I know you are probably reading this because you or a loved one is suffering from an eating disorder. Food and weight problems are painful, debilitating and life-threatening. But I know, from both personal and professional experience, that recovery from an eating disorder is possible. I know that people who suffer from eating disorders can recover, flourish, and develop healthy and fulfilling lives.
An eating disorder may include obsessing about calories, overeating, undereating, eating and purging, and overexercising. All of these can cause serious emotional and physical consequences. You or your loved one who suffers from an eating disorder can be helped by solid support and expert guidance
Parents, siblings and other family members are affected as well. They can experience pain, distress and confusion. But with the help of a skilled and experienced professional, they too can heal, recover and move forward with their lives.
I invite you to think of recovery from an eating disorder as a journey, not a destination. Whether you – or someone you love – suffer from an eating disorder, I can be your ally on your journey towards recovery. I welcome your calls and e-mails for more information.
Below are some questions you may be asking yourself. Feel free to read through them, or call me to talk about your concerns.
What is an Eating Disorder?[back to top]
A person who suffers from an eating disorder uses food in self-harming ways. The most common eating disorders are anorexia (undereating), binge eating disorder (overeating) and bulimia (overeating and purging.) The food behaviors are driven by negative, self-critical thoughts and painful feelings. The person uses food to try to soothe, control or suppress what is going on inside. These self-injurious behaviors are the external signs of an eating disorder, but the inner torment is the source of the problem.
Obsessing about food, focusing on weight, constantly self-criticizing for perceived physical and personal imperfections, and using food in self-harmful ways can compound distress and undermine health. They also rob the person of quality of life. People with eating disorders are plagued by self-hatred and feel uncomfortable living in their own skin. They may become severely anxious or depressed. They can develop physical problems that range from anemia, fatigue, sleep difficulties and chronic digestive problems, to severe dehydration, irregular heart rhythms and heart damage.
What Causes Eating Disorders?
Eating disorders are complex in origin. An interplay of cultural, biological, psychological and emotional factors contribute to their development. No one situation or event causes an eating disorder.
Cultural:
Our culture contributes to the development of eating disorders. We live in a society with distorted values around food and body image. We have an abundance of food, and a media that encourages us to eat for all reasons. Many of us lose sight of the original function of food: to satisfy physical hunger and give our bodies fuel.
In addition, our culture idealizes a female body type that few women are genetically programmed to attain. We develop unrealistic expectations of how we should look. If we feel bad about ourselves, it may seem like changing ourselves on the outside will make us feel better about ourselves inside. Some of us get caught in the trap of controlling food and weight to try to look like we think we should look.
Biological:
Some people are more susceptible to eating disorders simply because of their innate biological makeup. Certain personality traits seem to be more prevalent in people with eating disorders. These include, perfectionism, problems handling change, difficultly expressing feelings, and a need to please others. Of course, not everyone who has these traits develops an eating disorder.
Recent studies have shown that eating disorders can run in families. Genetic research has identified a couple of specific genes that are markers for susceptibility to eating disorders.
Brain physiology also plays a role in vulnerability to eating disorders. Brain imaging studies have shown that people with eating disorders have lower than normal levels of some neurotransmitters. Neurotransmitter imbalances can make someone more prone to anxiety or depression. These moods are common in people with eating disorders.
Psychological:
How we think about ourselves and others develops from innumerable interactions we have with other people throughout our life. We influence and are influenced by immediate and extended family members, authority figures, friends and peers. Some people who are vulnerable to eating disorders are more prone to insecurities and feeling bad about themselves, or to seeing others as more competent or more deserving than they are. They use food or focus on weight to manage uncomfortable thoughts about themselves and how they fit in the world.
Emotional:
Mood disturbances or difficulty handling feelings can make it harder for someone to cope with stress and to express feelings. People who develop eating disorders are often stressed and overwhelmed by feelings they don’t know how to handle. They focus on food or weight to control and manage their discomfort and pain.
Difficult situations can bring up intense feelings that a person vulnerable to an eating disorder may find unmanageable. This can include the sadness, anger or hurt of a breakup with a boyfriend or other partner, the grief and depression following the death of a loved one, or the anxiety and fear of starting at a new school or job. And sometimes there is a particular experience of trauma – from a car accident to a suicide in a close family member – that adds to the emotional overload. Food can become a source of comfort or a way to suppress painful feelings.
An eating disorder can begin when someone uses food as a way to feel better and to cope with painful thoughts and feelings. But using food as a way to manage emotions can be progressive. It can become a habit that the person can’t seem to stop.
When Emotional Eating Becomes an Eating Disorder[back to top]
In some people, with sufficient stress, inner conflict and pain, eating for emotional reasons can develop into an eating disorder. The person who had tried to use food – or dieting or exercise – to feel better instead feels compelled to keep doing these things. In addition, the person experiences even more emotional pain than before. The obsessive, self-critical thoughts and the self-harming behaviors get increasingly more difficult to manage. As thinking patterns and behaviors become more entrenched, recovery becomes more challenging.
No one “chooses” to have an eating disorder. And people who have eating disorders also can’t simply “choose” to stop having an eating disorder. When someone has an eating disorder, they are no longer able to control their food behaviors.
People with eating disorders often feel shame and despair. They may be unwilling to admit they need help because it seems like they “should” be able to fix it themselves. They may blame themselves for both having the problem and for not being able to overcome it. An ever more vicious cycle of self-blame gets added to whatever emotional problems, self-esteem issues and other internal and external stressors were causing the original pain and discomfort.
If you or someone you love has a problem with food or weight, do not hesitate to get help. The earlier you get help, the sooner recovery can begin.
Some symptoms that can occur with eating disorders:
- Increasing concern with weight or body size and shape
- Frequent negative comparison to other people’s bodies
- Pronounced weight change, especially over a short period of time
- A change in eating patterns, as when a “fad” becomes a habit
- Isolating or avoiding family or social meals
- Significant worrying about ingredients, especially fat, and calories
- Obsessing about food
- Feeling out of control with eating or exercising
- Eating when alone, and then feeling guilty or ashamed about it
- More frequent or severe anxiety or depression
For Parents of Teens[back to top]
Teenagers are more susceptible to eating disorders than any other segment of the population. While girls are more prone to eating disorders than boys, boys can develop eating disorders as well. The National Institute of Mental Health estimated in March 2011 that as many as half a million teens have had an eating disorder [1]. Furthermore, many of these teenagers never get help. Emotional eating and eating disorders are progressive. Eating disorders can lead to more serious physical and psychological problems, and they are life-threatening. Among females age 15 to 24, 12 times as many die from eating disorders than from all other causes combined [2]. Early intervention is essential.
Teens often have erratic eating habits and heightened concerns about appearance. However, if your teenager exhibits unusual, exaggerated or obsessive behaviors around food or weight, or a significant change in mood or a tendency toward isolation, it is important to take note. If you suspect your teen has a problem, do not ignore your concern. If you can, express your concerns with him or her in a calm, understanding, empathic and non-judgmental way. If you don’t know how to approach and talk with your teen about your fears, please don’t hesitate to call me to get help with how to do that.
If you are a mother or caretaker of a teenage girl, I also invite you to get a copy of my e-book, Tips for Mothers of Daughters with Eating Disorders, available here. Mothers can use these tips to begin making sense of what their daughters are going through, and to help their daughters and themselves.
Treatment[back to top]
Since eating disorders have emotional and physical components, effective treatment must address both. Initially when someone calls me, I will set up a meeting to talk about their concerns. We will talk about how the issues are a problem for them, what they would like to change, and what scares them about changing. We will discuss how to proceed – how often to meet, what kinds of things we will be talking about, how we can better understand what is going on, and what we can do to make a positive difference. We will discuss how to include medical and nutritional support as part of the recovery process. Sometimes it is helpful to bring in other family members to meet as well.
When the parent of a teen calls, I will set up a meeting with the parents first. After exploring the parents’ concerns, I will meet with the teen and the parents together. We will then decide how to address the problems that are there, both for the teen and for the family who is trying to help their son or daughter. Eating disorders, especially in teenagers, require family involvement and support.
For Loved Ones[back to top]
If your spouse, partner or significant other exhibits unusual eating patterns, yo-yo dieting, or self-harming eating behaviors, you may want to talk with a therapist about how to manage your concerns. It is important to express your feelings to your loved one with empathy and understanding, and also to realize that your loved one may not be open to hearing what you have to say. You may want support for yourself whether or not your loved one gets help. And often couples in a relationship which is stressed by food or weight issues can benefit from working with a therapist. A therapist can help you sort out what to do that best supports yourself and your loved one.
When the Person You Love Won’t Get Help[back to top]
Sometimes a family member has a problem with food, but the person refuses to get help. Often the person doesn’t recognize the severity of the problem or that it has progressed to an eating disorder and an addiction over which they have no control. They also may not realize the impact their behavior is having on others, or the level of concern others have about them. In these cases, it can be helpful to enlist the help of an interventionist. A skilled food addiction interventionist can help guide and educate all family members in understanding what they can and cannot do, how they unknowingly may be making the problem worse, and what to say to their loved one.
An intervention is a process in which loved ones come together to explore the situation. An addiction occurs within the family dynamics, and the resolution must occur within the family as well. As family members get clear about what they can and can’t do to help their loved one and how they can help themselves, they can prepare to meet and talk with their loved one who is suffering from food addiction. With the guidance of an interventionist, family members and friends can express their love and concern, their loss and their fear, and the limits of what they can tolerate in witnessing their loved one’s self harm. The food addict can also express their thoughts, fears and other feelings. When someone suffering from food addiction understands not only the depth of their problem, but also the severity of its impact on their relationships with others, sometimes they are willing to get the help they have refused before.
In addition to being an Eating Disorder Specialist and Licensed Marriage and Family Therapist, I am a licensed interventionist experienced at helping families with food problems. I would be happy to answer any questions you might have about the process and goals of an intervention. Please call me at (415) 924-2100 anytime.
What about 12-Step Programs?[back to top]
For some people, 12-Step Programs can help with recovery. Feel free to ask me for more information, or you may wish to check out the following websites.
Eating Disorders Anonymous -www.eatingdisordersanonymous.org
Fellowship of individuals who want to recover from eating disorders.
Food Addicts Anonymous – www.foodaddictsanonymous.org
Fellowship of individuals who want to recover from food addiction.
Overeaters Anonymous – www.oa.org
Fellowship of individuals who want to recover from compulsive eating.
Read the following related articles by Avis Rumney
Seasonal Tips for Mothers of Daughters with Eating Disorders
Weight Worry: Reimaging Your Priorities… And Your Body
How Can I Take Care of Myself When I’m So Busy Taking Care of Everyone Else?
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About 3 percent of U.S. adolescents are affected by an eating disorder, but most do not receive treatment for their specific eating condition, according to an NIMH-funded study published online ahead of print March 7, 2011, in the Archives of General Psychiatry.
[2] http://www.murrellcounselingservice.com/pubs/eatingdisorder.htm#sup6
The mortality rate among people with anorexia has been estimated at 0.56 percent per year, or approximately 5.6 percent per decade, which is about 12 times higher than the annual death rate due to all causes of death among females ages 15-24 in the general population.
Sullivan PF. Mortality in anorexia nervosa. American Journal of Psychiatry, 1995; 152(7): 1073-4.
