Westwind eating disorder recovery centre: specializing in the treatment of anorexia and bulimia.

Info on Eating Disorders

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At Westwind, we have a distinct bias toward a predominantly psychosocial model of treating eating disorders, rather than a medical model. The psychosocial model takes the view that eating disorders are as much a lifestyle choice as they are a disorder. While both thinking (about food, body image and self worth) and behaviour (eating) are disordered, this is not seen as an illness, and terms such as "disease" and "sick" do not apply. The behaviour is voluntary and can be altered using measures completely under the individual's control. There is no illness to be "cured", but rather a persistent dysfunctional pattern of cognitive and instrumental behaviour to be altered.

Biological aspects may predispose one toward the development of a psychological disorder, but are not seen as the "cause". Biological interventions such as medication, have so far proven to be fairly ineffectual in treatment, and at this point, psychological interventions, such as various forms of psychotherapy and skills training, seem far more effective.

 

 

 

 

Symptoms

If you recognize some of these symptoms in yourself you may have, or may be developing, an eating disorder. Talk to someone you trust about this. You might want to complete the Eating Attitudes Test (EAT 26).

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Anorexia

"A disorder characterized by fear of becoming fat and refusal of food, leading to debility and even death."

Anorexia, from the Greek an, not, and orexis, desire, means a loss of desire to eat. Nervosa, derived from the French word, nerveux, means having to do with the nerves (psychological cause). Therefore, Anorexia Nervosa is defined as the "loss of appetite caused by psychological illness".

Anorexia nervosa is a chronic debilitating illness in which the individual exhibits an altered eating pattern, often restricting and decreasing food intake, resulting in subsequent weight loss. In an attempt to somehow control their life, the sufferer undergoes a mixture of emotional, psychological and physical changes.

This misunderstood illness usually follows some stressful life event, such as the death of a loved one or increased pressure to perform well at school. Low self-esteem is often a major characteristic of someone suffering from anorexia. Anorexia usually begins with a form of dieting of some sort. The dieter begins by watching what she eats, then progressively becomes obsessed with what, how much, and when she consumes food. As the person loses weight, they receive positive reinforcement from others as thinness is worshiped in our society. These initial comments, such as "you look good, did you lose weight?", only intensify the disorder.

Suffers of anorexia see themselves differently from others. They have an abnormal attitude to weight and an abnormal perception of their body, often insisting that they are fat, when in reality they are emaciated. They experience a powerful desire to be abnormally thin, feeling that's the only thing they can control and do well in their life.

Food deprivation may lead to cessation of menstrual cycles, weakened muscle tissue, loss of bone density, lowered heart rate, and a persistent coldness in one's hands and feet. Anorexics often experience pain and physical discomfort, and poor sleeping patterns.

As anorexia progresses, the individual becomes socially and emotionally withdrawn, often due to the loss of energy caused by reduced food intake. Depression and irritability are often common. A person with anorexia may develop food rituals or unusual eating behaviours as a result of their obsession with food and weight. Discomfort is often felt when eating with other people, but are often eager to prepare meals for others.

Medical Criteria for Anorexia:

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Bulimia

"A disorder characterized by compulsive overeating followed by vomiting."

Bulimia, from the Greek bous, "ox" and limos, "hunger" means "hunger like an ox". Nervosa, from the French nerveux, means having to do with the nerves (psychological cause). Bulimia Nervosa can therefore be defined as a great hunger caused psychological illness".

Bulimia Nervosa is an eating disorder characterized by repeated episodes of binge eating and then purging to compensate for the unwanted food in an attempt to prevent weight gain. Binge eating commonly occurs as a response to emotion, which is soon followed by feelings of depression and self-loathing. During a binge the individual consumes abnormally large amounts of food in a short period of time with a sense of lack of control. The binge can last for minutes or hours, consisting of all kinds of food. The suffer knows the behaviour is not normal, and generally attempts to hide it from others.

Purging is engaging in an attempt to rid the body of unwanted food to prevent weight gain. Purging is most commonly self-induced vomiting, but can take the form of laxative abuse, diuretics, enemas, fasting or excessive exercise. Generally, purging does not result in much weight loss. Diuretics rid the body of water, resulting in dehydration and essential mineral loss. Vomiting only rids the body of some of the food ingested. Actually, the act of vomiting causes the body to be more efficient at absorbing calories. Laxatives work on the lower part of the large intestine causing the loss of water and other nutrients. Much of the food ingested has already been absorbed by the small intestine.

Vomiting is very dangerous and harmful to ones body. As a result of frequent vomiting, the stomach, esophagus, throat and heart are stressed. There is a considerable loss of sodium and potassium by any form of purging, which may lead to muscle cramps, cardiac arrhythmia (irregular heart beat) and even death.

Those suffering from bulimia often withdraw socially and emotionally from their surroundings. Often they feel a lack of control in many areas of their lives, not just eating. People with bulimia are persistently concerned with their body shape and weight, but unlike those suffering from anorexia, they are often normal weight.

Medical Criteria for Bulimia:

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Binge Eating/Compulsive Overeating

"eating to excess"

Binge Eating Disorder is defined as consuming large quantities of food in a short period of time with the feeling of lack of control over eating.

Often, binge eating is confused with compulsive overeating which involves consuming larger than normal quantities during everyday meals. The difference between the two disorders is the short period of time and the sense of lack of control over food consumption experienced during binge eating. Binge eaters feel they are unable to stop eating, similar to a bulimic without the purging activity.

Binges often occur when one begins to think about the food they are depriving themselves of, forming a strong desire to eat. Soon they feel unable to stop, therefore binge eating. Feelings of disgust, guilt and depression follow the binge. Binges, typically done in secret as the individual is ashamed of their "loss of control" over food, may be a result of overwhelming emotions, such as depression or loneliness. The feelings that follow episodes of binge eating lead to further depression, which in turn leads to more binge eating. It is a cycle that needs to be broken.

Compulsive overeating is defined as a regular overindulgence of food. It is most commonly associated with binge eating disorder.

Those suffering from compulsive overeating often eat in response to the same issues that bulimics and binge eaters experience - stress, depression, anxiety, loneliness. Instead of binge eating great amounts of food during short time periods, they compulsively consume larger portions on a regular basis. This becomes a habit, resulting in weight gain, therefore causing further depression and more binge eating.

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Orthorexia

From the Greek "ortho", meaning straight, true, correct, and "orexia", referring to appetite.

Orthorexia Nervosa refers to a fixation on eating healthy food. The term does not denote an actual recognized diagnosis, and was coined by Dr. Steven Bratman to describe what he saw as a behaviour pattern that was just as destructive to one's health and life in general as the better known eating disorders.

As with most eating disorders, this one starts out with good intentions, and the person begins to follow a diet for what he or she believes are health related reasons. As the diet progresses, however, food choices become increasingly narrow, and supplements may become increasingly important. Social outings become restricted, as there is more and more attention to a restrictive diet. Lapses from the diet are generally followed by feelings of guilt and a possible move to an even stricter diet. The diet eventually comes to rule the person's life to the point that thoughts and activities all revolve around food. Where people with anorexia and bulimia focus on the quantity of food, people with orthorexia focus obsessively on the quality of food.

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Body Dysmorphic Disorder

This is not an eating disorder, but rather a psychological condition which has close parallels with both anorexia and bulimia in terms of distortions of body image. It is typified by a preoccupation with an imagined defect in appearance. If there is a slight physical anomaly actually present, the person's concern is excessive. The preoccupation is severe enough to disrupt the person's social, vocational, educational or other important area of functioning.

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Eating Disorders in Men

Eating disorders are not limited to women. Anorexia, bulimia, and related eating disorders are becoming more common in men. In the past, men have not been under as much pressure as women to conform to the slim figures of models appearing on television and in magazines. But, in more recent years pressure has been placed on men to pursue the "perfect" body. More and more men are heading to fitness centres to lift weights, obsessing about muscle definition and their looks.

Although there are some differences, the main causes of eating disorders in men are the same as those seen in women. Often, there are underlying issues such as low self-esteem, distorted body image, being overweight at a child, or the fear of becoming fat.

Unfortunately, men with eating disorders are reluctant to seek professional counselling as they are afraid of accepting that they are suffering from what has been labeled as a woman's disease.

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Dangers of Eating Disorders

Anorexia

 

Bulimia

Bingeing and Purging

Laxatives

Ipecac Syrup

Diet Pills

Fad Diets

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For Family and Friends

When someone you love is suffering from an eating disorder you may not know what to say to them. You might find it difficult to understand what they are going through. Let them know that you are there for them, and that you care. Discuss your concerns, without judging or criticizing, at a time and location free of distractions. Be patient. They may refuse to admit that there is a problem at first because they are ashamed or embarrassed. Show that you care by being supportive and patient and by listening and trying to understand her situation.

Eating disorders require attention from professionals, don't try to cure the eating disorder on your own. The most important thing you can do is to educate yourself about eating disorders so that you will have a better understanding of her situation and be there to support and comfort her.

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References

Agras, W. S. & Apple, R.F. (1997). Overcoming Eating Disorders. A Cognitive-Behavioural Treatment for Bulimia Nervosa and Binge Eating Disorder. USA, Graywind Publications Inc.

Anderson, A.E, MD. (1999). Eating Disorders: A Guide to Medical Care and Complications. Baltimore, MA, The John Hopkins University Press.

Bratman, S. (2000). Health Food Junkies: Overcoming the Obsession With Healthful Eating. Broadway Books, New York, NY

Brownell, K.D. & Foreyt, J.P. (1986). Handbook of Eating Disorders: Physiology, Psychology and Treatment of Obesity, Anorexia and Bulimia. USA, Basic Books Inc.

Cooper, P.J. (1998). Bulimia Nervosa and Binge Eating. A self-help guide using Cognitive Behavioural Techniques. London, UK, Robinson Publishing Ltd.

Fairburn, C. (1995). Overcoming Binge Eating. New York, NY, The Gulliford Press.

Fairburn, C.G. & Wilson, G.T. (1993). Binge Eating. Nature, Assessment, and Treatment. New York, NY, The Gulliford Press.

Schmidt, U. & Treasure, J. (1998). Getting Better Bit(e) by Bit(e). A survival kit for Sufferers of Bulimia Nervosa and Binge Eating Disorders. East Sussex, UK, Psychological Press Ltd.

Kirkpatrick, J & Caldwell, P (2001). Eating Disorders. Anorexia Nervosa, Bulimia, Binge Eating and others. Toronto, ON, Key Porter Books, Ltd.