Signs and Symptoms of an Eating Disorder
- Skipping meals or making excuses for not eating
- Adopting an overly restrictive vegetarian diet
- Excessive focus on healthy eating
- Making own meals rather than eating what the family eats
- Withdrawing from normal social activities
- Persistent worry or complaining about being fat and talk of losing weight
- Frequent checking in the mirror for perceived flaws
- Repeatedly eating large amounts of sweets or high-fat foods
- Use of dietary supplements, laxatives or herbal products for weight loss
- Excessive exercise
- Calluses on the knuckles from inducing vomiting
- Problems with loss of tooth enamel that may be a sign of repeated vomiting
- Leaving during meals to use the toilet
- Eating much more food in a meal or snack than is considered normal
- Expressing depression, disgust, shame or guilt about eating habits
- Eating in secret
Causes of Eating Disorders
The exact cause of eating disorders is unknown. As with other mental health issues, there may be many causes, such as:
- Genetics. Certain people may have genes that increase their risk of developing eating disorders. People with first-degree relatives — siblings or parents — with an eating disorder may be more likely to develop an eating disorder. Eating disorders often run in families. Current research indicates that there are significant genetic contributions to eating disorder.
- Psychological and emotional health. People may have temperaments that make them more venerable to developing eating issues. Low self-esteem; feelings of inadequacy or lack of control in life; depression, anxiety, anger, stress or loneliness also make individuals more vunerable.
- Society. Success and worth are often equated with being thin in popular culture. Peer pressure and what we see in the media may fuel a distorted ideal.
Treatment for Eating Disorders
At Clarity Counseling Center we provide eating disorder treatment to the Wilmington, NC area using counseling and therapy with (CBT) strategies coupled by nutrition counseling. We aim to improve client quality of life through enhanced cognitive and emotional awareness and regulation. In treatment of eating disorders, we encourage a team approach to include clients, family members, psychiatrists, nutritionists, and primary care physicians working in collaboration to support clients during treatment. At Clarity Counseling Center we treat anorexia nervosa, bulimia, binge purge disorder, ARFID, as well as Body Dysmorphic Disorder in the Wilmington NC community. We have nutritionists and counselors on staff to ease collaboration.
CBT for Eating Disorders
CBT is structured treatment that focuses on the present and the future. The cognitive-behavioral model emphasizes the important role that both thoughts (cognitive) and actions (behavioral) can play in maintaining an eating disorder. Examples of maintaining factors include:
Cognitive Factors ~ over-evaluation of weight and shape, negative body image, core beliefs about self-worth, negative self-evaluation, perfectionism
Behavioral Factors ~ weight-control behaviors including dietary restraint, restriction, binge-eating, purging behaviors, self-harm, body checking and body avoidance
Individuals with eating disorders often hold a negative or distorted view of themselves and their bodies. These highly critical thoughts can result in feelings of shame, anxiety or disgust that often trigger weight control behaviors and fuel a cycle of negative self-evaluation. Guided by a therapist, CBT helps the individual to examine which specific factors are maintaining their disorder and to set personalized goals that are addressed throughout the various phases of CBT.
The phases of Cognitive Behavior Therapy:
CBT stresses education and skills training that help the patient gain a thorough understanding of themselves and their eating disorder so that healing can occur. Three phases of CBT may unfold over the course of the inpatient, partial hospital and IOP programs, and some or all of them may take place during outpatient therapy.
1. Behavioral Phase: The patient and therapist work together to formulate a plan for stabilizing eating and eliminating symptoms. Because emotions often intensify during this phase of treatment, tools (coping strategies) for managing these feelings are developed and become an important part of the work. CBT includes in-session activities as well as “homework” so that new behaviors can be practiced.
2. Cognitive Phase: As treatment progresses, cognitive restructuring techniques (e.g., techniques aimed at recognizing and changing problem thinking patterns) are introduced. Thoughts and beliefs that perpetuate the problems (“I will only be happy if I can lose this weight”) are identified and work aimed at developing new perspectives and ideas (“my self-worth doesn’t depend on my size or shape”) begins. Additionally, during this stage of treatment, broader concerns such as relationship problems, body image, self-esteem problems, and emotion regulation are addressed.
3. Maintenance & Relapse Prevention Phase: The final stage of CBT concentrates on reducing triggers, preventing relapse and maintaining the progress that’s been made.
Even though CBT is focused on the elimination of symptoms, the overall goal of the treatment is to assist the patient in making their return to a healthy and fulfilling life. So, very often, once symptoms are stabilized, treatment will expand to include other areas of concern and conflict that can help individuals move towards holistic healing and emotional well-being.
The role of nutrition services is very important in the treatment of an eating disorder. Our dietitians work with patients who are often terrified of eating, to help them achieve a balanced pattern of nutrition and reach their goals.