What is an Eating Disorder?
What Causes an Eating Disorder?
An eating disorder can arise from a combination of factors including genetics, environment, psychological characteristics, and sociocultural dynamics. While the exact causes of eating disorders are not fully understood, some common factors that contribute to the development of an eating disorder include:
Family History
Having a family history of eating disorders can increase the likelihood of developing an eating disorder. However, it is important to state that parents are not to blame for your child’s eating disorder.
Life Experiences
How each person interprets their own life experiences is incredibly powerful as it can determine their risk for developing an eating disorder. Individuals who have experienced trauma, strict achievement or performance expectations (in school, sports, relationships, etc.), life and developmental changes, or being expected to look a certain way are more likely to develop an eating disorder. The largest risk factor for the development of an eating disorder is dieting behaviors.
Psychological Characteristics
Every person is born with specific temperaments and personality traits. Some personality traits are more commonly associated with individuals that struggle with eating disorders. Examples include perfectionism, people pleasing, high emotional sensitivity, conflict avoidance, and low distress tolerance.
Sociocultural Dynamics
The societal and cultural influences can impact an individual’s risk of developing an eating disorder. We live in a society that is incredibly influenced by diet culture which stipulates that thin is ideal and promotes an unrealistic expectation of beauty. These messages can come from social media, television, internet, school, advertisements, and so much more! Teens are more at risk of succumbing to the extreme expectations of diet culture compared due to their stage of cognitive development as teens have fewer coping skills to process these messages in a neutral way.
Anorexia Nervosa
What is Anorexia Nervosa?
Common Signs and Symptoms:
- Significant weight loss
- Rigid dietary restrictions
- Constantly dieting
- Avoiding certain food types due to fear of weight gain
- Calorie counting
- Excessive exercise
- Extreme preoccupation with body size and weight
- Distorted body image
- Difficulty or refusal to maintain a healthy weight
- Social isolation or withdrawal
- Medical concerns including fatigue, dizziness, hormonal imbalances, loss of menstrual cycle (if applicable), dehydration, bone density loss, hair thinning, cardiovascular issues, or poor immune system
Avoidant Restrictive Food Intake Disorder (ARFID)
What is Avoidant Restrictive Food Intake Disorder?
Avoidant Restrictive Food Intake Disorder (ARFID) is often misunderstood as someone who is an “extremely picky eater”. ARFID is characterized by the avoidance or restriction of certain foods or entire food groups within one’s diet. Those that struggle with ARFID often report a narrowing of their safe foods/preferred foods overtime which can lead to nutritional deficiencies and impaired functioning if left untreated. Unlike other eating disorders, ARFID is not driven by body image issues but is associated with sensory sensitivity or avoidance (e.g., temperatures, smells, tastes, or textures), lack of interest in food, of fear of aversive consequences (e.g., choking, vomiting, nausea, or allergies).
Common Signs and Symptoms:
- Lack of interest in food
- Refusal to try new foods
- Experiences emotional distress when around unfamiliar foods
- Small list of acceptable foods (being a “picky eater)
- Elimination of entire food groups
- Eating foods with similar sensory characteristics such as texture or color
- Fear of eating due to the potential for allergic reactions, choking, nausea, or vomiting
- Prefers food to be prepared in a specific way
- Poor weight gain and growth
- Medical concerns including nutrient deficiencies, weight loss, failure to gain weight, gastrointestinal issues, fatigue, hair thinning, trouble concentrating, or loss of bone density
Binge Eating Disorder
What is Binge Eating Disorder?
Common Signs and Symptoms:
- Consuming an unusually large amount of food in a short period of time
- Feeling out of control during these episodes
- Eating past the point of fullness, often to discomfort of physical pain
- Eating quickly without physical hunger
- Intense feelings of guilt, disgust, shame, and distress after an episode
- Secretive eating behaviors (e.g., hiding evidence of eating food, eating in the car, eating alone, eating late at night when others are asleep)
- Negative self-perception in connection to body, weight, or eating habits
- Constant thoughts about food
- Medical concerns including obesity or cardiovascular issues (those with Binge Eating Disorder living in larger bodies often face weight stigma when attempting to access healthcare services and are told to diet/exercise rather than being diagnosed and treated for their eating disorder)
Bulimia Nervosa
What is Bulimia Nervosa?
Bulimia Nervosa is an eating disorder characterized by recurrent episodes of binge eating large amounts of food in a short period of time (binge eating) which is followed by compensatory behaviors such as self-induced vomiting, misuse of laxatives, or excessive exercise. Those struggling with Bulimia experience feelings of guilt, shame, and out of control during binge episodes. As Bulimia progresses, the cycle of binging and purging becomes more difficult to break despite extreme emotional distress or interference with daily activities. Bulimia is motivated by an unhealthy preoccupation with body size and weight.
Common Signs and Symptoms:
- Consuming an unusually large amount of food in a short period of time
- Feeling out of control and shame regarding how much food is consumed
- Secretive behaviors related to food
- Engaging in compensatory behaviors like self-induced vomiting, excessive exercise, fasting/limiting caloric intake, or misuse of laxative
- Frequent trips to the restroom after eating meals (to engage in a compensatory behavior in private)
- Self-esteem and self-worth heavily connected to body size and weight
- Distorted self-image
- Fluctuations in weight
- Medical concerns including dental concerns, electrolyte imbalances, cardiovascular issues, dehydration, gastrointestinal issues, fatigue, muscle weakness, swollen salivary glands, hoarse voice, loss of menstrual cycle (if applicable), or acid reflux
Orthorexia Nervosa
What is Orthorexia Nervosa?
Common Signs and Symptoms:
- Self-imposed rigid dietary restrictions (e.g., veganism, gluten-free, vegetarianism, intermittent fasting, or Whole30)
- Refusal to eat foods that are not designated to be “healthy” or “pure.”
- Constantly checking ingredient lists, nutrition labels, or counting calories
- Concerns with how food impacts health or creates medical concerns.
- Increased supplement usage
- Concerns about food preparation so that it is within the individuals’ control.
- Self-esteem is connected to adherence to food rituals and rules.
- Perfectionism
- Inflexibility
- Fear of processed foods
- Social withdrawal
- Choosing to not attend social gatherings due to fear of pressure or expectation to eat “unhealthy” foods.
- Medical concerns include malnutrition, compromised immune system, loss of menstrual cycle, cardiovascular issues, loss of bone density, or difficulty concentrating.
Treatment for Eating Disorders at CalmOCD
At CalmOCD we treat eating disorders with a combination of therapeutic approaches to fit individual’s specific and unique needs. Cognitive Behavioral Therapy (CBT) is focused on the connection between thoughts, emotions, and behaviors. CBT works to identify thoughts that are unhelpful or unrealistic and reframe them with healthy and realistic ones. Through this process, the individual can break free of behaviors that are no longer serving them. CBT helps individuals with eating disorders be able to utilize tools to challenge their distorted body image, gain insight into their dysfunctional thoughts regarding food and weight and gain healthy coping skills that improve self-esteem in place of unhealthy disordered eating behaviors. Exposure and Response Prevention (ERP) is another treatment modality that is used to treat eating disorders within CalmOCD. ERP helps individuals struggling with eating disorders confront the foods, fears, and worries that are holding them back in their daily life. Exposure therapy assists the patient in reducing negative coping skills and self-talk before, during, and after the exposure to build understanding and confidence of how to handle triggers when they arise.
Typically, the individual struggling with an eating disorder is engaging in behaviors that are not congruent to who they are as a person as they are listening to the eating disorder. Acceptance and Commitment Therapy (ACT) is designed to help individuals refocus on their values and accept their experiences, rather than trying to avoid or control their emotions. ACT helps individuals with eating disorders learn skills to cope with challenging emotions, take positive actions towards their goals, and build resilience through acceptance. Mindfulness-Based Therapy can assist individuals with an eating disorder in learning how to bring awareness to their current experiences rather than focusing on the past or the future. This allows the individuals to learn how to listen to their body to regain their hunger/fullness cues, reduce rumination on unhelpful thoughts, and improve emotional regulation.
Each set of skills works to address how the eating disorder has been functioning in the individual’s life and provides alternative skills to meet the need but in a way that is not disordered. Distress Tolerance skills provide tools to deal with overwhelming emotions and return to “baseline”. Emotional Regulation skills are focused on building a healthier relationship with emotions by learning about their purpose and how to manage them without turning to the eating disorder to cope. Interpersonal Effectiveness provides tools to support healthy communication with people in life which allows the individual to feel empowered to express their needs and be in connection with others. Mindfulness skills are focused on improving the individual’s ability to stay focused in the moment rather than listening to the eating disorder voice.
Intensive Outpatient Program (IOP)
Once an eating disorder is creating issues in a person’s ability to engage normally in their day-to-day life, an intensive program is a way to treat symptoms more aggressively and find tools to recovery much sooner than with single outpatient sessions drawn out over the course of several months.
The Intensive Outpatient Program (IOP) program at CalmOCD gives patient’s flexibility in their treatment and provides quality treatment and support from one of our ED specialists one-on-one. Each IOP is customized for the specific eating disorder to be addressed which is something that many patients seek after being in higher levels of care or programs that did not address their needs specifically, such as exposure work for those with ARFID or mindful eating practices for those with BED. The program will provide patients and their families with specific psychoeducation based on their eating disorder and co-occurring disorders and offer family support and community/home visits when needed.
Steps In Treatment
Step One
After completing the complimentary 15-minute phone consultation, CalmOCD will schedule a 60-minute psychiatric diagnostic evaluation with one of our eating disorder specialists or add you to our waitlist depending on our current availability.
Step TWO
During this evaluation, the therapist will collect background information and learn more about the patient's current functioning. The therapist will make treatment recommendations, whether they are appropriate for single sessions (45-minute or 60-minute) or if our Intensive Outpatient Program (IOP) may be a better fit.
Step THREE
The therapists at CalmOCD will evaluate presenting symptoms and develop an individualized treatment plan based on the needs of the individual. No two people are alike even if they are experiencing the same eating disorder, which is why our approach is unique.
Step FOUR
If single sessions are appropriate the therapist will recommend the frequency at which these sessions are conducted. This recommendation is based on patient severity, clinical assessments, and psychological evaluation. At the start of treatment, patients respond better when they can have therapeutic support consistently and sessions close together.
Step FIVE
Our clinicians will help the patient build a strong foundation of skills through psychoeducation on their specific diagnosis. Each patient and their family will receive a CalmOCD educational folder filled with resources they will refer to throughout treatment. The psychoeducation portion of treatment may take 2-4 sessions.
Step SIX
Next, the therapist and patient will work together to identify the function of the eating disorder and how it has been serving them in life, recognizing the negative and positive.
Step SEVEN
Behavioral therapy begins. A collaborative approach occurs where the therapist and patient work alongside one another utilizing various treatment modalities including ACT, DBT, CBT, and ERP.
Step EIGHT
The length of treatment depends on such factors as: the severity of symptoms, the patient's willingness to give up behaviors, consistency in doing the hard work, and the family's ability to stop accommodating their loved one’s symptoms.
Ready to Start Your Healing Journey?
If interested, please follow the steps below! Due to the high volume of inquiries please allow 48 hours for a response.
STEP 2
Response
You will receive a response from CalmOCD within 48 hours and a 15 minute complimentary consultation will be scheduled
STEP 3
Intake Session
If CalmOCD seems to be a good fit based on your individual needs, an intake session will be scheduled.
At CalmOCD we treat individuals ages 5 and up with obsessive-compulsive disorder, generalized anxiety disorder, social anxiety, eating disorders, panic disorder, agoraphobia, phobias, misophonia, body-focused repetitive behaviors (BFRBs), and co-occurring depression.
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