Eating disorder therapy

by Olimpia Etts, LCSW-CDownload a printable version of this article (PDF)

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And the day came when the risk to remain tight in a bud was more painful than the risk it took to blossom.

Anais Nin

What is disordered eating?

Disordered eating is when our most basic biological need for survival becomes a source of fear and hatred. In the mind, food is no longer fuel for the body, but something dangerous and frightening.

Disordered eating is thinking about or reaching for food when you are not physiologically hungry. It is feeling guilty after eating and compelled to get rid of the food through exercise, vomiting, laxatives or by depriving yourself because your thoughts have you convinced that eating will make you fat (bad, ugly, disgusting, etc).

It is an all or nothing pattern of thinking about food.

Disordered eating patterns develop when you are trapped in any or all of the following:

The reality is
weighing less
does not

go away.

The illusion of control

The original emotional discomfort is now disguised as a food or eating problem. The thought may be, “I may not be able to control how I feel, but I can control what I eat!”

When this happens over and over again, you lose yourself along the way. The original discomfort is temporarily avoided, but not gone. It’s just been relabeled “fat.” When you tell yourself, “If only I was thinner, I’d be happy, successful, attractive…,” you believe that the only thing that is wrong in your life is the way your body looks. You ignore the possibility that maybe you are dissatisfied with your job, relationships, education, lack of assertiveness, fun, money, down time, etc. You believe that if you weighed less, these other things wouldn’t be an issue. The reality is weighing less does not make problems go away.

Relying on disordered eating patterns to cope with life may have worked for a while, but it’s unsustainable. The challenge is examining how the eating pattern has served you and then slowly replacing it with a kinder, gentler, more effective way of taking care of yourself.

Is food
the right

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Eating compulsively is like putting an ice cream cone on a cut. You know something is wrong and want to take care of yourself, but food does not have the ability to cure anything but physiological hunger.

Overcoming Overeating (P. 55)

When the only thing that matters is the size of your body, you shift from feeling your feelings to feeling “fat. ” (Fat, by the way, is not a feeling). You have forgotten that your feelings are important because they tell you about what you need and what is important to you. You have forgotten that your weight does not define you. You have forgotten that you are lovable and whole and deserve to be treated with respect and kindness. When you make your weight, body size and food your only problem, your self-worth is measured by what you weigh, what you ate, didn’t eat, or how much you exercised. What happens to all the other wonderfully unique characteristics that you exhibit?

How does disordered eating develop?

Disordered eating often begins in adolescence when children experience an “identity crisis.” They begin to separate from parents and discover who they are as individuals. This is a difficult time for most parents and their children. Emotional development, at this stage, requires a balance between being overly protective and excessively absent. Healthy self-esteem begins in positive relationships with parents and other family members. Disordered eating provides a voice for unfamiliar emotions. The questions: “Who am I and where do I fit in?” reign supreme. The need for acceptance is very powerful.

Common family characteristics of people with disordered eating patterns

  • Over-concern with appearance, beauty and weight
  • Perfection is implied, demanded or expected
  • Expectations are too high and not reasonable for individual’s stage of development
  • Emotions are often not expressed effectively
  • Fathers are often less available than mothers
  • Infantilization (treating as though still a small child)
  • Unclear or inappropriate boundaries
  • Invalidation of feelings (for more information go here)

issues play
a role...

What is Bulimia?

Bulimia is the act of ingesting large quantities of food in a very short period of time and then regurgitating the food or using other means to purge the food, (i.e. laxatives, extreme exercise, diuretics).

What is binge eating, compulsive eating or emotional eating?

Binge eating is eating large amounts of food, quickly or continuously way past the point of satisfaction or fullness without the purging behavior.

What is Anorexia?

Anorexia is the act of eating very few calories in order to be thin despite already being underweight. The person often “feels fat” and is extremely fearful about gaining weight.

Recovery takes place on several levels

I encourage clients to work with a nutritionist or dietitian who is sensitive to disordered eating issues. I teach a non-dieting approach* to weight loss for emotional eaters. This means re-learning how to listen to your hunger/satisfaction cues, legalizing all foods, identifying emotions, and finding alternative ways to soothe or calm yourself.

*The non-dieting approach is about

My goal is to help you tap into your own internal resources and listen to yourself, to help you vocalize your feelings and thoughts, heal old wounds, and to help you learn self-soothing behaviors that nurture rather than harm you.