People often have complicated relationships with food, eating, and their bodies. In Western Europe and North America especially, the media and marketing have aggressively promoted an unhealthy ideal of weight and body image. At the same time we have become a very sedentary culture that eats a lot of high-calorie food. The result is a near epidemic of feeding and eating disorders as well as an epidemic of obesity. At CBT Associates, we provide evidence-based treatment for eating disorders as well as cognitive behavioural therapy (CBT) for weight management.
Feeding and eating disorders are characterized by eating habits that involve either too little or too much food intake. People with feeding and eating disorders are preoccupied with their weight and body image. In addition to restricting intake, they often engage in compulsive behaviour (counting calories, exercising, weighing) that results in serious problems with physical and mental health. Although there are three main types of eating disorders, including Anorexia nervosa, Bulimia nervosa and Binge-eating disorder, many people with feeding and eating disorders do not fit neatly into any one category.
Anorexia nervosa is characterized by extreme restriction of food intake to the point of excessive weight loss and self-starvation. The essential features of anorexia include:
The diagnosis of anorexia nervosa can be further broken down into two subtypes – the restricting type and the binge/purge type. People with the restricting type lose weight by restricting food intake and engaging in compulsive activity such as over-exercising. People with the binge/purge type may engage in binge eating and/or compensate by purging.
The extreme weight loss from anorexia nervosa often causes amenorrhea, a condition in which women to stop having menstrual periods.
Bulimia nervosa is characterized by binge eating and purging. The essential features of bulimia nervosa anorexia include
Although anorexia and bulimia may sound very similar, the big difference between the two disorders is body weight. People cannot be diagnosed with bulimia if they meet the criteria for anorexia nervosa (body weight that is less than 85% of what would be expected for that person or a Body Mass Index of less than 17.5).
Binge eating is characterized by recurrent binging in the absence of the compulsive compensatory or purging behaviours associated with anorexia nervosa and bulimia nervosa.
Eating disorders are endemic in western society, and women are especially at risk, however rates of male eating disorders are on the rise. Eating disorders are often serious problems that result in serious medical complications and severe consequences, including death. People with eating disorders often suffer from the cognitive symptoms of starvation and are “not thinking straight.” Eating disorders often occur with other problems, including mood and anxiety disorders and substance use problems. CBT is a proven treatment for several eating disorders in adulthood and can be highly effective.
Although evidence-based treatment can be highly effective in treating eating disorders, it is important that people with eating disorders receive an adequate amount of treatment. People with severe eating disorders usually need medical management and intensive day treatment or a residential program to achieve wellness. People with more moderate symptoms and those who have successfully completed a more intensive day treatment or inpatient treatment program can be treated successfully in an outpatient setting. At CBT Associates, comprehensive assessment and treatment for eating disorders involves working with the other professionals in your circle of care. Consistent with the Academy of Eating Disorders Guidelines, we know that optimal care includes a multidisciplinary team approach by eating disorder specialists, including medical, psychological, nutritional, and psychopharmacologic services. Families and spouses should also be included whenever possible.
Eating disorders are often difficult to diagnose and treat effectively. They are also often serious problems that require medical management and intensive treatment. Because of these complexities, the first step towards appropriate and effective treatment is a thorough and proper diagnostic assessment from a physician or psychologist.
If you struggle with your weight and body image, you are not alone. Most people have complicated relationships with food, eating, and their bodies. In Western Europe and North America especially, the media and marketing have aggressively promoted an unhealthy ideal of weight and body image. At the same time we have become a very sedentary culture that eats a lot of high calorie food. The result is an epidemic of obesity.
Losing weight is often the easy part; maintaining weight loss almost never is. Sustained healthy weight control is a “head game” that requires a lot of courage, knowledge, insight, tools and effort. Certainly diet and nutrition, as well as exercise and fitness, are important. As for other weight management programs, CBT for weight management includes personalized plans for eating and exercise. However, CBT for weight management also helps people to acquire the thinking (cognitive) and behavioural skills that are essential for success including how to:
Sustained healthy weight management is a challenge and CBT techniques can be an important part of the solution. However, because obesity often occurs with other common problems such as mood, anxiety and substance use disorders and often results in a number of serious medical conditions, the first step towards effective weight loss and management is thorough and proper assessment from a physician or psychologist.
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