Eating Disorders

ANOREXIA NERVOSA (AN)

Anorexia Nervosa (AN) is one type of eating disorder. People with AN limit the amount they eat, and, as a result, have a low body weight. They are also afraid of weight gain and, by and large, refuse to gain weight. Thinness is central to these individual’s self-evaluation. Because of this, people with AN fixate on their weight. In addition, their skewed perception often leads them to believe they are living larger bodies. Because of this, individuals with with the disorder may not even think that they need to gain weight.

Meanwhile, people with AN often receive praise for their low weight. This, likewise, makes those with this mental illness more reticent to gain weight. Most of those with this eating disorder also do not recognize how serious their condition is. This also encourages their desire to maintain an unhealthy weight. When taken together, these factors often make these people resistant to getting help. All told, they often like a great deal about their disorder in spite of its drawbacks.

​There are two types of AN:

• Restricting type involves a range of behaviors, for example: dieting, fasting and excessive exercise.
• Binge-eating/purging type involves purging behaviors, like self-induced vomiting or laxative abuse, after binges.

Even though the binge-eating/purging type sounds like Bulimia Nervosa, there is one key difference. Namely, those with Bulimia have a more “normal” weight than those with AN.

THERAPY FOR ANOREXIA NERVOSA

An Intuitive Eating approach is ultimately part of recovery for those with AN. To start, though, those with AN follow structured meal plans to restore a healthier weight. This may include a meal plan or the use of a food exchange to begin with.

In addition to Intuitive Eating, CBT-E is an evidence-based therapy for Eating Disorders. Like Cognitive-Behavioral approaches generally, CBT-E considers the function of behaviors. Thus, in this case, the focus is on understanding what causes and maintains Eating Disorder behaviors. In order to help those with AN gain awareness, CBT-E makes use of behavioral logging. In treatment, people consider how much importance they are giving to weight. More often than not, people with AN measure there worth based on a limited number of categories. As stated above, these individuals also place a lot of their self-worth on their weight. Therefore, it is important to explore other categories considered in self-evaluation and the amount of importance placed on each. For many with AN, moods also impact their behaviors. Therefore, learning how to manage feelings can be part of CBT-E.

BINGE EATING DISORDER

Binge Eating Disorder (BED) is similar to Bulimia Nervosa, but does not involve compensatory behaviors. When people with BED binge, they do feel the same lack of control as those with Bulimia do. A number of behaviors surface as a part of BED, for example eating in the absence of hunger, experiencing extreme fullness, hiding eating due to embarassment and shame, and feeling guilty or disgusted in the aftermath of a binge.

THERAPY FOR BINGE EATING DISORDER

Intuitive Eating helps those with BED in having a healthier relationship with food. First, those with BED must give themselves permission to eat all foods. This may seem strange given that those with BED tend to eat all sorts of foods. The reality is that those with BED still negatively judge their food choices. While they eat all sorts of foods, it is not with their “permission.” Thus they vacillate between being “good” and eating healthy foods or being “bad” and overeating unhealthy foods. So much of the work here is to learn to make space for all foods at the table.

Once all foods are allowed, individuals cease cramming in foods that they enjoy but “shouldn’t” eat. They start to actually listen to their hunger and fullness cues in order to optimize their overall satisfaction. It doesn’t take long for people to appreciate that the experience of eating past fullness is unpleasant and isn’t worth the enjoyable tastes associated with overeating.

CBT-E is also central to the treatment of BED. As with Anorexia and Bulimia, CBT-E for BED focuses on understanding the mechanisms by which binge eating is triggered and perpetuated. Thus, a main focus of treatment is regular eating. In CBT-E, people also learn to cultivate other aspects of their lives that they believe are more important than weight and shape. For those with BED, this shift of focus can help people to prevent the dietary restraint that often precedes binges. Shifting priorities helps to limit binges indirectly.

ORTHOREXIA

While not yet a formal diagnosis unto itself in the DSM, Orthorexia is becoming increasingly prevalent as the idea of “clean eating” gains popularity. Orthorexia involves rigidity related to eating “healthy” or nutrient-dense foods. Of course, there is nothing inherently wrong with attempting to infuse your eating with a fair dose of nutrition, but those with Orthorexia become fixated on rules related to what foods are and are not acceptable, resulting in upset and life challenges.

AVOIDANT RESTRICTIVE FOOD INTAKE DISORDER (ARFID)

ARFID involves food-related fears, a disinterest in food or a sensitivity to the sensory aspects of food that results in nutrient deficiency, weight loss or being underweight, dependence on supplements or feeding tubes, or interference with psychosocial functioning.

THERAPY FOR ARFID

Research supports the use of Cognitive Behavioral Therapy (CBT-AR) in the treatment of ARFID. CBT-AR includes a specific type of behavioral therapy known as Exposure and Response Prevention (ERP). In treatment, those with ARFID learn to slowly but surely face the foods that they’ve been avoiding. While facing the foods they’ve avoided, individuals with ARFID learn to refrain from safety behaviors. That is to say, people with ARFID practice eating without asking for reassurance or over chewing foods.

OTHER SPECIFIED OR UNSPECIFIED EATING DISORDER

AND DISORDERED EATING

Not everyone who has an eating disorder fits neatly into one of the categories above. Some people may restrict significantly without being underweight. Some people purge in the absence of binges. Just because your experience isn’t perfectly depicted by one of these diagnoses doesn’t mean that you shouldn’t seek out  support or treatment for an issue that is negatively impacting your life. People who still have clinically significant distress and impairment as a result of their relationship with food may meet criteria for Other Specified Eating Disorder or Unspecified Eating Disorder. 

More than that, you can seek help and support at the earlier stages, before your relationship with food turns disordered. If you have a lot of noise around food, your challenges and struggles are valid and deserve attention. You can click the links that follow to learn more about therapy for eating disorders including Intuitive Eating and CBT-E.

INTERESTED IN THERAPY FOR EATING DISORDERS?

Are you or a loved one struggling in relation to food and looking for help? Therapists at the Center for the Obsessive Mind use Intuitive Eating, Cognitive Behavioral Therapy and Acceptance and Commitment Therapy to support those with eating disorders. You can learn more about the treatments and services we provide here.

LOCATIONS

The Center for the Obsessive Mind offers

therapy in several states and internationally.

Learn more about where the staff practices, below.

CALIFORNIA

The Center for the Obsessive Mind’s staff therapists offer online therapy for eating disorders throughout California. Our Clients span from San Francisco down to Southern Orange County and San Diego. Whether you’re in Silicon Valley, Santa Barbara, Beverly Hills or Dana Point, the Center’s staff can support you in your recovery.

UTAH

Staff members at the Center for the Obsessive Mind offer treatment for eating disorders in the state of Utah. Since we provide teletherapy, we works with people who live in different areas of the Beehive State – from Salt Lake City and its suburbs, like West Jordan, Syracuse, Highland and Riverton, to Park City and St. George.

FLORIDA

Therapists at the Center for the Obsessive Mind also offer therapy for eating disorders online in Florida. We see people from all corners of the Sunshine state. Whether you’re from Naples, Orlando, Miami, or Boca Raton, we can provide specialized counseling remotely in your area.

NEVADA

Therapists at the Center for the Obsessive Mind also practice teletherapy in Nevada. So if you’re seeking help in Glenbrook, Incline Village, Reno or Las Vegas, we offer specialized therapy for eating disorders online across the Grand Canyon State.

INTERNATIONAL

In addition to all of the locations previously listed, the staff at the Center for the Obsessive Mind offer teletherapy for eating disorders to a number of countries internationally.

ONLINE

Online therapy isn’t right for everyone. An assessment must be done to determine if online therapy is appropriate for your needs. You can reach out here to learn more