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How to Get Help for Eating Disorders

June 09, 2019 | Behavioral Health Services | Behavioral Health Services , Family Medicine Residency Clinic


For many families, an eating disorder is a well-kept secret.

An eating disorder is a serious illness that affects eating behaviors and related thoughts and emotions. Common eating disorders include anorexia nervosa, bulimia nervosa and binge-eating disorder.

Millions of Americans are afflicted with eating disorders every year, and most of them — up to 90 percent — are adolescent and young women, according to John W. Lobb, PhD, licensed psychologist/clinical supervisor at Penn Highlands Behavioral Health Services. 

“An eating disorder is rarely talked about and can affect up to 5 percent of teenage girls,” he said.

The first step in getting help is to know what they are.

Anorexia

Anorexia, also known as anorexia nervosa, is the name for simply starving yourself because you are convinced you are overweight, Lobb said. If you are at least 15 percent under your normal body weight and you are losing weight through not eating, you may be suffering from this disorder.

Many of the associated complications of anorexia are similar to those of starvation or malnutrition, Jeril Goss, RD, LDN, CDE, Diabetes and Nutrition Wellness Center Manager at Penn Highlands DuBois, said. “Anorexia nervosa can cause harmful and potentially life-threatening medical complications, primarily from the effects of starvation,” she said. Anorexia causes thinning of the bones, mild anemia, muscle weakness, brittle hair and nails, dry/yellowish skin, growth of hair all over the body, low blood pressure, sluggishness and infertility. A person may also have a drop in internal body temperature and feel cold all the time. 

The most common cause of death for patients with anorexia is suicide, followed by cardiac complications. 
  
Anorexia in males seems to be less common but does occur and a female to male ratio of 10:1 is reported. “Males tend to present for treatment with a lower body mass index  - BMI - and in a more malnourished state than females,” Goss said, adding this may be partly the result of the assumption that males do not suffer from this condition, which may lead to a delayed diagnosis. 

Bulimia Nervosa

Bulimia, also known as bulimia nervosa, is characterized by excessive eating, and then ridding yourself of the food by vomiting, abusing laxatives or diuretics, taking enemas, or exercising obsessively, according to Lobb. “This behavior of ridding yourself of the calories from consumed food is often called ‘purging,’” he said.

A person who suffers from this disorder can have it go undetected for years, because the person’s body weight will often remain normal. He said “binging” and “purging” behavior is often done in secret and with a great deal of shame attached to the behavior.

People with bulimia nervosa may be slightly underweight, normal weight or over overweight. They may have a chronic sore throat, swollen glands in the neck and jaw, and worn tooth enamel from exposure to stomach acid.  They are also more likely to have acid reflux and gastrointestinal disorders, dehydration and imbalanced levels of sodium, calcium and potassium, which could lead to heart issues.

Binge-Eating Disorder

“Binge-eating disorder describes the illness of those who lose control over his or her eating,” Lobb said. “Unlike bulimia nervosa, periods of binge-eating are not followed by purging, excessive exercise or fasting. People who binge-eat often are overweight or obese,” Lobb said.  Binge-eating disorder is the most common eating disorder in the U.S., according to the National Institute of Mental Health.

People who have this disorder will eat large amounts of food in a short amount of time, such as over two hours. They eat when full or not hungry, and they eat fast. Often, they eat alone or in secret to avoid embarrassment and are ashamed. They will always try diets but with no results.

Research is showing there are a complex number of factors that cause this disorder and the others. And of course, being overweight has many complications for the body.

Diagnosis and Treatment for Eating Disorders

Eating disorders are serious problems and need to be diagnosed and treated like any medical disease, Lobb said. If they continue to go untreated, these behaviors can result in future severe medical complications that can be life-threatening.

There are two general treatment approaches used for eating disorders, Goss and Lobb noted.

For the most severe types, where a person’s health or life may be in danger, inpatient hospitalization in a facility that specializes in eating disorders may be needed or recommended.

When the degree of the eating disorder is less severe but still debilitating, most people are treated in an outpatient setting. Such outpatient treatment will usually include individual therapy, but may also include a group therapy component.

“Living with an eating disorder is living every day with the feelings of shame and guilt,” Lobb said. “Every meal is a potential triggering event or a disaster waiting to happen.”

Eating disorder management tends to focus on a “good thought turned into behavior” approach put into daily practice. Many find that mindfulness practices also can be helpful, such as taking time to think about each bite of a meal and pausing between bites. 

For most people struggling with an eating disorder, no matter the type, recovery is a lengthy process that requires a lot of effort, a sincere desire to change and the support of family, friends and professionals. 

“Some people find it helpful to begin their journey of recovery by talking to their physician or a close personal friend they trust,” Lobb said. “Eating disorders are best treated by a mental health specialist who is experienced in such treatment.”

Meal Tips

Since eating is essential for life, avoiding food is never an option. Goss offers a few tips to help someone start structuring his or her eating habits:

• Start by creating a structure for eating. Schedule yourself to eat three meals and 2-3 snacks daily to regain some structure with your nutritional intake. 
• Eat slowly to allow time for the body’s message of fullness to be recognized by your brain, and allow adequate time to enjoy your food in a pleasant setting.
• All foods are acceptable. Restricting food often can lead to binge eating. Meals should have a variety of foods, be nutritionally balanced and have moderate servings for health and taste enjoyment.

“Changing your behaviors and habits takes patience, time and planning,” Goss said. “You are taking care of yourself when you work with a knowledgeable medical treatment team and good support team with whom you feel comfortable on your journey to recovery.” 

If you need help, start by talking with your primary care provider. If you don’t have one, go to www.phhealthcare.org/doctor or call the Family Medicine Continuity Clinic at 814-503-4305 located in DuBois. If you would like to contact Penn Highlands Behavioral Health Services directly, call 814-375-6379, or if you would like to contact the Diabetes and Nutritional Wellness Clinic for its offices around the region, call 814-375-3890.