Eating Disorders Treatment

What are Eating Disorders?

Eating disorders are serious psychiatric conditions that are characterized by severe disturbances in eating, thoughts, and behaviors. At least 28 million people in the United States suffer from eating disorders of all types. Eating disorders do not discriminate. They can affect people of all races, ages, and genders.

Eating disorders can be life-threatening if not identified and treated appropriately. In fact, eating disorders have the highest mortality rate of any mental illness. About 28 percent of people with eating disorders attempt suicide. More people die of eating disorders each year than of depression, bipolar disorder, and psychotic disorders.

Types of Eating Disorders

The major types of eating disorders include anorexia nervosa, bulimia nervosa, binge eating disorder, and avoidant restrictive food intake disorder. Here is an in-depth look at these eating disorders, including the symptoms and risk factors.

Anorexia Nervosa

Anorexia is perhaps one of the most well-known eating disorders. It is characterized by excessive weight loss from self-starvation. People with this disorder have an intense fear of gaining weight and a distorted self-image. They perceive themselves as being overweight in spite of overwhelming evidence to the contrary.

Bulimia Nervosa

Bulimia is another common eating disorder that is characterized by a cycle of binge eating and compensatory behaviors designed to undo the binge. During a binge, a person with bulimia will eat an extremely large amount of food in a short time. For instance, they may eat up to 11,000 calories over a period of just a couple of hours. The person experiences a loss of control during the binge.

People with bulimia often feel like they can’t stop eating once they binge. After binging, the person will attempt to compensate for the binge by vomiting, using laxatives, fasting, or other behaviors, such as excessive exercise. It is a myth that all people with eating disorders are thin. People with bulimia are often normal to overweight.

Here are some of the symptoms of bulimia.

Orthorexia

You might not have heard of orthorexia. However, this eating disorder is increasing in the United States. Part of the reason for the increase may be due to the emphasis in social media on “clean eating” and other extremely restrictive diets. Family and friends may never know that a person has it because they appear to eat very healthily.

Orthorexia is an unhealthy obsession with eating healthy. People with this disorder have very restrictive eating habits. They may eat only raw food or foods that are “clean.” People with orthorexia may avoid eating entire groups of foods. They may avoid gluten or artificial purposes.

So, you might be wondering “what is the difference between healthy eating and orthorexia?” Orthorexia goes well beyond healthy eating. People with orthorexia may develop obsessive rituals about food and have no medical reason for intake restriction. Orthorexia sufferers may develop significant anxiety if they cannot control what they eat. They will experience shame, panic or guilt if they do not follow their “diet.” Thoughts about food and eating often consume them and impact their daily functioning. Orthorexia can lead to social isolation, depression, and malnutrition.

Here are the symptoms of orthorexia.

Binge Eating Disorder

Binge eating disorder is an illness that is characterized by episodes of binge eating. Unlike people with bulimia, those with binge-eating disorders do not use compensatory behaviors to negate the consumption. As a result, many people with binge-eating disorder are overweight or obese. Binge eating disorder affects both females and males at a similar rate.

Less Common Eating Disorders

Avoidant/Restrictive Food Intake Disorder (ARFID): ARFID is characterized by an extreme aversion to food, leading to inadequate intake of calories or nutrients. Unlike other eating disorders, ARFID is not driven by body image concerns. Individuals with ARFID may avoid certain foods due to their texture, color, or smell, or due to fears of choking or vomiting. This disorder is increasingly recognized, especially in children and those with sensory processing issues. If untreated, ARFID can persist into adulthood, significantly impacting physical health and social functioning.

Pica: This disorder involves the persistent eating of non-food substances, such as dirt, chalk, hair, or paper, for at least one month. This disorder is more common in children, pregnant women, and individuals with developmental disabilities. Pica can lead to serious health complications, including intestinal blockages, poisoning, and infections, making medical and psychological intervention crucial.

Rumination Disorder: Rumination disorder is characterized by the repeated regurgitation of food, which may be re-chewed, re-swallowed, or spit out. This behavior occurs without nausea or gastrointestinal illness and is not related to another eating disorder. Commonly seen in infants and individuals with intellectual disabilities, it can lead to malnutrition, weight loss, and social embarrassment. Behavioral therapy is often employed to address this disorder.

Risk Factors For Eating Disorders

Eating disorders affect people of all ages, races, and genders. Risk factors for eating disorders include a range of psychological, biological and environmental factors. Here are some of the most common:

• Having a close relative with an eating disorder
• Having a close relative with another mental disorder
• Perfectionism
• Body image dissatisfaction
• History of trauma
• History of being bullied
• Depression and other mental health issues

Diagnosis Of Eating Disorders

Eating disorders are serious mental disorders that should be diagnosed by an eating disorder therapist or specialist. The first step in getting a diagnosis is to visit your doctor. They will perform a physical exam and ask you about your eating behaviors. Then, they will likely refer you to an eating disorder therapist.

Treatment For Eating Disorders

Eating disorders are not just a matter of dieting or self-control. They have far deeper roots than that and require specialized treatment to address both the distorted thoughts and harmful behaviors. Additionally, eating disorders frequently occur with other mental illnesses, such as depression, anxiety disorders, and substance abuse. Professional treatment usually addresses all of these issues.

Here are some of the most common treatments for eating disorders.

Psychotherapy

A commonly-used type of psychotherapy for treating eating disorders is cognitive behavioral therapy (CBT). CBT involves teaching a person to notice their negative or distorted thoughts and self-talk. In learning to catch your destructive thoughts, you will then learn strategies for challenging and changing them. This does not mean putting an unnecessarily positive view onto your life but instead aims to teach people to see themselves more realistically.

The goal of psychotherapy is to help people with eating disorders live a relatively normal life, free from harmful behaviors. Another important goal is self-acceptance. Through therapy, a person with an eating disorder can learn to develop a more healthy mindset.

Inpatient Hospitalization

People with eating disorders may require inpatient hospitalization if the disorder is severe. Generally, an eating disorder specialist can recommend inpatient treatment when it is needed.

Residential Treatment

After inpatient treatment, many people with eating disorders participate in residential treatment for a period of time. This is a long-term treatment that provides 24-hour care in a non-medical setting.

Medications

Although there are no medications that are specifically used to treat eating disorders, medications are often used to treat co-occurring conditions, such as anxiety and depression, as these frequently occur in people with eating disorders.

Brain Stimulation Techniques

Brain stimulation techniques, like Transcranial Magnetic Stimulation (TMS) and Deep Brain Stimulation (DBS), are emerging as potential treatments for eating disorders, especially in severe cases like anorexia nervosa and bulimia nervosa. TMS uses magnetic fields to stimulate specific areas of the brain, which may help reduce symptoms like bingeing, purging, and depression. DBS involves surgically implanting electrodes in the brain to adjust neural circuits related to emotion and behavior control. Although these methods are still in the experimental phase, early studies show promise, suggesting that brain stimulation could become a valuable addition to traditional treatments for eating disorders .

Gut-Brain Axis

The gut-brain axis refers to the connection between the gut microbiome—the diverse community of microorganisms in the digestive tract—and the brain, influencing mood, behavior, and eating patterns. Research shows that an imbalance in gut bacteria, known as dysbiosis, may contribute to anxiety, depression, and disordered eating behaviors seen in anorexia nervosa, bulimia nervosa, and binge eating disorder. Improving gut health through dietary changes, probiotics, or other interventions could support mental health and aid in eating disorder recovery, though more research is needed to fully understand these connections and develop targeted treatments.

Self-Help Tips for Eating Disorder Recovery

Self-care is a crucial part of recovery from eating disorders, but it can often feel challenging. Incorporating small, manageable self-care practices can help build resilience and support mental and physical well-being during the recovery process. Here are some tips to help you on your journey:

1. Meditation and Mindfulness
   Engaging in meditation and mindfulness can be powerful tools in managing stress, anxiety, and negative thought patterns. Practices such as deep breathing, guided meditation, or mindful eating can help ground you in the present moment and promote a sense of calm. Apps like Calm or Headspace offer guided sessions tailored for relaxation and mental clarity, making mindfulness accessible at any time.
2. Social Media Breaks
   While social media can connect you with supportive communities, it can also amplify negative self-comparisons and trigger unhealthy eating behaviors. Consider setting boundaries around your social media use or taking periodic breaks to protect your mental health. Use this time to engage in activities that promote positive self-esteem and self-acceptance, such as reading, journaling, or spending time outdoors.
3. Music and Movement
   Music can be a great way to uplift your mood and express emotions. Create playlists of songs that inspire and soothe you. Incorporating movement, like dancing or gentle stretching, can also be a joyful way to reconnect with your body in a positive manner. The goal is to find pleasure in movement without the pressure of exercise routines tied to body image concerns.

These self-care tips are meant to complement professional treatment and support your overall recovery journey. Remember, recovery is not linear, and small steps can make a significant impact over time. If you’re struggling, reaching out to a therapist or support group can provide additional guidance and encouragement.

How to Find Help For Eating Disorders

If you or someone that you love has signs of an eating disorder, it is important to seek treatment from a therapist with experience in eating disorders. They will be the most effective at giving you the guidance you need to manage eating disorder symptoms and develop healthier behaviors.

Search therapytribe.com for an eating disorder specialist or recovery treatment center:

CASE STUDY

Post-Pandemic Update 

The pandemic has resulted in an alarming rise in eating disorders globally. According to eating disorder experts, people with eating disorders have significant difficulty with unpredictability, uncertainty, and inconsistency, all of which resulted from the pandemic. This is likely what led to the increase in hospitalizations for eating disorders. In addition, staying home, being lonely, and having little to do also lead to increases in binge eating behaviors, as well. 

Treatment for eating disorders is crucial because it can help people with eating disorders cope more effectively during times of stress like during the pandemic. To find an eating disorder therapist in your area search the TherapyTribe therapist directory.

References

1. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Association.
2. ANAD. (2021). Eating Disorder Statistics | General & Diversity Stats. National Association of Anorexia Nervosa and Associated Disorders. ANAD
3. Katella, K. (2021, June 15). Eating Disorders on the Rise After Our Pandemic Year. Yale Medicine. Yale Medicine
4. Mayo Clinic. (2018, May 10). Bulimia nervosa: Symptoms and causes. Mayo Clinic. Mayo Clinic
5. Mayo Clinic. (2018, February 20). Anorexia nervosa: Symptoms and causes. Mayo Clinic. Mayo Clinic
6. Post-COVID-19 rise in eating disorders tackled with new guidelines. (2022, May 24). Medical News Today. Medical News Today
7. Scarff, J. R. (2017). Orthorexia Nervosa: An Obsession With Healthy Eating. Federal Practitioner, 34(6), 36–39. PubMed
8. Solmi, M., et al. (2020). Risk factors for eating disorders: An umbrella review of published meta-analyses. Brazilian Journal of Psychiatry, 43(3). DOI
9. Ursumando, L., et al. (2023). The efficacy of non-invasive brain stimulation in the treatment of children and adolescents with Anorexia Nervosa. Journal of Eating Disorders, 11(1), 127. DOI
10. Clapp, M., et al. (2017). Gut microbiota’s effect on mental health: The gut-brain axis. Clinical Practice & Epidemiology in Mental Health. PubMed
11. Papini, N. M., et al. (2024). Prevalence and recurrence of pica behaviors in early childhood within the ALSPAC birth cohort. International Journal of Eating Disorders, 57(2), 400-409. DOI