Eating Disorders: Myth, Fact, Experience Sarah Carnahan

Anorexia Nervosa (Diagnostic Criteria)  1. Refusal to maintain body weight at or above a minimally normal weight for age and height  2. Intense fear of gaining weight or becoming fat, even though underweight.  3. Disturbance in the way in which one's body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight.  4. The absence of at least three consecutive menstrual cycles).  2 Subtypes: Restricting Type, Binge/Purge Type

Bulimia Nervosa (Diagnostic Criteria)  1. Recurrent episodes of binge eating.  2. Recurrent inappropriate compensatory behavior in order to prevent weight gain  3. Bingeing/Purging occurs, on average, at least twice a week for 3 months.  4. Self-evaluation is unduly influenced by body shape and weight.  5. The disturbance does not occur exclusively during episodes of Anorexia Nervosa.  2 Subtypes: Purging, Non-Purging

Eating Disorder Not Otherwise Specified  This is a clinical category of disordered eating meant for those who suffer but do not meet all the diagnostic criteria for another specific disorder. Examples include:  1. “Sub-clinical” AN or BN  2. An individual of normal body weight who regularly engages in inappropriate compensatory behavior after eating small amounts of food (eg, self-induced vomiting after the consumption of two cookies).  3. An individual who repeatedly chews and spits out, but does not swallow, large amounts of food.  4. Technically, Binge Eating Disorder.

Binge Eating Disorder (ED-NOS)  Recurrent episodes of binge eating that are associated with at least three of the following: –Eating more rapidly than normal –Eating until uncomfortably full –Eating large amounts of food when not feeling physically hungry –Eating alone due to embarrassment –Feeling disgusted, depressed, or guilty after binge –Feeling distressed about binge eating –Occurs at least once a week for three months –Binging is not associated with purging behavior, nor is it present only during course of BN or AN

Different Types of Treatment and Levels of Care  Outpatient  Intensive Outpatient (IOP)  Partial Hospitalization (PHP)  Residential  Inpatient (IP)  Family-Based Therapy (FBT)/Maudsley  CBT (cognitive behavioral therapy)  DBT (dialectical behavior therapy)  Feminist Pyschotherapy

Life With “Ed”  For people with e.d.’s, the disease can often feel like a separate entity inhabiting their bodies - sometimes this “person” or “monster” is referred to as “Ed.” “Ed” often “talks to” people with eating disorders inside of their heads.  Want to know what it sounds like? cs/ED_Sound.mp3 cs/ED_Sound.mp3

Life with “Ed”  Eating disorders are biopsychosocial illnesses. In the words of Aimee Liu, “The onset of eating disorders is like the firing of a gun. Genetics form the gun. Cultural influences such as the fashion industry and familial attitudes about weight then load it. And intense emotional distress pulls the trigger.”  Most people with eating disorders will experience more than one type of eating disorder or eating disordered behavior over the duration of their illness.

Life With “Ed”  Many people with eating disorders, as well as their loved ones, are unable or unwilling to believe that the sufferer has an eating disorder. Thus, treatment may be delayed or not sought.  Eating disorders are unique because they are a mental illnesses with serious medical complications.

Life With “Ed”  Recovering from an eating disorder is difficult for many reasons, including the fact that e.d.’s are ego-syntonic (they become incorporated into a person’s sense of self and value system).  People with eating disorders have high rates of relapse, and may require multiple rounds of treatment.

Life With “Ed”  Successful eating disorder treatment usually requires a “team” approach. The team is usually lead by a therapist and includes a dietitian, psychiatrist, and medical provider at the very least.  Only one out of 10 people with eating disorders get formal treatment.

Life  It may take years and on-going professional support, AND Recovery is possible.

Local Resources  The Center for Balanced Living:  Body Sense OSU:  OSU Body Image & Health Task Force:  OSU Counseling & Consultation Service

General/National Resources  National Eating Disorders Association:  National Association of Anorexia Nervosa and Associated Disorders:  For more on the neurobiology of eating disorders from the director of CBL: Eating Disorders from the Inside Out: Laura Hill at TEDxColumbusEating Disorders from the Inside Out: Laura Hill at TEDxColumbus

Still have questions?  Feel free to post any follow-up questions on the discussion board post about this presentation. I will answer them there!