Anorexia Nervosa
Anorexia Nervosa is an illness that involves the restriction of food intake relative to one’s requirements, leading to a body weight that is significantly low for the individual.
People with Anorexia Nervosa often experience
- a sense of self-worth that is largely (even, exclusively) influenced by their ability to control their eating behaviour and body weight/shape,
- an intense fear of gaining weight, and
- an inability to recognition the seriousness of their illness.
Note: Being above or within the ‘healthy weight’ BMI range does not exclude someone from having Anorexia Nervosa.
We understand it’s not easy to admit to yourself or others that you or someone you love may be struggling with concerns such as these however it is important that if you suspect this is an issue, that you seek guidance and support from a professional as soon as possible. Anorexia Nervosa has the highest mortality rate of all mental illness. As such, we encourage anyone dealing with concerns around eating and/or their body-image to seek help as quickly as possible.
Bulimia Nervosa
Bulimia Nervosa is categorised by episodes of binge eating (eating a large amount of food in a relatively short period of time whilst experiencing a sense of loss of control) followed by inappropriate compensatory behavior (for example, self-induced vomiting or laxative abuse).
Individuals with Bulimia Nervosa also tend to overvalue the importance of controlling their eating behaviour and weight, experience body image disturbance, and have an intense fear of weight gain.
We understand it’s not easy to admit to yourself or others that you or someone you love may be struggling with concerns such as these however it is important that if you suspect this is an issue, that you seek guidance and support from an experienced professional as soon as possible. Although we understand that you might be experiencing a lot of shame around your concerns, our practitioners are warm, caring, and non-judgmental. They understand that you’re not to blame and they’re here to help you overcome your eating disorder one step at a time.
If you or someone you know are struggling with concerns, such as Bulimia Nervosa, we urge you to seek professional support. Left untreated, Bulimia Nervosa can lead to long-term, irreversible health complications.
Treatment
The team at CFIH work in a collaborative manner, ensuring everyone involved in your care (both within and external to CFIH) communicates regularly and is on the same page. We view you and your loved ones as an integral part of the treatment process. As such, therapy will first seek to develop a shared understanding of your concerns as well as your treatment goals.
Your medical stabilisation is major priority of treatment. We will seek to ensure you are monitored closely by a Medical Practitioner to minimise the need for hospitalisation.
Once you are medically stable, treatment will involve supporting you to achieve and sustain a pattern of eating as well as a weight that is healthy for you. From there, therapy will progress to explore your emotional concerns, both directly and indirectly related to your eating disorder.
Our professionals draw upon evidence-based approaches to treatment, including Family-based therapy (FBT), Cognitive Behavioural Therapy – Enhanced (CBT-E) and the Maudsley model of Anorexia Nervosa treatment for adults (MANTRA).
Your treating team will aim to involve your loved ones in treatment (where appropriate) and/or link you in with additional supports so as to ensure you have support between sessions.
Children
Family-based therapy (FBT) has been demonstrated to be the most effective treatment for Anorexia Nervosa and Bulimia Nervosa in children and adolescents.
This approach actively involves parents in the child’s recovery through supporting parents to help their child restore their weight, reverse malnutrition, and re-learn healthy eating behaviours.
On average, treatment is conducted within 15-20 treatment sessions over a period of approximately 12 months.
Adults
Recovery from Anorexia Nervosa and Bulimia Nervosa has been proven to be more successful when treatment:
- Involves family and/or significant others (where appropriate);
- Is recovery orientated;
- Occurs in the least restrictive (for example, outpatient, rather than inpatient) treatment setting possible;
- Takes a multidisciplinary, collaborative approach;
- Utilises evidence-based therapies.
Binge Eating Disorder (BED)
BED is categorised by episodes of binge eating; eating a large amount of food in a relatively short period of time whilst experiencing a sense of loss of control over eating. Unlike Bulimia Nervosa, individuals with BED do not partake in inappropriate compensatory behaviours (such as self-induced vomiting or laxative abuse).
Binge eating episodes are associated with eating rapidly, when not hungry, in secret, until extreme fullness, and are often associated with emotions such as depression, shame and/or guilt.
BED is not something to be embarrassed about. It is a mental health condition. It is not your choice, not your fault, nor something you can control or simply get over. With support of an experienced professional however, full recovery is possible.
Treatment
The most effective evidence-based treatment method for BED is Cognitive Behavioural Therapy-Enhanced (CBT-E). This approach focuses on restoring regular eating, eliminating episodes of binge-eating, reducing distress surrounding weight and shape, and learning effective emotional regulation skills.
The primary goal of BED treatment is to resolve the eating disorder symptoms as follows:
- Abstinence from binge eating;
- Reduction of weight and shape related concerns; and
- Weight stabilisation.
Weight-loss is not a part of treatment of BED. If there are concerns about the individual’s health, these concerns will be addressed through lifestyle and behaviour changes (such as increased physical activity and improved nutrition).
While treatment with an experienced therapist is always recommended as the first line approach, there is also evidence of Guided-Self Help (GSH) approaches being successful in achieving sustained recovery.
Overcoming Bulimia and Binge-Eating: A self-help guide using Cognitive Behavioral Techniques. Rev Ed. Auth: Peter Cooper Pub: Robinson UK, 2009
Selective Eating and Food Avoidance
Selective or “Fussy” Eating in Children
Across all cultures, enjoying a meal can represent more than simply consuming our daily nutrient requirements. Food can bring people together, celebrate an occasion, convey our feelings and is an important aspect of many cultural and religious identities. However, for some families, meal times represent a battleground of distress, avoidance and anxiety when children have selective eating.
Approximately one in four children experience eating problems during early childhood, with one in two families stating that their child actively avoids particular foods. These difficulties are present in some children from birth and infancy, whilst other children develop eating difficulties related to environmental or psychological triggers.
Eating problems are a common challenge for many parents. However, when these behaviours are accompanied by physical health, behavioural or emotional problems or are causing significant distress to the child or parent, it is important for them to seek support and for a diagnosis of Avoidant and Restrictive Food Intake Disorder (ARFID) to be ruled out.
Without intervention, insufficient nutrient consumption can lead to delays in motor skills, speech and language development, as well as stress and mental health difficulties.
Children with eating difficulties are usually restricted in either:
- The variety of foods consumed (typical description of picky eaters);
- The quantity of foods consumed (including appetite issues, lack of interest, avoiding eating);
- The texture of foods consumed (e.g. children only eating pureed or chewy foods).
By the time many families present for treatment, meal times are well established as a negative experience for both parents and children. Children have often developed an intense fear of foods and can become highly distressed at the sight or suggestion of new foods.
Behavioural family interventions are the most effective approaches to the treatment of child feeding problems. This involves helping parents to alter the family’s feeding practices to promote improvements in their child’s eating behaviours.
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Here are our top 5 tips for helping your child with their picky or selective-eating habits.
Avoidant and Restrictive Food Intake Disorder (ARFID)
ARFID is defined by a disturbance in eating that results in a failure to meet the nutritional or energy needs a person leading to
- weight loss or failure to gain weight as expected;
- nutritional deficiencies;
- a dependence on enteral feeding or food supplements; and/or
- an impairment in psychosocial functioning (e.g. it negatively impacts on the individual’s social life).
This avoidance may be due to a lack of interest in food, concerns about consequences of eating (such as a fear of choking or vomiting), or the displeasure experienced with the tastes and/or textures of foods. Unlike other eating disorders, individuals diagnosed with ARFID do not experience disturbances in body-image and/or a fear of weight gain.
To be diagnosed with ARFID, the avoidance of food must not be explained by:
- normal culture practices;
- food allergies;
- another eating disorder.
Unlike typical picky eating experienced early in childhood, people do not outgrow ARFID without specialist and targeted treatment. Due to the negative impact ARFID can have on an individual’s physical, emotional, and social health, we urge you to speak to a trained professional in the field if you suspect that you or someone you know might be experiencing ARFID.
Orthorexia
Although not yet a formally-recognised diagnosis, the notion of ‘Orthorexia’ is certainly a very real and concerning one. Literally meaning “fixation on righteous eating,” those with Orthorexia are described as being obsessed with healthy eating.
With all the hype about gluten-free, dairy-free, sugar-free, organic, grain-free, it’s no wonder that many are left feeling guilty no matter what they consume. Its tendency to be a common and wide-spread phenomenon does not mean it doesn’t warrant specialist treatment.
In addition to deleterious effects on mental health, Orthorexia can negatively impact physical health through its tendency to lead to Anorexia Nervosa, binge eating (a commonly occurring side-effect of overly restrictive eating), purging, and malnutrition.
While there is nothing wrong with wanting to improve your health through making more nutritious choices, a focus on health that does not include mental health and social relationships is not healthy at all.
All food is morally neutral. The type of person you are is not determined by the types of food you eat. |
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If you need support in striking a sustainable balance that improves your physical health without depriving you of life’s pleasures, contact our team to discuss how we might be of support.
Body Dissatisfaction in Males
Despite misconceptions, rates of body dissatisfaction among males are approaching similar rates to that among females. While females generally pursue thinness, males typically desire mesomorphic proportions; combining the drive for thinness/leanness as well as the drive for muscularity.
Increasingly more men are resorting to complex and dangerous strategies to achieve body ideals, with the current rates reported to exceed those of Anorexia Nervosa or Bulimia Nervosa. Although it is not currently recognised or identified as an illness, there is help available.
If you, or someone you know, seems to be experiencing body dissatisfaction to a degree that interferes with physical, mental or emotional health, CFIH can offer the support and advice to help.
Other Specified Feeding and Eating Disorder (OSFED)
Just because a person’s disordered eating behaviours and symptoms doesn’t exactly match those of a listed eating disorder, it by no means is any less serious or less worthy of receiving professional help.
Eating disorders are complex illnesses and not everyone will experience the same behaviours, symptoms and emotions. If a person is suffering from disordered thoughts, feelings or behaviours concerning food and/or weight and shape, it is important that they get the support they deserve.
For further guidance and information, please feel free to reach out to our team for a obligation-free 15-minute phone consultation.