Eating Disorders and Psychotherapy

At the start of 2017 many of us will turn our attention to exercise and healthy eating to shift those few extra Christmas pounds and re-energise ourselves into the New Year. However, for some there may be a much darker side to the resolution to look and feel better.

The rise of a form of disordered eating called Orthorexia is becoming increasingly mainstream, fuelled by the mania for healthy eating and our growing anxiety around obesity it lies somewhere on the blurred boundary between being health-conscious and a health obsessive. Defined as a “fixation with righteous or correct eating”, what begins as an attempt to improve one’s lifestyle can morph into an unhealthy fixation. It’s unknown how widespread the condition is because it is not currently recognized as a clinical diagnosis, however, it can be just as harmful psychologically as it possesses the same joyless preoccupation with appearance and food.

Eating disorders are a relatively common psychological illness but are not always well diagnosed. They describe illnesses characterized by irregular eating habits and severe distress or concern about body weight or shape. Eating disturbances may include inadequate or excessive food intake, ultimately damaging an individual’s wellbeing by both physiological damage to health and psychological illness. There are also the more hidden negative social, employment and lifestyle effects associated with eating disorders.

As a defence mechanism they represent a maladaptive approach to tolerating the unbearable, and demonstrate a continued conflict of desire. Those with anorexia may refuse food in order to maintain a space to keep desire alive. Those patients who eat junk food or partake in fad diets only to then indulge in violent bodily purges are attempting to feel or subvert desire. These feelings are further complicated by the influences of culture, social media and peer pressure.

The NHS recently revealed that the number of teenagers being admitted to hospital with eating disorders has nearly doubled in the last three years. The Royal College of Psychiatrists has laid the blame for this unprecedented rise firmly at the door of social media and particularly pro-anorexia and pro-bulimia websites offering tips on how to avoid food.
As clinicians we may also become aware of the significant percentage of those with eating disorders who also struggle with alcohol and substance use disorders. In 2003, the National Centre on Addiction and Substance Abuse issued the seminal report, “Food for Thought: Substance Use and Eating Disorders,” which highlights this relationship.
The report established that Individuals with eating disorders were up to 5 times as likely as those without eating disorders to abuse alcohol or illicit drugs, and those who abused alcohol or illicit drugs were up to 11 times as likely as those who did not to have had eating disorders. Specifically, up to 50% of individuals with eating disorders abused alcohol or illicit drugs, compared to 9% of the general population. Other research has offered similar findings. Struggling with an eating disorder ¬ or a substance use disorder ¬increases one’s chances of developing the other disorder.
There can be many underlying issues which lead to an eating disorder, these may include, difficult relationships in early life, low self-esteem, loss of a loved one or the end of a relationship. Different forms of psychotherapy, such as individual, family, or group, can be helpful in addressing the underlying causes of eating disorders. Therapy can be fundamental to treatment because it affords an individual in recovery the opportunity to address and heal from traumatic life events and learn healthier coping skills and methods for expressing emotions, communicating and maintaining healthy relationships.

Confronting the eating disorder is the first step of recovery. If you are suffering, it is important to admit that you need help. Though this can be the most painful and difficult part of the process, it is essential in order for recovery to begin. By reaching out for help and confiding in others trust about your struggles, you are taking the biggest step towards overcoming your eating disorder. If you have a loved one who is suffering from an eating disorder and are worried about their eating behaviours or attitudes, it is crucial to communicate your concerns in a loving and supportive way. Confronting the person you care about is a necessary step towards getting them the help and treatment they deserve.

If you are concerned about someone else with eating disorders then please consult your doctor or seek advice on reputable websites such as:

https://www.b-eat.co.uk/
https://www.nationaleatingdisorders.org/
http://www.nhs.uk/Livewell/eatingdisorders/Pages/eating-disorders-advice-parents.aspx
http://www.nhs.uk/Livewell/teengirls/Pages/treatmentforeatingdisorders.aspx