Can An Eating Disorder Therapist Help?

According to the National Eating Disorders Organization, a person living with an eating disorder will often center most of their emotions, behaviors, and attitudes on food decisions. Eating disorders can include anorexia nervosa, binge eating disorder, bulimia nervosa, rumination disorder, and restrictive food intake, among others. Because eating disorders can have serious impacts in the short and long term, it can be very important to get help if you or a loved one are experiencing symptoms of an eating disorder. There are often many options to treat eating disorders, and you may get in touch with a local mental health professional or reach out for help through an online therapy platform.

There are often many misconceptions about what causes an eating disorder, which is generally considered a type of mental illness. Some people mistakenly believe that these conditions are simply a choice that someone makes. What they typically fail to acknowledge when they believe this is that these disorders are really mental health conditions. According to the National Eating Disorders Association, these conditions are typically caused by a “range of biological, psychological, and sociocultural factors”. For example, studies show that those who have a family member with unhealthy dietary habits or a related mental health condition may have an increased risk of developing an eating disorder themselves.

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Who experiences them?

Eating disorders can be common in teenagers. Often, those who experience these conditions have an inaccurate perception of their physical appearance or other body image concerns. Because they may have a negative body image, regardless of the changes they make to their body, they may be unable to see the results of their behavioral patterns.

It's possible for young children, adults, and the elderly to develop these conditions as well. In addition, those who are extremely underweight, at a healthy weight, or overweight can all experience eating conditions.

Signs and symptoms of an issue

While low body weight may result from one of these conditions, it is important to know that an individual may be affected by an eating disorder without having a thin appearance. Knowing other signs and symptoms can help you recognize if you or a loved one may be dealing with disordered dieting habits. For example, an individual who seems to be fixated on their consumption patterns and meal planning may be experiencing disordered eating, especially if they experience additional psychological problems and other factors associated with these disorders.

Many people are familiar with anorexia, but that's not the only type of eating disorder. There are multiple types of these conditions, including anorexia nervosa, binge eating disorder, and bulimia nervosa.

Anorexia nervosa

Anorexia nervosa generally refers to a person who fails to consume enough calories to fuel their body properly. Individuals with anorexia nervosa experience obsessive thinking about weight and extreme fear of weight gain. Anorexia nervosa can be a life-threatening condition. Left untreated, it can lead to serious health problems, dangerous medical complications, and death. Some potential signs and symptoms of anorexia nervosa can include the following:

• Severely restricted food intake
• Denial of hunger, skipping meals, or making excuses for not participating in meals
• Maintaining a very low weight
• Overwhelming fears of weight gain, which may lead to obsessions about preventing any and all weight gain
• Inability to see the damage of not eating and what it is doing to the body and brain
• Some elements of binging and purging
• Dizziness, fainting, fatigue, seizures, or other health problems
• Muscle atrophy
• Absence of menstrual cycle
• Thinning hair, brittle nails, dehydration, low blood pressure, difficulty concentrating

In some cases, substance abuse of diet pills may take place as well. The Substance Abuse and Mental Health Services Administration can be a helpful resource for individuals experiencing this challenge.

If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources. Support is available 24/7.

Binge eating disorder

Binge eating typically consists of a person consuming many more calories than their body needs to survive and flourish. A person with a binge eating disorder (BED) may restrict their food intake much of the time and then binge on large quantities of food. As the National Alliance on Mental Illness explains, those in bed typically do not follow binges with purging or excessive exercise. Therefore, BED may result in obesity. Signs of binging may consist of the following:

• The intake of very large portions of food at one time, often alone
• Thoughts of guilt and shame during a binge, low self-esteem
• Feeling "out of control" while binge eating
• Eating food when not feeling hungry
• Eating until feelings of physical discomfort occur

Evidence of binging on large quantities of food within a short time, such as the disappearance of food or numerous empty wrappers appearing.

Bulimia nervosa

Bulimia nervosa can be similar to binge eating disorder, but after the person binges, they usually purge their food. For example, they may induce vomiting or take laxatives. This often allows them to continue the appearance that they are eating while still feeling like they have control over their food and weight. Bulimia nervosa signs and symptoms can include the following:

• Obsession with not gaining weight
• Hiding or hoarding food
• Eating to the point of feeling physically uncomfortable or even in pain
• Feeling out of control while binge eating
• Self-esteem that is obsessively correlated to body image
• Purging (forced vomiting) after binges

Other unhealthy habits and illnesses

The above three are the most common eating conditions. However, they aren't necessarily the only conditions around diet that can be experienced. The following are a few other examples of disordered eating. 

• Rumination disorder – With rumination disorder, a person may consistently regurgitate food after they eat it. This is something that can occur in young children and people who live with various intellectual disorders.
• Restrictive food intake - This is generally when people avoid consuming certain foods due to an aversion to certain colors, smells, or textures.

If you or one of your family members are experiencing symptoms of any of the above eating disorders or otherwise have a difficult relationship with food and body image, please reach out for the help you deserve. For more information on the signs and symptoms of eating disorders—as well as effective treatment options—consider visiting the National Eating Disorders Association’s site. This national association offers additional resources that can be helpful.

Many people who live with these conditions can be very good at hiding their symptoms. If you question them about it or express your concerns, they aren't likely to be open with you. In fact, eating conditions can impede individuals’ abilities to enjoy fulfilling relationships since feelings of guilt and secrecy about eating behaviors can affect trust and intimacy.

Know that therapy can help. Some of the signs to watch for can include the following:

• Excessive exercise
• Lack of emotion or flat affect
• Weighing oneself repeatedly
• Frequent checking in the mirror for perceived flaws
• Wearing baggy or layered clothing
• Constant complaining about their weight or appearance

If these conditions go untreated, it’s possible that the person with the eating disorder may experience severe medical complications. Often, the underlying mental health issues contributing to the eating disorder may need to be addressed and treated. If possible, please encourage loved ones who display signs of these conditions to get professional help.

If you’re looking for treatment, there are several options that can help. While reaching out to other health professionals can be a starting point, it may be most effective to get help from an eating disorder counselor who is experienced in treating these mental health conditions. 

A comprehensive treatment plan for these conditions may include a combination of medical interventions and counseling techniques. For example, medical doctors can help stabilize patients’ weight and address medical complications such as electrolyte loss, while mental health professionals can address the underlying mental health challenges resulting in disordered dietary habits. Proper treatment may include nutrition education or nutrition counseling as well. Any associated conditions may also need to be addressed for successful treatment.

Psychotherapy is typically the primary form of care when treating eating disorders. Cognitive behavioral therapy (CBT) has been established as the leading form of treatment for bulimia nervosa. Enhanced cognitive behavioral therapy has emerged as an even more effective form of CBT for treating bulimia nervosa and may also effectively treat other types of eating disorders, including anorexia nervosa. In some cases, family-based therapy may be a suitable form of treatment for eating disorders as well. It can be important to consistently attend therapy sessions to improve the mental and behavioral health symptoms associated with these conditions.

It can be vital for those with eating illnesses to get professional treatment so that they can heal and live a healthier life, both mentally and physically. However, it can sometimes be challenging to take the leap and get help in person. It can be easier for some people to get help from the comfort of their own homes, and this is where online therapy can be helpful. Although online therapy may not be suitable for all people with eating illnesses, it can be a valuable resource for many people seeking to develop healthy eating behaviors.

As this study explains, eating disorder therapy delivered through telemedicine can be effective and beneficial for those living with these mental health conditions. Please know that support and guidance is available if you are willing to reach out.