Eating Disorders
Eating disorders are serious mental health conditions involving severe problems with your eating behaviours and related thoughts and emotions. They are complex conditions that can significantly impact your health, emotions, and functioning, as they affect your ability to get proper nutrition. If you have an eating disorder you may become extremely preoccupied with food and your body shape or weight, and may eat much more or much less than you need to be. This preoccupation can make it harder to focus on other important aspects of your life and can cause extreme emotional concerns about eating. Eating disorders tend to coexist with depression, anxiety, substance-abuse, emotional trouble, low sense of control, and low self-esteem; At times the disorder may be a way to cope with emotional issues. This causes a destructive, constant cycle consisting of the eating disorder leading to emotional problems, and those emotional problems causing the eating disorder. Eating disorders are linked to body dysmorphic disorder, which is a mental health condition that causes you to spend a lot of time worrying about minimal and unnoticeable flaws in your appearance. The dangerous eating behaviours caused by eating disorders, such as binge-eating, purging, or restricting intake, can harm your digestive system, bones, teeth, and heart, and can make you more susceptible to diseases. Globally, 70 million people (around 10% of the world's population) struggle with eating disorders. Eating disorders can spiral out of control and take over your life, causing serious long-term, potentially fatal, health issues if left untreated. Treatment is essential for these disorders and can help you return to healthy eating habits, build your self-esteem, and even help reverse health complications caused by the eating disorder.
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Causes
Eating disorders can be caused by a variety and combination of reasons, including biological, genetic, psychological, and social/environmental factors.
Genetics
Eating disorders can be hereditary and run in families, so if you have parents or siblings who have had an eating disorder, you are at a significantly higher risk of developing one. This shows a genetic link.
Biological factors
Brain chemicals, such as serotonin and dopamine, can also play a role in the development of eating disorders. Certain changes or imbalances (lack or excess) of these chemicals can cause irregular hormone functions and put you at risk. Your brain structure and activity can also cause eating disorders.
Psychological and emotional factors
Psychological problems and personality traits such as low-self esteem, negative body image, impulsivity, perfectionism, and neuroticism, as well as having troubled relationships can all contribute to developing an eating disorder.
Social factors
Societal and media pressures that promote unrealistic standards of beauty play a significant role in causing eating disorders. As young people look to the media and see cultural preferences of thinness, they begin to idealize that and focus to reach that level no matter what it takes. Society and popular culture make individuals believe that a specific body shape or size is the key to popularity, beauty, and success. Due to this, you are likely to develop an eating disorder in hopes of achieving happiness only after attaining a specific body type. In societies where thinness is not the cultural ideal, individuals are far less likely to have eating disorders.
Peer pressure, in the form of bullying, teasing, or ridiculing a certain weight/size, can also contribute to the development of eating disorders. This largely impacts young people, especially if coming from friends and colleagues.
Vocational factors
Professions and hobbies where specific body weight and size are emphasized, such as modelling, gymnastics, ballet/dancing, wrestling, figure skating, and horse-riding, can increase the likelihood of eating disorders. As having a slim body and weighing less is promoted for enhanced performance in these professions, individuals are highly pressurized to control their eating and maintain the required body type, no matter the cost.
Risk Factors
Eating disorders can affect people of any age, gender, or background, but they usually develop during adolescence and early adulthood and are much more common among females. However, it is important to understand that men can also have a distorted sense of body image and can develop eating disorders, and this may go under-diagnosed due to less treatment-seeking.
Certain factors can increase your risk of developing an eating disorder. These include:
Age - Eating disorders are much more common during the teenage years and early 20s.
Gender - Females are more likely to be diagnosed with an eating disorder.
Stressful changes - Times of change that can bring about stress, such as starting a new job, a breakup/divorce, or going off to college, can increase your risk of developing an eating disorder.
Dieting - Dieting can at times go too far and turn into an eating disorder. Starvation and weight-loss that comes with extreme dieting can change your appetite and even your brain's functioning and can lead to restrictive eating behaviours. This can make it difficult to return to normal eating behaviours, causing an eating disorder.
Other mental health disorders - Eating disorders are often comorbid with anxiety disorders (mainly obsessive-compulsive disorder and social anxiety disorder), mood disorders and depression, substance-use disorders, and post-traumatic stress disorder.
History of abuse - Experiencing a dysfunctional family dynamic, childhood trauma, and abuse (physical or sexual), can lead to the development of an eating disorder.
Types of Eating Disorders
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) classifies eight overall categories of eating disorders, which includes six specific disorders and their diagnosis, and two umbrella disorders (Other Specified Feeding or Eating Disorder and Unspecified Feeding or Eating Disorder). The most common disorders are binge-eating disorder, bulimia nervosa, and anorexia nervosa.
1. Anorexia Nervosa
Anorexia nervosa is a very serious, and potentially life-threatening eating disorder, which causes you to have a distorted perception of your body weight or shape. Anorexia causes you to severely restrict calorie intake in order to control your weight. It is characterized by abnormally low body weight, excessively monitoring and limiting your food intake and an intense fear of gaining weight. You may try extreme efforts to reduce your body weight, including excessive exercise and dieting, avoiding certain foods, missing meals, and using laxatives or vomiting after eating; it can even get to the point of dangerous self-starvation. Reduced food-intake can slow down your metabolism, which in turn makes you gain weight more easily. There are two subtypes of anorexia nervosa, the restrictive type which focuses on weight-loss through extreme dieting and exercise, and the binge-eating/purging type which involves eating (either a lot or a little), and then getting rid of that food by vomiting, taking laxatives and diuretics, and excessive exercise. The latter type is similar to bulimia nervosa. Individuals with anorexia have a distorted body-image. They tend to view themselves as overweight and never feel that they are thin enough, even if they have gone through severe weight-loss and are dangerously underweight. Anorexia is linked to psychological conditions such as anxiety, depression, suicidal thoughts, body dysmorphia, and obsessive-compulsive disorder. Obsessive-compulsive symptoms cause you to be preoccupied with worrying about food and weight and make you feel a need to control them through counting calories and limited eating. It can also be significantly harmful to your health as overtime it can cause hair fall, nutrient deficiency, thinning of bones, infertility, anemia, muscle deterioration, organ failure (mainly liver, kidney, and heart), brain damage, and even death. It is often the most serious eating disorder and has the highest death rate of any other mental disorder.
2. Bulimia Nervosa
Bulimia nervosa is another serious and harmful eating disorder. It is characterized by episodes of bingeing and purging due to a lack of control over your eating behaviours. When suffering from bulimia, you eat large amounts of food in a short period (binge-eating/bingeing), until you are extremely full and cannot eat anymore. During binges, you may feel like you cannot stop and control how much you are eating. You may try to restrict your food intake and avoid eating certain foods, but this often leads to more binging, especially of the avoided food, later. This is then followed by purging to compensate for the calories consumed, feelings of discomfort, guilt/shame, and fear of weight gain due to overeating. Purging can be done through forced vomiting, fasting, taking laxatives or diuretics, and excessive exercising. Characteristics of bulimia are similar to those of the binge-eating/purging subtype of anorexia, however, individuals with bulimia are usually a normal weight (or slightly underweight or overweight). They usually maintain their weight rather than becoming underweight. Bulimia also causes you to be preoccupied with your body weight and shape and causes a distorted body image, making you harshly criticize yourself and your self-perceived flaws. It involves a fear of gaining weight and wanting to lose weight, however it does not always lead to significant weight reductions. There are several side effects of bulimia including tooth decay and enamel erosion, acid reflux, inflamed throat and salivary glands, gastrointestinal problems, anemia, severe dehydration, low blood pressure, and irregular heart rate. Over time it can also cause more severe issues such as hormonal disturbances leading to reproductive problems, esophageal ruptures from excessive vomiting, and electrolyte imbalances which can cause kidney failure, a stroke, or a heart attack.
3. Binge-Eating Disorder (BED)
Binge-eating disorder causes regular and uncontrollable episodes of eating large quantities of food in short periods of time. You may eat more than you want and need, even when you are not hungry, and may continue to eat even after you are full, until you cannot possibly eat more. This overeating is caused by a lack of control over your earring behaviour. This then causes discomfort, along with feelings of disgust, guilt, shame, distress, and embarrassment. It is similar to the characteristics of bulimia and the binge-eating/purging subtype of anorexia, however, unlike in those, binge-eating disorder does not make you purge. Although you feel bad about the excessive food intake, you do not try to compensate for it through purging, exercise, or restricting calories. Instead of overeating all the time, you experience frequent binging episodes, which occur at least once a week and tend to be done in private due to embarrassment. But this shame causes a vicious cycle as the more distressed you are about your eating behaviours, the more likely you will be to have a bingeing episode, which then again increases distress. Binge-eating disorder is the most common eating disorder, especially in the United States. It usually begins during early adulthood and many people develop it later on. Unlike other eating disorders, it is almost as common among men as it is in women. Individuals with binge-eating disorder are often overweight or obese due to overeating and a lack of purging or exercise after. This can lead to medical problems such as heart disease, type 2 diabetes, stroke, and even death. Due to its link to obesity, it can have serious health consequences if left untreated.
4. Pica
Pica is a potentially fatal eating disorder that involves persistently eating substances that are not considered food. You may crave things such as ice, chalk, soil, soap, paper, wool, hair, laundry detergent, cloth, clay, pebbles, or other non-food items. These substances must not be considered culturally or religiously acceptable or normal. Pica can occur in children, adolescents, and adults, but is most commonly seen among children, pregnant women, and individuals with mental disabilities. The items that are eaten usually vary with age and availability. Pica is highly dangerous and can be fatal as it can put you at risk of gastrointestinal injuries, infections, nutritional deficiencies, and poisoning, depending on the ingested substance.
5. Rumination Disorder
Rumination disorder involves voluntarily regurgitating food that you have previously chewed and swallowed, to then re-chew it, and either re-swallow it or spit it out. This is done within the first half an hour of eating a meal, and the food is brought back to the mouth without nausea or gagging. Over time it may become unintentional. The regurgitation must not be due to any other disorders. Rumination disorder can develop at any age from infancy to late adulthood. It is common in infants and tends to occur between 3 and 12 months of age and then disappear on its own. Older children and adults usually need therapy to help resolve it. It is also common among individuals with an intellectual disability. As rumination disorder can reduce the amount of food being taken in, it can cause weight loss and severe malnutrition. This can also occur as you may try to eat less or not eat in public to avoid regurgitation. The effect of this can be harmful to your health.
6. Avoidant/Restrictive Food Intake Disorder (ARFID)
ARFID, previously known as “a feeding disorder of infancy and early childhood” causes individuals to under-eat due to either a lack of interest in food or an intense distaste for certain looks, smells, tastes, textures, colours, or temperatures of food. The food is not avoided due to a fear of weight gain, but due to the sensory characteristics of it or a fear of the consequences of eating it such as choking or vomiting. It causes disturbed eating and the avoidance of certain foods, resulting in you eating very little. This goes beyond normal pickiness, preferences, diets, and religious/cultural restrictions. The limited preferences of food that you do have can reduce overtime, leading to even less food intake. It leads to a failure to meet your minimum daily nutrition requirements causing dramatic weight-loss, inability to gain weight in childhood, and nutritional deficiencies, which result in significant health problems. ARFID usually develops during infancy or early childhood, but can continue into adulthood. It is equally common among men and women. It is also different from other eating disorders as it does not make individuals worry about body weight and shape and is not linked to body image disruptions.
7. Other Specified Feeding or Eating Disorders (OSFED)
If you present several of the symptoms for eating disorders such as anorexia nervosa, bulimia nervosa, or binge-eating disorder but do not meet the full diagnostic criteria for any of them, you will be put into the OSFED category. It also involves other eating disorders that are not specified in the DSM-5. This typically involves having a distorted body image, being overly critical about your body shape and weight, possessing an intense fear of gaining weight, and presenting dysfunctional eating behaviours. It can cause significant distress and impairment in daily functioning. Around 30% of individuals seeking treatment for an eating disorder have OSFED, making it the most commonly diagnosed eating disorder. The therapist communicates the specific reasons that result in an OSFED diagnosis instead of any other eating disorder, by listing what is missing or what the problem is instead.
OSFED can be used as an umbrella category for conditions such as:
Atypical anorexia nervosa: Where you meet all the criteria for anorexia nervosa except for significant weight loss. Your weight will be within or above the normal range.
Bulimia nervosa of low frequency and/or limited duration: Where you meet all the criteria for bulimia nervosa, however, the bingeing and purging occurs less than once a week and for less than 3 months. Because of this, you miss the diagnosis for bulimia nervosa.
Binge-eating disorder of low frequency and/or limited duration: Where you meet all the criteria for BED, however, the binge-eating occurs less than once a week and for less than 3 months.
Purging disorder: Which involves conducting persistent purging behaviours (vomiting, misusing laxatives, extreme exercise) to impact your body weight or shape, without binge-eating first.
Night eating syndrome: Which involves recurrent episodes of excessively eating at night after dinner or even waking up from sleep to do so. This is done under your awareness and is not due to any problems in your sleep-wake cycle, binge-eating disorder, or any other medical and psychological disorders.
Orthorexia: Which involves an obsessive focus on healthy eating and strict self-imposed diet rules, to a point where it starts to disrupt your daily life. You may eliminate entire food groups which then causes severe malnutrition, weight loss, and distress.
8. Unspecified Feeding or Eating Disorders (UFED)
This category applies to situations in which you may present symptoms of an eating disorder that do cause significant distress and impairment, but do not meet the complete criteria for a diagnosis of any of the specified eating disorders. Unlike in OSFED, the therapist chooses to not specify why the criteria of another eating disorder have not been met and may believe there is not enough information to make a specific diagnosis.
Signs and Symptoms
Some common overall warning signs and symptoms of eating disorders can include:
Chronic dieting, even if underweight
Extreme concern with body weight, shape, and size
Preoccupation with calories, carbohydrates, and fat contents of food
Reduced food intake, skipping meals, or avoiding certain foods
Unusual eating behaviours
Weight fluctuations
Inability to view extreme thinness as a problem
Excessive eating/bingeing
Poor health and reduced immunity due to malnutrition
Low energy and lethargy
Avoidance of eating around people and in public
Low self-esteem related to body image
Constant gastrointestinal problems
Dental erosions from vomiting
Hair loss
Brittle bones and nails
Muscle injuries and pain from excessive exercise
Menstrual cycle irregularities
Use of laxatives, diuretics, or diet pills
Mood swings
Dizziness and fainting
Disrupted sleep
Low blood pressure and heart rate
Low thyroid and hormone, iron, and potassium levels, and low blood cell count
Complications
Apart from the severe symptoms caused by eating disorders, there are also a number of long-term complications that can have serious effects on your life. These complications can be fatal. The more severe or long-lasting the eating disorder is, the more serious the complications are.
Eating disorders can cause problems:
With your growth and development
In your relationship
With substance use
In school and work
With your physical and mental health, which can cause hospitalisation or even death
Eating disorders are one of the highest mental health-related causes of hospitalisation. 11% of hospital admissions are due to life-threatening complications. Individuals with bulimia are twice as likely to die prematurely, and individuals with anorexia are around 5.8 times more likely. As eating disorders cause low-self esteem and depression, they can also lead to suicidal thoughts and behaviours. Around 26% of people with eating disorders attempt suicide.
Comorbidity With Other Disorders
Eating disorders are highly comorbid with other psychiatric and medical conditions.
Research findings have shown that approximately 60-95% of individuals with an eating disorder also have at least one other psychological condition. The most common comorbidities include anxiety disorders (especially obsessive-compulsive disorder and social anxiety), mood disorders and depression, impulse-control disorder, post-traumatic stress disorder, substance-use disorder, self-harm, and suicidal thoughts. Anxiety disorders occur in 50-80% of individuals suffering from eating disorders. In many cases, the anxiety disorder is present before the eating disorder is developed. One study conducted on women with eating disorders found that 94% of them had a comorbid mood disorder and 92% of them had depression. Many individuals with eating disorders also present medical complications. Malnutrition, dehydration, electrolyte imbalance, low blood pressure, cardiac irregularities, low blood sugar level, and low immunity are all common alongside eating disorders. These conditions as well as the eating disorder itself can lead to a need for hospitalisation.
Diagnosis
Eating disorders are serious and harmful conditions that require treatment. The earlier you are diagnosed, the faster and easier your recovery process will be. If you believe you or a loved one have symptoms of an eating disorder it is important to seek professional help. Your medical doctor may partake in the diagnosis if they suspect you have an eating disorder by conducting physical tests to evaluate your health levels. Your therapist will additionally conduct a psychological evaluation, and may further examine the physical test results, to determine exactly which disorder you have and the best treatment plan for it. Your family history, eating habits, body image beliefs, diet plans, and exercise behaviours, will all be assessed.
Specific Diagnosis
Each disorder has its own diagnostic criteria according to the DSM-5 and you meet the required symptoms for a diagnosis. It is as follows:
Anorexia Nervosa
Restriction of energy intake in relation to your requirements, causing significantly low body weight for your age, gender, developmental trajectory, and physical health.
Intense fear of gaining weight or becoming fat, even at a significantly low weight.
Disturbances of the perception of your body weight or shape, excessive concern with body weight or shape for self-evaluation, and denial of being severely underweight.
Specification based on -
Restrictive type: Excessive dieting, fasting, or exercising, and not engaging in persistent bingeing or purging episodes in the last three months.
Binge-eating/purging type: Engaging in recurrent episodes of binge-eating and purging behaviour in the last three months.
Bulimia Nervosa
Recurrent episodes of binge-eating, which are characterized by both:
Eating an unconventionally large amount of food (larger than most people would eat in a similar period under similar circumstances), in a short and discrete amount of time (a 2 hour period)
A lack of control over eating during the bingeing episode (feeling that you cannot stop eating or control what and how much you are eating)
Consistent inappropriate compensatory behaviours to prevent weight gain (e.g. vomiting, misusing medications, fasting, or excessive exercise).
The binge-eating episodes and compensatory behaviours both occur at least once a week for 3 months, on average.
Self-evaluation is heavily influenced by body shape and weight.
The behaviour (binge-eating or purging) does not only occur during episodes of anorexia nervosa.
Binge-Eating Disorder
Recurrent episodes of binge-eating, which are characterized by both:
Eating an unconventionally large amount of food (larger than most people would eat in a similar period under similar circumstances), in a short and discrete amount of time (a 2 hour period)
A lack of control over eating during the bingeing episode (feeling that you cannot stop eating or control what and how much you are eating)
Bingeing episodes consist of three or more of the following:
Eating until feeling uncomfortably full
Eating much faster than normal
Eating large amounts of food even when you are not feeling hungry
Eating alone due to feeling embarrassed about how much you eat
Feeling disgusted, depressed, or guilty afterwards
Notable distress related to the binge-eating.
The binge-eating episodes occur at least once a week for 3 months, on average.
The binge-eating is not linked to inappropriate compensatory behaviours (purging), as it is in bulimia nervosa, and must not only occur during episodes of bulimia or anorexia nervosa.
Pica
Persistent eating of non-food and non-nutritive substances for a period of at least 1 month.
The eating of these substances is inappropriate for your developmental level.
The eating behaviour is not related to a culturally, socially, or religiously normative practice.
If the eating behaviour occurs due to or alongside another psychological disorder (e.g. intellectual disability) or a medical condition (e.g. pregnancy), it must be severe enough to warrant additional clinical attention.
Rumination Disorder
Repeated regurgitation of food, which is then re-chewed and either re-swallowed or spit out, for at least one month.
The regurgitation is not due to any gastrointestinal or other medical condition (e.g. reflux).
The behaviour does not only occur during episodes of anorexia nervosa, bulimia nervosa, BED, or ARFID.
If the behaviour occurs due to or alongside another psychological disorder (e.g. intellectual disability), it must be severe enough to warrant additional clinical attention.
Avoidant/Restrictive Food Intake Disorder
A disturbance in eating or feeding (due to a lack of interest in eating, avoiding certain foods based on their sensory characteristics, or concerns about the consequences of eating), which is displayed by a consistent failure to meet the appropriate nutritional requirements associated with one or more of the following:
Significant nutritional deficiency
Significant weight loss, an inability to meet expected weight-gain, or a hindrance of growth in children
Dependence on enteral feeding or oral supplements
Noticeable interference with psychosocial functioning
The eating disturbance is not due to a lack of available food or a cultural/religious practice
The disturbance does not only occur during episodes of anorexia nervosa and bulimia nervosa, and is not due to the way in which you view your body weight or shape
The eating disturbance is not due to any concurrent medical and psychological conditions. If the disturbance occurs or alongside another disorder, it must be severe enough to exceed normal behaviour and to warrant additional clinical attention.
Other Specified Feeding or Eating Disorders and Unspecified Feeding or Eating Disorder
Presence of symptomatic characteristics of a feeding or eating disorder that cause clinical distress or impairment in functioning.
However, these symptoms do not meet the full criteria for any of the disorders in the feeding and eating disorders diagnostic class.
Treatments
Eating disorders can be difficult to manage yourself and they can start to take over your life. If you think you have an eating disorder you should seek professional help. Even if you do not have all the symptoms necessary for the diagnosis of an eating disorder, you can still benefit from getting psychological help with eating behaviours and body-image related issues. It is also useful for managing concurrent mental conditions. There are a wide range of treatment options including psychotherapy, medication, nutritional counselling and education, medical monitoring, and in extreme cases hospitalisation. Your treatment plan depends on the type and severity of your eating disorder and can include a team approach consisting of doctors, psychologists, and nutritionists.
Psychotherapy
Therapy is the most important component in the treatment of eating disorders. It involves regularly seeing a therapist to address both the symptoms and impairments caused by the disorder, as well as the psychological and interpersonal factors that contribute to it. It can last anywhere from a few months to a few years. Psychotherapy will help you normalize your eating patterns by teaching you how to monitor your eating behaviours and replacing unhealthy eating habits with healthy ones. It will also improve the way you evaluate yourself and your body image and help you gain self-esteem, allowing you to maintain a healthy weight. Along with this, you will learn healthy coping and problem-solving skills to handle stress and your emotions. This will improve your mood, relationships, and self-control. Your therapist may give you ‘homework’ tasks and ask you to keep a food journal to identify situations that cause unhealthy eating behaviours and assess what helps you control them.
Various forms of therapy can be used as a treatment option, such as:
Cognitive Behavioural Therapy (CBT)
CBT aims to identify the thoughts, beliefs, and behaviours that have led to your eating disorder. These thoughts and feelings can be about issues with food, weight, appearance, or body shape. It then teaches you strategies to monitor, manage, and modify your eating habits, thoughts, and moods. It also provides you with problem-solving skills and helps you develop healthy methods to cope with stressful situations. CBT is commonly used to treat bulimia nervosa, binge-eating disorder, rumination disorder, and the binge-eating/purging subtype of anorexia nervosa. This is because it effectively helps you eliminate bingeing, purging, and regurgitating behaviours by allowing you to identify and change unhelpful thought patterns and inaccurate beliefs that cause the distorted eating behaviour. It can also help with symptoms of comorbid conditions such as anxiety and depression. CBT-E (enhanced) is intended to be useful in the treatment of all types of eating disorders.
Family-based treatment (FBT)
FBT, also referred to as the Maudsley method, is effective in the treatment of eating disorders amongst children and adolescents. This is because it involves the parents or other family members in helping you recover by ensuring you follow healthy-eating patterns and maintain a healthy weight. It helps to increase awareness, understanding, and support within the family. You may have individual sessions where you are taught more amount managing and changing your unhealthy eating behaviours. FBT can incorporate approaches from different forms of therapy. It is useful in treating all types of eating disorders.
Dialectical behavior therapy (DBT)
DBT focuses on the difficult feelings and emotions that cause you to develop an eating disorder. It will help you learn skills to manage these feelings and your moods, and change your unhealthy behaviours. DBT can also help you enhance your interpersonal and communication skills as well as your emotional expression, allowing you to be more open and flexible. It can also encourage mindfulness and teach you coping strategies for dealing with distress. This can prevent the emotions that cause distorted eating behaviours. It has been found effective in the treatment of anorexia nervosa, bulimia nervosa, and binge-eating disorder.
Psychodynamic psychotherapy
Psychodynamic therapy focuses on helping you understand the underlying root cause of your eating disorder. It makes you look to the past and dive deep into your unconscious mind to unfold internal problems that have led to unhealthy behaviours. Once you recognize the cause you will be able to address and resolve it. It can also help you manage your symptoms. As you combat the cause of the behaviours and eating disorder, psychodynamic therapy reduces the risk of relapse. This can help treat anorexia nervosa, bulimia nervosa, BED, and ARFID.
Interpersonal psychotherapy (IPT)
IPT causes you to explore your eating disorder in the context of social and interpersonal relationships. You will focus on your interpersonal deficits, expectations from different people, life transitions, and feelings of grief. Your therapist will help you understand how these problems can be contributing to your eating disorder. You will then be taught interpersonal and communication skills to help reduce your symptoms. IPT is especially efficacious in treating bulimia nervosa and binge-eating disorder.
Acceptance and commitment therapy (ACT)
ACT makes you focus on changing your actions and behaviours instead of your thoughts and feelings. You will examine your values and develop goals to fulfill them. ACT makes you accept all your feelings, good and bad, and then makes you commit to changing your behaviours so that they can meet your goals and values. Due to this, you will stop engaging in unhealthy eating behaviours. It is an effective treatment for many eating disorders.
Nutrition Counselling
This involves doctors, nurses, therapists, and dieticians helping you learn how to reach and maintain a healthy weight. Your old eating habits and beliefs about food, dieting, and exercise will be changed as you will learn information and develop new skills on how to conduct healthy patterns. This can be linked with family therapy as your family may often be involved to monitor your eating behaviours.
Medications
Medication cannot cure an eating disorder, however, it may help control urges to binge or purge, control your mood, and manage feelings of anxiety and depression. They can help control symptoms and are most effective when combined with psychotherapy. Although the medications do not treat the eating disorder itself, they help manage underlying issues that may be causing the disorder. Antidepressants are the most commonly prescribed medication as they can treat disorders that involve bingeing or purging behaviours (bulimia or BED), and can reduce commonly co-occurring symptoms of depression or anxiety. Anti-anxiety medications, antipsychotics, and mood stabilizers can also be useful. As eating disorders can cause a range of medical problems, medications may also need to be taken to help with the physical health problems caused by them.
Hospitalisation or Residential Treatment Center
In extreme cases that cause serious health problems, such as severe weight loss and malnutrition due to anorexia nervosa, hospitalisation is required. This involves monitoring and specialized eating disorder programs. It may be necessary when you are unable to eat or gain weight and the eating disorder has resulted in life-threatening medical problems. Once serious medical symptoms are stabilized and you are able to eat again, you may be moved to a residential treatment center for eating disorders instead. Here you will begin to return to a normal healthy weight and learn to normalize eating.
Thrive Specialists in Eating Disorders
Dr. Kate Prozeller
Licensed Psychologist
Dr. Kate Prozeller is a CDA-licensed psychologist. She holds her PsyD in Counseling Psychology from Saint Mary’s University in the United States. Dr. Kate provides individual therapy to adults, couples therapy, and English-language art, sand, and play therapy to children and adolescents. Prior to relocating to Dubai in 2019, she has worked as a psychologist in the United States, serving a variety of patient populations and across hospitals, private practice, and university settings.
Dr. Vassiliki Simoglou
Licensed Psychologist
Dr. Vassiliki Simoglou is a CDA-licensed psychologist. She completed all her studies in Psychology in France, and is a licensed psychologist in Greece and the European territory, and in Dubai by the CDA. Dr. Vassiliki holds a PhD in Psychoanalysis and Psychopathology from Sorbonne Paris Cité - Paris Diderot University in Paris, and a Bachelor’s and Master’s Degree in Clinical Psychology from the University Louis Pasteur of Strasbourg. She also holds a Master’s degree in Psychoanalytic Studies from the University of Essex in the UK. She has been working as a psychodynamically oriented psychotherapist for more than 14 years, in Dubai, Paris and Athens. She offers individual counseling and psychotherapy for adults and adolescents (15+), couples therapy, family therapy, and perinatal and infertility counseling - in French, English and Greek.
Maša Karleuša Valkanou, M.Sc.
Licensed Psychologist
Maša Karleuša Valkanou is a CDA-licensed psychologist in Dubai. As a certified Systemic Family psychotherapist, she works with individual clients, adults or children. She is specialised in work with adolescents. She works with couples, parents or the whole family together. Her work covers various psychological difficulties and background including psychotic disorders, addictions, neurotic disorders (depression, anxiety, panic attacks etc.), psychological trauma, abuse, self-harm, suicidal thoughts and feelings, behavioural, emotional and problems in relationships or family problems.
Joslin Gracias, M.A.
Licensed Psychologist
Joslin is a CDA-licensed psychologist. She holds an M.A. in Clinical Psychology from S.N.D.T. University in India. Joslin works with adolescents, adults, and couples who are experiencing depression, anxiety, relationship difficulties, trauma, and burnout/stress.
Dr. Ash Shishodia
Consultant Psychiatrist
Dr. Ash Shishodia is a Western-trained General Adult Psychiatrist (Addiction Psychiatry endorsement) and Neuropsychiatrist with over 15 years experiencing working with an ethnoculturally diverse population. I am comfortable working with mild, moderate, and severe cases, including major mental illness, and neurological disorders with mental health.
Michelle Estekantchi, M.Ed.
Licensed Psychologist
Michelle Estekantchi is a Licensed Psychologist with a Master’s degree in Counseling Psychology from Memorial University (Canada). She works with children, adolescents, and adults across a range of issues including anxiety, depression, relationship issues (peer, family), burnout, and self-esteem issues. Michelle also conducts psychoeducational and ADHD assessments.
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