A wide range of situations can precipitate eating disorders in susceptible individuals. Family members or friends may repeatedly tease people about their bodies. Individuals may be participating in gymnastics or other sports that emphasize low weight or a certain body image. Negative emotions or traumas such as rape, abuse, or the death of a loved one can also trigger disorders. Even a happy event, such as giving birth, can lead to disorders because of the stressful impact of the event on an individual's new role and body image.
Once people start engaging in abnormal eating behaviors, the problem can perpetuate itself. Bingeing can set a vicious cycle in motion, for instance, as individuals purge to rid themselves of excess calories and psychic pain, then binge again to escape problems in their day-to-day lives.
Why is it important to seek treatment for these disorders?
Research indicates that eating disorders very often go untreated. In one study (PDF, 382KB), for example, less than 13 percent of adolescents with eating disorders received treatment.(2)
But leaving eating disorders untreated can have serious consequences. Research has found that individuals with anorexia have a mortality rate 18 times higher than peers who don't have eating disorders, for example. (3)
Eating disorders can devastate the body. Physical problems associated with anorexia, for instance, include anemia, constipation, osteoporosis, even damage to the heart and brain. Bulimia can result in a sore throat, worn-away tooth enamel, acid reflux, and heart attacks.. People with binge eating disorder may develop high blood pressure, cardiovascular disease, diabetes, and other problems associated with obesity.
Eating disorders are also associated with other mental disorders like depression. Researchers don't yet know whether eating disorders are symptoms of such problems or whether the problems develop because of the isolation, stigma, and physiological changes wrought by the eating disorders themselves. What is clear from the research (PDF, 399KB) is that people with eating disorders suffer higher rates of other mental disorders - including depression, anxiety disorders, and substance abuse - than other people.
How can a psychologist help someone recover?
Psychologists play a vital role in the successful treatment of eating disorders and are integral members of the multidisciplinary team that may be required to provide patient care. As part of this treatment, a physician may be called on to rule out medical illnesses and determine that the patient is not in immediate physical danger. A nutritionist may be asked to help assess and improve nutritional intake.
Once the psychologist has identified important issues that need attention and developed a treatment plan, he or she helps the patient replace destructive thoughts and behaviors with more positive ones. A psychologist and patient might work together to focus on health rather than weight, for example. Or a patient might keep a food diary as a way of becoming more aware of the types of situations that trigger bingeing.
Simply changing patients' thoughts and behaviors is not enough, however. To ensure lasting improvement, patients and psychologists must work together to explore the psychological issues underlying the eating disorder. Psychotherapy may need to focus on improving patients' personal relationships. And it may involve helping patients get beyond an event or situation that triggered the disorder in the first place. Group therapy also may be helpful.
Some patients, especially those with bulimia, may benefit from medication. It's important to remember, however, that medication should be used in combination with psycho-therapy, not as a replacement for it. Patients who are advised to take medication should be aware of possible side effects and the need for close supervision by a physician.
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1 National Institute of Mental Health. (2007). "Eating disorders."
2 Merikangas, K.R., He, J., Burstein, M., Sendsen, J., Avenevoli, S., Case, B., Georgiades, K., et al. (2011). "Service utilization for lifetime mental disorders in U.S. adolescents: Results of the National Comorbidity Survey-Adolescent Supplement (NCS-A)." Journal of the American Academy of Child & Adolescent Psychiatry, 50 (1): 32-45.
3 Steinhausen, H.C. (2009). "Outcomes of eating disorders." Child and Adolescent Psychiatric Clinics of North America, 18 (1): 225-242.
4 Hudson, J.I., Hiripi, E., Pope, H.G., & Kessler, R.C. (2007). "The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication." Biological Psychiatry, 61 (3): 348-358.