EATING DISORDERS
Eating disorders are amongst the most complex and least understood of all psychiatric disorders. According to the BEAT website 1.25 million people in the UK struggle with an eating disorder. One quarter of whom are males.
Eating disorders can have devastating ripple effects and impact all areas of life. There are many possible reasons for their development but, despite the general rule, eating problems will have their own meaning to each individual.
Rate and length of recovery varies significantly and whilst some people will experience a full recovery it is estimated that over 20% remain chronically ill. It can take time to overcome an eating disorder, but recovery is significantly improved when treatment is sought early in their development. There are many types of eating disorders:
Anorexia Nervosa: is characterized by low weight, or fast weight loss, due to restricted food and fluid intake. In addition, many individuals also engage in over-exercise and other compensatory behaviours aiming to use up more energy than they consume. Initial weight loss goals are recurrently re-adjusted in a self-competitive manner, which can feel difficult to halt.
Bulimia Nervosa: A significant proportion of individuals attempt to restrict food intake, often bingeing when control over food is lost. In the past we used to believe that people dieted because they binged. Nowadays we understand people will binge after a period of food restriction, when control invariably breaks down. This is an evolutionary mechanism to preserve life (replenish fat storages in the presence of resources to survive periods of food scarcity). In panic many will attempt to compensate for their binges by over-exercising, abusing laxatives, diuretics or other metabolic drugs, and induce vomiting. Thus maintaining the binge-purging cycle.
Binge Eating Disorder (BED): Is characterized by loss of control and consumption of large amounts of food over short periods of time and is not followed up by compensatory behaviours. Binges often feel emotionally distressing and can be painful. People report a variety of reasons for bingeing, and for many it may also be a way to numb or replace difficult feelings. Binge Eating can be associated to weight gain (though not always) and also other medical conditions such as high blood pressure, cholesterol, heart disease and diabetes.
OSFED (Other Specified Feeding or Eating Disorder): Is a diagnostic used when people do not fit into a neat category, for example night feeding or Bulimia Nervosa which is not characterized by purging. OSFED is the most common diagnosis amongst eating disorders.
ARFID (Avoidant/Restrictive food intake disorder): When someone avoids certain types of food or restricts their food intake because of their characteristics, rather than due to concerns with shape, weight or control.
As you may have noticed, clinicians and researchers have made considered efforts to classify eating disorders in neat categories. However, there are many similarities between them with food often used to modulate uncomfortable emotions which feel difficult to tolerate.
The “Transdiagnostic Model” postulates that an eating disorder will likely change presentation if not treated. A familiar trajectory in the absence of treatment is from Anorexia to Bulimia to Binge Eating. A common feature of eating disorders is underlying low self-esteem and an initial quest for control. Unfortunately, initial soothing feelings (often of power and control) are quickly replaced by a sense of powerlessness and loss of control over food and life, accompanied by intense emotional distress and shame. Consequently, many people will keep their eating difficulties a secret, preventing them from reaching out at a time when they most need help.
However, there is hope and specialist therapy can be effective. Our specialist clinicians at Oxford Mind & Body we are trained in a variety of therapeutic approaches used in the treatment of eating disorders and we are keen to find a way of working that fits your individual needs. The therapy journey is often difficult, as it can be intensely distressing to do the opposite from what the eating disorder mindset tells one to do. These challenges notwithstanding, we have found that those who persevered reported significant symptom improvement and amelioration of emotional distress. Do get in touch to book an appointment.
