Eating Disorders


Eating Disorders

Eating Disorders I Can Help With


Eating Disorders

Some eating disorders are more widely recognised than others and there is often a misconception that to have an eating disorder you have to be a particular weight. Eating disorders can present in many different ways and can have different symptoms even within the same eating disorder. The severity and duration can also be different, some eating problems are more ‘secret’ than others but all eating difficulties have an impact on a person’s quality of life. Eating difficulties that don’t meet the threshold for a formal diagnosis are not any less distressing. Seeking help early has a much better prognosis for recovery. Below is a summary of some of the main eating difficulties that I am able to help with. All treatments offered are recommended by the National Institute for Health and Care Excellence (NICE) for treatment of Eating Disorders. Other evidence based treatments such as Schema informed therapy or Dialectical Behavioural informed Therapy may be incorporated if helpful.

Anorexia Nervosa

Someone who has Anorexia Nervosa may limit their intake of food or engage in excessive exercise in order to maintain a significantly low body weight. In addition, they have an intense fear about gaining weight and engage in behaviours that prevent weight gain, despite weight often being significantly low. They may see themselves as much larger than they actually are and be unable to recognise their low body weight. People with Anorexia may also binge or purge whilst maintaining a significantly low weight. Treatments offered to help recovery from Anorexia Nervosa include eating disordered focused Cognitive Behaviour Therapy (CBT-ED) and the Maudsley model of Anorexia Nervosa for adults (MANTRA); both are recommended by the NICE guidelines for treatment of Eating Disorders.

Bulimia Nervosa

Someone who has Bulimia Nervosa may engage in binge eating, where they eat a large amount of food in a discrete period of time and in doing so experience feelings of being unable to stop their binge eating. They often describe having a lack of control over their binge eating. The frequency of this can vary but it is normally at least once a week for a period of at least three months. People with Bulimia Nervosa engage in compensatory behaviours, examples of these might be self induced vomiting, misuse of laxatives, diuretics, fasting/skipping meals or excessive exercise. Their self evaluation is significantly influenced by body shape and weight concerns. The treatment offered to help with Bulimia Nervosa is Eating Disordered focused Cognitive Behaviour Therapy (CBT-ED) as recommended by the NICE guidelines.

Binge Eating Disorder

Someone who has Binge Eating Disorder may engage in binge eating where they eat a large amount of food in a discrete period of time and feel a lack of control over their eating during this time period. People who struggle with Binge Eating Disorder may experience eating much more quickly than normal, eating until uncomfortably full, eating large amounts of food when not feeling hungry, eating alone because of embarrassment and may experience feelings of disgust, shame or guilt following a binge. Unlike in Bulimia Nervosa, binges are not followed by compensatory behaviours to try and get rid of the food consumed. How frequently this occurs can vary but it is normally at least once a week and for at least for a period of three months. The treatment offered to help recovery from Binge Eating Disorder is Eating Disordered focused Cognitive Behaviour Therapy (CBT-ED) as recommended by NICE guidelines.

Other Specified Feeding or Eating Disorder (OSFED)

Anorexia, Bulimia and Binge Eating Disorders are diagnosed when certain criteria are met. However, some eating disorder presentations might not meet the full criteria but they still cause distress and impairment. When this occurs the term OSFED (other specified Feeding or Eating disorder ) is often used. Some examples of OSFED presentations might be when someone has the symptoms of Anorexia but their weight is within or above a ‘normal’ weight range or when the criteria for Bulimia are met but the occurrence of bingeing/purging is less frequent and the duration is shorter and similarly for Binge Eating Disorder all the criteria are met but the bingeing is less frequent and the duration is shorter. The OSFED category also includes eating problems such as Purging Disorder (purging without bingeing) and Night Eating Syndrome (waking and eating in the night). For people with OSFED NICE guidelines recommend using the treatments for the eating disorder it most closely resembles.

Emotional Eating

Although emotional eating is not classified as a formal eating disorder it is something that effects many people and can cause significant distress . As the name suggests emotional eating occurs as a way to manage emotions, whether that is to regulate, self soothe or numb feelings. Eating in this way might feel like a relief in the moment but the effects tend to be temporary and short-lived and it often leads people feeling worse afterwards and so a viscous cycle develops that keeps this type of eating problem going. Emotional eating is often a symptom of deeper unmet needs that have not been fulfilled. Eating in this way also means that people stop themselves from learning more healthier and adaptive ways to manage their feelings. Treatment using CBT can help identify and understand specific eating responses highlighting unhelpful cycles that continue to maintain the problem. Treatment aims to address the underlying reasons that people might be emotionally eating, with an aim to help develop more healthier and adaptive ways to manage feelings and connecting with oneself in a more authentic way.