Eating Disorders

We offer treatment for binge eating, eating disorder not otherwise specified, anorexia, and compulsive overeating.
Our program for eating disorders includes cognitive behavior therapy combined with dialectical behavior therapy. Dialectical Behavior Therapy provides skills training for leaning constructive ways to manage emotions including the anxiety about food and eating and cognitive behavior therapy address directly the distorted cognitions evident in eating disorders. Both address directly the issue of behavior change needed to recover. In addition to outpatient weekly individual and group sessions, we offer an intensive outpatient program (9 hours per week) and a process oriented program that is 4 hours of group per week.

Anorexia Nervosa
Bulimia
Eating Disorders NOS

What is Anorexia Nervosa?

It’s important to know that everyone will not have the same symptoms. Some people willhave a mix of symptoms and you do not need to have all these symptoms to have an eating disorder.

‘Anorexia nervosa’ means ‘loss of appetite for nervous reasons. This is misleading because in reality people with anorexia have lost the ability to allow themselves to satisfy their appetite. They restrict the amount they eat and drink and at times do so to the point of death or significant damage to their health. Some people may exercise to excess to burn off calories and may try to burn off calories their body needs. Purging can also occur in other ways. There is a strong focus on food in an attempt to cope with life and manage their emotions It can be about control or about self punishment or perfectionism or a combination. While people may see themselves as being in control of food and weight, the disorder actually takes control and the chemical changes in the body affect the brain and distort thinking, making it almost impossible to make rational decisions about food or treatment.

The effects of anorexia on your body

• Constipation and abdominal pains
  
• Dizzy spells and feeling faint
  
• Bloated stomach, puffy face and ankles
  
• Downy hair on the body; occasionally loss of hair on the head when recovering
  
• Poor blood circulation and feeling cold
  
• Dry, rough, or discoloured skin
  
• Loss of ‘periods’, loss of interest in sex
  
• Loss of bone mass and eventually osteoporosis (brittle bones)
  
• Psychological signs of anorexia
  
• Intense fear of gaining weight and obsessive interest in what others are eating
  
• Distorted perception of body shape or weight
  
• Denial of the existence of a problem
  
• Changes in personality and mood swings
  
• Becoming aware of an ‘inner voice’ that challenges your views on eating and exercise

Behavioural signs in anorexia

• Rigid or obsessional behaviour attached to eating, such as cutting food into tiny pieces
  
• Mood swings
  
• Restlessness and hyperactivity
  
• Wearing big baggy clothes
  
• Vomiting; taking laxatives
  
• The long-term effects of anorexia

The long-term effects of anorexia on the body and mind can be alarming and severe. Women with anorexia tend to find it more difficult to become pregnant and may develop infertility in the long term. Fortunately, many of these effects can be reduced - once the body receives proper and regular nourishment. For both men and women there is a high likelihood of developing osteoporosis.

Once you are on the path to recovery, it can take some weeks or months for the body and mind to re-adjust. Eating and drinking regularly can cause your body to become bloated temporarily. On one hand you may experience enormous hunger whilst on the other, weight gain can seem an alarming prospect. Dealing with the expectations of others around you can also be stressful. Personality and mood swings can also take a while to settle, depending on the emotional difficulties that you may be facing.

Anorexia and the family
Anorexia not only affects the whole family is affected Each family is different but some common trends have been identified. Perfectionism is a part of some families and other families may have chaotic lives that seem out of control. While some families set high standards in other cases the person who develops anorexia has self imposed unreasonable standards. They have often hidden their inner feelings and anxieties. They may fear failure and be fearful of establishing their own lives. Some families are so close and loving that the child finds it difficult to become independent. They may be fearful that they cannot manage on their own away from the family, or feel under pressure to remain within the family regardless of their own feelings.

Anorexia represents an attempt to demonstrate independence through control over food and eating. It is also very difficult for many people to understand that although food is an important issue, an eating disorder is actually all about feelings and emotions. This can lead to frustration and misunderstanding. Many frustrated family members find themselves saying ‘Why don’t they just eat?’ Many families also find that the person with an eating disorder requires much attention which can seriously affect relationships between brothers and sisters, and parents.

What is Bulimia?

Bulimia nervosa, is a psychological eating disorder. Bulimia is characterized by episodes of binge-eating followed by purging, which could include vomiting, enemas, excessive use of laxatives and diuretics, or compulsive exercising. Excessive shape and weight concerns are also characteristic of bulimia. A binge is an episode where an individual eats a much larger amount of food than most people would in a similar situation.. It is usually a response to emotional stress. During the binge episode, the individual experiences a loss of control. However, the sense of a loss of control is also followed by a short-lived calmness. The calmness is often followed by self-loathing. The cycle of overeating and purging usually becomes an obsession and is repeated often.

Some of the most common complications of bulimia are:

• Erosion of tooth enamel because of repeated exposure to acidic gastric contents.
  
• Dental cavities, sensitivity to hot or cold food.
  
• Swelling and soreness in the salivary glands (from repeated vomiting).
  
• Stomach Ulcers.
  
• Ruptures of the stomach and esophagus.
  
• Abnormal buildup of fluid in the intestines.
  
• Disruption in the normal bowel release function.
  
• Electrolyte imbalance.
  
• Dehydration
  
• Irregular heartbeat and in severe cases heart attack
  
• A greater risk for suicidal behavior
  
• Decrease in libido

Symptoms of Bulimia

• Eating uncontrollably
  
• Purging
  
• Strict dieting
  
• Fasting
  
• Vigorous exercise
  
• Vomiting or abusing laxatives or diuretics in an attempt to lose weight.
  
• Vomiting blood
  
• Using the bathroom frequently after meals.
  
• Preoccupation with body weight
  
• Depression or mood swings. Feeling out of control.
  
• Swollen glands in neck and face
  
• Heartburn,
  
• Bloating,
  
• Indigestion,
  
• Constipation
  
• Irregular periods
  
• Dental problems
  
• Sore throat
  
• Weakness
  
• Exhaustion
  
• Bloodshot eyes

Bulimia is often a source of shame for those who suffer from it. Treatment can help people free themselves from the cycle of the illness.

Eating Disorder Not Otherwise Specified

Basically, the formal diagnosis of "Eating Disorder Not Otherwise Specified" is a catch-all for eating disorders that don't exactly fit the parameters of anorexia or bulimia. It is a very broad category, because it may can mean many things:

• A person who severely restricts food intake but is not yet underweight by DSM-IV standards
  
• A female who meets all other criteria for anorexia but continues to have regular menstrual periods.
  
• A person who regularly binges WITHOUT engaging in inappropriate compensatory behaviors such as purging (also known as binge eating disorder).
  
• Someone who binges and purges but does not meet the frequency or duration requirements for a diagnosis of bulimia
  
• Someone who regularly purges after eating regular amounts of food, but is not yet "clinically underweight
  
• Someone who regularly chews food and spits it out without swallowing, but does not meet the criteria for either bulimia or anorexia.
  
• Any individual who is recovering from or just about to enter one of the "specified" eating disorders.
  
• Often, people categorized as having ED-NOS are basically anorexic or bulimic, but cannot be classified as such because of a technicality. Obviously, ED-NOS can very easily lead to a diagnosis of one of the two other clinical eating disorders.

Taken from an article written by Evan Keraminas