Understanding The Psychological Effects Of Eating Disorders

Eating disorders are mental health conditions characterized by persistent disturbances in eating behaviors. They commonly occur alongside other mental disorders like anxiety or depression, and they can affect anyone. People with these conditions can become so preoccupied with food and their weight that they find it difficult to focus on other areas of their lives, which can have profound psychological effects. Understanding the interplay between eating disorders and mental health can play a crucial role in early detection and effective treatment.

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Common eating disorders

There are multiple types of eating disorders, each with its own unique symptoms and features. There are other eating disorders to consider, but the following are some of the most common eating disorders: 

Anorexia nervosa

Anorexia nervosa is typically characterized by an intense fear of gaining weight that leads to food restriction and weight loss. Someone with anorexia may only eat small amounts of low-calorie food and engage in excessive exercise to lose or avoid gaining weight. This condition can be very serious and cause extensive damage to the body that can lead to death.

Bulimia nervosa

People with bulimia nervosa typically go through periods of binging and purging. During binges, they usually eat a large amount of food in a short period of time, feeling like they cannot control themselves and even eating until discomfort. Purging can include a number of compensatory behaviors to prevent weight gain, such as vomiting, exercising excessively, fasting, or using laxatives.

Binge eating disorder

Binge eating disorder leads to consuming large quantities of food in a brief period of time while experiencing a loss of control. People with binge eating disorder may feel distressed by their behavior, but they typically do not engage in compensatory weight loss behaviors like people with bulimia do.

Mental health conditions that commonly occur with an eating disorder

Anxiety

Anxiety is the most common mental health condition in the United States. It’s typically characterized by overwhelming distress or fear that can affect a person’s ability to engage in everyday activities. Research has shown that many people with anorexia or bulimia also have one or more anxiety disorders. In many cases, a person may have anxiety symptoms first that put them at risk for developing an eating disorder, but this is not always the case.

Depression

Depression can lead to a variety of emotional and physical problems. Research shows that people with eating disorders have an increased risk of developing depression, particularly those with bulimia. Some evidence suggests that eating disorders and depression have a bi-directional relationship where depression can predict or influence an eating disorder and an eating disorder can predict or influence depression.

Obsessive-compulsive disorder (OCD)

OCD is characterized by repetitive, intrusive, and unwanted thoughts or obsessions as well as compulsions, or urges to manage those thoughts. OCD is one of the most common mental health conditions that co-occur with eating disorders. Research has shown that those with eating disorders are statistically more likely to have OCD and vice versa. In both anorexia and bulimia, people often become preoccupied with thoughts about body weight, food, dieting, and exercising, which can influence the ritualistic behavior of self-starvation, excessive exercise, binging, and purging, similar to the obsessions and compulsions in OCD.

Alcohol and substance use disorders

Research shows that people with alcohol or substance use disorders may begin using substances before or after they develop symptoms of an eating disorder, or they may appear at the same time. The substances most commonly misused include nicotine and alcohol, but caffeine, cannabis, diuretics, laxatives, sedatives, stimulants, and opioids are also common.

Other mental health conditions and their effects on eating disorders

Other mental health conditions can also contribute to developing eating disorders. Some of these may include:

• Attention deficit hyperactivity disorder (ADHD): Research suggests that impulsivity symptoms of ADHD can contribute to overeating and that childhood ADHD increases the risk of developing anorexia, bulimia, or binge eating disorder later in life.
• Bipolar disorder: Studies have shown that the severity of bulimia or binge eating disorder is worse in women who also have bipolar disorder and that approximately 33% of people living with bipolar disorder also have an eating disorder.
• Self-injury and suicide: Multiple studies show that binging, purging, and binge eating disorder are associated with a greater risk of suicidal behaviors and that young adults and adolescents with eating disorders are more likely to engage in non-suicidal self-injury.

How eating disorders affect mental health

Many mental health conditions can have psychological effects on people with eating disorders, but eating disorders can also have significant effects on mental health.

People with eating disorders often have a preoccupation with food, calorie counting, and weight loss, and their fixation on these things often interferes with other areas of their lives. For example, they may make excuses to skip meals with friends and family, experience mood swings, and stop engaging in activities that they used to enjoy as a result of their fixation of food and weight loss.

Different eating disorders can also affect mental health in other ways. For example, people with bulimia or binge eating disorder who feel out of control when they are binging or purging may feel ashamed or embarrassed about their behavior. They can develop anxiety, low self-esteem, or depression and may feel angry or helpless. Those with anorexia may find it hard to focus, experience significant anxiety about gaining weight, and feel alone or depressed. People with eating disorders may have trouble coping with stressful events in their lives and experience problems at home, work, or school as a result of their disorder.

Treating eating disorders

Treatment for eating disorders can depend on the specific diagnosis, the severity of the disorder, and the presence of other mental or physical health problems.

Treatment teams usually consist of medical doctors, dieticians, and mental health professionals. For people with eating disorders who are significantly underweight or who have significant medical problems due to malnutrition, hospitalization may be necessary for refeeding, correcting electrolyte imbalances, and monitoring them closely.

Some people with eating disorders may require more intense long-term treatment in a residential or day treatment program where they receive significant mental health support while working on changing eating habits and their thoughts about diet, exercise, and their bodies. Others may find success in outpatient therapy and support groups. 

Mental health treatment for eating disorders

Medication and psychotherapy can both be crucial to recovering from an eating disorder. Doctors may prescribe medications to help manage any comorbid mental health conditions that may contribute to symptoms of eating disorders. These can include antidepressants, mood stabilizers, or anti-anxiety medication.

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Psychotherapy is often a crucial part of treatment and long-term recovery. A trained therapist may help people with eating disorders learn how to identify and replace inaccurate thoughts, develop healthy ways to combat stress, and work on improving their relationship with food and their bodies. 

Multiple types of psychotherapy can be helpful for people with eating disorders. For example, cognitive-behavior therapy (CBT) may help people learn how their thoughts contribute to their behaviors and how to recognize and change distorted thinking. CBT has been shown to be effective for bulimia and binge eating disorder. Dialectical behavioral therapy (DBT), which is often a mix of individual and group therapy, may also help people with eating disorders learn how to cope with their emotions and improve relationships. It, too, has been shown to help people with binge eating disorder and bulimia.

Online therapy for eating disorders, including binge eating disorder

Online therapy can be a convenient and effective option for people recovering from eating disorders and managing symptoms of other mental disorders. With an online therapy platform, you can work with a licensed mental health professional from the comfort of your home or anywhere you have a reliable internet connection. Most people are matched with a therapist within 48 hours of signing up, and you can change providers at any time for no charge until you find a therapist that you feel comfortable working with. 

Are online mental health services effective for eating disorders?

Research has found that online therapy can be effective for treating eating disorders and co-occurring mental health conditions. For example, one small study of online therapist-delivered CBT saw “large effect sizes for the reduction of ED psychopathology and body dissatisfaction” and found that these results were sustained one year post-treatment.