Eating Disorder Therapy

Anorexia Nervosa

Anorexia nervosa is a disorder distinguishable by highly controlled behaviors related to eating. Persons suffering from anorexia typically adhere to strict diets where they may eat only certain foods or small portions of specific foods, restrict calorie intake, closely monitor and obsess on weight or BMI, or/and excessively exercise to achieve weight loss or avoid weight gain. 

The two recognized sub-types of anorexia are restrictive type (in which one severely restricts the calories they consume) and binge-purge type (wherein they may ingest large amounts of food followed by inducing vomiting or using laxatives to evacuate what they have eaten). They may have distorted views of themselves and believe they are overweight despite being below healthy standards for their height and age. 

These restrictive behaviors can have dire physical consequences in addition to causing mental and emotional distress. Thinning or brittle hair and bones, jaundiced skin, decreased pulse and breathing, heartburn and reflux, constipation, infertility, and, in severe cases, damage to major organs, including the heart, kidneys, and brain, may be observed. 

Bulimia Nervosa

Bulimia nervosa is characterized by periods of rapid, excessive eating of large amounts of food, followed by behaviors meant to compensate for and "correct" the effects of bingeing. Purging behaviors such as self-induced vomiting, fasting using laxatives or diuretics, or obsessively exercising are ways someone with bulimia may attempt to offset the effects of bingeing.

Persons struggling with bulimia exist along the whole weight continuum and may be underweight, normal weight, overweight, or even obese. They often experience painful and dangerous physical symptoms such as gastrointestinal issues, reflux, dehydration, tooth decay and weakened enamel, and chronic throat pain.

Binge-Eating Disorder

Binge-eating disorder and bulimia nervosa both involve the rapid consumption of excessive amounts of food during brief, unbridled episodes. During these episodes, individuals often feel unable to control or moderate how much food they eat. This lack of control causes a great deal of anxiety and stress. These persons may feel ashamed, disgusted, embarrassed, or depressed after a binge.

Binge-eating disorder differs from bulimia in that these individuals do not rely on regular compensatory behaviors to mitigate the effects of binge episodes. Because they do not purge, they may be overweight or obese. Complications of binge-eating disorder are typically associated with excess weight, such as hypertension, diabetes, heart disease, and stroke risk.

Compulsive Exercise

Compulsive exercise refers to the obsessive desire and need to exercise to the extent that it interferes with health and other facets of daily life. It is also known as "exercise addiction," as individuals exhibit compulsory behaviors and depend on exercise to feel they can function normally.

These individuals may feel unable to control the amount of time they exercise. Additionally, they may feel distressed, guilty, anxious, or depressed if they cannot exercise as much as they desire. They may use exercise to manage difficult emotions, purge unwanted calories, "earn" permission to eat, or compensate for feelings of inadequacy and low self-worth. Some may adhere to rigid, overzealous workout regimes and push themselves past the point of injury and fatigue. They may prioritize exercise over relationships, jobs, and other interests, exercise secretly, or exercise at inappropriate times or places.

Compulsive exercise can have harmful physical impacts such as loss of bone density, chronic bone and joint pain, physical injuries such as overuse and fractures, weakened immune systems, and relative energy deficiency in sports (RED-S).

Orthorexia

Orthorexia is a recently coined term for individuals obsessed with eating only food perceived as extremely "healthy" and strictly avoiding foods considered "unhealthy." Persons with orthorexia may fixate on rigid guidelines for what constitutes food "healthy" enough for eating. They may fanatically research dietary practices and nutritional approaches to the extent that it interferes with regular functioning and physical and mental well-being. The focus on adhering to these guidelines may result in prioritizing lifestyle maintenance over relationships, interests, values, and physical health.

Without treatment, physical health may ultimately deteriorate. Symptoms associated with orthorexia include malnourishment, lessened immunity, organ failure, kidney and cardiovascular issues, and cognitive decline. People with orthorexia may derive a sense of "goodness" or "worthiness" from following these eating restrictions. Conversely, they may experience deep shame or low self-worth when they fail to adhere to these guidelines.