Eating Disorders
What are Eating Disorders?
Eating Disorders are serious conditions that imply bad habits about diet and food intake, an abnormal concern about weight or body shape and severe physical and psychological consequences.
Eating disorders usually develop at an early age (most frequently during adolescence), causing severe consequences on the body and brain development.
When we talk about Eating Disorders, we refer to Binge Eating Disorder, Anorexia Nervosa. Bulimia or Eating Disorder not otherwise specified (EDNOS).
Binge eating disorder
Binge Eating Disorder (BED) implies the presence of frequent binges without any compensating behaviour (such as the use of laxative, physical activity, vomiting, …).
Binges are usually followed by intense emotional consequences, such as shame, guilt, disgust or depression for what has just happened.
A binge can be defined as the ingestion of a great amount of food (much more than what the person would normally ingest) in a short period of time (maximum 2 hours).
Moreover, the binge is usually accompanied by a great sense of lack of control, put into practice in secrecy and triggered by intense emotional states. Overeating may indeed become a way to cope with difficult emotions.
BED is usually associated with overweight and obesity.
If you want to know more about BED, read my article: “Overeating as a coping mechanism: Binge Eating Disorder” by I. Tedeschi.
Anorexia Nervosa
Anorexia Nervosa (AN) is a very severe condition implying a refusal to adequately eat and gain the weight expected depending on the age and height.
The person is unreasonably scared of getting weight and becoming fat; this leads to severe diet restrictions and checks of calories intake.
Usually the is an abnormal self -perception, with weight having such a great impact in defining self-esteem.
The greatest problem about AN is making the person aware that there is a problem, as they very difficulty admit the severity of their condition.
Bulimia Nervosa
Bulimia Nervosa (BN) is characterised by recurrent binges and the presence of compensating behaviours to cope with the ingestion of such a high amount of food. Compensating behaviours include vomiting, practising intense physical activities, intake of laxatives or other drugs, diet restrictions, …
Also in BN self-esteem is totally relying on weight and body shape, but the main difference with AN is the alternation of periods of intense diet restrictions and not controlled binges.
How can they be treated?
Depending on the type of disorder, different guidelines are suggested by NICE.
- BED: guidelines suggest Cognitive Behavioural psychotherapy and/or pharmacotherapy with SSRI. CBT can be very helpful for Binge Eaters in breaking the vicious cycles that maintain the problem. Therapy usually goes through regularising eating habits and working in recognising the chain of events responsible for the binges, while fostering new coping mechanisms.
- BN: as for BED, guidelines suggest CBT as the first choice treatment (or Interpersonal Psychotherapy as second choice) and/or pharmacotherapy. Seeking different healthcare professionals health could be useful to check on the physical consequences of BN. CBT can help in strengthening self-esteem, working on perfectionism and emotions’ coping mechanisms.
- AN: as AN is a potential life-threatening disease, it should be treated by a team of professionals always monitoring the physical risk of the patient. Depending on the severity the treatment can be offered as outpatient or inpatient. Different forms of psychotherapy are suggested (CBT, interpersonal psychotherapy or Cognitive Analytic Therapy).