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Counselling for Eating Disorders
An Eating Disorder is a way of coping with uncomfortable emotions triggered by, amongst other things, difficult or distressing experiences, overwhelming pressure/expectations and low self-esteem. A focus on controlling eating and weight gives the sufferer a goal that takes them away from problems in life, or within themselves that feel unmanageable and inescapable, and provides them with a sense of control and potential achievement in the face of fear or failure and negative evaluation by others (and themselves). An Eating Disorder is not a diet that has gotten out of control or of fussing eating (in the case of someone who is restricting what they eat) or a result of greediness or lack of control (in the case of someone who is bingeing).
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Who is it for?
Do you deliberately try to limit your food to influence your shape and weight? Does thinking about food, eating and weight make it hard for you to concentrate? Are you afraid of losing control of your eating? Are you afraid of gaining weight? Do you often have episodes of feeling out of control when you eat? Have you ever made yourself sick or taken laxatives to try and lose weight? Do you exercise in a ‘driven’ way to try and lose weight or change your shape?
If you have answered ‘yes’ to one or more of these questions you may be suffering from an eating disorder and may benefit from some counselling to help you with the way that you think and feel about eating, weight and yourself.
A Recent Testimonial
Philippa - Marylebone“I would just like to say a big thank you for everything you have done for me. When I came into therapy I had no idea in what way it could help, in the past I thought honesty was the answer to all and since I had already achieved that I was unsure how therapy would work for me. I never thought it would be so, but I honestly believe that having a fuller comprehension of myself has really helped me come to terms, understand and be at peace with myself. I feel much more grounded and in no way out of control”.
How It Works?
To start with one of our Psychologists will meet with you to find out about the nature of your eating problems. They will ask you what you eat and when, whether you binge, purge and exercise and how you feel about your weight and body shape. They will also ask you about other aspects of your life including your physical and mental health in order to get a complete picture of how things are for you. Finally, they will discuss with you what you would like to change and what you would like to stay the same to ensure that the treatment plan they develop fits exactly with what you need and feel able to work on.
Depending on your goals your Psychologist will then help you to adjust your current eating pattern and behaviours. This may include keeping a diary of what you eat, strategies for reducing bingeing and purging and ways of increasing your calorie intake in a tolerable way if this is what you would like to do.
Next your Psychologist will help you to identify the thoughts and feelings that are maintaining you’re eating problems and then modify them so that they support a healthier attitude to eating, weight and shape.
You will then work with your Psychologist to identify the factors that have led to the development of your eating disorder and either resolve these factors or temper their influence so that you can move forward with your life and no longer need your eating disorder to support you.
The final stage of counselling will involve a period where your Psychologist supports you to live without your eating disorder, helping you to address the normal slips and occasional relapses that inevitably occur when you are working to overcome such a problem.
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All of our Psychologists offer Eating Disorder counselling, click here to view the team.
Facts about Eating Disorders
An Eating Disorder is a problem that involves unbalanced eating habits that are so erratic and/or restrictive that they interfere with a person physical and or emotional well being. There are three main types:
1. Anorexia Nervosa
Anorexia Nervosa usually develops in adolescence and early adulthood. The defining features of Anorexia Nervosa are as follows:
- Excessive food restriction as a result of an overwhelming and irrational fear of weight gain
- Additional strategies aimed at weight loss (e.g. excessive weight loss, vomiting, laxative abuse)
- Distorted body image (including an intense dislike and distorted perception of body shape and weight)
- A tendency to evaluate self-worth according to shape and weight
- Excessive weight loss that can threaten physical health and cause metabolic and hormonal disturbances. A person with Anorexia Nervosa has a Body Mass Index of less than 17.5 (Body Mass Index health range is 20-25)
‘Anorexia’ is not the same as ‘Anorexia Nervosa’. ‘Anorexia’ is a medical term for lack of appetite and subsequent weight loss (usually the result of a physical problem). People with ‘Anorexia Nervosa’ do not lose their appetites but instead intentionally override hunger cues in order to restrict their intake and lose weight.
How common is Anorexia Nervosa?
Anorexia Nervosa is 10 times more likely to occur in women than in men and BEAT (The British Eating Disorders Association) estimates that 1-2% of young women is suffering from Anorexia Nervosa at any one time.
2. Bulimia Nervosa
Bulimia Nervosa usually develops in a person’s late teens. The key features of Bulimia Nervosa are:
- An overwhelming fear of weight gain
- Distorted body percept and concept
- Low self-esteem based on shape and weight
- Binge eating; consuming food in a frantic and out of control way. If more than 1,000 kcals are consumed the episode is defined as an ‘objective binge’, if less than 1,000 kcals are consumed the episode is defined as a ‘subjective binge’. The defining feature of a binge is not the amount of food that is eaten but the sense that the individual cannot stop.
- Purging; this is an attempt to get rid of the food consumed during a binge either by self-induced vomiting or abuse of laxative or diuretics. Research suggests that a maximum of only 1/3 of food consumed during a binge can be purged via vomiting and only water is purged through laxative and diuretic abuse. Both methods put the individual at significant risk of dehydration and electrolyte imbalance which in extreme cases can be life threatening.
- Non purging; this is an attempt to get rid of the food consumed during a binge via other methods e.g. excessive exercise.
How common is Bulimia Nervosa?
90% of Bulimia Nervosa sufferers are women and it is estimated to be five times more common than Anorexia Nervosa occurring in approximately 8% of women.
3. Eating Disorder Not Otherwise Specified (e.g. Binge Eating Disorder)
A diagnosis of Eating Disorder Not Otherwise Specified is given to individuals who experience some of the symptoms of Anorexia Nervosa and/or Bulimia Nervosa but do not fulfil all the diagnostic criteria for them. For example, you may be bingeing and purging but not frequently enough (i.e. twice per week ) to fulfil criteria for Bulimia Nervosa or you may restrict your food intake but your weight might be above the cut off point for Anorexia Nervosa (Body Mass Index of 17.5).
The most common Eating Disorder Not Otherwise Specific is Binge Eating Disorder. Binge Eating Disorder is characterised by episodes of frantic eating (bingeing) which are not followed by purging. It usually develops between the ages of 30-40 years.
How common is an Eating Disorder Not Otherwise Specified?
An Eating Disorder Not Otherwise Specified (EDNOS) is the most common type of eating disorder occurring in approximately 4-6% of the population.
Although a significant physical and emotional problem, Obesity is not currently considered to be Eating Disorder, however its cause and treatment are similar. The debate regarding its inclusion as an Eating Disorders continues.
What causes an Eating Disorder?
There is no single cause of an Eating Disorder; however, underlying most is low self-esteem. A person develops an Eating Disorder in order to cope or compensate for feelings of worthlessness often reasoning, ‘I may be defective but at least I can be thin’ or ‘People will like me more if I am thin’. An Eating Disorder also commonly occurs when a person feels out of control in other aspects of their life e.g. during major life changes including adolescence and leaving home for the first time. A poor self-image makes it harder for someone to adjust to the changes demanded during these periods leaving them vulnerable to the development of an Eating Disorder; their shape and weight become the only thing that they feel they can control.
Although the thin ideals promoted in the media are often blamed for the development of Eating Disorders it is only those who are already vulnerable as a result of low self-esteem and confidence that will be influenced by these.
What is the treatment for an Eating Disorder?
The most effective treatment currently available for an Eating Disorder is Cognitive Behavioural Therapy (CBT). As such it is recommended by the government body NICE as the treatment of choice.
Should you wish to find out more about Eating Disorders then you can check out our eating disorder related blog articles here.