Support for Eating Disorders
Do you spend most of the day obsessing about food or planning how to avoid eating? Do you feel guilty, ashamed, or depressed after you eat?
Are you afraid that when you start eating, you won’t be able to stop?
Do you restrict your food during the day, only to binge at night?
Do you get rid of excess calories by vomiting, using laxatives, or exercising to excess?
About Eating Disorders
As many as 10 million females and 1 million males have an eating disorder such as anorexia or bulimia.
Approximately 15 million more struggle with binge eating disorder. Eating disorders such as these involve emotions, attitudes, and behaviors surrounding weight and food issues. Body dissatisfaction and disordered eating attitudes and behaviors are also common, and they can be very painful to manage alone.
Anorexia nervosa is characterized by self-starvation and weight loss. Symptoms include: • Restricting food intake • Extreme weight loss or low body weight • Absence of menstruation • Intense fear of weight gain or being “fat” • Extreme concern with body weight and shape Bulimia nervosa is characterized by a secretive cycle of binge eating followed by purging. Bulimia includes eating large amounts of food, then getting rid of the food and calories through vomiting, laxative abuse, or overexercising. Many people with eating disorders also purge “normal-sized” meals. Symptoms include: • Lack of control over eating • Alternating between overeating and fasting • Using laxatives, diuretics, or enemas • Excessive exercising Binge eating disorder is characterized by periods of uncontrolled or continuous eating beyond the point of feeling comfortably full. People with binge eating disorder do not compensate for calorie consumption through purging, but there may be efforts to restrict food, such as dieting. After binges, people often have feelings of shame or self-hatred. Those with binge eating disorder struggle with anxiety, depression, and loneliness, which can contribute to binges. Avoidant restrictive food intake disorder (ARFID) is characterized by food avoidance and highly selective eating. Many people with ARFID avoid food with certain textures, or have a history of food traumas, including choking. ARFID can occur at all ages. Other eating disorders can include some combination of the signs and symptoms of anorexia, bulimia, and/or binge eating disorder. While these behaviors may not be clinically considered a full syndrome eating disorder, they can still be physically dangerous and emotionally draining. With proper treatment, people with eating disorders can recover. Treatment generally involves a combination of factors, including assessing the function that the eating disorder serves, learning healthy coping and self-soothing skills, breaking the unhealthy cycles of binging and restricting, and changing thoughts and patterns. Dr. Dalzell works with a team of clinicians, including nutritionists and family therapists. If you or a loved one struggle with an eating disorder, please contact Dr. Dalzell to schedule a confidential assessment.
Midlife Eating Disorders
While women of all ages are exposed to unrealistic standards regarding weight and appearance, midlife women (aged 40+) are especially vulnerable to these ideas. At a time at which many women begin to notice universal body changes, they are exposed to messages that fat of any kind is unacceptable. Often, these messages globalize into the sense that the woman is unacceptable if she no longer retains a “perfect,” youthful body.
Most advertisements lack images of people who are older, further reinforcing a woman’s sense of invisibility. When adult women are pictured in advertisements, they rarely resemble “real” women, and are often depicted wearing shorts with a tennis racket or yoga mat in hand. What causes or helps to maintain eating disorders? Some themes include: •Sociocultural and internal stresses to look or appear a certain way •Feelings of not meeting these beauty standards •Relational disconnections, such as marital concerns, not fitting in, or relocations •Empty-nest syndrome •Past or current traumas •Eating disorder symptoms, resulting in even more isolation and disconnection •The presence of dual addictions or a recent recovery from another substance, such as alcohol •Confusion about treatment and where to get help Women with midlife eating disorders may fit a number of categories. They may be experiencing an eating disorder for the first time, this may be a reoccurrence of a previous eating disorder, or they have struggled with eating disorders for many years. It is often difficult to find professionals who truly understand their needs. Treatment generally involves assessing the function that the eating disorder serves, reconnecting women to positive role models and supports, learning healthy self-soothing skills, and changing thoughts and symptoms patterns. Dr. Dalzell will: •Meet you where you are in your eating disorder, which means collaborating on treatment goals •Allow for self-growth that does not rely on body size or appearance •Create an environment that honors all body sizes •Enable people to resolve past and present issues connected to body image If you are struggling with a midlife eating disorder, please contact Dr. Dalzell to schedule a confidential assessment.
Eating Disorders in LGBTQ Community
Research has shown that eating disorders are especially common in LGBTQ communities. Transgender and gender-expansive people are at particular risk. This can be due to a number of factors, including LGBTQ body image ideals, stigma and marginalization, past traumas and body/gender incongruence. It is important for members of the LGBTQ community to have a safe space to work on eating disorders and to feel affirmed in their identities.
Eating disorders can occur at any age. For example, teens and young adults may develop eating disorders when exploring the initial stages of sexual and gender identification. Adults may be at a time in their life where they feel more free to explore who they are but may struggle with leaving behind old roles. Gender/body dysphoria is often a factor in people who are gender expansive. Gender/body dysphoria represents the distress of living in a body that is incongruent with internal gender identity, frequently coinciding with the desire to change the body and with dissonance from gendered features (e.g., chest dysphoria, hip dysphoria, or voice dysphoria). Affirming services While many providers offer eating disorder services, the key to recovery is in finding open and affirming services. Dr. Dalzell will: •Foster an environment in which clients feel respected in the uniqueness of their gender identities •Value body diversity and expression •Understand that gender is multidimensional, not binary •Recognize sources of sexual, gender, and body privilege •Provide clients with space and reassurance to take their own journeys, without an outcome in mind If you are struggling with an eating disorder, please contact Dr. Dalzell to schedule a confidential assessment.
EMDR and Eating Disorders
Eye movement desensitization and reprocessing (EMDR) is is a research-based method of treatment that is used for a wide variety of concerns, including eating disorders and body image. Using EMDR, the therapist leads the client through a series of eye movements (or tapping) that allows gentle resolution of the root cause of the problem.
EMDR is especially helpful in working with eating disorders. EMDR protocols can help decrease urges (such as to binge or purge), helping to change the frequency of symptom use. EMDR is also a way to resolve past experiences which can lead to or prolong eating disorders, low self-esteem and body image concerns. How can EMDR help? Many people with eating disorders can identify specific events that trigger an eating disorder. The first step in reducing symptoms (such as binge eating) is to identify these triggers. EMDR then can be used to disconnect the trigger from the symptom. Pairing EMDR with self-soothing skills is especially useful. Additionally, EMDR can be used to help reduce the “feeling state,” often a feeling of power or high, that can accompany eating disorders and other addictive behaviors. In addition to working at the symptom level, EMDR can help to resolve root causes of eating disorders and body-image distress. Individuals with trauma are more likely to develop eating disorders than those without traumas, such as bullying, relationship disruptions, significant losses, physical and or/sexual abuse, or neglect. When trauma occurs, the brain often does not process the event fully. The trauma gets stuck in the unconscious mind and can be retriggered. Eating disorder symptoms can begin as a way to numb emotions or to cope with the trauma. EMDR provides a way to work on and resolve stuck traumas or aspects of traumas in a way that allows for full resolution. It can be especially effective for people who have found that talk therapy does not fully allow them to reduce or resolve symptoms. Using EMDR, we can: •Identify sources of trauma and how these may be connected to disordered eating •Uncover negative thoughts and thought processes (“cognitions”). Examples include “I’m not good enough” or “I’m not in control” •Install more positive cognitions that support better overall functioning •Process the traumatic memory so that it is no longer consciously or unconsciously distressing, so that there is no need for eating disorder symptoms To learn more about how EMDR may be helpful in the treatment of eating disorders, please contact Dr. Dalzell to schedule a confidential assessment.