The holidays are upon us. For some, this means time spent with family and friends. For others, this means church and worship services. But for those who suffer with an eating disorder, the holidays simply mean fear. Fear of overeating. Fear of losing control. Fear of overeating then binging afterwards. Fear of making excuses so that not even a morsel of food is eaten. And most of all, fear of gaining weight. For people with eating disorders, some of their worst battles with their families surround the dinner table and eating or refusing to eat. Therefore, any holiday associated with food is overshadowed by sheer fear. So what is an eating disorder and how does it start?
The Diagnostic and Statistical Manual of Mental Disorders Fourth edition (DSM IV) indicates that eating disorders are characterized by severe disturbances in eating behavior. There are three primary eating disorders:
Individuals with Anorexia Nervosa pursue and/or maintain excessively low body weight (i.e., 85% of normal weight) through a reduction in food ingested or through laxative abuse, excessive exercise, or self-induced vomiting. These persons typically have a distorted image regarding their body shape or weight. They are extremely frightened that they will gain weight and therefore go to great lengths to avoid gaining weight despite their current appearance to others. Younger children may fail to make expected weight gains as they increase in age and height. There are two subtypes: Restricting Type (primarily restriction of food intake) and Binge-Eating/Purging Type (purging with/without binging).
Individuals with Bulimia Nervosa also possess a great deal of fear surrounding their body shape and weight. These individuals respond to their fear by engaging in recurrent episodes of binge eating coupled with the use of inappropriate compensatory behaviors to prevent associated weight gain (i.e., self-induced vomiting, fasting, misuse of laxatives, enemas, excessive exercise, or diuretics). There are two subtypes: Purging Type (regular self induced vomiting, and/or the abuse of diuretics, enemas or laxatives) and Nonpurging Type (use of other compensatory behaviors such as exercise or fasting).
Eating Disorder NOS
Individuals with ED NOS do not fully fit in either an Anorexia Nervosa or Bulimia Nervosa category. Individuals with this diagnosis exhibit behaviors such as repeatedly chewing food and spitting it out, but not swallowing. A very common disorder within this category is Binge Eating Disorder: repeated episodes of excessive rapid food consumption in a short amount of time coupled by feelings of shame and guilt surrounding the behavior despite efforts to discontinue the behavior.
So where does the eating disorder originate? It is clear that there is a “starting point” because you do not see a toddler saying that she cannot wear a certain outfit because it makes her butt look big! Nor do you see a pre-schooler indicating that she has to skip dessert because she is trying to lose that last 10lbs! At some point, in the life of the person that struggles with an eating disorder, there was normalcy surrounding food and emotions. Food was seen as a small component in life rather than at the center of every waking thought. However, unrealistic images in the media, subtle messages communicated by well meaning family/friends and internal distorted thinking are a few of the responsible culprits to the origin of eating disorders. And, as is the case when discussing the origin of any mental health issue, the age old debate of nature vs. nurture comes to surface. But contrary to popular opinion, eating disorders are not primarily about food or weight. Rather, eating disorders are about stress, control, and overwhelming emotions. But whatever the origin of an eating disorder, how should they be treated once it has been diagnosed?
Traditionally, eating disorder prevention programs have been didactic and psycho educational, showing little efficacy (Littleton & Ollendick, 2003).
At Adolescent Growth however, we offer a comprehensive interactive treatment approach that is individualized to the specific eating disorder needs of the child. Moreover, Adolescent Growth uses research based proven methods that are capable of disrupting the paralyzing eating disorder cycle. We realize that not all persons with an eating impairment need residential care; therefore the Adolescent Growth program includes a residential, partial hospitalization, and an intensive outpatient program option. Prior to intake, the intake specialist will obtain background information and conduct an extensive assessment. The intake coordinator will also check insurance benefits and consult with the doctor regarding treatment recommendations. Regardless of the program recommended, the Adolescent Growth is committed to seeing hurting families heal; therefore there is a recommendation for strong family support/participation in each program. We feel it is great for a client to come to treatment and demonstrate improvement. However, it is most imperative that the client transfers the skills learned in treatment to the home environment. Therefore, we view the family as a central component in the healing journey.
Adolescent Growth’s trained staff is cognizant of the stress, anger, depression, and fear that accompany an eating disorder. Therefore we offer hope and an opportunity to be free of the bondage and the “weight” that weight management can bring.
Please call today for a free telephone assessment. Your healing process is a phone call away 888.948.9998 option 1.
Littleton, Heather L., Ollendick, Thomas. (2003). Negative Body Image and Disordered Eating Behavior in Children and Adolescents: What Places Youth at Risk and How Can These Problems be prevented? [Electronic version]. Clinical Child & Family Psychology Review, Vol. 6 Issue 1, p51-66, 16p.