Eating Disorders Therapy: Symptoms, Research, And Treatments
The American Psychiatric Association (APA) estimates that up to 5% of the population experiences eating disorders, with many developing these conditions in adolescence and young adulthood. However, the National Eating Disorders Association states that eating disorders can affect people of all ages, genders, sexual orientations, and backgrounds.
With the significant prevalence of eating disorders, it can be important to recognize the symptoms and learn about available treatments, whether for you or a loved one. However, to determine whether eating disorders therapy or another form of treatment is right for you, it may be helpful to start by learning more about what eating disorders are.
What are eating disorders?
According to the American Psychiatric Association, eating disorders are serious behavioral conditions that can be characterized by disturbances in a person’s eating behaviors. These disorders can also affect how a person thinks about eating and the emotions they associate with food. Research shows that one person dies every 52 minutes in the United States as the result of an eating disorder. Statistics like this underscore the severity of these disorders and the importance of understanding their eating disorder symptoms.
Symptoms of eating disorders
While the symptoms of eating disorders can vary, they can include food restriction, avoidance of specific foods, preoccupation with food or the act of eating, intense focus on body weight or shape, and feelings of anxiety about the consequences of eating certain foods. However, the precise symptoms a person has typically depend on what type of disorder they are experiencing.
What are the different types of eating disorders?
There are various types of eating disorders that a person may experience, each with its own set of symptoms. To begin, we’ll look at some eating disorders that may not be as well known as others but that can still have a significant impact on a person’s health: avoidant/restrictive food intake disorder (ARFID), pica, and rumination disorder.
Avoidant restrictive food intake disorder (ARFID)
ARFID can be characterized by a severe dislike of specific foods or food groups. This can cause a person to be seen as “picky” or generally having a low appetite, as they may only be willing to eat a small number of foods. These individuals may have preferences due to sensory aspects of the foods, including smell, color, and texture. Individuals experiencing ARFID could also worry about these foods harming them in some way, such as through choking, food poisoning, and allergic reactions.
Pica
Individuals with pica may consume things that are not typically considered foods or that have no nutritional value. These items may vary and can include:
- Rocks
- Hair
- Soap
- Paper
- Paint chips
- Cloth
Pica may be more common during specific parts of a person’s life, including during childhood. This disorder can be dangerous, as the items a person eats could result in poisoning or intestinal distress.
Rumination disorder
Those with rumination disorder typically regurgitate and re-chew food several times before swallowing or spitting it out. For rumination disorder to be diagnosed, this behavior typically needs to occur repeatedly for a period of at least one month and cannot be attributed to a medical condition.
Are there other types of eating disorders?
In addition to avoidant restrictive food intake disorder (ARFID), pica, and rumination disorder, there are several other eating disorders a person can experience. These eating disorders (which can potentially be more common) include binge eating disorder, bulimia nervosa, and anorexia nervosa. These disorders can each present with their own unique set of symptoms that may impact how a person thinks about and interacts with food.
What are the symptoms of binge eating disorder?
Binge eating disorder (BED) can cause a person to consume significant quantities of food in a short amount of time, which can be referred to as a binge episode. During these episodes, those with BED may feel as though they lose control and cannot stop themselves from eating, even if they want to. Other symptoms can include:
- Using food as a way to cope with difficult emotions
- Eating until one feels significant discomfort
- Eating even when one isn’t hungry
- Hiding the act of eating or how much one is eating
- Becoming preoccupied with food or the act of eating
- Feeling guilt or shame surrounding eating
Is binge eating always a symptom of binge eating disorder?
While binge eating can indicate that someone is experiencing binge eating disorder, this may not always be the case. It is possible for a person to occasionally binge-eat without developing BED. In order to be diagnosed with BED, binge-eating typically needs to occur at least one day a week for three months on average.
What are the symptoms of bulimia nervosa?
Like those with binge-eating disorder, individuals with bulimia nervosa can experience binge-eating episodes where they feel an uncontrollable compulsion to consume large quantities of food. However, one primary difference between these disorders is that individuals with bulimia nervosa typically purge after binging. These purges can involve a variety of behaviors, such as forced vomiting, use of laxatives or diuretics, excessive fasting, and excessive exercise. Other symptoms of bulimia nervosa can include:
- Irregular periods
- Feelings of anxiety or depression
- Fatigue
- Preoccupation with appearance
- Low self-esteem
- Fear of gaining weight
What are the symptoms of anorexia nervosa?
Anorexia nervosa can be characterized by an obsession with food, eating, and body weight. Individuals with anorexia nervosa can also experience challenges with self-image, sometimes believing that they are overweight even if they are at a “healthy weight” or underweight as determined by a medical professional.
The specific symptoms of this condition can vary depending on which subtype a person is experiencing: binge-purge anorexia nervosa or restrictive anorexia nervosa. Individuals with restrictive anorexia nervosa may consume very little calories or exercise excessively to burn calories, while those with binge-purge anorexia nervosa can experience periods of binge-eating and purging.
Other symptoms of anorexia nervosa may include:
- Dizziness
- Fainting
- Brittle nails and hair
- Acid reflux and heartburn
- Muscle weakness
- Constipation
Can an eating disorder impact a person’s mental health?
Eating disorders can have a significant negative impact on a person’s mental health. Research shows that those with an eating disorder may be at a higher risk of developing a comorbid psychiatric disorder. In a 2023 study, researchers found that more than 70% of individuals with an eating disorder experienced a comorbid mental illness, either before or during the acute stages of their disorder (or in the long-term course.) These comorbidities include substance use disorder (>10%), mood disorders (>40%), anxiety disorders (>50%), and personality disorders (>53%).
If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources. Support is available 24/7.
Treating eating disorders may involve addressing these mental health conditions. However, to treat eating disorders and comorbid conditions, it is typically essential to talk to a mental health or medical professional. These individuals can provide a diagnosis and help determine what treatments could be the most effective.
What mental health therapies can help those with an eating disorder?
One of the primary therapies that may help those experiencing an eating disorder is a form of talk therapy known as enhanced cognitive behavioral therapy (CBT-E). This type of therapy can follow four distinct stages:
- Stage One: With the help of a CBT-E provider, individuals can understand the source of their struggles with eating and find ways to modify their eating patterns. This stage can also involve addressing concerns that individuals have with their appearance or weight.
- Stage Two: The second stage of CBT-E can be brief, as progress from stage one is assessed and the structure of the primary stage of treatment (stage three) is determined.
- Stage Three: During stage three, individuals may attend weekly sessions that can focus on the processes that could be contributing to eating-related challenges. This can involve addressing the concerns that a person shared in stage one, such as worries about body shape and food consumption. Stage three can also allow a person to work through the emotions they feel before, during, or after meal times and the effects that restrictive dieting can have on an individual.
- Stage Four: The final stage of CBT-E can involve preparing for any setbacks a person may experience in the future and maintaining the changes they’ve made.
Other types of therapy may also be beneficial for those living with eating disorders, such as acceptance and commitment therapy and family-focused therapy. However, while these therapeutic approaches can be beneficial, in-person forms of therapy may not be available to everyone. Some individuals may live in an area without a sufficient number of mental health professionals, which can increase the challenge of finding a therapist. Others might prefer to talk with a mental health professional through different communication formats, such as texting, phone calls, or video chats. In these situations, it may be beneficial to explore online therapy.
Research shows that online therapy can be as effective as therapy delivered in person. In a 2023 study, researchers analyzed data from multiple trials to determine whether in-person and telehealth therapy differed in efficacy. They found no significant differences between these approaches on a variety of outcomes, such as function, overall improvement, working alliance, client satisfaction, and symptom severity after treatment.
Takeaway
If you’re experiencing symptoms of an eating disorder, know that you don’t have to face it alone. With BetterHelp, you can be matched with a therapist who has experience treating eating disorders, usually within 48 hours. Take the first step toward connecting with a therapist and reach out to BetterHelp today.
What type of therapy is best for eating disorders?
The type of eating disorder treatment that is most likely to be effective depends on several factors, including which type of eating disorder requires treatment, the severity of the disorder, and the unique circumstances surrounding the individual seeking treatment. While the exact therapy may change based on a person’s need, eating disorder professionals utilize evidence-based treatments that have been validated through research.
One study found that bulimia nervosa and binge eating disorder responded well to cognitive behavioral therapy and interpersonal therapy, and many certified eating disorder specialists consider family-based treatment to be the gold standard for treating anorexia nervosa, especially for young people. Many of those diagnosed with an eating disorder feel their physical and mental health improve after attending psychotherapy. Still, many also require the services of other professionals, such as a registered dietician, to provide nutrition education or a substance abuse counselor to address co-occurring substance misuse concerns.
How to help someone with an eating disorder?
Likely, one of the best ways to help someone with an eating disorder is to encourage them to seek treatment from a professional qualified to address concerns related to disordered eating. Many people find themselves turning to eating disorder treatment provided by a qualified professional after being encouraged to do so by friends and family members. Eating disorder behaviors can be complex and nuanced, and it is almost always advisable to pursue eating disorder recovery under the supervision of a therapist or medical professional. Several treatment options are available, and many people work with an entire treatment team comprised of medical, mental health, and nutritional professionals. Often, medications, psychotherapy, and nutrition counseling are required to help someone return to regular eating patterns.
What not to do with someone who has an eating disorder?
It is typically helpful to maintain a positive, supportive presence while avoiding judgment when supporting someone who has an eating disorder. As with many mental health problems, eating disorders are surrounded by misconceptions and misunderstandings, with one of the most prominent being that disordered eating is a choice. Eating disorders are complex and often occur alongside other types of mental illness, such as obsessive-compulsive disorder. They can arise due to many factors, and a judgemental or dismissive approach is unlikely to be helpful.
What type of therapy helps a person who has an eating disorder manage stressful emotions?
There are many therapeutic approaches that have demonstrated effectiveness helping those with eating disorders adjust the thinking patterns that contribute to disordered eating habits and stressful emotions. Typically, eating disorders develop due to distorted thoughts regarding one’s body image, but other factors can also play a role. The exact therapy that is likely to be helpful depends on the underlying reasons that contribute to the overarching concern. Dialectical behavioral therapy, cognitive behavioral therapy, and interpersonal therapy have all shown utility for managing eating disorders and other mental health concerns that contribute to stressful emotions.
How can I treat my binge eating disorder?
Binge eating disorder is characterized by episodes of eating an abnormally large amount of food, often due to emotional distress. Those with the condition often report feeling out-of-control of their eating during a binge episode, and many experience guilt or other adverse feelings when the episode ends. Binge eating disorder can also significantly impact physical health, most often through rapid or uncontrolled weight gain.
Because of the legitimate risks associated with binge eating disorder, it is typically best to treat the condition under the guidance of a qualified professional. Mental health professionals, registered dietitians, and medical professionals often work together to help manage eating disorders. Mental health professionals typically address underlying mental health concerns that contribute to the eating disorder, while dieticians may help with meal planning or nutrition guidance. Medical professionals can help manage the physical impact of the disorder and investigate possible underlying medical causes.
What triggers eating disorders?
There is no single cause of an eating disorder. They are complex conditions with biological, psychological, and sociocultural risk factors. Personal circumstances also play a role. For example, children are likely to develop an eating disorder in response to different factors than adults. Some common risk factors for eating disorders include having a close relative with an eating disorder or mental health condition, a history of dieting, and body image dissatisfaction.
Can you ever fully recover from an eating disorder?
Many people achieve recovery with help from friends, family, and professionals. Family therapy might be used to help bolster the support network of someone with an eating disorder, while individual therapy and nutritional counseling can help address mental health concerns and develop healthy eating habits. While recovery may take time and effort, no evidence suggests eating disorders are untreatable. Likely, some people do not seek support due to shame or fear, which can delay treatment and prolong the disorder, meaning it is generally helpful to seek out treatment as early as possible.
How can you treat eating disorders naturally?
Eating disorders are potentially life-threatening conditions, and the only treatments that are considered effective by professionals are those that have been empirically validated through robust scientific research. “Natural” treatments for eating disorders likely do not have the degree of scientific support required for them to be considered valid. The National Institute of Health lists several treatments that are known to be safe and effective.
What is the average time to overcome an eating disorder?
Recovering from an eating disorder often takes months or years, but there is no consensus regarding how long it takes to overcome an eating disorder. The exact duration is determined by which eating disorder a person is diagnosed with, the severity of the disorder, and extenuating life circumstances that may interfere with treatment. For example, someone with a severe eating disorder may qualify for residential treatment, which consists of being admitted into a facility for 24/7 observation and treatment. Others may qualify for intensive outpatient programs, which require attending treatment for several hours per day most days of the week.
Typically, the most intensive treatments are offered to those with the most severe conditions. Someone with a severe eating disorder may experience an accelerated recovery through intensive treatment, but the severity of their condition may limit how quickly they can recover from the disorder. Conversely, someone with a less severe eating disorder may not be able to pursue intensive treatment, which could slow their progress. However, they may not require as much treatment to recover.
How to start ED recovery?
The path to recovery from an eating disorder typically begins by reaching out to a professional for guidance. Letting friends and family know that you are seeking treatment is also often helpful. Recovering from an eating disorder is typically easier with ample support, and it is typically beneficial to allow loved ones, friends, and professionals to take an active role in your care.
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