Eating Disorders

Eating disorders are not a choice. They are serious mental illnesses that are associated with severe, debilitating, complex and potentially life-threatening complications. Eating disorders are associated with a host of serious consequences on physical and psychological, productivity and relationships.

Eating disorders involve unhelpful beliefs about eating, weight, body shape and appearance. This results in disruptive eating habits and interacting with food in dangerous and harmful ways. Destructive behaviors associated with eating disorder may include:

• drastically restricting the amount of food you eat (e.g., fasting, skipping meals)

• refusal to eat certain food, or restrictions against whole categories of food (e.g., no carbohydrates)

• eating excessive amounts of food in one sitting

• engaging in unhealthy behaviours to influence food and weight, such as induced vomiting, laxative abuse, or excessive exercise

• extreme concern with body appearance (e.g., checking in the mirror for perceived flaws in appearance)

• a combination of the above

These behaviors may have severe negative impacts on your mental and physical health. Untreated eating disorders carry the highest preventable mortality rate out of all other mental health disorders. They can happen to anyone, at any age, from any background, and of any gender.

It can be confusing and frightening when problems with eating arise, and you may not know what to do or who to turn to. It’s important to recognize that you don’t have to suffer on your own-expert treatment, support and therapy is available, and the quicker you seek treatment, the more likely you are to overcome your eating disorder and return to the healthy, fulfilling life you want.

How do you know if you have an Eating Disorder?

Eating disorders come in many forms. It may feel like other areas of your life are going well, but thinking about food, the way you eat, or your body interferes with your life and keeps you filled with shame and self-loathing. Maybe you think something is not quite right, but are unsure if what you’re dealing with is enough to reach out. It can be tricky to recognize if you’re dealing with an eating disorder, as many of the symptoms are silent or easily hidden. Maybe you think having a love/hate relationship with your body and/or food are normal, or maybe you are too embarrassed to tell people that you’re struggling.

Common Signs and Symptoms of an Eating Disorder

Some common symptoms of eating disorders include:

• an overwhelming desire and attempt to lose weight and a preoccupation with food, calories, and feeling like food has taken over your life

• an obsession with your physical appearance and how other people perceive your body

• a reduction in dietary intake (e.g., eating small amounts of food, going long periods of time without eating)

• rigid rules about eating, including the types and amount of food you are “allowed” to eat

• episodes of overeating, or binge eating (e.g., consuming a large amount of food in a short period of time)

• experiencing intense stress during mealtimes or extreme guilt and shame when you eat

• abnormally low or high weight

• feeling as though you have lost control over your eating habits

• wanting to eat alone or in secret

Other symptoms may include a desire to exercise in a driven or compulsive way, taking laxatives or diuretics, diet pills, and/or making yourself sick after eating (also referred to as ‘purging’). These symptoms are know as ‘compensatory behaviours’, as they are used to ‘compensate’ for food that has been eaten, in an attempt to control shape or weight.

These symptoms may be experienced due to concerns over shape and/or weight, or as an attempt to manage difficult emotions or distress.

Living with an eating disorder can be different for each individual. It is common to experience co-occurring mental conditions including depression, anxiety, and obsessive compulsive disorder. You may feel anxious and sad because you don’t know how to handle it. You fight with family and friends because you’re not eating enough, or are eating too much. You feel alone and ashamed and wonder what’s wrong with you.

If you are experiencing any of the symptoms mentioned above, you may be suffering from an eating disorder. If you are dealing with other problems related to eating, that are not mentioned here, feel free to contact me, as I can provide you with clarity about whether treatment may be helpful for you. Whatever your symptoms, please know that help is available and many people recover from their eating disorders and develop a healthier relationship with their bodies, food and eating.

Treatment

At Zen Psychology in Calgary, I provide clinical expertise in treating eating disorders. I am dedicated to providing high quality, compassionate and individualized eating disorder treatment and specialize in delivering Cognitive Behaviour Therapy-Enhanced (CBT-E), which is the leading evidence-based treatment for eating disorders. CBT-E was initially developed to treat adults with eating disorders at the Centre for Research on Eating Disorders at Oxford (CREDO). CBT-E has been defined as “enhanced” because it uses a variety of innovative strategies and procedures to enhance the effectiveness of the original CBT for eating disorders and addresses the psychopathology of eating disorders rather than a specific diagnosis of eating disorders. CBT-E has been evaluated in several clinical trials and is recommended by international guidelines for the treatment of all clinical forms of eating disorders for adults (National Guideline Alliance, 2017), and has been adapted for teens with eating disorders.

CBT-E treatment involves an assessment appointment, which lasts 90 minutes. In this meeting, you will gain a better understanding of your eating problem and we can determine whether CBT-E is the best treatment for you.

If CBT-E is the right treatment for you, we will agree on the number of sessions needed to resolve your eating problem. The average duration of CBT-E is up to 20 weekly therapy sessions for individuals who are a healthy weight or overweight, and up to 40 therapy sessions for individuals who are underweight. Each therapy session lasts 60 minutes.

CBT-E is a collaborative treatment, meaning that you and I will work together as a team. CBT-E is an empowering treatment that allows you to have choices about the changes you decide to make. Agreed upon changes to your eating will be implemented at doable pace, while addressing factors that are maintaining your eating problem. This may include working through concerns about your eating, weight and shape, helping you develop emotional coping strategies, or working on issues related to low self-esteem, perfectionism, or your interpersonal relationships.

Working with a Multidisciplinary Treatment Team

Eating disorders are complicated and require a multidisciplinary treatment team. You will be asked to maintain regular contact with your GP at all times during treatment in order to monitor your physical health (e.g., medical monitoring of low weight and the complications associated with eating disorder behavior). Your physician typically provides ideal body weight estimation, monitors weight, and makes recommendations regarding the speed of weight gain, participation in activities, or the appropriateness of school/work. A dietician specialized in eating disorders may be recommended to provide individualized education about nutritional needs, specific recommendations for meals and snacks and for titrating you to a full meal plan.