Eating disorders have been prominent within society for decades now. Body image is something that a lot of us are affected by, some more than others. With magazines, television and now social media, it is hard for us to have clarity on what is healthy for us and what is purely done to “look good”. There are those individuals who begin view body image in a fairly unhealthy manner, that their relationship with food becomes toxic.
What is an eating disorder?
Eating Disorder is an illness where people experience severe disturbances in their eating behaviors and related thoughts and emotions. People with eating disorders typically become pre-occupied with food and their body weight. In many cases, eating disorders occur together with other disorders such as anxiety, panic, obsessive compulsive disorder and alcohol and drug abuse problems.
There are various types of eating disorders. They are the following:
- Anorexia Nervosa
- Binge Eating Disorder
- Other Specified Feeding and Eating Disorders (OSFED)
- Avoidant Restrictive Food Intake Disorder (ARFID)
- Rumination Disorder
- Unspecified Feeding or Eating Disorder (UFED)
Treatment for eating disorder
Eating disorder clearly illustrate the close links between emotional and physical health. The first step in treating anorexia nervosa is to assist clients with regaining weight to a healthy level; for patients with bulimia nervosa interrupting the binge-purge cycle is key. For client with binge eating disorder it is important to help them interrupt and stop binges.
That being said, restoring a person to normal weight or temporarily ending the binge-purge cycle does not address the underlying emotional problems that cause or are made worst by the abnormal eating behavior. Psychotherapy helps individuals with eating disorders to understand the thoughts, emotions and behaviors that trigger these disorders. Your physician or psychiatrist is the right person to discuss whether medication has a place in your overall care.
Cognitive Behavioral Therapy for eating disorders
Cognitive Behavioral Therapy (CBT) for eating disorders is a well-established, evidence-based approach for bulimia nervosa and binge eating disorder. It can also be provided in group formats and higher levels of care, such as residential or inpatient settings.
One randomized controlled trial compared five months of CBT (20 sessions) for women with bulimia nervosa with 2 years of weekly psychoanalytic psychotherapy. Seventy patients were randomly assigned to one of these two groups.
After 5 months of therapy, 42% of patients in the CBT group and 6% of patients in the psychoanalytic therapy group had stopped binge- eating and purging. At the end of 2 years, 44% of the CBT group and 15% of the psychoanalytic group had stopped binge eating and purging.
Source: Poulsen S, Lunn S, Daniel SIF, Folke S, Mathiesen BB, Katznelson H, Fairburn CG. A randomized controlled trial of psychoanalytic psychotherapy or cognitive-behavioral therapy for bulimia nervosa. American Journal of Psychiatry, 2014;171(1):109-116.
Components of CBT Treatment
CBT is a structured treatment. Goals are set and sessions and typically spent weighing the client, reviewing the case formulation, teaching skills and problem-solving.
CBT typically includes the following components:
- Challenge of dietary rules. This involves identifying rules and challenging them behaviorally (such as eating after 8 p.m. or eating a sandwich for lunch).
- Completion of food records immediately after eating and noting thoughts and feelings as well as behaviors.
- Development of continuum thinking to replace all-or-nothing thinking.
- Development of strategies to prevent binges and compensatory behaviors, such as the use of delays and alternative and problem-solving strategies.
- Exposure to fear foods. After regular eating is well-established and compensatory behaviors are under control, patients gradually reintroduce the foods they fear.
If you or anyone you know is showing signs of any form of an eating disorder, do not hesitate to contact one of our psychotherapists that are more than happy to help with any issues you might be facing! We are one click away from a brighter, healthier future.
Our scope of practice
InnerSight is not a medical or dietetic service. Registered Psychotherapists do not diagnose, prescribe, meal-plan or medically monitor. We work alongside your physician and dietitian as part of your wider care team.
If you need support with an eating disorder right now, NEDIC (the National Eating Disorder Information Centre) can be reached at 1-866-633-4220. If you are in crisis, call or text 988 for the Suicide Crisis Helpline. If you or someone else is in immediate danger, call 911.