Taking the Mystery Out of Eating Disorder Treatment

For years, individuals with eating disorders were simply told to eat more (or in cases of binge eating disorder, eat less) or otherwise discounted. Fortunately, in recent decades, there has been a distinct shift in the way eating disorder treatment specialists, nutritionists,and clinicians look at eating disorder signs and symptoms. It’s resulted in a sea change in what treatment for eating disorders looks like in the modern age – there is a much greater focus on accentuating natural eating, i.e. eating foods a person likes and when they like. The focus is now much more on treating behavior rather than weight although concerns about weight can be a trigger for disordered eating behaviors, the goal of treatment should be to correct disordered behaviors primarily. This has also started a slow, but promising, change in the way society at large perceives these common but dangerous conditions.

People With Eating Disorders Aren’t Crazy; They Have a Disorder

Although eating disorders are mental health conditions recognized by the medical and psychiatric professions (most eating disorders are listed in the DSM-V since binge eating disorder was added in 2013), there remains a tendency for people who haven’t encountered an eating disorder to think sufferers are “crazy.” These conditions are normally marked by a sense of lost control when it comes to eating, whether engaging in food restriction, binging, or purging. Individuals who have an eating disorder feel compelled to engage in disordered behaviors like self-starvation, associated with anorexia nervosa, or self-induced vomiting after meals, associated with bulimia nervosa. These behaviors seem unfamiliar and extreme to laypeople, but they’re no different than more “acceptable” mental health disorders like chronic depression or anxiety disorders.

What Makes Them Different from Depression or Anxiety?

Although the more well-known disorders can sometimes result in disordered behaviors like increased sleeping with depression, or repetitive actions that may occur with OCD, eating disorders are different in that they by definition involve disordered eating or exercise patterns. This often results in serious physical complications, which vary depending on the type of disorder but normally include some form of nutritional imbalance. Additionally, people with an eating disorder also have depression and a wide range of anxiety disorders at a much higher rate than the general population.

There are some similarities between eating disorders and other mental health disorders, of course. Both kinds often begin with a few small symptoms and increase incrementally. Nearly everyone goes through phases where they might compulsively overeat or restrict their food intake, just like nearly everyone gets down or anxious from time to time. A major warning sign of eating disorder development is when someone begins to display this type of behavior regularly. Frequent binge eating episodes and in particular planning for them by hoarding food and making an effort to hide the binges, for example, are a sign that disordered behavior has progressed from a possible problem to a true disorder, just as panic attacks can increase in frequency, indicating a full-blown case of anxiety disorder. Simply put, eating disorders are treatable conditions just like any other mental health disease.

Exploring and Explaining Eating Disorder Treatment

Any man or woman can be affected by an eating disorder — even those who have what is medically considered to be a “normal” weight. This contradicts the media-driven idea that everyone with an eating disorder is malnourished or obese, depending on the type of disorder.The shift in treatment philosophy we mentioned above is directly related to this understanding. Unlike the misconception many people hold that an eating disorder treatment facility is a lock-down hospital setting where people are force-fed, eating disorder treatment has largely centered on cognitive retraining designed to eliminate disordered behaviors and a HAES philosophy that encourages eating for pleasure and satiety, ignoring weight gain. HAES stands for Healthy At Every Size, and it strives to remove the preoccupation with body weight and size that affects many people with eating disorders.

Physical and Medical Treatment Is Part of Treatment, But Not All of It

While there may be extremely dangerous physical symptoms resulting from untreated eating disorders, ranging from malnutrition to osteoporosis and even death, treating the psychological aspects of the diseases is just as important as treating the physical ones. For example, guilt and shame about both the person’s body and their disordered behaviors are almost always part of an eating disorder, and these must be factored into any recovery program for eating disorders that the individual undergoes.

Additionally, many people who have an eating disorder, such as compulsive overeating disorder, often have a co-occurring mental health condition. The previously mentioned anxiety and depression, for example, can both trigger and be triggered by the symptoms of various eating disorders. That’s why a course of treatment that focuses on self-improvement through guided talk therapy and evidence-based methods like DBT are so frequently used. They are time-tested and help people see that they have a manageable disease, not a death sentence or an admission of fault.

It must be mentioned that trauma is a common triggering factor for disordered eating behaviors; many disordered eating behaviors begin as coping mechanisms for PTSD. Many disordered eating behaviors trigger the release of chemicals into the brain that improve the mood and bring contentment, such as serotonin and dopamine. The relief from negative emotion and PTSD that this brings can lead to repeated behaviors, almost like an addiction.

There are various forms of treatment used at eating disorder treatment centers, ranging from standard talk therapy in individual and group sessions to what has come to be known as “alternative therapies” like art classes, yoga, massage, and animal-assisted therapy. Normally a combination of different therapeutic techniques will be included in a treatment program; relying on a single method normally does not prove successful.

Especially in cases where trauma is present, cognitive retraining treatment methods are useful, especially CPT (Cognitive Processing Therapy). This retraining method was specifically designed to work with individuals whose PTSD is contributing to eating disorder behaviors. Normally conducted over 12 stages, CPT begins with education about PTSD and how it influences the way people think and feel. With time and increased knowledge, the individual comes to see how their trauma has influenced the way they act. They can then learn to disassociate their feelings related to their trauma from their actions. These are sometimes known as their “automatic” feelings, and with the blessings of awareness, they can be identified and stopped as soon as they happen. CPT has proven extremely successful in treating trauma, PTSD, and related mental health disorders since its created several decades ago.

What Are the Causes of Eating Disorders?

While there are often no clear answers regarding what causes eating disorders,research has found that a combination of factors most often combines to create them. These include a large genetic component, social factors, and emotional/psychological factors.

As mentioned previously, compulsive overeating and conditions like depression, low self-esteem, and anxiety are often related.The presence of these psychological conditions can contribute to binge eating disorder, ARFID, bulimia nervosa, and others. Trauma in the form of abuse or violence, for example, could result in the individual developing PTSD, whose stresses then resulting in disordered eating as a coping mechanism.

The enormous social pressure that exists in regards to being thin could lead to some people turning to eating as a way to manage their emotions. In other cases, there is a biological and genetic component to most eating disorders – people whose parents showed signs of eating disorders are more likely to develop one.[i]This is why it’s necessary for any course of eating disorder treatment to begin with a thorough assessment – to determine the underlying causes and treat them with clear eyes.

Eating Disorders Are Very Treatable

Eating disorder treatment still faces an untrue image problem – that it’s harsh and the people receiving the treatment are “crazy” or past help. The truth is, like any other mental health issue, eating disorders are potentially dangerous, but completely treatable through compassionate psychological counseling and medical treatments. More specialized treatment methodologies have been developed that provide better outcomes for the majority of patients – and more steps are taken each day to provide more inclusivity for people in treatment, including teenagers, men (who have been underserved in the past), LGBTQ individuals, and BIPOC.

An eating disorder diagnosis can be scary, and the prospect of entering a treatment facility just as much so. However, eating disorder treatment is more than capable of helping people with eating disorders make a full recovery. If you or a loved one is experiencing an eating disorder – don’t panic. Reach out to an eating disorder treatment facility today and get the treatment you need.