Feeding and eating disorders

Feeding and Eating disorders

Feeding and eating disorders are characterized by a persistent disturbance of eating or eating-related behavior that results in the altered consumption or absorption of food and that significantly impairs physical health or psychosocial functioning. There are several types of eating and feeding disorders including pica, rumination disorder, avoidant/restrictive food intake disorder, anorexia nervosa, bulimia nervosa, and binge-eating disorder.

 

Causes

Though the exact cause of eating disorders is unknown, it is generally believed that a combination of biological, psychological, and/or environmental abnormalities contribute to the development of these illnesses.

 

Examples of biological factors include

• Genetics (the tie between eating disorders and one’s genes is still being heavily researched, but we know that genetics is a part of the story).
• Nutritional deficiencies
• Irregular hormone functions

Examples of psychological factors include:

• Negative body image
• Poor self-esteem

Examples of environmental factors that would contribute to the occurrence of eating disorders are:

• Dysfunctional family dynamic
• Professions and careers that promote being thin and weight loss, such as ballet and modeling
• Aesthetically oriented sports, where an emphasis is placed on maintaining a lean body for enhanced performance.
  • Examples include:
    • Rowing
    • Diving
    • Gymnastics
    • Wrestling
    • Long distance running
    • Ballet
• Family and childhood traumas: childhood sexual abuse, severe trauma
• Cultural and/or peer pressure among friends and co-workers
• Stressful transitions and life challenges

 

Symptoms

Symptoms vary, depending on the type of eating disorder. Anorexia nervosa, bulimia nervosa and binge-eating disorder are the most common eating disorders. Other eating disorders include rumination disorder and avoidant/restrictive food intake disorder.

• Chronic dieting despite being hazardously underweight
• Constant weight fluctuations
• Obsession with calories and fat contents of food
• Engaging in ritualistic eating patterns, such as cutting food into tiny pieces, eating alone, and/or hiding food
• Continued fixation with food, recipes, or cooking; the individual may cook intricate meals for others but refrain from partaking
• Depression or lethargic stage
• Avoidance of social functions, family, and friends. May become isolated and withdrawn
• Switching between periods of overeating and fasting

 

Treatment

Psychological therapy

Psychological therapy is the most important component of eating disorder treatment. It involves seeing a psychologist or another mental health professional on a regular basis.

Therapy may last from a few months to years. It can help you to:

• Normalize your eating patterns and achieve a healthy weight
• Exchange unhealthy habits for healthy ones
• Learn how to monitor your eating and your moods
• Develop problem-solving skills
• Explore healthy ways to cope with stressful situations
• Improve your relationships
• Improve your mood

Treatment may involve a combination of different types of therapy, such as:

• Cognitive behavioral therapy.This type of psychotherapy focuses on behaviors, thoughts and feelings related to your eating disorder. After helping you gain healthy eating behaviors, it helps you learn to recognize and change distorted thoughts that lead to eating disorder behaviors.
• Family-based therapy.During this therapy, family members learn to help you restore healthy eating patterns and achieve a healthy weight until you can do it on your own. This type of therapy can be especially useful for parents learning how to help a teen with an eating disorder.
• Group cognitive behavioral therapy.This type of therapy involves meeting with a psychologist or other mental health professional along with others who are diagnosed with an eating disorder. It can help you address thoughts, feelings and behaviors related to your eating disorder, learn skills to manage symptoms, and regain healthy eating patterns.

 

Family-based treatment (FBT)

• You may also see this type of therapy referred to as the Maudsley Method. It’s often used for children or adolescents that have an eating disorder.
• In FBT, your family members are vital parts of your recovery process. They’re involved in helping you do things like maintaining healthy eating patterns, restoring and maintaining a healthy weight interrupting unhealthy behaviors, such as binge eating or purging.

 

Your psychologist or other mental health professional may ask you to do homework, such as keep a food journal to review in therapy sessions and identify triggers that cause you to binge, purge or do other unhealthy eating behaviors.

 

Nutrition education

Registered dietitians and other professionals involved in your treatment can help you better understand your eating disorder and help you develop a plan to achieve and maintain healthy eating habits. Goals of nutrition education may be to:

• Work toward a healthy weight
• Understand how nutrition affects your body, including recognizing how your eating disorder causes nutrition issues and physical problems
• Practice meal planning
• Establish regular eating patterns — generally, three meals a day with regular snacks
• Take steps to avoid dieting or bingeing
• Correct health problems that are a result of malnutrition or obesity

 

Medications for eating disorders

Medications can't cure an eating disorder. They're most effective when combined with psychological therapy.

Antidepressants are the most common medications used to treat eating disorders that involve binge-eating or purging behaviors, but depending on the situation, other medications are sometimes prescribed.

Taking an antidepressant may be especially helpful if you have bulimia or binge-eating disorder. Antidepressants can also help reduce symptoms of depression or anxiety, which frequently occur along with eating disorders.

You may also need to take medications for physical health problems caused by your eating disorder.

 

Efficient therapy

• No single therapy method was most effective for adults with anorexia nervosa. However, many people with anorexia do see an improvement with therapy.
• CBT and IPT are the most established treatments for binge eating disorder and bulimia nervosa.
• FBT is the most established type of therapy for children and adolescents with anorexia nervosa, and may also be beneficial for those with bulimia nervosa.