Identifying unseen struggles during Eating Disorders Awareness Week
Today, we're delving into the world of eating disorders, something that deserves our attention and understanding. Eating Disorders Awareness Week is all about shining a light on the complexities of these challenges, emphasizing the need for early intervention, professional support, and breaking down the stigma that often surrounds those who face these struggles.
You've probably heard of eating disorders, but the details can be a bit blurry. This week gives us a chance to share stories, increase awareness, and offer support to those who could use a helping hand.
Different types of eating disorders
Eating disorders aren't one-size-fits-all; there's a spectrum of experiences. Anorexia nervosa, bulimia nervosa, binge eating disorder, avoidant/restrictive food intake disorder, and other specified feeding or eating disorder—all unique battles, yet they can overlap.
Anorexia nervosa
Deliberately losing a lot of weight or keeping your body weight much lower than is healthy for your age and height
Being dishonest about what you’ve eaten and avoiding eating with others
Intense fear of weight gain
Bulimia nervosa
Purging after eating a large amount of food
Fasting or exercising excessively
Lack of control around eating
Binge eating disorder
Eating a lot of food in a short amount of time
Eating when not hungry
Feelings of guilt and shame after binge eating
Avoidant/restrictive food intake disorder
Selective eating habits/disturbed feeding patterns
Extreme nutrition and energy deficiencies
Other specified feeding or eating disorder
Symptoms similar to one or more eating disorder, but may not fully meet the criteria for other eating disorder diagnoses
When thinking about eating disorders, anorexia often takes the spotlight, but did you know that binge eating disorder is over three times more common than anorexia and bulimia combined? As such, identifying factors associated with eating disorder behaviours are significant in developing more effective intervention programmes.
Biopsychosocial factors of eating disorders
No one chooses an eating disorder. Eating disorders are mental health conditions influenced by a mix of biological, social and psychological factors, which increase the likelihood of an individual developing an eating disorder.
Biological
Genetics – having a close relative with an eating disorder
Puberty/menopause
Social
Trying to meet appearance standards
Body/fat shaming
Psychological
Symptoms of other mental health conditions e.g. anxiety, depression, trauma
Low self-esteem
Emotion dysregulation
Emotion dysregulation and eating disorders
Recent literature has identified a correlation between emotion dysregulation and eating disorder behaviours. Emotion regulation can be described as a state in which we feel calm and in balance. Whilst in this state, we are more likely to have a healthy appetite and feel motivated to eat a range of different foods. However, emotion dysregulation refers to poorly managed emotional responses, which deviate from the typically accepted emotional reaction spectrum. Picture it as a rollercoaster of intense emotions—struggling to find that calm, balanced state. It is usually caused by an individual’s inability to manage or control their emotional responses, when perceiving a threat from an external stimuli. This can lead to a person becoming either overactive or under active, commonly known as the fight/flight/freeze states.
Intense emotions, impulsivity, random mood swings, and trouble controlling one’s emotions can all be signs of emotion dysregulation. Dysregulated individuals may experience nausea, lack of appetite and may cry hysterically. It's possible that they lose interest in food and are unaware of how much or how quickly they eat. Individuals who regularly battle with these strong emotions often resort to coping strategies as a form of support. Regrettably, this might involve unhealthy coping strategies like purging, food restrictions, self-harm, or episodes of binge eating. Emotion dysregulation may also develop as a primary condition which feeds into the development of disordered eating behaviours, or it may coexist with the disorder and eventually act as its catalyst. Regardless of the risk factors contributing to both the development and maintenance of eating disorders, it is imperative that healthier coping strategies are put in place.
Eating disorders and treatment: a path to recovery
An eating disorder can become a strong part of an individual’s identity making recovery seem daunting. I am here to tell you that recovery is possible. With knowledge comes awareness and with awareness, the desire to do better for ourselves. As a counselling psychologist, the way in which we offer support is through various therapies. Each of which are designed to help, each offering a unique approach, some of which are listed below.
Cognitive Behavioural Therapy (CBT)
CBT is a goal-oriented, collaborative therapy, which aims to recognise and reframe unhelpful cognitive distortions and behaviours. It operates on the notion that an individual’s thoughts, emotions, physical sensations, and behaviours are all connected, and by altering one aspect can impact by the rest. Almost like a domino effect!
The CBT model acknowledges the significance of thoughts and behaviour in perpetuating an eating disorder. Treatment approach can include work around cognitive restructuring, coping strategies, nutritional counselling, relapse prevention and homework assignments. More specifically, interventions may look like psychoeducation about eating disorders, mood tolerance, unhelpful thinking styles, collaborative weekly weighing, proactive problem solving, maintenance of change and relapse prevention.
Person-Centred Therapy (PCT)
In comparison to CBT, PCT is a non-directive therapy which entails a more open-ended exploration of an individual’s thoughts and feelings. The clinician offers a safe and encouraging space for client exploration for them to achieve self-realisation and personal growth. PCT is a therapeutic approach that works well for clients presenting with an eating disorder because it redirects the focus from the problem to the client as a whole. As aforementioned, eating disorders can be influenced by a range of different factors. Through a person-centred framework, clients are able to decide what results are significant in their own recovery process.
Acceptance and Commitment Therapy (ACT)
ACT is another therapeutic framework which aims to help individuals in addressing unhelpful thoughts and emotions in a more proactive and constructive manner. The approach helps clients recognise and accept their negative thoughts as a natural range of emotions, as opposed to trying to challenge or reframe specific thoughts or thinking patterns. The first stage of eating disorder treatment from an ACT lens can involve clients accepting that there is a problem to begin with. This can be done through cognitive defusion, also known as ‘unhooking the thoughts’, which involves seeing your thoughts as thoughts without creating an emotional attachment to them. Ultimately, an ACT approach would aim to improve one’s quality of life, promote self-compassion and build resilience
If you are experiencing an eating disorder or disordered eating and the above approaches sound like something you could benefit from, then feel free to book in a free consultation with us at MAPP Psychology to find out more.
Dr Amirah Khan