Eating disorders: test and treatment recommendations. How to treat an eating disorder Treatment of eating behavior
Disorders eating behavior(RPP)- these are diseases characterized by unhealthy eating behavior, which is based on concern for one's own weight and appearance.
Eating disorders may include inappropriate or overconsumption food, which can ultimately significantly worsen the well-being of the individual. The most common forms of eating disorders (EDs) are anorexia, bulimia and compulsive overeating- all of them are found in both women and men.
Eating disorders can develop at any stage of life, but tend to develop and become more common during adolescence or early adulthood. The right therapy can be very effective in treating many types of eating disorders.
If eating disorders are not treated and left without proper attention, the symptoms and consequences can be very disastrous, lead to the destruction of health and even lead to the death of the patient. Eating disorders are often accompanied by mental disorders, For example, anxiety disorders, depression, neuroses, abuse of psychotropic substances and/or alcohol.
Types of Eating Disorders. RPP is:
The three most common types of eating disorders are:
- Bulimia - This eating disorder is characterized by frequent overeating, accompanied by “compensatory” behavior - artificial vomiting, excessive physical activity and abuse of laxatives and diuretics. Men and women suffering from Bulimia may fear weight gain and feel dissatisfied with the size and shape of their own body. Binging and purging tend to happen in secret, creating feelings of shame, guilt and lack of control. Side effects of bulimia include problems with gastrointestinal tract, severe dehydration and heart problems caused by electrolyte imbalances.
Causes of Eating Disorders
The exact cause of eating disorder at the moment has not yet been officially confirmed. Anna Vladimirovna Nazarenko, head of the Eating Behavior Recovery Clinic, based on more than 15 years of practical experience, believes that one of common reasons is an individual feature of the aesthetic perception of a person, which is laid down in us even before birth. Speaking in simple language, the main reason is the desire to be thin and beautiful from an aesthetic point of view, as an individual personality trait. The type of eating disorder a patient has depends on psychological characteristics and external social factors.
Examples of psychological characteristics:
- Negative perception of one's own body;
- Low self-esteem.
Examples of social factors:
- Dysfunctional family dynamics;
- Profession and activity that promote weight loss, for example, ballet and modeling business;
- Aesthetically oriented sports that promote a muscular, toned body;
- Examples:
- Body-building;
- Ballet;
- Gymnastics;
- Struggle;
- Long distance running;
- Family and childhood trauma;
- Cultural pressure and/or pressure from peers and/or friends and colleagues;
- Difficult experiences or life problems.
To date, no research has been conducted on eating disorders and no evidence has been found to support the theory of a genetic predisposition to eating disorders. The only thing that has been reliably proven is that the risk of developing bulimia is higher if someone in the family has an addiction (alcohol, drugs or bulimia).
Signs and Symptoms of an eating disorder
A man or woman with an eating disorder may exhibit a range of signs and symptoms, such as:
Treatment of eating disorders in 2019
Given the severity and complexity of these diseases, patients require comprehensive treatment under the supervision of a team of different specialists specializing in the treatment of eating disorders. Here, too, everything depends on the level of personality destruction. Specialists include: professional specialist in the field of eating disorders, psychotherapist, in some cases gastroenterologist, internist and neurologist.
At the moment, in Israel and Russia they are mainly used outdated methods of inpatient treatment with antidepressants, which destroy the liver and kidneys, have a short-term effect. The patient is constantly in a inhibited state and the psychotherapist does not have the opportunity to effectively work and conduct personality psychotherapy in this patient’s state. This condition only helps doctors in the hospital feed the patient and has a short-term effect, i.e. gives a short time of remission, but does not provide a long-term sustainable and successful final recovery, since it is necessary to work with the patient through awareness. As practice shows, the latest PSYCHOTHERAPY indicates that the most the best method treatment for eating disorder is outpatient treatment and psychotherapy without hospitalization and antidepressants (the only exception may be cases of acute anorexia, when we are talking about life and death).
To solve many of the problems that a man or woman faces in restoring their health and well-being, individual treatment plans. Treatment of eating disorder usually takes place under the supervision of one or more specialists (psychologist, neurologist, etc.):
- Medical supervision and care. The most big problem in the treatment of eating disorders - this is a solution to any health problems that could be a consequence of eating disorders;
- Nutrition: This is about restoring and stabilizing a healthy weight, normalizing eating habits and developing individual plan nutrition;
- Psychotherapy: Various shapes Psychotherapy (individual, family or group) can help address the underlying causes of eating disorders. Psychotherapy is a fundamental part of treatment because it can help the patient survive traumatic life events and learn how to properly express their emotions, communicate and maintain healthy relationships with others;
- Medicines: some medicines can be very effective in relieving symptoms of depression or anxiety that may occur with eating disorders or in reducing binge eating and purging.
Depending on the severity of the eating disorder, the patient may be advised different levels treatments ranging from outpatient support groups to inpatient treatment centers. In any case, the patient first of all needs to recognize the presence of an eating disorder and seek help from specialists.
Stories of girls cured from eating disorders
Key Points About Eating Disorders
- Anorexia kills. This disease actually has the most high level mortality among all mental disorders. Means mass media Cases of celebrities dying from anorexia are often reported. Perhaps the first such case was the death of Karen Carpenter in the early eighties. The singer suffered from anorexia and abused emetics. She ultimately died of heart failure. Many years later, her sad experience repeated by Christina Renee Henrich, a world-famous gymnast who died in 1994.
- "Female Athlete Syndrome" - dangerous disease, which can leave professional female athletes at risk of getting serious problems with health for life. Their coaches, friends and family should support them and help prevent them from developing an eating disorder.
- Major changes in life can trigger the development of eating disorder. Starting university studies is no exception. A young man or woman leaves home, leaves friends and family behind to venture into the unknown. For some, college can be much more difficult emotionally than for others. The beginning of adulthood can be a serious psychological shock and, unfortunately, being a student can trigger the development of an eating disorder.
- Eating disorders are believed to be more common among wealthy women with good education who belong to a high socio-economic class. Eating disorders are also often considered to be a uniquely “European” disease and are therefore rarely seen in other ethnic groups. However, this is all a big misconception. In fact, eating disorders have existed for quite a long time in many cultures and ethnic groups. And this is further proof that there are no barriers or restrictions for eating disorders. Men, women, Europeans, African-Americans, residents of the Caucasus, Kazakhstan, etc. can become victims of eating disorders. For example, in the Anna Nazarenko Eating Behavior Recovery Clinic, the second place in terms of the number of requests belongs to Kazakhstan, third place is shared by Belarus and Ukraine, and first place belongs to Russia.
- According to the National Eating Disorders Association, lesbian, gay, bisexual and transgender people (and other members of the LGBT community) experience more high risk development of eating disorders, incl. anorexia and bulimia. Single gay and bisexual men are more likely to suffer from anorexia (because they are forced to maintain thinness as a competitive advantage), while gay and bisexual men in relationships are more likely to suffer from bulimia. Lesbian and bisexual women with eating disorders are not much different from heterosexual women with eating disorders, but lesbian and bisexual women are more likely to have mental health disorders.
- In pursuit of the ideal. Ballerinas work hard to succeed in their profession, but as a result, they often become victims of eating disorders. It's no secret that ballet dancers often suffer from eating disorders, and this is understandable, since during training and rehearsals in front of a large mirror they have to compare themselves with their competitors. Moreover, professional ballet itself promotes unhealthy thinness.
- Does vegetarianism contribute to the development of eating disorders? Currently, about five percent of Americans consider themselves vegetarians (they exclude meat and animal products from their diet). This percentage does not take into account those who consider themselves “quasi-vegetarians” (people who eat some animal products but whose diet is mostly plant-based). Vegetarianism is much more common among those who suffer from eating disorders. About half of patients struggling with an eating disorder practice some form of vegetarian diet.
- The most serious complications resulting from eating disorders are malnutrition or an unstable heartbeat. However, a number of complications associated with eating disorders can have serious long-term consequences for the patient's health, even if they are not obvious and practically do not manifest themselves. Bone loss, or osteoporosis, is a silent but very serious disease that often affects patients with anorexia.
- Because of huge amount
– a group of psychogenic behavioral syndromes characterized by deviations in the intake and processing of food. This group includes anorexia nervosa, bulimia nervosa, overeating and some other disorders. Symptoms are varied and include refusal to eat, binge eating, induced and involuntary vomiting, use of laxatives, and denial of the subjective significance of the weight problem. The diagnosis is based on the results of a conversation with a psychiatrist and data psychological testing. Treatment is based on individual and group psychotherapy and the use of medications.
General information
IN International classification Eating disorders are classified under a separate heading “Eating Disorders”. A common characteristic of the group is the contradiction between physiological need in food and the patient's desires. The peak incidence occurs in adolescence and young adulthood. A stable gender predisposition is determined, girls and women make up 85-95% of patients with anorexia and bulimia, 65% of people with psychological overeating. According to recent studies, psychogenic eating disorders more often develop in people from wealthy families, with a high level of education and income, and in residents of economically developed countries.
Causes of eating disorders
In the occurrence of disorders of this type a significant role is played by the patient’s psychological and physiological characteristics and social relationships. Specific causes are determined by a specialist during the diagnostic process. As a rule, several factors are identified that predispose to the disease, and one or two that served as triggers. Among the possible conditions for the development of psychogenic eating disorder highlight:
- Psychological characteristics. Disorders are formed on the basis of emotional instability, feelings of guilt, low self-esteem, suggestibility, and dependence on the opinions of others. Adolescents experiencing an age crisis are at risk.
- Microsocial living conditions. A large role in the formation of disorders is played by the family’s eating habits - lack of a diet, addiction to sweet foods, as well as methods of education - overprotection, authoritarianism, the use of food as a tool for punishment or reward. In adolescence and young adulthood, comments from parents, peers, and spouses regarding appearance become significant.
- Stress. Psychogenic increase or decrease in appetite, mechanical gluttony without the feeling of hunger arise as ways to compensate for emotional stress. Gradually, changes in food intake and its results become independent sources of stress.
- Social values. Eating disorders are directly formed by the imposed “ideals” of beauty – slimness, thinness, fragility. Indirectly, violations are formed as a result of increased requirements for success, ability to work, and resistance to stress.
- Hereditary predisposition. Features are genetically transmitted physiological processes, forming the basis of perverted, decreased or increased appetite, the development of obesity. These include hormonal imbalances and neurotransmitter transmission disorders.
- Mental illnesses. Psychogenic syndromes are often identified in schizophrenia, bipolar affective disorder, depression, and psychopathy. Such cases differ in their pronounced clinical signs, resistance to therapy.
Pathogenesis
Pathological changes in eating disorders occur at two levels - mental and physiological. Initially, a conflict is formed between the basic need to eat food and a person’s actual desires, which arise as a result of social relationships, adaptation to stress, one’s own self-esteem, etc. Desire forms an obsessive, overvalued idea that determines motives and behavior. With anorexia, the thought of losing weight dominates; with bulimia nervosa, the fear of gaining weight dominates; psychogenic overeating– desire to relax, avoid tension. In rarer cases, ideas are idiosyncratic. For example, the patient is afraid to eat foods certain type, considering them dangerous. Following mental changes, the process of processing and assimilation of food is disrupted, and a deficiency of nutrients, vitamins, and microelements develops.
Classification
Eating disorders come in a wide range of varieties. The most common and clinically distinct types are considered in ICD-10 as separate disease entities. Less studied features - orthorexia nervosa, drankorexia, selective nutrition - continue to be studied and are not considered as a pathology by all specialists. In accordance with the international classification of diseases, the following are distinguished:
- Anorexia nervosa. It is characterized by the dominant idea of weight loss, severe restrictions on the volume and calorie content of food, and exhaustion. Accompanied by a risk of death.
- Bulimia nervosa. It manifests itself as bouts of gluttony, followed by feelings of guilt and forced disposal of what has been eaten. Weight remains stable or increases slowly.
- Psychogenic overeating. Gluttony occurs in response to a stressful situation and is consolidated in behavior as a way of getting rid of affective tension. Leads to weight gain.
- Psychogenic vomiting. Seizures develop against a background of strong emotions. Accompanying somatoform diseases, hypochondriacal and dissociative disorders, pregnancy.
- Eating inedible, inorganic origin. This group includes adults eating chalk, clay, and leaves of inedible plants. Violations lead to serious somatic diseases.
- Psychogenic loss of appetite. The craving for food decreases with prolonged depression and intense experiences that accompany psychotrauma. The severity and duration of the disorder directly correlates with emotional disturbances.
Symptoms of eating disorders
Symptoms of psychogenic anorexia are exhaustion, persistent desire for thinness, reluctance to maintain normal weight, distortion of body image, obsessive fear of weight gain. Patients adhere to overly strict diets with the maximum possible limitation of calories and food volumes, eating 1-2 times a day. If the rules of the “diet” are violated, they feel guilty, provoke vomiting, and use laxatives. Signs of dysmorphophobia are identified - a distorted image of one’s own body. Patients consider themselves fat when they actually have normal or insufficient weight. They are characterized by a depressed, depressed state, isolation, social distancing, and excessive preoccupation with nutrition and physical activity.
With bulimia, periodic episodes of eating large amounts of food are observed. Bouts of uncontrollable binge eating are followed by purging, a type of behavior aimed at ridding the body of eaten foods. Patients induce vomiting, take laxatives, do enemas, undergo a period of strict dieting and torture the body with physical exercise. Fear of weight gain, dissatisfaction with appearance, and feelings of guilt dominate. Episodes of bulimia often occur in secret from other people. The cycle of binge eating and purging repeats several times throughout the week.
Psychological overeating is manifested by gluttony, which develops when emotional stress, stress. Patients do not realize the onset of satiety and continue to eat until discomfort– feelings of heaviness, fullness of the stomach, nausea. When eating food, they understand that control of actions has been lost, but they cannot restore it. Feelings of shame and guilt become a source of additional stress and again provoke gluttony. With psychogenic vomiting, attacks occur due to a stressful external situation and internal experiences. Eruption of stomach contents occurs involuntarily. Psychogenic loss of appetite is characterized by an indifferent attitude towards food. Patients unintentionally skip meals, eat reluctantly, and quickly become full.
Complications
In disorders characterized by restricted food intake, there is a risk of developing gastrointestinal pathologies and diseases associated with a deficiency of vitamins, minerals, and nutritional compounds. Patients experience thinning bones, osteopenia, osteoporosis, B12-deficiency and iron deficiency anemia, hypotension, lethargy, muscle weakness, brittle nails, hair loss, dry skin. In severe cases of anorexia, the functioning of almost all organs and systems is disrupted, and there is a risk of death. Complications of psychogenic vomiting and bulimia are chronic inflammation and sore throat, destruction of tooth enamel, irritation and intestinal upset, kidney problems, dehydration.
Diagnostics
Primary diagnostic examination often carried out 1-3 years after the onset of the disorder, when the patient consults a doctor due to the appearance somatic symptoms– disorders of the gastrointestinal tract, significant change weight, weakness. Diagnosis is carried out by a psychiatrist, clinical psychologist, and somatic specialists. Specific research methods include:
- Conversation. The psychiatrist finds out the medical history and symptoms of the disease. He asks about eating habits, the patient’s attitude towards his own appearance, existing stressful and traumatic situations. The conversation can be held in the presence of close relative, since patients themselves tend to deny the presence of the disorder and the underlying psychological problems.
- Personality questionnaires. The study is aimed at identifying character traits, emotional states, social problems, contributing to the development of eating disorders. Unstable self-esteem, dependence on the opinions of others, a tendency to self-accusation, a state of stress, and psychological maladjustment are determined. SMIL, Eysenck questionnaire, Dembo-Rubinstein technique, Eating Behavior Rating Scale are used.
- Projective techniques. Drawing and interpretation tests are carried out in addition to the questionnaires. Allows to identify tendencies denied, hidden by the patient - fear of gaining weight, lack of acceptance of one’s own body, need for positive assessment others, impulsiveness, lack of self-control. The test of color choices, drawing “Self-Portrait”, Thematic Apperception Test (TAT) is used.
With a purpose differential diagnosis– distinctions psychogenic disorders with somatic diseases - consultations with a gastroenterologist, cognitive behavioral therapy, psychoanalysis, and group trainings are prescribed. Work is being done to understand existing distorted ideas about oneself, correct self-esteem, change behavior, and master skills to cope with a stressful situation.
Prognosis and prevention
The prognosis is determined by the type of disorder and the timeliness of therapy. A favorable outcome is most likely in the absence of other mental illnesses (schizophrenia, depression, psychopathy), the preservation of the patient’s critical abilities, and motivation for recovery. Prevention includes adherence to proper nutrition with early childhood, formation in children and adolescents of the value of health, acceptance of their body, development of skills to withstand stressful situations, relieve emotional tension(sports, creativity, correctly defending one’s own opinion, productive conflict resolution).
Diets, detoxes, proper nutrition and even Instagram intuitive eating - eating disorders are insidious and successfully disguised. Irina Ushkova tells how to recognize eating disorder and names five main signs common to all disorders.
Today I want to talk about the main signs of eating disorders. Yes, my colleagues and I have talked many times about various diagnoses, various manifestations eating disorders. Today I want to talk about what is common and key. Why do you need this? In order to notice the peculiarities of eating behavior in yourself or in your loved ones. This is especially true for relatives of people suffering from eating disorders.
There are 5 main points on which eating disorders are built. These are dietary restrictions, bouts of overeating, various types of compensation, negative body image and weight fluctuations throughout life.
Diet restrictions
With severe eating disorders, a person has many inflexible, strict food rules that he follows. It is clear that with anorexia a person long time can eat a meager set of food, but sometimes disturbed forms of eating behavior are disguised as other manifestations. Sometimes it’s self-care, sometimes it’s some supposedly somatic manifestations. And in general, people who have an eating disorder say: “Well, I’m not on a diet, I just follow certain food rules.” In general, all restrictions that go beyond common sense are always a certain trigger, a danger for the development of an eating disorder. What else can food restrictions be mimicked within the framework of eating disorders?
Food allergies. It is a serious disease with often significant health risks, but it affects a small percentage of the world's population. But at the same time, many people with an eating disorder exclude entire food groups from their diet, such as dairy products, sugar-containing products, and gluten-containing products. All this is disguised under the “I have food allergies” sauce. It makes sense to be wary if a person ate bread all his life and then said that he is now gluten-free. There is reason to think about what this is connected with, and whether it is connected with some kind of intolerance.
Sugar addiction. Idea food addiction is actively exploited by all sorts of diet gurus, they suggest replacing refined sugars with “healthy” ones that are not dangerous. But there is no evidence that any component of food has addictogenic properties, that is, they cause addiction. Everything contained in food is completely safe. We are all dependent on sleep, rest, oxygen, food! None of us can do without it, but there is no special component in food that is addictive. I had an episode on this topic, if you are interested, you can listen to it in more detail.
Detoxification. All kinds of detoxes are time-limited, but very pronounced and destructive food restrictions, when, for example, you have to eat only juices for a whole week. In fact, the human body is such a wisely organized system in which everything is taken into account, there are such fine settings. Our body has innate and complex organized systems self-cleaning. The most dangerous thing we can do is interfere if everything is working fine there. It’s clear that if you have any diseases, then you need to go to a specialist and take care of your health, but if you just decided to cleanse yourself of toxins in the spring, please throw this idea out of your head. This is a painful practice.
Vegetarianism. Initially, vegetarianism is associated with the rejection of meat foods on ethical and environmental grounds. There are quite convincing arguments “for” and “against” too. But there is a certain number of people for whom vegetarianism is a form of dietary restriction. You look at the Instagram of a beautiful yogini, where she preaches veganism and think, that’s what I want too. You need to stop at this moment, check the facts and think about how useful it is for you, how safe it is. Because any dietary restrictions, forced including when you medical indications follow the restrictions, increase the risk of developing eating disorder in a person. There is evidence that people who practice vegetarianism have had episodes of an eating disorder in almost half of the cases. Dear vegetarians, this is not an attack on you, but simply a statement of the fact that for some people this sometimes takes painful forms. The same applies to religious fasts. Literally in my circle there are people who fast because it would be cool to lose weight by summer.
And my favorite thing that the limitations inherent in eating disorders can be disguised as is Instagram intuitive eating. It's very difficult for me not to be sarcastic here, but I'll try. If people who sometimes, due to their own illness, begin to practice intuitive eating and interpret it completely incorrectly, as best they can. It's not their fault, it's their fault that they promote this idea to the masses. If there is a marathon where you are offered to eat intuitively and lose weight, but you need to follow certain rules, for example, do not eat after 6, eat 1000 kcal, only raw uncooked foods, do not eat fruits or meat, even if you really like it, if you They suggest eating only round-shaped foods, only 30 minutes after a glass of cold water - just know: this is NOT intuitive nutrition, but a certain system of food rules, which is wrapped in a beautiful wrapper of intuitive nutrition. We talk a lot about intuitive eating, and you probably already know a lot about it. But again, intuitive eating is eating based on what you eat when you're hungry, eat what you want, what you like, and stop eating when you're full. There are no food restrictions or rules, you can mix any products, even eat pasta with jam, start with dessert, etc.
Binges of overeating
The second symptom of all eating disorders is bouts of overeating.
Typically, people with eating disorders are proud of their willpower, that they follow some food rules, but at the same time they are ashamed of bouts of overeating, because for them this is an indicator that they have failed in their super mission. Of course, this is not for this reason, there are psychological, biological reasons for this, we have talked about this many times. People with eating disorders try to hide their bouts of overeating. It happens that for a very long time, to the point that the husband, after 20 years of marriage, does not know what happens to his wife when he is not around. Sometimes these are objective attacks of overeating, when a person eats large amounts of food, someone measures it in calories and it is 4-5 thousand calories. Sometimes there is subjective overeating when a person breaks his eating rules. He cannot help but violate them, because they are very inflexible and incompatible with life. A person gets upset because of this, this effect is called “to hell with the diet”, he thinks that now I can eat everything, and this often leads to objective bouts of overeating. In any case, these are quite painful conditions. If you have them from time to time, it's worth considering why this happens. People with normal eating behavior do not overeat, except in very rare cases, and this is still not such a severe condition. If you realize that you are overeating, you need to take control of it and, perhaps, consult a specialist.
Compensation
The third point, which is also a definite marker that eating behavior does not correspond normal indicators, these are various types of compensation. There are quite a few of them, but in general, these are any attempts that you make in order to compensate for what was eaten. This has major negative consequences because any compensation perpetuates the cycle of the eating disorder. It all usually starts with the thought that something is wrong with me, I need to lose weight, the person resorts to some form of food restrictions, then he overeats, the person thinks about how I can compensate for this, and the circle closes. This is very painful, and most people cannot break out of this circle without the help of a specialist. Forms of compensation include inducing vomiting, abuse of diuretics and laxatives, and diet pills. This is something that usually immediately alarms relatives of people with eating disorders, so they are carefully kept secret. And here everything is obvious that there is nothing healthy in these practices.
There is another form of compensatory behavior. This is a sport, and this area is actively supported by society and the environment. Everyone gives a standing ovation when a person with an eating disorder already runs to the gym on January 2, because that’s it, it’s over, he ate so much on January 1st. If you hear snippets of phrases “I ate today, and then I’ll have to work it out in training,” this is also not normal.
Any dietary restrictions or fasting as a punishment and a form of compensation for what was eaten is a practice that we classify as compensatory forms of eating disorders. If a person eats a piece of cake one day and spends the next day drinking juices or green tea, then this also does not correspond to healthy behavioral manifestations.
Negative body image
The fourth pillar that underpins an eating disorder is negative body image. Most people are dissatisfied with their body from time to time, we have wrinkles, gray hair appears, hair appears somewhere. Here we are all under social pressure. For example, there is evidence that until television came to the island of Fiji, there were no disorders such as bulimia nervosa. And literally within 10 years there was a dramatic increase in these diseases. We don’t attribute everything to the influence of society, but we remain quite critical of the role it plays in the formation of eating disorders. It’s really difficult for us when the ideals of beauty are the same, standardized; if you are different, you feel the pressure of not conforming. Have you noticed what big eyes anime characters? This means that there is a single standard beautiful eyes– these are big eyes on the floor of the face. We live in a world where supermodels don't look like supermodels thanks to advances in photo retouching. But for a person with an eating disorder, this is especially pronounced, and body image completely dominates all areas of his life. When you ask a person what areas of life are significant for you (significant is that if something works out there, then you feel good, great, if there are difficulties there, then you feel much worse), for most people with Eating disorders are simply total dominance of the body, weight, numbers on the scale. They may be successful in other areas, but that all becomes insignificant if they can't fit into a certain size of jeans.
Another way negative body image manifests itself for someone with an eating disorder is body checking. In English this is called body checking. This is when people excessively often, sometimes several times a day, use forms of control, checking whether everything is in order with their body. Frequent weighing on scales, several times a day. This is not exactly a signal, but behavior that does not correspond to normal, we do not have to know our weight every day. These could be measurements. If you've watched The Marvelous Mrs. Maisel, there's this part where she measures her calves, her hips, her waist. Frequently looking at oneself in the mirror, when a person checks literally every reflective surface to see if a double chin has appeared or if the belly has grown. The problem with these checks is that it increases body dissatisfaction. Whatever we look at closely and carefully, we will find flaws there. Plus there are purely perceptual difficulties with perception, i.e. a person looks in the mirror and he sees only one part of the body, conditionally, his stomach. He does not focus on everything else, and is perceived as larger than he really is. I like the comparison that when a person has a phobia, such as a fear of spiders, they perceive the size of the spider not objectively, but larger because it is a threat. The same thing happens to people with eating disorders. They perceive those areas that they consider as problematic to be large because they compare them with the general background. People with eating disorders do not pay attention to their strengths, which in principle they like.
Eat reverse side checks - complete avoidance of the body. This is what we often see in the example of weighing. The man weighed himself every day for three years, then the phase changed, he gained weight and stopped weighing himself. This is a very traumatic event for him. But this is also a signal that there is pronounced dissatisfaction with your body. Avoidance can be expressed in the fact that a person does not like to be touched, he cannot touch himself, he cannot even wash himself without a washcloth, because he is disgusted. The man doesn't buy himself new clothes, walks around in nothing but a robe, because it’s hard for him to go to the fitting room and face his body. It is difficult for him to face the fact that clothes that have become too small must be given away, and he must live life at his new weight.
Frequent weight fluctuations
The last sign, not absolute, is fairly frequent weight fluctuations. Typically, people who do not suffer from eating disorders have a stable weight throughout their lives, which gradually increases with age, which is natural. People with eating disorders quite often have situations where a person lost weight by 15 kilograms, then gained it back, and this can happen for three or four cycles in life. And this could also be a signal. Although RPPs do not discriminate against anyone, they can be of any weight, but this is also a signal.
Here are the main warning signs that you should pay attention to in order to suspect an eating disorder. Of course, it is sometimes difficult to detect them even for specialists, psychologists, psychiatrists who do not work with eating disorders, so for accurate diagnosis It’s better to contact those who work with this problem. If you are interested, in the next broadcast I can tell you how to choose a psychologist if you have a negative attitude towards your own body and disordered eating behavior.
Question from our subscriber:
I recently switched to intuitive eating, but have encountered some problems. I get full very quickly, and it worries me. It seems like I’m trying to savor food, feel its taste, but I almost always don’t feel pleasure, although I eat different foods. I fill up quickly, then I get upset because I wanted to eat more. I just can't get any pleasure. Should I wait for stronger hunger or is it better to give my body a break from food for a day or two?
Thank you for describing the situation in such detail. I feel how important this is to you. There is some belief that intuitive eating will help you cope with some experience of relationships with food. Look, under no circumstances do we restrict food (except if you cannot eat due to surgery). I was a little lacking in information about what happened before you came to intuitive eating. I can throw out ideas, and if you still have questions, you can write by mail, or in the comments, or contact us for diagnostics. It seems that you feel some kind of hunger, you begin to feel full very early. Quite often this happens in cases where a person has extensive experience of dietary restrictions. We call this a feeling of overcrowding, i.e. I ate a normal portion, even a little less, and you feel heavy. If it goes away after 15 minutes, it means you ate normally. If you want to eat soon enough after this, then the portion was small. If you want to eat after three hours, then OK. The second point I hear is food perfectionism - food should always be a pleasure. But even with intuitive eating, this is not always the case; sometimes food is just food. I ate and went to work. The first thing is not to limit yourself, it is worth continuing to eat intuitively, it may be better to start with the stage of structured eating, which is what we do with our clients who want to switch to intuitive eating after they had a restrictive form of eating behavior. Have patience, time, listen to yourself. I hope I was able to help with the answer. If not, write, it’s important to me.
Video of the release:
Eating disorders are a very common and serious problem. modern society, which takes the lives of tens of thousands of people around the world. She has psychological aspects, more often occurring in adolescence, during the formation of personality. At first, refusing to eat or eating in stressful situations is rare, and subsequently turns into a way of life that even a very strong-willed person cannot change on his own. The problem is that people with eating disorders do not agree to admit the problem until the very end and resist any help offered.
Manifestations of eating disorder
It is not so easy to identify the presence of a tendency towards an eating disorder, because the patient does his best to hide deviations and sometimes resembles the behavior of a drug addict or alcoholic. He begins to eat furtively or provoke vomiting after eating together with his family, thereby averting suspicion from himself. In psychiatry, there are many cases where teenagers managed to mask their eating problems for a long time, and parents began to sound the alarm only at the moment of pronounced deviations.
Routine observation of a person will help to promptly suspect the prerequisites for the development of the disease. Eating disorder in children in preschool and early childhood school age Only parents can notice, so you should be especially careful about their behavior. The most serious reasons, leading to the disease, are formed in childhood. Their timely detection will help to avoid global problems in adolescence and adulthood. The presence of an RPP will be indicated by:
- concern about your appearance, body structure, figure;
- inadequate perception of food, a great need for it or imaginary indifference;
- rare or frequent eating;
- quirks during lunch, such as the desire to split a sandwich into many small pieces;
- meticulous calculation of the calorie content of dishes and division into portions by weight;
- uncontrolled eating even in the absence of hunger;
- nausea and vomiting after eating;
- permanent refusal of certain types of products;
- great interest in celebrities who have ideal, according to stereotypes, body proportions.
The more deviations in behavior are noticed, the more likely that the subject of observation has the makings of developing an eating disorder or is already progressing the disease e.
Bulimia
Bulimia is a neurogenic disorder that leads to the development of uncontrolled eating in large quantities and does not always coincide with a person’s taste preferences. Bouts of gluttony are replaced by violent attacks based on self-criticism. A person eats until he feels a clear overabundance due to overstretching of the stomach and esophagus. Usually bouts of gluttony end with vomiting and extremely bad general condition. But after some time, everything repeats again, and a person is unable to interrupt this pathological cyclicality, because the areas of the brain responsible for eating behavior cannot be controlled.
The patient tries to cope with the disorder on his own, takes laxatives, induces vomiting, and resorts to gastric lavage measures. As a result, a person loses contact with himself and falls into deep depression. The eating disorder persists and even gets worse. Attempts to cope with the disease on your own lead to the development of anorexia, and after a breakdown - again to uncontrolled weight gain. Long-term similar condition leads to complete imbalance in the body and often ends fatal.
Anorexia
The main features of the manifestation of anorexia are a sharp restriction in quantity and changes in quality composition food. Most often it affects women. Eating even small portions plant food, they experience strong fear that there will be a sharp increase in volumes and the process of weight loss that has begun will be disrupted. In their minds, the body mass index should be several points lower than normal, but there are no limits to perfection, and what slimmer waist And thinner legs, the more attractive the figure seems to others. Having a body mass index of less than 16 and pronounced signs exhaustion, patients do not deviate from these beliefs and continue to follow a strict diet with a gradual refusal to eat at all.
In order to enhance the effect, you can often notice manipulations that speed up the process of getting rid of “extra” kilograms. Refusal of fats, carbohydrates and the required amount of liquid. Taking appetite suppressants, diuretics, intense and too frequent training - even to the point of loss of consciousness. The most dangerous symptom in anorexia is specially induced vomiting. At this stage, patients suppress their appetite and provoke the development of gastrointestinal diseases.
Exhaustion leads to the development of physiological abnormalities, which are manifested by the cessation of menstruation, lack of libido, and fading of all vital functions and muscle atrophy. With severe anorexia, the patient loses the ability to move and self-care. Even a few spoken words cause severe shortness of breath and fatigue. In order to preserve vital important functions, such as breathing, heartbeat and others, patients are forced to be at rest and not waste energy on talking and moving. This is all due to the irreversible consequences that have arisen, as a result of which the body stops taking nutrients from the outside, even in the form of drip administration in a hospital setting.
Compulsive overeating
Compulsive overeating disorder is a subtype of bulimia. The fundamental difference is that a person does not accept the condition as pathological and does not seek to unload. He regularly consumes larger and too high-calorie portions, explaining this by necessity increased nutrition. This type of disorder is the most common and has a sluggish course.
The disease has a cyclical nature of symptoms. At first the person feels very severe hunger and has the same strong appetite, then eats as much as he can. When oversaturated, he tries to limit himself, but still cannot cope and resorts to snacking too often. Even at a moment of slight hunger, he tends to eat a portion several times larger than the standard size. When eating delicious food, he cannot stop and deny himself the pleasure, which leads to regular gluttony. Partly in this way, patients overcome stressful situations.
Treatment
Given the severity of the disease and the multifaceted nature of its manifestations, a multidisciplinary approach is required. The key principle will be the work of a psychotherapist, who at the initial stage must identify the psychogenic cause and be sure to eliminate it. Until a person has healed from the provoking factor, talk about full recovery it can't be. The specialist begins work on recreating the correct image of a person, pushing him towards self-knowledge and restoring the perception of himself as a part of society.
The course of treatment lasts at least one year, but on average full recovery it takes 3-5 years. Half of the patients respond to psychotherapy and get rid of the disease forever, a quarter manage to partially cope, and the rest are doomed to an unfavorable outcome.
The recovery process can be considered launched only after a person realizes the presence of an illness and shows a desire for healing. Eating disorders do not respond to forced therapy. Psychotherapy sessions are held on an outpatient basis, and the patient attends them independently, if necessary, with a family representative. Treatment in forcibly is possible only in cases of long-term anorexia, when staying without medical supervision at any time can result in death.
Psychotherapy sessions take place in individual, group and family modes. Their duration and timeliness depend on the degree of the disease and its manifestation. Family psychotherapy is an integral part of treatment, because the patient needs support and achieving complete harmony in relationships with others and loved ones. At this stage, a culture of nutrition is instilled, and training courses are conducted on the balance and rationality of consumed foods. Gradually, a person gets rid of fixated attention on his appearance, abandoning his previous diet.
In order to channel energy in the right direction, it is very important to find activities of interest. Many plunge into the mysterious world of yoga and meditation. Self-knowledge and self-development has big role in the process of recovery and turning to a new rhythm of life. Often, a psychotherapist suggests living according to a schedule, where all actions are performed within a clearly allotted time. In this mode there is definitely room for walks fresh air, visiting sports sections, such as a swimming pool, and time for hobbies. Over time, a person gets used to living according to a new daily routine and gives up planning.
Great importance is given to the restorative and supportive stages of the treatment process. The patient should never return to his usual way of life, because each new breakdown poses an even greater danger to health, and the psyche becomes resistant to influence on it with the help of psychoanalysis.
Eating disorders come in many forms, but they all affect a person's relationship with food and can cause serious health problems if left untreated. To determine whether you have an eating disorder, you need to know what actions and feelings it manifests itself in and how it affects your body. If you think you have this disorder, seek help as soon as possible. If left untreated, an eating disorder can progress.
Steps
How to recognize the signs of an eating disorder
- feeling depressed and anxious
- intense fear of gaining weight or becoming fat
- avoidance of friends and family
- unusual attention to food and nutritional value consumed products
- fear certain products(for example, those containing sugar or fat)
- avoiding food-related situations
- denial of eating problems or weight changes
- trying to get rid of food after eating a large amount of food by physical exercise, vomiting, use of laxatives
- daily weigh-ins
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Learn to recognize the signs of anorexia. People with anorexia do not want to maintain a healthy weight. They are very afraid of gaining weight and consider themselves fat, even if they look thin or are underweight. A person with anorexia may fast for several days in a row or eat extremely small amounts of food. The person feels satisfied because he sees that he can adhere to such strict rules.
- A person can have very strict rules regarding food, including the color of foods that should not be eaten, acceptable times of day for eating, and strict calorie restrictions.
- If a person has anorexia, they are afraid of being fat or experiencing their body as fat, even if they are underweight. Even if a person is thin, he is not happy with his figure and feels better if he manages to lose a few more kilograms.
- Think about whether any of your relatives or friends have commented on your weight or weight loss.
- Consider whether you believe your value as a person is determined by your weight, clothing size, or food choices.
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Understand the symptoms of bulimia. People with bulimia eat first large number food, and then try to get rid of it, because it leads to extra pounds. A person understands that he should not overeat and gain weight, but he cannot stop and from time to time begins to eat everything. After eating he may try to get rid of possible consequences overeating: induce vomiting, use laxatives or diuretics.
Know the symptoms of binge eating disorder. People with this eating disorder eat large amounts of food in a short period of time. However, they feel that they cannot control themselves during these attacks. There is nothing pleasant about binge eating disorder, and people experience negative emotions even when eating. These feelings continue after they stop eating. People with this disorder do not vomit or take laxatives after an attack.
- The person may feel depressed, self-loathing and shame.
- You may have gained a lot of weight over lately as a result of compulsive overeating.
Psychological factors
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Analyze the feelings associated with control. People with anorexia use their habits to maintain control over themselves - they make them feel stronger. People with bulimia feel helpless and unable to control themselves. People with compulsive overeating disorder also have trouble controlling what they eat.
- If a person feels that his life is out of control, anorexia helps him regain a sense of order and self-affirmation through the ability to fast.
- Consider how you feel about feeling in control and whether you are happy with your condition. Are you striving to gain more control over your life or, on the contrary, do you want to get rid of it? Do you think that you are in control of your life, or do you try to achieve this through control over food?
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Think about the feeling of shame. A person may feel shame about their eating behavior, especially if they have binge eating disorder. A person may overeat and vomit when no one is looking, or throw food off a plate when no one is looking. This behavior is an attempt to hide traces of one’s eating behavior, but the underlying reason is shame for what a person is willing to do to maintain his habits.
- If you feel shame about your eating behavior, this may be a symptom of an eating disorder.
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Analyze your feelings towards your body. People who don't like their bodies are more likely to develop eating disorders. Not loving your body means feeling fat, ugly, unwanted, or feeling ashamed of certain features of your body (such as scars). These feelings may arise due to the fact that a person sees images of celebrities every day or communicates with beautiful people.
- A person may decide that the only way to accept their body is to lose weight. You may be thinking, “When I lose weight, I will feel happy.”
- Reflect on your beliefs about your weight and whether you like your body. Ask yourself if you think losing weight is the only way to love your body.
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Think about the excuses you make for others. Do you hide your habits? If they ask you why you don't eat, do you lie? What do you say when people ask you about changes in your weight? If you make excuses for your habits, there is a chance that you have an eating disorder.
- Perhaps distorting reality is the only way for you to maintain your eating habits and hide them from others. Do you make excuses for the way you eat? Do you avoid meeting in cafes or coffee shops?
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Take a closer look at yourself. You don't need to look at yourself in the mirror to do this - just think about how you perceive your body. You may think you are overweight when in fact your body mass index is below normal. Then think about how you feel about your body: how much you like the shape and capabilities of your body, how you perceive your body (positively or negatively). Thoughts and behavior also influence your body image - for example, you may decide that you are overweight and should isolate yourself from others.
- Think about how you perceive your body and whether your assessment is objective. Ask yourself how you feel about your shortcomings and whether you agree that shortcomings are normal.
Physical manifestations
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Know the risks associated with anorexia. Anorexia has a significant impact on the body. If you notice changes in your body's functioning, this may be due to anorexia. Fasting can not only lead to dangerous weight loss, but also cause such negative consequences, How:
- constipation or bloating
- damage to teeth or gums
- dry yellow skin
- brittle nails
- headaches
- dizziness and loss of consciousness
- change in bone density
- growth of a layer of fine hair throughout the body and face
- memory problems and slow thinking
- depression, mood swings
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Find out how bulimia affects your body. People with bulimia often exhibit physical effects of the disorder, especially those who induce vomiting. If you vomit after eating, you may experience the following symptoms:
- stomach pain or bloating
- weight gain
- swelling of the hands or feet
- chronically sore throat or hoarse voice
- damage blood vessels in the eyes
- weakness and dizziness
- mouth ulcers
- swelling of the cheeks (due to vomiting)
- tooth decay due to acid in vomit
- absence of menstruation
- Digestive problems including constipation, ulcers, acid reflux
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Know what the consequences of binge eating may be. Overeating primarily leads to obesity, but there are other health risks. To better understand what compulsive overeating poses to you, you should make an appointment with a doctor and get blood tests. TO frequent consequences overeating include:
- type 2 diabetes
- elevated blood cholesterol levels
- high blood pressure
- joint and muscle pain
- digestive problems
- temporary cessation of breathing during sleep (apnea)
- heart problems
- some types of cancer
Help from specialists
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Seek help from your doctor. An eating disorder can cause harm to your body, so you should get tested and consult with your doctor to better understand your condition. See your doctor regularly during treatment.
Look for your main symptoms. Many people with eating disorders worry excessively about their weight, body size, and appearance. TO frequent symptoms eating disorders include:
