Are There Different Eating Disorders And Can They Be Treated?
Linda Wechter-Ashkin PhD NCSP BC-TMHC ADHD CCSP
Anorexia Nervosa-The most commonly known eating disorder is Anorexia Nervosa which involves persistent restriction of energy intake(food) leading to significantly low body weight (in context of what is minimally expected for age, sex, developmental trajectory, and physical health) • Individuals have an intense fear of gaining weight or of becoming fat, or persistent behavior that interferes with weight gain (even though significantly low weight such as dieting or over-exercising). They have disturbance in the way they view their body and there is an over influence of body shape and weight on their self-evaluation. They also tend to have a persistent lack of recognition of the seriousness of their current low body weight. •
Bulimia Nervosa- This involves recurrent episodes of binge eating and then recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self-induced vomiting, misuse of laxatives, diuretics, or other medications, fasting, or excessive exercise. • The binge eating and inappropriate compensatory behaviors both occur, on average, at least once a week for three months. • Again, with bulimia nervosa self-evaluation is unduly influenced by body shape and weight. Binge eating and purging seems to increase after other dopamine-related activities (sex, fun event etc.) which appears to be a way of medicating the dopamine drop and keeping the dopamine flowing.
Binge Eating Disorder -This involves recurrent episodes of binge eating characterized by both of the following: – Eating, in a discrete period of time (e.g. within any 2-hour period), an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances. – A sense of lack of control overeating during the episode (e.g. a feeling that one cannot stop eating or control what or how much one is eating). Episodes are associated with three or more of the following:
- Eating much more rapidly than normal
- Eating until feeling uncomfortably full
- Eating large amounts when not feeling physically hungry
- Eating alone because of feeling embarrassed
- Feeling disgusted, depressed or very guilty afterward
- Marked distress regarding binge eating is present
- Binge eating occurs, on average, at least once a week for three month
Avoidant/Restrictive Food Intake Disorder (ARFID) This involves an eating or feeding disturbance as manifested by persistent failure to meet appropriate nutritional and/or energy needs associated with one (or more) of the following:
- Significant loss of weight (or failure to achieve expected weight gain or faltering growth in children).
- Significant nutritional deficiency
- Dependence on enteral feeding or oral nutritional supplements
- Marked interference with psychosocial functioning
Night Eating Syndrome- Night eating syndrome (NES) is an eating disorder that occurs along with interrupted sleep. NES causes people to wake up during the night to eat, usually several times throughout the night. Untreated, NES makes it difficult to maintain a healthy weight. It also increases the risk of health problems like diabetes and high blood pressure. Individuals feel like they won’t be able to fall asleep if they don’t eat and that they have no control over their night eating. They also may experience increased depression and anxiety at night.
Chew and Spit– Among the lesser-known and less-studied eating disorder behaviors is chew and spit (CHSP) behavior. This behavior consists of chewing a highly palatable and energy-dense food and spitting it out instead of swallowing it. The intent of chewing and spitting is to enjoy food’s flavor without ingesting calories. CHSP is similar to bingeing because it involves larger than intended quantities of high-calorie foods. It also shares elements of restrictive eating because the food is not actually consumed.
Treatment-Only 1 in 10 people with eating disorders receives treatment. The following outpatient treatments have the best outcome, but it varies based on the individual, the disorder, and the severity.
- Cognitive-Behavioral Therapy (CBT)-The idea is to change the individuals’ thoughts in order to change their behaviors.
- Dialectical Behavior Therapy- This type of therapy is a modified form of CBT that emphasizes both psychological and social factors. It focuses on mindfulness, interpersonal effectiveness, distress tolerance, and emotional regulation
- Acceptance and Commitment Therapy (ACT) focuses on helping the individual to stop denying and avoiding their inner emotions. People learn to accept that their feelings are, in some circumstances, appropriate responses. The goal is for individuals to accept the difficulties and issues in their lives and then commit to making changes in their current behavior.
- Family Based Therapy Often there are family dynamics that need to be addressed for the individual to maintain a healthy relationship with food.
- Nutritional Therapy- Nutritional therapy is often used in conjunction with other types of psychotherapy. The idea is to help individuals establish a new relationship with food.