Eating Disorders: Recovery

It’s estimated that 20 million women and 10 million men will experience an eating disorder at some point in their lives.1 People with eating disorders take such concerns to extremes, developing abnormal eating habits that threaten their well-being and even their lives. This fact sheet explains how psychotherapy can help people recover from these dangerous disorders.

What are the major kinds of eating disorders?

People with anorexia nervosa have a distorted body image that causes them to see themselves as overweight even when they’re dangerously thin. Often refusing to eat, exercising compulsively, and developing unusual habits such as refusing to eat in front of others, they lose large amounts of weight and may even starve to death.

Individuals with bulimia nervosa eat excessive quantities, then purge their bodies of the food and calories they fear by using laxatives, enemas, or diuretics; vomiting; or exercising. Often acting in secrecy, or feeling a lack of control as they binge, yet relieved of tension and negative emotions once their stomachs are empty again.

Like people with bulimia, those with binge eating disorder experience frequent episodes of out-of-control eating. The difference is that binge eaters don’t purge their bodies of excess calories.

It’s important to prevent problematic behaviors from evolving into full-fledged eating disorders. Anorexia and bulimia, for example, usually are preceded by very strict dieting and weight loss. Binge eating disorder can begin with occasional bingeing. Whenever eating behaviors start having a destructive impact on someone’s functioning or self-image, it’s time to see a highly trained mental health professional, such as a licensed psychologist experienced in treating people with eating disorders.3

Who suffers from eating disorders?

According to the National Institute of Mental Health, eating disorders are most common in teenagers or young adults, but can also affect almost anyone.3 People of all ages, backgrounds, body weights, and ethnicities can be affected by eating disorders. Although common in teenage women, men and boys can also be vulnerable. People sometimes have eating disorders without their families or friends ever suspecting that they have a problem. Aware that their behavior is abnormal, people with eating disorders may withdraw from social contact, hide their behavior, and deny that their eating patterns are problematic. Making an accurate diagnosis requires the involvement of a licensed psychologist or other appropriate mental health expert.

What causes eating disorders?

Certain psychological factors and personality traits may predispose people to developing eating disorders. Many people with eating disorders may suffer from low self-esteem, feelings of helplessness, and intense dissatisfaction with the way they look.

Specific traits are linked to each of the disorders. People with anorexia tend to be perfectionistic, for instance, while people with bulimia are often impulsive. Physical factors such as genetics may also play a role in putting people at risk.

A wide range of situations can precipitate eating disorders in susceptible individuals. Family members or friends may repeatedly tease people about their bodies. Individuals may be participating in gymnastics or other sports that emphasize low weight or a certain body image. Negative emotions or traumas such as rape, abuse, or the death of a loved one can also trigger disorders. Even a happy event, such as giving birth, can lead to disorders because of the stressful impact of the event on an individual’s new role and body image.

Once people start engaging in abnormal eating behaviors, the problem can perpetuate itself. Bingeing can set a vicious cycle in motion, for instance, as individuals purge to rid themselves of excess calories and psychic pain, then binge again to escape problems in their day-to-day lives.

Why is it important to seek treatment for these disorders?

Research indicates that eating disorders very often go untreated. In one study, for example, less than 13% of adolescents with eating disorders received treatment.

But leaving eating disorders untreated can have serious consequences. Research has found that individuals with anorexia have a mortality rate 18 times higher than peers who don’t have eating disorders, for example.5

Eating disorders can devastate the body. Physical problems associated with anorexia, for instance, include anemia, constipation, osteoporosis, even damage to the heart and brain. Bulimia can result in a sore throat, worn-away tooth enamel, acid reflux, severe dehydration, and intestinal distress. People with binge eating disorder may develop high blood pressure, cardiovascular disease, diabetes, and other problems associated with obesity.

Eating disorders are also associated with other mental disorders like depression. Researchers don’t yet know whether eating disorders are symptoms of such problems or whether the problems develop because of the isolation, stigma, and physiological changes wrought by the eating disorders themselves. What is clear from the research is that people with eating disorders suffer higher rates of other mental disorders—including depression, anxiety disorders, and substance abuse—than other people.6

How can a psychologist help someone recover?

It’s important to remember that there is not a one-size-fits-all approach to the treatment of eating disorders. Psychologists can play a vital role in the treatment of eating disorders and are integral members of the multidisciplinary team that may be required to provide patient care. As part of this treatment, a physician may be called on to rule out medical illnesses and determine that the patient is not in immediate physical danger. A nutritionist may be asked to help assess and improve nutritional intake.

A psychologist can help to identify the underlying issues and develop a treatment plan to help a patient work through some of the destructive thoughts and behaviors and replace them with more positive ones. For example, the focus may be on overall health and well-being, rather than weight. Or a patient might be asked to keep a food diary as a way of becoming more aware of the types of situations that trigger bingeing.

Simply changing one’s thoughts and behaviors may not be enough, however. A psychologist may recommend evidence-based treatments such as psychotherapy to help address the underlying psychological issues of the eating disorder, or it may be used to focus on improving one’s personal relationships. It may involve helping one get beyond an event or situation that triggered the disorder in the first place. Group therapy may also be helpful in the treatment of an eating disorder.

Some patients may be prescribed medications as part of their treatment plan, but it’s important to follow the instructions of your health care or mental health professional about taking medications and the possible side effects.

Does treatment really work?

In most cases, eating disorders can be treated successfully by appropriately trained health and mental health care professionals. But treatments do not work instantly and for many, treatment may be long-term.

Incorporating family or marital therapy into one’s care may help to prevent relapses by resolving interpersonal issues related to the eating disorder. Therapists can guide family members in understanding the disorder and learning new techniques for coping with problems. Support groups can also help in overcoming an eating disorder.

The sooner treatment starts, the better. The longer abnormal eating patterns continue, the more deeply ingrained they become and the more difficult they are to treat.

Eating disorders can severely impair one’s functioning and health. But the prospects for long-term recovery are good for those who seek help from appropriate professionals. Qualified therapists, such as licensed psychologists with experience in this area, can help those who suffer from eating disorders regain control of their eating behaviors and their lives.

References

1, 2 National Eating Disorders Association. (2018). Other Specified Feeding or Eating Disorder.

3 National Institute of Mental Health. (2018). Eating disorders.

4 Merikangas, K. R., He, J.-p., Burstein, M., Swendsen, J., Avenevoli, S., Case, B., Georgiades, K., Heaton, L., Swanson, S., & Olfson, M. (2011). Service utilization for lifetime mental disorders in U.S. Adolescents: Results of the National Comorbidity Survey-Adolescent Supplement (NCSA). Journal of the American Academy of Child & Adolescent Psychiatry, 50(1), 32–45. https://doi.org/10.1016/j.jaac.2010.10.006

5 Steinhausen, H.-C. (2009). Outcome of eating disorders. Child and Adolescent Psychiatric Clinics of North America, 18(1), 225–242. https://doi.org/10.1016/j.chc.2008.07.013

6 Hudson, J. I., Hiripi, E., Pope, H. G., Jr., & Kessler, R. C. (2007). The Prevalence and Correlates of Eating Disorders in the National Comorbidity Survey Replication. Biological Psychiatry, 61(3), 348–358. https://doi.org/10.1016/j.biopsych.2006.03.040

This article was reprinted with permission by the American Psychological Association (APA).

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