treatment for those with eating disorders. DBT Therapy helps people develop new coping skills and relationship skills. For many their disordered eating behaviours may be a coping mechanism, DBT can help brainstorm alternative coping strategies and focus on developing new skills. Skills learned in therapy include mindfulness, distress tolerance, interpersonal effectiveness, and emotional regulation. DBT can be useful for many types of mental disorders including anxiety, eating disorders, and personality disorders. Often family members are asked to get involved with treatment as well.
Other evidence-based treatment widely used for eating disorders includes Cognitive behavioural therapy (CBT). CBT works by helping people stop unwanted behaviour and feelings by changing the way they think. Coupled with Exposure and Response Prevention (E/RP for short). the client works on exposing themselves to feared elements of eating and holding back any disordered or unhelpful response.
Therapists at Brookhaven Psychotherapy are trained in delivering DBT and CBT (with E/RP) in individual and group settings. As a community of therapists, we operate as a team to deliver high-quality care in this area. Contact us today to talk about starting treatment.
Learn more about Dialectical Behaviour Therapy here.
Learn more about Cognitive Behaviour Therapy here.
