Eating Disorders Are Treatable
If you are struggling with eating disorder symptoms, help is available. Eating disorder treatment can help you change the way you feel about yourself and your body. You can learn new coping skills and find a path towards self and body love. Most importantly you can step out of the trap of negative thinking and feeling into a more fulfilling life.
At Eddins Counseling Group we offer individual therapy and group therapy for eating disorders.
The Rationale For This Study
A phenomenological study of diagnostic crossover is of relevance to both clinical practice and academic bioethics.
Bioethics is inherently concerned with ethical issues arising in the life sciences, particularly medicine. Therefore, this research is of relevance to bioethics in that it brings to light and investigates the moral dimensions of psychiatric diagnosis. Philosophers such as Fulford and Sadler have examined how psychiatric diagnostic classifications are influenced by the values held by mental health professionals and the society in which they practice. The present study contributes to this literature by exploring ways in which a specific group of five ex-patients understand and experience the interplay of moral value and psychiatric diagnosis, and how this impacts their self-understanding and moral identity.
Validation And Comparison Of The Two Sets Of Questions
Single Level Cutoff Analysis.
For the SCOFF questions, a cutoff of 2 or more abnormal responses gave a sensitivity of 78% and a specificity of 88% . The corresponding positive LR was 6.6 and the negative LR was 0.25 .
A cutoff of 2 or more abnormal responses to the ESP questions maximized sensitivity at 100% with a corresponding specificity of 71% . The associated likelihood ratios were LR+, 3.4 , and LRâ, 0.0 .
Multilevel Analysis
Multilevel analysis was performed by separating out the questions . With 1 or no abnormal responses, the ESP questions provided a positive likelihood ratio of 0.0 and the SCOFF questions gave a positive likelihood ratio of 0.25 . Three or more abnormal ESP responses gave a positive likelihood ratio of 11 . Likewise, 4 or more abnormal SCOFF responses gave a positive likelihood ratio of 11 .
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Diagnosis And Diagnostic Crossover
DSM-5 lists eight categories of feeding and eating disorder, and this paper focuses on three: anorexia nervosa , bulimia nervosa , and binge eating disorder . AN can also be separated into two sub-types: anorexia-restrictive type and anorexia-binge-purge type . An individual will not be given more than one diagnosis at a time, however, there are many similarities between the ED diagnostic categories in DSM-5. Notably, several diagnostic criteria are shared by more than one disorder. For example, binge eating is common to the diagnostic criteria of ANBP, BN, and BED, and self-evaluation is unduly influenced by body shape and weight in both AN and BN . In this sense, it is the distinct combination of symptoms or behaviours that determines the diagnosis, and acquiring or losing one symptom can result in transition to a new diagnostic category, a process known as diagnostic crossover.
An individuals experiences or behaviours need not change dramatically to warrant a different diagnostic label for example, a patient with ANBP who gains sufficient weight will transition to BN, and vice versa. Given that weight and symptoms tend to fluctuate regularly, and that diagnosis is made on the basis of positive symptoms over just three months, some individuals may experience recurrent diagnostic crossover over time .
When Should A Person With Anorexia Go To The Emergency Room
Someone with anorexia should go to the emergency room if theyre experiencing any of the following physical symptoms:
- Unusually low blood pressure.
If youre having thoughts of harming yourself, get to the nearest hospital as soon as possible or call the National Suicide Prevention Lifeline at 1-800-273-8255. Someone will be available to talk with you 24/7.
If you recognize suicidal behaviors in someone with anorexia, get them care as soon as possible.
A note from Cleveland Clinic
Anorexia is a serious and potentially life-threatening condition. The good news is that recovery is definitely possible. If you or someone you know is experiencing signs and symptoms of anorexia, its essential to seek help and care as soon as possible. Its never too late to seek treatment, but getting help early improves the chance of a lasting recovery.
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Whats The Difference Between Overeating And Binge Eating
While it is normal to occasionally eat more food than is considered typical, such as at a buffet dinner or a special occasion, people with binge eating disorder tend to have episodes of overeating more often than other people.
They also feel that they are not in control of their eating, versus someone who is overeating simply because they are enjoying their meal.
What Are The Warning Signs Of Anorexia
There are many potential warning signs of anorexia, including feeling preoccupied with food, exercise, or body weight. Experiencing feelings of guilt or shame after eating, avoiding situations that involve food, and withdrawing from friends, hobbies, or activities are a few other possible warning signs.
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Warning Signs Of An Eating Disorder In Someone Else
It can be very difficult to identify that a loved one or friend has developed an eating disorder.
Warning signs to look out for include:
- dramatic weight loss
- lying about how much they’ve eaten, when they’ve eaten, or their weight
- eating a lot of food very fast
- going to the bathroom a lot after eating
- exercising a lot
- cutting food into small pieces or eating very slowly
- wearing loose or baggy clothes to hide their weight loss
Do I Have An Eating Disorder Take The Screening Test Below And Find Out
Has your relationship with food or your body gotten out of control? Do you feel trapped in routines or habits you cant break? Does it feel like food has become an enemy? Has your social life, career, or relationship with yourself suffered because of your habits or behaviors? Take the screening test below and find out if you have symptoms of an eating disorder.
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What Is An Eating Disorder
An eating disorder is a serious mental health condition that involves an unhealthy preoccupation with eating, exercise or body shape.
Anyone can develop an eating disorder, regardless of cultural background, gender or age. Eating disorders are estimated to affect approximately 4 in every 100 people in Australia . About 1 in 7 people experience disordered eating in their lifetime.
If you have an eating disorder, you may experience any the following:
- A preoccupation and concern about your appearance, food and gaining weight.
- Extreme dissatisfaction with your body you would like to lose weight even though friends or family worry that you are underweight.
- A fear of gaining weight.
- You let people around you think you have eaten when you haven’t.
- You are secretive about your eating habits because you know they are unhealthy.
- Eating makes you feel anxious, upset or guilty.
- You feel you are not in control around food.
- You keep checking your body for example, weighing yourself or pinching your waist.
- Making yourself vomit or using laxatives in order to lose weight.
What Are The Signs And Symptoms Of Anorexia
You cannot tell if a person has anorexia just by their appearance because anorexia also involves mental and behavioral components not just physical. A person does not need to be underweight to have anorexia. Larger-bodied individuals can also have anorexia. However, they may be less likely to be diagnosed due to cultural stigma against fat and obesity. In addition, someone can be underweight without having anorexia. Remember, anorexia also includes psychological and behavioral components as well as physical.
There are several emotional, behavioral and physical signs and symptoms of anorexia. If you or someone you know experiences the signs and symptoms of anorexia below, its important to seek help.
Emotional and mental signs of anorexia
Emotional and mental signs of anorexia include:
- Having an intense fear of gaining weight.
- Being unable to realistically assess your body weight and shape .
- Having an obsessive interest in food, calories and dieting.
- Feeling overweight or fat, even if youre underweight.
- Fear of certain foods or food groups.
- Being very self-critical.
- Experiencing thoughts of self-harm or suicide.
Behavioral signs of anorexia
Behavioral signs of anorexia include:
Physical signs and symptoms of anorexia
Physical signs of anorexia include:
Physical symptoms of anorexia that are side effects of starvation and malnutrition include:
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Having Arfid And Another Condition
Sometimes people with another condition, such as OCD or autism spectrum disorder, also have ARFID. When a person has more than one condition, its called comorbidity.
If a person with a specific mental health diagnosis demonstrates food avoidance that causes significant psychosocial, medical, and nutritional disturbances, experts recommend that the person also be diagnosed with ARFID.
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What Should I Do If I Think I Have An Eating Disorder
People with an eating disorder may feel it helps them stay in control of their life. However, as time goes on, the eating disorder can start to control them. If you have an eating disorder, you may also have the urge to harm yourself or misuse alcohol or drugs.
Talk to someone you trust such as a close friend or family member if you think you have an eating disorder. You can also call the Butterfly Foundation National Helpline . You can also call the Butterfly Foundation for advice if youre concerned about a family member or friend.
Your doctor can advise you on diagnosis and possible treatment options, which will depend on your individual circumstances and the type of eating disorder you have.
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Who Develops An Eating Disorder
Put in the simplest of terms, eating disorders dont discriminate. Even though they are more common in adolescents, adults can develop them as well. While stereotypically it might seem that women and girls are more predisposed to them, men can and do, struggle with eating disorders. In fact, 9% of the US population in total, that is, 28.8 million Americans struggle with an eating disorder.
What Is The Difference Between Anorexia And Bulimia
Anorexia nervosa and bulimia nervosa are both eating disorders. They can have similar symptoms, such as distorted body image and an intense fear of gaining weight. The difference is that they have different food-related behaviors.
People who have anorexia severely reduce their calorie intake and/or purge to lose weight. People who have bulimia eat an excessive amount of food in a short period of time followed by certain behaviors to prevent weight gain. Such behaviors include:
- Intentional vomiting.
- Misuse of medications such as laxatives or thyroid hormones.
- Fasting or exercising excessively.
People with bulimia usually maintain their weight at optimal or slightly above optimal levels whereas people with anorexia typically have a body mass index that is below 18.45 kg/m2 .
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What Causes Eating Disorders
It is unlikely that an eating disorder has one single cause. Its normally due to a combination of many factors, events, feelings or pressures. A person might use food to help them deal with painful situations or feelings without realising it.
These factors may include low self-esteem, problems with friends or family relationships, problems at school, university or work, high academic expectations, lack of confidence, concerns about sexuality, or sexual assault or emotional abuse.
Traumatic events can trigger an eating disorder, such as the death of someone special , bullying, abuse or divorce. Someone with a long-term illness or disability may also have eating problems.
Studies have shown that genetics may also be a contributing factor to eating disorders.
Eating Disorders And Moral Character
Since the 1960s and 70s it has been well established in the literature that EDs are closely intertwined with moral values, both in the minds of those diagnosed and within society . As Giodano writes: at the basis of the admiration for a thin body or an empty body there are moral values: self-control, perfectionism, purity, intellectual achievement, will power and hard work, a cluster of values with a long history . Research has also shown how BN and BED are typically viewed in opposition to AN, and therefore become symbolic of moral weakness. Indeed, despite significant similarities between the various different EDs, they are often conceived of in binary terms: chaos and control disgust and purity vice and virtue . These virtues and vices are gendered, often focused on ideal notions of specifically feminine morality .
Additionally, it is well known that EDs strongly impact self-identity. This is especially likely in the case of ego-syntonic disorders such as AN, when patients sometimes struggle to identify an authentic self that is separate from the disorder . Consequently, individuals with AN may incorporate symptoms within their self-concept and ideal identity, and pursuing the disorder comes to represent the pursuit of personal values . In this sense ED identity and the moral values it entails can become sources of pride and of shame .
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What Signs And Symptoms Indicate An Eating Disorder
As an eating disorder develops, certain signs might come to light that contributes to the diagnosis of an eating disorder. These signs are mostly specific to certain types of eating disorders.
- Signs of anorexia nervosa
- Those with anorexia tend to be incredibly underweight even if they dont perceive themselves to be.
- They develop restrictive modes of eating.
- Their violent fear of gaining weight leads to behaviors that prohibit weight gain, such as calorie counting, limiting food intake, inducing vomiting after eating, abusing laxatives or diuretics or exercising excessively.
- Bodyweight and shape play a role in self-esteem and body image.
- They constantly are plagued by the need to be thin and lose weight even if they are already very thin.
- Signs of bulimia nervosa
- Recurring binging episodes where the individual feels little control/fails to stop eating until theyre painfully full, followed by unhealthy purging behaviors to prevent weight gain
- Fear of gaining weight, even though those with bulimia nervosa tend to maintain an average weight
- Self-esteem is dictated by body image
- Signs of binge eating disorder
- Secretly eating large amounts of food until theyre painfully full, regardless of actual hunger
- Lacking control over the act of binging, but feeling corresponding guilt, shame or disgust in regards to the behavior of binge eating
- Not following the act of binge eating with some form of purging behavior, thereby leading to obesity
Working With A Professional
If you think that you are struggling with an eating disorder, please reach out to a professional to confirm your diagnosis. Talking to an eating disorder expert will afford you many benefits, starting with accurate information about these complex conditions.
When you reach out to a healthcare professional, you will undergo a thorough physical exam to check for any ailments that might be causing the symptoms youve been experiencing. By taking this step, you can make sure that you dont have any other health conditions that may continue to worsen over time.
A healthcare provider will also conduct a detailed assessment of your medical history and symptoms. This process will help them identify what conditions you may be suffering from, along with the type and level of care that will best meet your needs.
Afterward, theyll work with you to set a plan for how to approach your healing process, including recommendations for places to get treatment or any appropriate referrals.
Self-diagnosis can sometimes be the start to a persons recovery journey. But by working with a healthcare provider, youll have a built-in support system to guide you through the entire recovery process, from confirming your diagnosis to getting you all the resources you need to experience lasting success.
With the help of experts, you can get real answers and start on the path to recovery.
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Treatments For Eating Disorders
Starting treatment as early as possible is important because there can be long-term health consequences for people with chronic eating disorders.
There is no ‘one size fits all’ approach to treating eating disorders since everyone is different. Often a team of health professionals is involved in an individual’s treatment, including a psychologist, dietitian and doctor.
Some of the treatment options include:
Are There Complications Related To Treating Anorexia
The most serious complication of treating anorexia is a condition called refeeding syndrome. This life-threatening condition can occur when a seriously malnourished person begins to receive nutrition again. Basically, their body cannot properly restart the metabolism process.
People experiencing refeeding syndrome can develop the following conditions:
Since refeeding syndrome can have serious and life-threatening side effects, its essential for people with anorexia to receive medical treatment and/or guidance.
People who have one or more of the following risk factors for developing refeeding syndrome may need to be treated in a hospital:
- Are severely malnourished .
- Have had little or no calorie intake for more than 10 days.
- Have a history of refeeding syndrome.
- Have lost a lot of weight in a very short period of time .
- Drink significant amounts of alcohol.
- Have a history of misusing laxatives, diet pills, diuretics, or insulin .
- Have abnormal electrolyte levels before starting refeeding.
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Shame As A Moral Emotion
For participants in this study, diagnostic crossover was a shameful experience. Although they described shameful behaviours and bodily shame, they often also spoke of the shameful character traits that they felt caused and were revealed through their body size or behaviour. Participants associated AN with virtues such as self-control, strength, diligence, resilience, perfectionism, and hard work, whereas BN and BED were associated with morally bad character traits such as laziness, greed, weakness of will, and lack of self-discipline. Therefore, crossover from AN to BN or BED was experienced as moral failing.
There is a significant philosophical literature on shame including insightful discussion of the phenomenology of shame . It is generally held that shame is a moral emotion at its simplest, moral emotions are those emotions that make fundamental contributions to human morality . In this context, shame is often described in terms of its differences from guilt whilst guilt arises in response to immoral actions and their consequencessuch as the act of stealing from a friendshame is centrally concerned with faults in ones character. Consequently, whilst individuals often respond to guilt through desiring to make amends or confess, feelings of shame are more likely to elicit a desire to conceal and isolate oneself.