Eating Disorders

 

The four most common eating disorders are anorexia nervosa (anorexia) bulimia nervosa (bulimia), binge eating disorder and Orthorexia nervosa.

 

Anorexia is an eating disorder in which an individual is terrified of gaining weight and so decreases the amount of food that (s)he will eat until (s)he literally begins to starve.

 

Bulimics, in contrast, consume an excessive amount of food in one sitting and then purge by making themselves sick or taking laxatives/diuretics.

 

Binge eaters eat excessively in one sitting, or eat constantly and excessively such as by “grazing” all day, but do not usually engage in any purging behaviours afterwards.

 

Orthorexia may be diagnosed if the person develops an obsession with "healthy" eating and any foods perceived by the individual as "unhealthy" (such as those containing fats, preservatives & other additives) may be avoided.

 

Although eating disorders manifest themselves in varying ways, the underlying themes are the same. Sufferers of eating disorders cannot separate their emotions from their eating habits and this influences the way, and the amount, that they eat. Most often those with eating disorders feel overwhelmed by life, have low self-esteem and self-confidence and believe that they are physically unattractive and weigh too much (regardless of how much they truly weigh). Although those with eating disorders rely on their eating behaviours as a way of coping with these emotions, often, behaviours such as binging and purging bring further feelings of guilt, shame, or remorse.

 

People suffering with anorexia and bulimia often endure a variety of physical ailments related to their eating disorders. Those with anorexia, or those whom fear weight gain and combat it by restricting their caloric intake, can suffer from the effects of malnutrition including a weakening of the stomach muscles, ulcers, and stomach “shrinking” or distending. Those with bulimia, or individuals whom routinely binge and then purge, can also suffer from stomach problems such as a similar weakening of the stomach muscles, ruptures or tears in the stomach walls, stomach pain or a general upset stomach, damage to the oesophagus and stomach ulcers. These problems all present very real health risks, and if left untreated they can even lead to death

 

Formulation

Cognitive & Behavioural Psychotherapists collaborate with the patient to assess and identify all maintaining factors; including thoughts, behaviours, emotions and physical symptoms associated with the problem and develop a working formulation which will be utilised to guide the course of therapy.

 

Treatment

A number of techniques will be employed to test predictions and beliefs which may include behavioural strategies such as exposure and cognitive interventions aimed at identifying and challenging unhelpful thoughts and beliefs, possible thinking errors and misinterpretations. These may then be challenged through a combination of verbal reattribution, Socratic questioning and behavioural experiments.

 

Final stages of the therapeutic interventions are aimed at relapse prevention strategies.