Conditions and their Treatment - Eating Concerns
What are Eating Disorders?
Eating disorders are moderate to severe mental health conditions which are often accompanied by moderate to severe medical issues. Eating disorders are characterised by disturbances in behaviour and thinking around food, eating, weight and/or shape.
Eating disorders do not discriminate. They can affect people of both genders; of all ages, shapes, and sizes; and from all cultural backgrounds. They are serious, potentially-life threatening, and are not a lifestyle choice.
Eating disorders are classified into different diagnoses, depending on the kind of symptoms and frequency of behaviours.
Anorexia Nervosa (AN)
Restriction of energy intake relative to an individual’s requirements, leading to a significantly low body weight in the context of age, sex, developmental trajectory and health status.
Note: Being within the ‘healthy weight’ BMI range does not exclude someone from having Anorexia Nervosa.
Undue influence of body shape and weight on self-evaluation, disturbance of body image, an intense fear of gaining weight, lack of recognition of the seriousness of the illness and/or behaviours that interfere with weight gain are also present ..read more
Bulimia Nervosa (BN)
Binge eating (eating a large amount of food in a relatively short period of time with a concomitant sense of loss of control) with purging/compensatory behaviour (e.g. self-induced vomiting, laxative or diuretic abuse, insulin misuse, excessive exercise, diet pills) once a week or more for at least 3 months.
Disturbance of body image, an intense fear of gaining weight and lack of recognition of the seriousness of the illness may also be present ..read more
Binge Eating Disorder (BED)
Binge eating, in the absence of compensatory behaviour, once a week for at least 3 months. Binge eating episodes are associated with: eating rapidly, when not hungry, until extreme fullness, and/or associated with depression, shame or guilt ..read more
Other Specified Feeding and Eating Disorder (OSFED)
Disordered thoughts/feelings/behaviours concerning food and weight/shape that does not meet full criteria for one of the above categories, but has specific disordered eating behaviours such as restricting intake, purging and/or binge eating as key features.
Avoidant/Restrictive Food Intake Disorder (ARFID)
Significant weight loss, nutritional deficiency, dependence on nutritional supplement or marked interference with psychosocial functioning due to caloric and/or nutrient restriction, but without weight or shape concerns ..read more
Nine Truths about Eating Disorders
Truth #1: Many people with eating disorders look healthy, yet may be extremely ill.
Truth #2: Families are not to blame, and can be the patients’ and providers’ best allies in treatment.
Truth #3: An eating disorder diagnosis is a health crisis that disrupts personal and family functioning.
Truth #4: Eating disorders are not choices, but serious biologically influenced illnesses.
Truth #5: Eating disorders affect people of all genders, ages, races, ethnicities, body shapes and weights, sexual orientations, and socioeconomic statuses.
Truth #6: Eating disorders carry an increased risk for both suicide and medical complications.
Truth #7: Genes and environment play important roles in the development of eating disorders.
Truth #8: Genes alone do not predict who will develop eating disorders.
Truth #9: Full recovery from an eating disorder is possible. Early detection and intervention are important.
Produced in collaboration with Dr. Cynthia Bulik, PhD, FAED, who serves as distinguished Professor of Eating Disorders in the School of Medicine at the University of North Carolina at Chapel Hill and Professor of Medical Epidemiology and Biostatistics at the Karolinska Institutet in Stockholm, Sweden. “Nine Truths” is based on Dr. Bulik’s 2014 “9 Eating Disorders Myths Busted” talk at the National Institute of Mental Health Alliance for Research Progress meeting.
CFIH are dedicated to providing the most effective, evidence-based treatment approaches in order to obtain optimal client outcomes.
Eating disorders in children
Family interventions that directly address the eating disorder should be offered to children and adolescents with anorexia nervosa - Nice
Family-based therapy has been demonstrated to be the most effective treatment for eating disorders in children and adolescents. This approach actively involves parents in their child’s recovery.
It supports parents to help their child restore weight and relearn healthy eating behaviours. On average, treatment is conducted within 15-20 treatment sessions over a period of approximately 12 months.
Anorexia Nervosa in adults
Most people with anorexia nervosa should be managed on an outpatient basis with psychological treatment provided by a service that is competent in giving that treatment and assessing the physical risk of people with eating disorders - Nice
Cognitive Behavioural Therapy for Eating Disorder (CBT-E) is effective for the treatment for eating disorders in adults. CBT-E addresses the behaviours, thoughts, and emotions associated with an eating disorder.
It involves establishing regular eating patterns, reducing rigid dieting, minimising triggers, reducing weight and shape concerns, and improving body image and self-esteem. Treatment involves 20-40 sessions (depending on severity). Session are initially conducted weekly but then spread out to fortnightly as the client nears recovery.
Maudsley Model of Anorexia Nervosa Treatment for Adults (MANTRA) is a cognitive-interpersonal treatment method which has demonstrated good treatment outcomes in adults with severe and chronic anorexia nervosa.
Treatment is tailored to the specific individual and can include strategies aimed at addressing thinking styles, emotional and relational styles, beliefs about one’s identity as well as the utility of anorexia, and interpersonal relationships.
It consists of 20–40 individual weekly sessions (depending on illness severity), together with 4 or 5 follow-up sessions which are more spread out (monthly).
Bulimia Nervosa in Adults
Cognitive behaviour therapy for bulimia nervosa (CBT-BN), a specifically adapted form of CBT, should be offered to adults with bulimia nervosa. The course of treatment should be for 16 to 20 sessions over 4 to 5 months - Nice
Overweight and Obesity
These approaches involve improving awareness of eating behaviours, establishing regular eating routines, reducing rigid dieting, eating in response to hunger and satiety, minimising triggers for overeating, developing alternative approaches to managing emotions, and improving body image and self-esteem.
Obesity and eating disorders are not opposite ends of the same spectrum. Obesity and eating disorders may be viewed as occurring at the same end of a spectrum with healthy beliefs, attitudes, and behaviours at one end, and problematic beliefs, attitudes, and behaviours at the other end - NEDC
Child feeding problems
Behavioural family interventions are the most effective approaches to the treatment of child feeding problems.
This involves helping parents to alter the family’s feeding practices to promote improvements in their child’s eating behaviours.
Individuals with weight, shape and body image concerns often experience physical- health (e.g., diabetes, polycystic ovary syndrome, sleep apnoea) and emotional health (e.g., depression, anxiety, adjustment disorders) issues.
Optimal treatment involves integrated care that considers physical, psychological, and social aspects of illness.
At CFIH, we are passionate about ensuring our clients get the best possible treatment and that treatment translates to meaningful change.
For this reason, CFIH embraces a Feedback Informed Treatment (FIT) approach, which means that we use data to tell us how each of our clients is progressing.
Prior to each session with one of our practitioners, we will ask you to complete the 4-item Outcome Rating Scale (ORS).
We will then monitor, analyse, and report on your progress every step of the way. If treatment is not assisting you, we will will review this with you and offer you alternative treatment approaches.
Our priority is to get you the right treatment individually tailored.
As such, our psychologists are trained and highly skilled in a number of therapies and treatment approaches. Our treatment options include:
- CBT (Cognitive Behaviour Therapy)