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Tuesday, March 12, 2019

EATING DISORDERS

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Medical and psyhciatric conditions can be fatal

Acondition that affects all demographics of people, regardless of age, race, sex or socioeconomic status, and has one of the highest mortality rates of any mental illness, raising awareness of eating disorders is critical in breaking the stigma and saving lives. The National Association of Anorexia Nervosa and Associated Disorders (ANAD) estimates that at least 30 million people suffer from an eating disorder in the U.S. and that every 62 minutes, someone dies as a direct result from an eating disorder.

Dr. Mimi Neathery, a licensed clinical psychologist in Chicago, Ill., who works with adults diagnosed with eating disorders, said one of the most important factors in understanding the illness is the symptoms not visible to others.

“Eating disorders can develop at any age and affect individuals regardless of their weight, gender or sex,” said Neathery. “One of the main aspects of an eating disorder that is ‘unseen’ is the destructive pattern of thinking. These thoughts can persist for months and often years after a person diagnosed with an eating disorder has maintained normalized meals and a normalized weight.”

Disordered eating can manifest in a number of different diagnoses. The National Eating Disorders Association (NEDA) offers in-depth information on each disorder, including anorexia nervosa, bulimia nervosa, binge eating disorder, orthorexia, other specified feeding or eating disorder (OSFED), avoidant restrictive food intake disorder (ARFID), pica, rumination disorder, unspecified feeding or eating disorder, laxative abuse and compulsive exercise. For more information on specific symptom presentations of these disorders, visit www.nationaleatingdisorders.org.

Neathery explained that her clients often have difficulty sustaining consistent meals and snacks each day, reporting histories with notable weight fluctuations, and most clients are no longer able to determine when they are hungry or sated.

“The majority of my clients come to therapy for help with stabilizing their daily food intake and developing a body image that fosters a greater sense of well-being and allows them to effectively live more fulfilling lives,” she said. “Because I treat adults, many of my clients have struggled with an eating disorder for several years, such that they have histories of caloric restriction, overeating/ binge eating and purging through excessive exercise, self-induced vomiting and laxative use.”

Neathery continued, explaining that a significant part of her treatment focuses on a hallmark of disordered eating, body image. This is to say, what a person sees when they look in the mirror and how they envision themselves in their mind, as well as the beliefs they hold about themselves. NEDA states that people who have a negative body image have a greater likelihood of developing an eating disorder.

“Additionally, I work with individuals who have antagonistic relationships with their bodies in which they harshly criticize their physical appearance, avoid certain activities because of their beliefs about their bodies or their fears of being judged by others, and may seek out drugs and alcohol to further disconnect from their physical experience of their body,” she said. “Eating disorders are complex medical and psychiatric illnesses that are fatal. They are not about going on a diet to achieve a desired physical appearance.”

Because of the high mortality of eating disorders, understanding the warning signs/ symptoms and the impact they have on physical and mental health is imperative.

“Eating disorders symptoms can begin at any age,” said Neathery. “Some of the current research indicates that children as young as 6 years old have been diagnosed with an eating disorder. The majority of people diagnosed with an eating disorder are in their late teens and early 20s. Some of the possible warning signs and symptoms present in adults include but are not limited to weight changes, missing food, hyperfocus on talking about food while saying they are too busy to eat or telling others they already ate, avoiding eating meals with others, wearing clothes that are oversized to hide their bodies, increased anxiety, difficulty adapting to unexpected changes in plans, difficulty concentrating, irritability, sleep disturbance and social isolation.”

Warning signs and symptoms can be both emotional and behavioral, such as food rituals or an extreme preoccupation with dieting or concern with body size and shape, as well as extreme mood swings and feeling uncomfortable around others.

Treatment for eating disorders takes a commitment, collaboration and support. Neathery explained that she will often consult with a multidisciplinary team in providing the most effective care, in addition to her own individual work.

“I emphasize the importance on change being demonstrated through action,” she said. “I recommend that clients keep selfmonitoring food and emotion journals, complete weekly journaling assignments, and I utilize skills-based workbooks and recovery narratives specific to eating disorder recovery to foster motivation for change and to help them develop the willingness to take actions that align with recovery. In addition to individual therapy, I have established relationships with treatment programs locally and nationally if a client needs more intensive care. I also encourage clients and their families and other supports to participate in recovery support groups that focus on body image and psycho-education on eating disorders.”

“I collaborate with registered dietitians who have specialized training in working with eating disorders who can provide meal plan support and nutrition counseling,” Neathery continued. “I also work with psychiatrists who are knowledgeable about eating disorder treatment, and I recommend that clients establish a relationship with a [primary care physician] in order to monitor the medical risks associated with eating disorders.”

Support, education and connection are crucial in maintaining a recovery plan with an eating disorder. Neathery explains that support for those struggling with the illness and their loved ones comes with finding others who have shared experiences.

“It’s important for clients and the people in their support systems to recognize that recovery is often cyclical and occurs in phases,” she said. “I encourage clients to get connected with a recovery community where they can both give and receive support from other individuals recovering from an eating disorder. I encourage families and friends to also seek out groups for ongoing support.”

Ultimately, Neathery stressed that having an individualized plan that affords them access to therapy services, nutrition services, medical care and peer support is necessary as they navigate their recovery journeys.

– Kate Ho

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