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Contributor: Camille Williams, MA, LCPC, Eating Disorder Specialist at Timberline Knolls Residential Treatment Center

Thoughts can be very powerful, especially obsessive thoughts that surface over and over again. With an eating disorder, thoughts about body image may be the most frequent throughout the day. Negative body image thoughts can have a significant impact on a person’s view of self and behaviors.

Such as “I am so fat and need to restrict all day” or “my body is disgusting” so there’s no way I can go out in public.” These examples demonstrate how easily a thought can dictate worth and command a person’s behaviors.

CBT Approach to Body Image

There are many therapeutic approaches and techniques that challenge distorted thinking. Cognitive Behavioral Therapy (CBT) encourages exploration about whether or not the thought is fact, “am I actually disgusting “or “is my perception distorted?”

Another approach promotes change from negative to positive, instead of thinking “I am fat,” the individual reframes to “my body is good enough.” These techniques are incredibly beneficial and promote recovery.

However, CBT can be challenging for individuals with eating disorders because it is difficult to believe in the reframed thoughts. This is most likely due to the obsessive thoughts being so strongly in place; they carry a lot of “weight” in dictating a person’s worth and behaviors.

DBT and ACT Therapies

Dialectical Behavioral Therapy (DBT) may be a more appropriate place to begin because the significance and power of thoughts can be decreased. In DBT an individual will observe and acknowledge thoughts and values to determine worth and behaviors.

In this way, an individual can begin to recover without “fixing” negative body-image thoughts. A complementary therapeutic approach to DBT is called Acceptance and Commitment Therapy (ACT). It promotes acceptance of thoughts and feelings and acting in ways that align with commitments.

One component of ACT is called thought defusion, which emphasizes the separation between thoughts and self. If an individual has struggled with negative thoughts about their body for years, it is unlikely that the thought will be easily changed or removed; instead, a person can work to accept the thought and respond differently.

The pattern reinforced with an eating disorder is “I’m fat” followed by eating disorder behaviors. An individual with this type of disorder can get very attached to this pattern as an attempt to find relief from body image thoughts.

This is often unsuccessful and usually leads to increased obsessive thoughts and further dissatisfaction with self and body. Unfortunately, this cycle also moves an individual further from recovery and deeper into the eating disorder.

Create a New Pattern

A new pattern can be created through applying DBT and ACT techniques. Thought defusion starts with changing the thought “I’m fat” to “I’m having the thought that I’m fat.” It acknowledges that the negative body image thoughts are still present and valid.

Thought defusion helps separate self from thoughts and creates space rather than defining self by a thought. A person is able to be less fused to their thoughts, and therefore, thoughts can begin to have less impact on determining worth or dictating behaviors.

As the impact of negative body thoughts decreases, it will be easier to apply the DBT skill of radical acceptance to body image work. Ultimately, an individual may continue to struggle with negative thoughts about the body, and overall there can be an understanding and appreciation of the body the way it is.

This acceptance will also help the individual increase effectiveness in achieving recovery goals and commitments.

About the author: Camille Williams, MA, LCPC is an Eating Disorder Specialist at Timberline Knolls Residential Treatment Center. Her primary responsibilities consist of facilitating group therapy, creating individualized support plans, and education and awareness for resident’s continued success in recovery.

She received a Bachelor of Arts Degree in Psychology and Sociology from Augustana College. She was awarded a Master’s Degree in Clinical Professional Counseling from Roosevelt University.

The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published on May 21, 2018.
Reviewed on May 22, 2018 by Jacquelyn Ekern, MS, LPC

Published on EatingDisorderHope.com

The post New Approach to Body Image appeared first on Eating Disorder Hope.

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We have all read magazines about certain celebrities or even models, who are going on the next ‘Craze diet.’ Do you ever wonder why they are dieting in the first place? Are they merely just not happy with their bodies? Is it that they have been told to, or is it the pressure from the media?

If they lose weight because they are not happy with their body being overweight, that’s fine. But, when does it become too much? When is it enough? There are numerous liquid diets out there which involve replacing solid foods with liquid meal replacements, juices or smoothies. When no food is allowed on the diet; this surely can’t be good for you mentally and physically.

Are Dieting and Weighing Ourselves Really Healthy?

With most diets, are you really getting the right nutrients that you need daily? Our bodies are designed to eat, chew and digest food. Diets that are overly restrictive can be dangerous, can lead to deep-rooted eating issues, and even unintentionally, put pressure on others to look like the images in magazines.

Society and the media have made us think that we should aim to look ‘skinny’ or ‘slim’ because it is considered beautiful. The societal message is that ‘fat’ and ‘curvy’ are ugly and wrong.

We have become a society fixated on diets, our clothing size, and our weight. This isn’t right; this isn’t how it should be. Who has the right to say what weight or size we should be? All sizes are beautiful! If we are happy and healthy shouldn’t that be enough?

The NHS (National Health Service in England) produced a ‘BMI healthy weight calculator,’ which shows what you should weigh, due to your height. The problem with this is, people feel they need to live by it.

You can then find that you are weighing yourself frequently to see if you are the ‘correct’ weight. However, the scale doesn’t tell the real story. The scale does not take into account the body mass percentage of muscle, bone, tissue, fat, etc.

For example, you may be categorized as ‘Overweight’ due to a larger mass of muscle, which weighs more. The scale is just not an accurate measurement of our health.

We Should Love Ourselves and Our Unique Bodies

Remember, it’s important to be happy in your own body. If you are healthy and happy, shouldn’t that be what’s important?

No one has the right to tell you what size you should be, and no one should tell you what food you can and can’t eat. It is your body, so it is your decision and responsibility to take the best care of it you can.

About the Author: Kathryn Moyes is a guest contributor who wanted to share her life experience with the Eating Disorder Hope online community.  She has suffered from obsessive-compulsive disorder since she was little. She then developed anorexia nervosa in her early 20’s had been battling with anorexia for 4 and a half years. During her recovery, she started to study and practice yoga, which has helped her through the recovery process. She still continues to practice. Kathryn developed a website that has been up and running for almost 5 months, www.mymentalhealthandme.com. This is where she discusses everything she has gone through, hoping that one day it could help someone else in the same situation.

Kathryn lives in a Cottage, with her partner and works at a Veterinary Hospital. She also has a dog walking business and loves losing herself in a good book, going to the gym and socializing.

The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published on May 21, 2017.
Reviewed on May 22, 2018 by Jacquelyn Ekern, MS, LPC

Published on EatingDisorderHope.com

The post Can Dieting and Weighing Ourselves too Much be Dangerous? appeared first on Eating Disorder Hope.

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Prevalence & Features of Eating Disorders in Males

As a clinical psychologist and supervisor of eating disorder services with Rogers Behavioral Health, we’re very fortunate to be able to share some important clinical tidbits and knowledge from a successful history that we have treating males with eating disorders.

My objective is to help clinicians who may routinely treat males with eating disorders in their practice and provide some guidance on how to go about this treatment effectively.

To give you a little bit of an overview of what I’ll be covering in the presentation today, I’ll start with just a brief review of eating disorders in males.

We’ll talk a little bit about prevalence rates as well as some of the unique features that stand out in males with eating disorders.

We’ll also talk about how these unique features directly contribute to several important treatment considerations.

I will then be spending the majority of my time talking about two particular behavioral therapy interventions that we found to be quite effective in the treatment of males with eating disorders.

Those two interventions are Exposure-Based Therapy and Behavioral Activation.

We’ll talk a little bit about the roots and the history of those treatment strategies and how they’re uniquely applied to this population.

Unique Features and Effective Strategies in Treating Males with Eating Disorders - YouTube

Then to drive some of these key teaching points home, I’ll wrap up with a couple of case examples in hopes of bringing these two behavioral treatment strategies to life.

Prevalence of Males with Eating Disorders

To begin, let’s talk a little bit about the prevalence rates among males with eating disorders.

According to the most recent iteration of the DSM (Diagnostic and Statistical Manual of Mental Disorders), the lifetime prevalence rates for anorexia nervosa, bulimia nervosa, and binge eating disorder are pretty scant, hovering around the ballpark of 0.5% to 1.0%.

What’s a little bit more telling is when we start to look at the entire population of individuals who have been diagnosed with anorexia or bulimia. What we find is that a quarter of those individuals are actually male.

In the context of Binge Eating Disorder, we see that an estimated 36% are male, which is greater than one-third.

One of our newer eating disorder diagnoses, Avoidant and Restrictive Food Intake Disorder (ARFID), is fascinating because we see no gender differences in terms of lifetime prevalence. In fact, there are several studies now suggesting ARFID may be somewhat more prevalent in males.

What this all points to is that eating disorders are significantly more prevalent among males than we had previously imagined.

From the literature, we can currently estimate that close to about 10 million men in the United States will experience an eating disorder at some point throughout the lifespan.

What we know to be more troubling is the increased prevalence of eating disorders as males develop through the turbulent adolescent years.

There is an unfortunate statistic out there showing that from the ages of 12 through the age of 20, the prevalence of eating disorders among males more than doubles.

All of this indicates that, while eating disorders are something we’ve historically thought of as being predominantly a female condition, they are very much a guy thing, too.

Features

Now, let’s look at some of the unique features of eating disorders and how these features manifest in males.

The first important point that should be made is that, unfortunately, very limited research has been done comparing eating disorder features in males versus females.

Based on the limited work that has been done, one very striking finding that we see consistently is that the vast majority of eating disorder features tend to present more severely in females.

These are often some of the more “classic” eating disorder features that we think of such as body image dissatisfaction, the extent of restraint in one’s dietary intake, purging behaviors, preoccupation with thinness or the idealized body type.

Again, the data is very limited, but there do seem to be a few features that we actually see present as more severe in males.

These features include preoccupation with muscularity, engagement in excessive or compulsive exercise aimed at trying to influence one’s physique significantly.

We derived some interesting findings from a recent study that was done with just under 1900 patients. These patients were treated over the last 15 years at various levels of care at Rogers Memorial Hospital.

In this study, we compared a wide variety of eating disorder features among 390 male patients and just over 1500 female patients, all diagnosed with eating disorders.

The two key instruments that we used to assess the variety of eating disorder features were the Eating Disorder Examination Questionnaire (EDEQ), a widely used, well-validated, and accepted measure of global eating disorder severity.

We also used the 3rd Revision (version) of the Eating Disorders Inventory.

In our findings, these key assessment instruments, not surprisingly, corroborated previous conclusions from the literature:

Nearly all of the eating disorder features that we examined in this study were experienced at significantly higher severity levels amongst our female patient group.

However, we did see some evidence for higher rates and intensity of exercising as well as frequency and intensity of binge eating in some of our male patients.

Looking a little bit more globally at the unique nature of body image concerns and our male patients, we see more of a pronounced desire for a very athletic and muscular physique compared to what we think of as the very slender thin ideal that is classic among females with eating disorders.

We know that when healthy, well-functioning males are exposed to any type of media depiction that idealizes this very muscular bulked up physique, this tends to lead to increases in males body image dissatisfaction as well as an increased drive for muscularity.

It shouldn’t surprise us, then, that when we survey adolescent males who routinely exercise and ask them about their intentions or motivations, a significant majority of this group reports that they are trying to bulk up and to gain more muscle mass.

We know that, in very extreme forms, this can manifest as something called “muscle dysmorphia,” or what is more playfully termed “Bigorexia.”

Muscle Dysmorphia is looked at as kind of a strain or variant of Body Dysmorphic Disorder where the body area viewed as concerning from an appearance-related standpoint is the musculature of the body.

Often, individuals who struggle with Muscle Dysmorphia view themselves as insufficiently muscular and engage in a lot of extreme, unhealthy behaviors aimed at trying to bulk up.

Source:

Virtual Presentation by Dr. Nicholas Farrell in the Dec. 7, 2017 Eating Disorder Hope Inaugural Online Conference & link to the press release at https://www.prnewswire.com/news-releases/eating-disorder-hope-offers-inaugural-online-conference-300550890.html

About the Author: Dr. Nicholas R. Farrell, Ph.D. is a licensed clinical psychologist who directs and supervises the treatment of patients in eating disorder programs at Rogers Memorial Hospital. Dr. Farrell specializes in the use of empirically-supported cognitive behavioral therapy (CBT) treatment strategies that are used to help patients in our eating disorders programs.

Additionally, Dr. Farrell is a regular contributor to scientific research on the effectiveness and dissemination of CBT for eating, anxiety, and mood disorders and has published over 20 peer-reviewed journal articles and book chapters. Dr. Farrell has been the gracious recipient of federal grant funding to study the role of social stigma in the context of eating disorders.

About the Transcription Editor: Margot Rittenhouse is a therapist who is passionate about providing mental health support to all in need and has worked with clients with substance abuse issues, eating disorders, domestic violence victims, and offenders, and severely mentally ill youth.

As a freelance writer for Eating Disorder and Addiction Hope and a mentor with MentorConnect, Margot is a passionate eating disorder advocate, committed to de-stigmatizing these illnesses while showing support for those struggling through mentoring, writing, and volunteering. Margot has a Master’s of Science in Clinical Mental Health Counseling from Johns Hopkins University.

The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published on May 10, 2018.

Published on EatingDisorderHope.com

The post Prevalence & Features of Eating Disorders in Males – Part 1 appeared first on Eating Disorder Hope.

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Mikayla Kendal, MS, LPC, Eating Disorder Specialist at Timberline Knolls Residential Treatment Center

The thoughts associated with an eating disorder (ED) tend to be intrusive, obsessive, and rigid. These thoughts can even develop a whole separate identity.

Viewing an ED through this lens can help people separate themselves from their disorder. But, not all ED identities or relationships manifest in the same way. They can take on various traits.

In working with individuals who experience EDs, the idea of the disorder as its own entity is common. However, each identity and relationship with an ED is different.

When exploring the eating disorder as its own entity, individuals reflect on the tone and presentation of their distorted thoughts and can start to imagine a personality and even an image to match their disorder. With each person having their own unique relationship with this other entity, there have been several different examples reported.

One individual described her ED as a “ghost.” This spirit would come and go and seemed to float around her. At times the “ghost” would be haunting and could even become possessive.

Another example is envisioning an ED as a friend/enemy, or “frenemy.” As a friend, the disorder can be comforting, and during hard times, it is someone to count on. At other times, this friend becomes an individual’s worst enemy through betrayal and ultimately working toward causing death.

The entity can take on the voice and mannerisms of an authoritative parent. It may even reflect one’s experience with their own parent figure(s). ED as a parent has been described as controlling and demeaning with strict rules and punishments.

Contrary to this manifestation, the entity has also been experienced as a toddler in a tantrum. This toddler has been reported to have an attitude and throws fits when the individual does not give in to its demands.

By identifying these entities, one can discover how they relate to them, and how they want to change this relationship through their recovery. If you connect to experiencing your ED as a ghost, perhaps it’s time to shine a light on that ghost to bring it out of the darkness.

If the ED acts like a frenemy, it may be time to reconsider this “friendship” which may include tattling on that “friend” for lying and not playing fair.

With ED being an authoritative parent, one might try to rebel and find independence by breaking the rules and taking responsibility for themselves. And, if you are experiencing ED as a toddler, you don’t have to give in to its cries. Reinforcing the toddler’s behaviors will only make them stronger, so instead put it in a “time out.”

Ultimately, you can utilize awareness about how you experience your ED in order to find an effective way to respond to it in recovery.

About the author: Mikayla Kendal MS, LPC, is an eating disorder specialist at Timberline Knolls Residential Treatment Center. She has experience with leading psychoeducational groups, process groups, and individual therapy. She also has taught psychology courses at Benedictine University, where she received her Master’s degree in Clinical Psychology.

The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published on May 11, 2018.
Reviewed by Jacquelyn Ekern, MS, LPC on May 11, 2018
Published on EatingDisorderHope.com

The post The Many Faces of an Eating Disorder appeared first on Eating Disorder Hope.

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Prevalence & Features of Eating Disorders in Males

As a clinical psychologist and supervisor of eating disorder services with Rogers Behavioral Health, we’re very fortunate to be able to share some important clinical tidbits and knowledge from a successful history that we have treating males with eating disorders.

My objective is to help clinicians who may routinely treat males with eating disorders in their practice and provide some guidance on how to go about this treatment effectively.

To give you a little bit of an overview of what I’ll be covering in the presentation today, I’ll start with just a brief review of eating disorders in males.

We’ll talk a little bit about prevalence rates as well as some of the unique features that stand out in males with eating disorders.

We’ll also talk about how these unique features directly contribute to several important treatment considerations.

I will then be spending the majority of my time talking about two particular behavioral therapy interventions that we found to be quite effective in the treatment of males with eating disorders.

Those two interventions are Exposure-Based Therapy and Behavioral Activation.

We’ll talk a little bit about the roots and the history of those treatment strategies and how they’re uniquely applied to this population.

Unique Features and Effective Strategies in Treating Males with Eating Disorders - YouTube

Then to drive some of these key teaching points home, I’ll wrap up with a couple of case examples in hopes of bringing these two behavioral treatment strategies to life.

Prevalence of Males with Eating Disorders

To begin, let’s talk a little bit about the prevalence rates among males with eating disorders.

According to the most recent iteration of the DSM (Diagnostic and Statistical Manual of Mental Disorders), the lifetime prevalence rates for anorexia nervosa, bulimia nervosa, and binge eating disorder are pretty scant, hovering around the ballpark of 0.5% to 1.0%.

What’s a little bit more telling is when we start to look at the entire population of individuals who have been diagnosed with anorexia or bulimia. What we find is that a quarter of those individuals are actually male.

In the context of Binge Eating Disorder, we see that an estimated 36% are male, which is greater than one-third.

One of our newer eating disorder diagnoses, Avoidant and Restrictive Food Intake Disorder (ARFID), is fascinating because we see no gender differences in terms of lifetime prevalence. In fact, there are several studies now suggesting ARFID may be somewhat more prevalent in males.

What this all points to is that eating disorders are significantly more prevalent among males than we had previously imagined.

From the literature, we can currently estimate that close to about 10 million men in the United States will experience an eating disorder at some point throughout the lifespan.

What we know to be more troubling is the increased prevalence of eating disorders as males develop through the turbulent adolescent years.

There is an unfortunate statistic out there showing that from the ages of 12 through the age of 20, the prevalence of eating disorders among males more than doubles.

All of this indicates that, while eating disorders are something we’ve historically thought of as being predominantly a female condition, they are very much a guy thing, too.

Features

Now, let’s look at some of the unique features of eating disorders and how these features manifest in males.

The first important point that should be made is that, unfortunately, very limited research has been done comparing eating disorder features in males versus females.

Based on the limited work that has been done, one very striking finding that we see consistently is that the vast majority of eating disorder features tend to present more severely in females.

These are often some of the more “classic” eating disorder features that we think of such as body image dissatisfaction, the extent of restraint in one’s dietary intake, purging behaviors, preoccupation with thinness or the idealized body type.

Again, the data is very limited, but there do seem to be a few features that we actually see present as more severe in males.

These features include preoccupation with muscularity, engagement in excessive or compulsive exercise aimed at trying to influence one’s physique significantly.

We derived some interesting findings from a recent study that was done with just under 1900 patients. These patients were treated over the last 15 years at various levels of care at Rogers Memorial Hospital.

In this study, we compared a wide variety of eating disorder features among 390 male patients and just over 1500 female patients, all diagnosed with eating disorders.

The two key instruments that we used to assess the variety of eating disorder features were the Eating Disorder Examination Questionnaire (EDEQ), a widely used, well-validated, and accepted measure of global eating disorder severity.

We also used the 3rd Revision (version) of the Eating Disorders Inventory.

In our findings, these key assessment instruments, not surprisingly, corroborated previous conclusions from the literature:

Nearly all of the eating disorder features that we examined in this study were experienced at significantly higher severity levels amongst our female patient group.

However, we did see some evidence for higher rates and intensity of exercising as well as frequency and intensity of binge eating in some of our male patients.

Looking a little bit more globally at the unique nature of body image concerns and our male patients, we see more of a pronounced desire for a very athletic and muscular physique compared to what we think of as the very slender thin ideal that is classic among females with eating disorders.

We know that when healthy, well-functioning males are exposed to any type of media depiction that idealizes this very muscular bulked up physique, this tends to lead to increases in males body image dissatisfaction as well as an increased drive for muscularity.

It shouldn’t surprise us, then, that when we survey adolescent males who routinely exercise and ask them about their intentions or motivations, a significant majority of this group reports that they are trying to bulk up and to gain more muscle mass.

We know that, in very extreme forms, this can manifest as something called “muscle dysmorphia,” or what is more playfully termed “Bigorexia.”

Muscle Dysmorphia is looked at as kind of a strain or variant of Body Dysmorphic Disorder where the body area viewed as concerning from an appearance-related standpoint is the musculature of the body.

Often, individuals who struggle with Muscle Dysmorphia view themselves as insufficiently muscular and engage in a lot of extreme, unhealthy behaviors aimed at trying to bulk up.

Source:

Virtual Presentation by Dr. Nicholas Farrell in the Dec. 7, 2017 Eating Disorder Hope Inaugural Online Conference & link to the press release at https://www.prnewswire.com/news-releases/eating-disorder-hope-offers-inaugural-online-conference-300550890.html

About the Author: Dr. Nicholas R. Farrell, Ph.D. is a licensed clinical psychologist who directs and supervises the treatment of patients in eating disorder programs at Rogers Memorial Hospital. Dr. Farrell specializes in the use of empirically-supported cognitive behavioral therapy (CBT) treatment strategies that are used to help patients in our eating disorders programs.

Additionally, Dr. Farrell is a regular contributor to scientific research on the effectiveness and dissemination of CBT for eating, anxiety, and mood disorders and has published over 20 peer-reviewed journal articles and book chapters. Dr. Farrell has been the gracious recipient of federal grant funding to study the role of social stigma in the context of eating disorders.

About the Transcription Editor: Margot Rittenhouse is a therapist who is passionate about providing mental health support to all in need and has worked with clients with substance abuse issues, eating disorders, domestic violence victims, and offenders, and severely mentally ill youth.

As a freelance writer for Eating Disorder and Addiction Hope and a mentor with MentorConnect, Margot is a passionate eating disorder advocate, committed to de-stigmatizing these illnesses while showing support for those struggling through mentoring, writing, and volunteering. Margot has a Master’s of Science in Clinical Mental Health Counseling from Johns Hopkins University.

The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published on May 10, 2018.

Published on EatingDisorderHope.com

The post Unique Features & Effective Strategies in Treating Males with Eating Disorders – Part 1: Prevalence & Features of Eating Disorders in Males appeared first on Eating Disorder Hope.

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Orthorexia is as deadly, as obsessive, and as unhealthy as a more recognized eating disorder. It is not is not listed as an official diagnosis or classified in the DSM-V. In 1998, the term “orthorexia” was coined. It is defined as “an obsession with proper or ‘healthful’ eating.” [1]

What is Orthorexia

An individual can become all-consumed with what to eat, how much to eat, what is in the food, and the lifestyle of “pure” eating. Orthorexia is about rigidity and the ‘right’ way of eating.

People believe the idea of rising above others in dieting behaviors and ‘self-punishing’ if they slip-up, through stricter eating, fasting, or exercising to rid the body of any non-pure foods they eat.

Frequently, those who struggle with orthorexia have their self-esteem wrapped up in the idea of purity and feeling superior to others, especially when it comes to what they eat [1]. The restrictions on food and the types of food they can eat can soon become so restrictive that a person’s health can suffer.

When battling orthorexia, a person’s relationships can suffer, he or she may isolate themselves, and their physical health can deteriorate, and their life can become consumed by the “pure” eating lifestyle. In essence, like other eating disorders, their day and life become obsessed with food.

Self-Assessment of Orthorexia

When considering if someone has orthorexia, there are fortunately questionnaires like the one on NEDA’s (National Eating Disorders Association) website that help in determining if help is needed.

If a person answers ‘yes’ to more questions than not, then it may be wise to talk to a physician about the possibility of that person struggling with the disease. [3].

  1. Do you wish that occasionally you could just eat and not worry about food quality?
  2. Do you ever wish you could spend less time on food and more time living and loving?
  3. Does it seem beyond your ability to eat a meal prepared with love by someone else – one single meal – and not try to control what is served?
  4. Are you constantly looking for ways foods are unhealthy for you?
  5. Do love, joy, play, and creativity take a back seat to following the perfect diet?
  6. Do you feel guilt or self-loathing when you stray from your diet?
  7. Do you feel in control when you stick to the “correct” diet?Have you put yourself on a nutritional pedestal and wonder how others can possibly eat the foods they eat?
Stages of Orthorexia

Orthorexia develops in two stages. The first stage is when a person develops a thought and belief system around healthy eating. Often the belief system revolves around clean eating, paleo, vegan, raw foods, and “elimination” diets [2].

Some of these may be unsafe or medically unstable and lead to malnutrition. More popular diets that may be associated with orthorexia can be followed safely, but regardless of the diet, all are restrictive in nature and can lead to orthorexia or an eating disorder.

The second stage is when the person begins to obsess about the foods. Like most diets, they can lead to the restriction of foods and food categories. The person becomes obsessed with food, preparing food, and planning the most perfect and pure meals.

Regularly, food rules are created, and these rules may become harder to follow, which can lead to ‘cheating.’ This “cheating” can lead to detoxes or cleanses to rid the body of ‘toxins’ from the unclean or impure foods eaten which in and of itself can be quite dangerous.

Symptoms of Orthorexia

The individual begins to have a drive for purity, both internal and external. The sufferer begins to worry about being impure. The need to eat flawlessly is never met. The person feels that they can always do better, or they have never ‘cleansed’ enough [2].

Foods develop a moral quality and are seen as ‘good’ or ‘bad.’ Eating the ‘right’ food is how positive self-esteem is developed for the person with orthorexia, and often, it can create a sense of virtue.

If a person eats ‘bad’ food, it is literally seen as a sin and can lead to feelings of guilt and self-punishment. Even if loved ones eat ‘bad’ foods, they are seen as inferior and unclean [2].

Within orthorexia, pure food is used as a coping mechanism for stress, anxiety, and fear in daily life. It is almost impossible for the sufferer to connect with others who do not eat in the same way because they are ‘bad’ because they do not eat as purely and cleanly as the sufferer. It is almost spiritual for the sufferer.

Treatment Modalities

Treatment for orthorexia is about stabilization. Since the disease is harder to detect, physical issues often arise that begin to deteriorate the body. Attention must first be directed to treating any medical conditions created due to the orthorexia and then addressing the cognitive and emotional issues second.

Meeting with a psychotherapist, a nutritionist, and psychiatrist to address the co-occurring disorders of anxiety, depression, and other issues for medication management are key elements in recovery.

Addressing the underlying physical and emotional needs does not necessarily mean abandoning the healthy eating lifestyle, but the person needs to understand that orthorexia is not a healthy way of living.

Therapy is about the sufferer understanding the contributing factors of orthorexia such as anxiety, self-esteem, perfectionism, and food. Recovery involves implementing coping strategies and learning other activities outside the disorder.

Nutritional support helps with relearning how to connect with food. The sufferer needs to learn that meals and snacks include all food groups. Setting up a meal plan and a support system consisting of loved ones will help throughout the recovery process.

Types of Therapies

Cognitive Behavioral Therapy (CBT) is often successful with sufferers of orthorexia. CBT can help in all aspects of the recovery process as it can aid in reframing a person’s thought process, emotions, and behavior response to triggers and situations around the orthorexia.

Mindfulness-based activities are also a therapeutic module to use with individuals to help with stress reduction and using coping skills for distress tolerance. These types of therapy modules can aid in the way the sufferer approaches recovery.

Levels of Care

Levels of care for orthorexia are most often outpatient or hospitalization for medical stabilization. Due to orthorexia not being a diagnosis or classified in the DSM-V, insurance companies often do not cover higher levels of care for treatment.

Many individuals can recover at the outpatient level from orthorexia. With professional treatment including a therapist, nutritionist, and group therapy, it is possible to recover from this type of disordered eating.

About the Author: Libby Lyons is a Licensed Clinical Social Worker and Certified Eating Disorder Specialist (CEDS). Libby has been practicing in the field of eating disorders, addictions, depression, anxiety and other comorbid issues in various agencies. Libby has previously worked as a contractor for the United States Air Force Domestic Violence Program, Saint Louis University Student Health and Counseling, Saint Louis Behavioral Medicine Institute Eating Disorders Program, and has been in Private Practice.

Libby currently works as a counselor at Fontbonne University and is a Adjunct Professor at Saint Louis University, and is a contributing author for Addiction Hope and Eating Disorder Hope. Libby lives in the St. Louis area with her husband and two daughters. She enjoys spending time with her family, running, and watching movies.

References:

[1] Orthorexia Nervosa. (n.d.). Retrieved February 06, 2018, from https://www.nationaleatingdisorders.org/orthorexia-nervosa
[2] Bratman, S., Ph.D. (2015). Orthorexia Nervosa . Retrieved February 06, 2018, from https://www.mirror-mirror.org/orthorexia-nervosa.htm
[3] http://theplate.nationalgeographic.com/2015/02/27/when-it-comes-to-eating-how-healthy-is-too-healthy/

The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published on April 30, 2018.

Published on EatingDisorderHope.com

The post Self-Assessment of Orthorexia appeared first on Eating Disorder Hope.

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Binge Eating Disorder (BED) is a type of eating disorder that can easily effect anyone. The range of severity varies, but it can affect both men and women and individuals of any age.

Unfortunately, BED is commonly seen in people who have experienced a trauma or abuse, especially in childhood, and it is used to in a way that allows the person to self-medicate to numb the pain.

Binge Eating Disorder Symptoms

Binge eating can be described as eating a substantial amount of food within two hours or less. Many individuals say that they feel their eating is out of control, and that they are unable to stop the behavior even when they want too.

Sufferers also state that they are unaware of their binge eating until after the episode has occurred [1].

People who engage in binge eating tend to eat when they are not hungry and continue to eat when they are full. Some people state they do not have any sensation of hunger, fullness, or satiety. Often, these individuals will eat rapidly outside of a binge episode but especially during a binge.

During a binge, people will eat until they notice that they are uncomfortably full, such as if overeating at a holiday meal. Many times sufferers will state that this is the only time that they know when they have eaten enough [1].

Co-Occurring Disorder

Co-occurring disorders such as anxiety, depression, bipolar disorder, and suicidal thoughts often coincide with this eating disorder. Typically, extreme guilt and shame, as well as embarrassment, immediately follow a binge episode. There appears to be no reward for BED behaviors [1].

Individuals who struggle with BED may start at an average weight but will gain and continue to gain weight as the eating disorder becomes more severe. The person will eventually become overweight and obese as the eating disorder takes hold and becomes chronic.

Some individuals first go to their primary medical doctor for help and treatment for weight loss. Often this is unsuccessful due to the nature of the eating disorder [1]. Many sufferers have a history of dieting behavior and food restriction, but this can regularly trigger binge eating behaviors.

Medical Complications

Binge Eating Disorder can trigger some medical problems to worsen. Many health issues such as obesity, joint pain, chronic pain, heart disease, type 2 diabetes, gastroesophageal reflux disease (GERD), and sleep apnea can all worsen due to binge eating.

Often when a person is feeling depressed, sleep deprived, or anxious, they are not thinking or behaving as they usually would. The eating disorder can affect the sufferer’s judgment, clarity, and perception, leading to behavior and emotional troubles.

This, in turn, can cause issues that affect sleep, eating, and daily activities, which can trigger episodes of binge eating episodes [1].

Emotional Changes

A person may feel depressed, disgust, shame, guilt or upset over a binge episode [2]. Emotions such as anger, anxiety, or shame will frequently trigger another binge episode, which will again work to numb these feelings.

Those with binge eating disorder commonly feel disgust over their body weight and size, and both men and women state social isolation due to body dissatisfaction. Commonly, sufferers share experiences of being bullied over their weight as a child which can lead to BED behaviors as an adult [2].

Treatment

Treatment for binge eating is necessary for recovery [3]. There are a variety of levels of care. The most common type of treatment modality for binge eating is outpatient, but residential, partial hospitalization and intensive outpatient programming can also be powerful tools for recovery.

Trauma and Abuse Work

Many treatment programs also offer programs that address trauma and trauma resolution interventions. These tracts are used to assist those with BED and their trauma in the recovery processes [3].

Typically evidence-based practices, such as cognitive-behavioral therapies, mindfulness-based interventions, and psychodynamic psychotherapies are used to help in the treatment of binge eating disorder.

Regardless of the severity of the eating disorder, it is essential that the sufferer gains treatment for the binge eating disorder. Find help from a treatment professional and begin the journey to recovery.

About the Author: Libby Lyons is a Licensed Clinical Social Worker and Certified Eating Disorder Specialist (CEDS). Libby has been practicing in the field of eating disorders, addictions, depression, anxiety and other comorbid issues in various agencies. Libby has previously worked as a contractor for the United States Air Force Domestic Violence Program, Saint Louis University Student Health and Counseling, Saint Louis Behavioral Medicine Institute Eating Disorders Program, and has been in Private Practice.

Libby currently works as a counselor at Fontbonne University and is a Adjunct Professor at Saint Louis University, and is a contributing author for Addiction Hope and Eating Disorder Hope. Libby lives in the St. Louis area with her husband and two daughters. She enjoys spending time with her family, running, and watching movies.

References:

[1] Binge-eating disorder. (2017, August 23). Retrieved February 06, 2018, from https://www.mayoclinic.org/diseases-conditions/binge-eating-disorder/symptoms-causes/syc-20353627
[2] Binge Eating Disorder in Males. (n.d.). Retrieved February 06, 2018, from https://www.nationaleatingdisorders.org/binge-eating-disorder-males
[3] Understanding Binge Eating Disorder. (n.d.). Retrieved February 06, 2018, from https://bedaonline.com/understanding-binge-eating-disorder/

The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published on April 27, 2018.

Published on EatingDisorderHope.com

The post Do I Have Binge Eating Disorder? appeared first on Eating Disorder Hope.

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Signs of Bulimia

Typically, a person who is struggling with bulimia has a preoccupation with their weight. Often those with disordered eating behaviors, or an eating disorder, may struggle with being somewhat overweight and trying to lose the weight.

The person may also have a fear of gaining weight or may start to talk obsessively about their weight, appearance, diet, and weight loss. This can all be an indicator of bulimia or another eating disorder.

Bulimia, like other eating disorders, can quickly become a severe health and mental concern. At first, the individual may have disordered patterns of behaviors and eating habits.

As a person begins to lose weight, he or she may hear praise or compliments from peers or loved ones that encourage the behaviors. As the disordered behaviors continue, it strengthens the eating disorder.

Individuals may start to eat alone, especially when engaging in a binge episode. They may hide binges by throwing away all the food wrappers, fast food containers, or replacing some of the food eaten. The person is trying to hide all evidence of a binge.

After binging, the sufferer begins to self-induce vomiting. This may be evident through cuts or scars on a person’s knuckles or small red pinprick marks on their face from burst blood vessels from the forced vomiting.

Someone struggling with bulimia may tend to spend long periods of time in the bathroom after eating. He or she might also tend to purge in the shower. Their loved ones may begin to notice that the shower and toilet are clogging more often than usual due to all the food from vomiting.

Binging Complications

When a person is engaging in daily vomiting, it can cause arrhythmia, heart palpitations, heart attacks and even death. Repeated vomiting can erode the enamel of a people’s teeth, leading to yellow teeth, mouth sensitivity, and rapid tooth decay.

Binging episodes can stretch a person’s stomach thus increasing the amount of food a person can eat. Increasing binges can rip the stomach lining causing stomach acid to spill into the body, which can lead to death [1].

Gastrointestinal problems such as painful stomach issues can result. Gastric reflux, inflammation of the esophagus, and paralysis of the stomach muscles can all occur due to bulimia.

Bulimia Defined

According to the National Institute of Mental Health, 1% of the adult population in the U.S. suffer from bulimia at some point in their life [1]. Women are more likely to develop bulimia than men [1]. Bulimia is recognized as a mental health disorder in the DSM-V defined diagnoseable criteria

Binge eating is defined in the DSM-V as eating a larger amount of food that other people would in a similar timeframe and similar circumstances [2]. A person, when binging, feels helpless and a lack of control over the behavior.

The individual will often state being unable to stop a binge, even if they want to do so. After a binge, the person will then engage in behaviors to prevent weight gain such as throwing up.

Physical Symptoms

A person with bulimia work to gain physical perfection, but the physical effects of binging, purging, and over-exercising can be extremely harmful and life-threatening to the sufferer.

Physical symptoms can include facial swelling, blood when vomiting, complaints of a sore throat, scarring on hands and/or knuckles, and tooth decay. Individuals may also have an irregular heartbeat, hemorrhoids, dry skin, dizziness or feeling faint, especially when standing, rising from laying down or going up or down stairs [2].

A person may have red eyes or burst blood vessels from vomiting, and difficulty with fertility. Other issues may include reduced sexual drive and complications in childbirth.

Psychological Symptoms

Psychological issues usually develop due to the distorted thought process. A person can have a continued preoccupation with body weight and shape, chronic fear of gaining weight, and a fear of becoming fat [2].

A sufferer may also have a distorted view of self when looking in a mirror or a reflective surface and may try to hide their body through baggy clothing. The person may also isolate themselves socially and not eat in front of others.

Self-Diagnosis

Often looking to online tools for assessments can be helpful. Questionnaires through the National Eating Disorder Association (NEDA) offer free; confidential assessment of the eating disorder and can recommend if you need to seek professional help and treatment.

Treatment

Treatment can come in various forms. Treatment includes psychotherapy, nutritional counseling, psychiatric care, and group and family therapy [3].

Cognitive-Behavioral

Psychotherapy includes Cognitive Behavioral Therapy which focuses on a person’s thoughts and emotions to change a person’s behaviors to a situation or trigger. This can help with triggers in a person’s environment that can make it difficult to recover from the eating disorder.

Nutritional Therapy

Nutritional Therapy can help a sufferer with setting a meal plan to regulate a person’s hunger cues and satiety level. A nutritionist can also work with an individual to dispel food myths and distorted food thoughts.

Medication Management

Meeting with a psychiatrist can help with medication management and co-occurring disorders such as depression and anxiety. Working with a psychiatrist can help manage symptoms and behaviors that might prolong the eating disorder.

Levels of Care

Residential, partial hospitalization, intensive outpatient programming, and outpatient therapy are the various levels of treatment for someone who has bulimia. All levels offer a team approach that works with the individual, family and friends, a medical doctor, therapist, nutritionist, psychiatrist, and group therapy [3].

Residential

Residential care is 24-hour support through an eating disorder treatment facility where all meals, group and individual therapy, nutritional support, and psychiatric sessions are provided. The person stays in the facility, typically for 30 days, depending on insurance coverage.

Partial Hospitalization

Partial hospitalization offers the same benefits as residential care except the person goes home at night. This offers the individual to be able to practice skills learned in individual and group therapy at home outside of the group, but to have the full support of meals and group therapy during the day. A typical length of stay at this level is two weeks to 30 days.

Intensive Outpatient Programming

Intensive outpatient therapy is group support. This level of care is offered three hours per day up to seven days per week, depending on the facility. Meals are provided by the client and checked by the eating disorder staff. Individual therapy, nutritional therapy, and psychiatric sessions are done outside of IOP group time. The length of stay at this level can be two weeks to one month.

Regardless of the severity level on the continuum of bulimia that a sufferer is dealing with, it is important to seek treatment. The earlier a person seeks professional care, the earlier they can recover.

About the Author: Libby Lyons is a Licensed Clinical Social Worker and Certified Eating Disorder Specialist (CEDS). Libby has been practicing in the field of eating disorders, addictions, depression, anxiety and other comorbid issues in various agencies. Libby has previously worked as a contractor for the United States Air Force Domestic Violence Program, Saint Louis University Student Health and Counseling, Saint Louis Behavioral Medicine Institute Eating Disorders Program, and has been in Private Practice.

Libby currently works as a counselor at Fontbonne University and is a Adjunct Professor at Saint Louis University, and is a contributing author for Addiction Hope and Eating Disorder Hope. Libby lives in the St. Louis area with her husband and two daughters. She enjoys spending time with her family, running, and watching movies.

References:

[1] Find the Best Bulimia Treatment Programs and Dual Diagnosis Rehabs. (n.d.). Retrieved February 06, 2018, from https://www.bulimia.com/topics/bulimia/
[2] Bulimia Signs and Symptoms – Am I Bulimic? (n.d.). Retrieved February 06, 2018, from https://americanaddictioncenters.org/bulimia-treatment/signs-symptoms/
[3] Bulimia nervosa. (2017, August 23). Retrieved February 06, 2018, from https://www.mayoclinic.org/diseases-conditions/bulimia/diagnosis-treatment/drc-20353621

The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published on April 26, 2018.

Published on EatingDisorderHope.com

The post Signs I Have Bulimia? appeared first on Eating Disorder Hope.

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Contributor: Margaret Garrity, RD, LDN, Director of Nutrition Services, Timberline Knolls Residential Treatment

The American culture has long been obsessed with the importance of being thin, especially in the female population. Girls, adolescents and adults alike feel the pressure to be thin every day.

Additionally, throughout recent decades, our society has become ever more focused on fitness and exercise. This creates a perfect storm for women and girls in the general population to diet and work out excessively.  By and large, such behavior receives across-the-board approval and reinforcement from family and friends.

The world of competitive athletics presents a whole new, and worrisome, problem for females.

This concern does not extend to group sports such as soccer and basketball; instead, the problem is confined to individual sports where the scrutiny is on a single person’s performance and appearance versus an entire team.

Participation in such activities as gymnastics, ballet, dance and ice skating, often starts at a very young age. Young girls quite routinely attend classes, even workshops, to refine their individual skills in a specific sport.

If even a modicum of innate talent is displayed and if parents have the time and resources, these skills are frequently nurtured into the pre-teen and adolescent years. And, that is when disordered eating can begin, and anorexia can take hold.

Female Athletes and Anorexia

The human body is designed to grow and mature according to a certain predetermined timeline. Girls are intended to eventually grow into women.

Unfortunately, breasts, rounded hips, and bottoms are contrary to the “look” so highly valued in the sports mentioned above, to say nothing of the weight-gain typically associated with this physical maturation.

As these very normal changes begin, it is not unusual for coaches and trainers to personally weigh their female athletes and place them on calorie-restricting diets.

The same holds true in endurance sports such as track and field, running, swimming or diving. Although these are less appearance-driven than ballet and dance, the perception is that a lower weight will improve the athlete’s performance.

Young female athletes often share similar personality traits: they are often highly competitive and disciplined, perfectionistic, and importantly, very eager to please their coaches and trainers. If this means starving themselves, then that is what it takes.

If severe restriction is started in the pre-teen years, menses and all that it implies can be negated completely. If body fat is too low, a female will not menstruate, simply because her body cannot sustain a pregnancy; therefore the possibility is not placed on the biological table.

Amenorrhea is still viewed as a red flag for diagnosable anorexia and has immediate and long-term medical consequences of its own.

Calcium and bone-loss can lead to stress fractures and over time can result in osteoporosis.

Due to heightened awareness of eating disorders in the competitive world of athletics, it is possible for females to participate in sports, even on an elite level, and still be safe.

Much of this involves the coaches. It is helpful if they have a positive, person-oriented style instead of a negative, performance-obsessed coaching style.

It is also preferable to have a coach who is more concerned with an athlete’s motivation and enthusiasm rather than body weight or shape.

Parents also need to be onboard, recognizing that the human body will change and develop as a girl ages and that is not a bad thing.

About the Author: Margaret Garrity, RD, LDN, is Director of Nutrition Services at Timberline Knolls Residential Treatment Center.

As Director of Nutrition Services, Maggie‘s job entails many duties. She oversees the dietitians and diet technicians, carries a caseload of adolescents, supervises the menu and meal planning stages and develops nutrition-related protocols. She also implements current nutrition recommendations, participates in community outreach and trains dietitians.

Prior to joining Timberline Knolls, Maggie was the Nutrition Manager at Revolution in Chicago. She started with Timberline Knolls as a diet technician and progressed to a Registered Dietitian.

Maggie attended Eastern Illinois University for her undergraduate degree in Dietetics and Nutrition and then completed her dietetic internship at Ingalls Memorial Hospital.

She is a member of the Academy of Nutrition and Dietetics, Behavioral Health DPG and South Suburban Academy of Nutrition and Dietetics.

The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published on January 12, 2018.
Published on EatingDisorderHope.com

The post Competitive Female Athletes & Anorexia Nervosa appeared first on Eating Disorder Hope.

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Residential Eating disorder treatment offers various levels of care and knowing which level is right for you depends on the severity of your disorder. Depending on the duration, the severity of your symptoms, and your needs will ultimately determine the type and level of care will be best suited for you.

Delivery of Services

Treatment for eating disorders can be received in hospitals, residential treatment facilities, private offices among other options [1]. The type of treatment can be acute, long-term, partial hospitalization or intensive outpatient care.

Numerous treatment offerings are provided during the day or evening, depending on work or school schedules. Facilities try to offer flexible treatment programs and schedules to best suit the sufferer’s needs.

Residential Eating Disorder Treatment

Typically a person will enter a hospital or residential setting when their eating disorder causes them to be medically unstable, or the symptoms are so severe that they need 24-hour care.

Once symptoms are stabilized, then the person can move to partial-hospitalization.

The treatment setting should ideally be in line with the goals of treatment. Most goals are to stabilize the individual medically, to help the person stop eating disorder behaviors, and to address and underlying mental health issues that could be maintaining the eating disorder [1].

Unfortunately, many eating disorder sufferers are primarily dependent on insurance for treatment coverage. Frequently, a person’s insurance coverage will determine the level of care that can be received.

Since health insurance has limits on what they will cover and pay, the severity and the duration of the eating disorder will also play a determining role as to what type of treatment can be received. Other influencing factors will include the eating disorder diagnosis and mental health co-occurring disorders.

Other influencing factors such as medical lab work, vital signs, and complications from medical issues such as diabetes, high cholesterol, etc. will be factored into the insurance’s coverage [1]. Insurance companies will also consider psychiatric problems that may worsen and possible suicidal risks when evaluating the options for level of care.

There are other mitigating factors that need to be addressed when considering what level is best [2]. One is the sufferer’s relationship with food and their eating behaviors. Frequently, sufferers who have eating disorders have unhealthy relationships with food.

Many times people will socially isolate and withdraw from activities due to their eating disorder and their obsession with food. Restriction, fasting, binging or purging and other behaviors become all-consuming in the person’s life.

These all-consuming issues are significant signs that something is wrong and the person is more than likely struggling with an eating disorder.

Regardless of the level of treatment, dieticians can play a significant role in recovery as they help with meal planning, dispelling food myths, and re-establishing healthy food thoughts or interactions

Treatment programs, whether residential, partial hospitalization, intensive outpatient, or outpatient should include various options. Often these options can include educational interventions, awareness tools, therapy, nutrition and meal planning, and psychiatric care [3].

Some key aspects of treatment options include:

Residential Care

Residential care is when you stay at a facility for 24-hour care. All meals, snacks, and support groups, therapy, and medication management is taken care of at the facility. A typical stay is two weeks to 30 days.

Partial Hospitalization

Partial hospitalization is the same is residential except the person gets to go home at night to sleep and come back for breakfast in the morning. A typical stay for partial hospitalization is two weeks to 30 days depending on insurance benefits.

IOP

Intensive outpatient treatment is the next step down in care which is 3 hours per day and up to 7 days a week depending on the facility. At this level, the individual provides their own meals which are checked by the facility staff.

If the sufferer’s meal does not meet the meal plan requirements, supplements are then provided. Normally, IOP programming is conducted in a group therapy format. Most other individual therapeutic and nutritional sessions are done outside of IOP sessions.

Outpatient Therapy

Outpatient therapy is when a person meets once per week up to three times per week with their outpatient counselor. They can meet with a nutritionist once per week or less depending on the sufferer’s needs. Psychiatric appointments are scheduled as needed.

Regardless of the level of care that an individual enters, eating disorder treatment is an invaluable resource. It is the initial step stone towards real recovery.

About the Author: Libby Lyons is a Licensed Clinical Social Worker and Certified Eating Disorder Specialist (CEDS). Libby has been practicing in the field of eating disorders, addictions, depression, anxiety and other comorbid issues in various agencies. Libby has previously worked as a contractor for the United States Air Force Domestic Violence Program, Saint Louis University Student Health and Counseling, Saint Louis Behavioral Medicine Institute Eating Disorders Program, and has been in Private Practice.

Libby currently works as a counselor at Fontbonne University and is a Adjunct Professor at Saint Louis University, and is a contributing author for Addiction Hope and Eating Disorder Hope. Libby lives in the St. Louis area with her husband and two daughters. She enjoys spending time with her family, running, and watching movies.

References:

[1] Treatment Settings and Levels of Care. (n.d.). Retrieved February 06, 2018, from https://www.nationaleatingdisorders.org/treatment-settings-and-levels-care
[2] Haines, S. (n.d.). Do I Need Treatment for My Eating Disorder: 5 Thoughts to Consider. Retrieved February 06, 2018, from https://www.waldeneatingdisorders.com/do-i-need-treatment-for-my-eating-disorder-5-thoughts-to-consider/
[3] Treatment Options. (n.d.). Retrieved February 6, 2018, from https://www.aedweb.org/learn/resources/treatment

The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published on April 25, 2018.
Reviewed By: Jacquelyn Ekern, MS, LPC on April 25, 2018.
Published on EatingDisorderHope.com

The post Do I Need Residential Eating Disorder Treatment? appeared first on Eating Disorder Hope.

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