What is an Eating Disorder?

Eating disorders are complex mental illnesses with physical manifestations. Eating disorders are considered to be behavioral conditions characterized by severe and persistent disturbance in eating behaviors and associated distressing thoughts and emotions. They can be very serious conditions affecting physical, psychological, and social function. Types of eating disorders include anorexia nervosa, bulimia nervosa, binge eating disorder, avoidant restrictive food intake disorder, other specified feeding and eating disorder, pica and rumination disorder. 

What causes an Eating Disorder?

A variety of factors can contribute to the development of an eating disorder, including genetics and mental health as well as cultural factors. 

Eating disorders are often associated with preoccupations with food, weight or shape or with anxiety about eating or the consequences of eating certain foods. Behaviors associated with eating disorders including restrictive eating or avoidance of certain foods, binge eating, purging by vomiting or laxative misuse or compulsive exercise.

Eating disorders often co-occur with other psychiatric disorders most commonly, mood and anxiety disorders, obsessive-compulsive disorder, and alcohol and substance use disorders. Evidence suggests that genes and heritability play a part in why some people are at higher risk for an eating disorder, but these disorders can also afflict those with no family history of the condition. 

Who does Eating Disorders effect?

Eating disorders affect people of all genders, ages, classes, abilities, races and ethnic backgrounds. These complex disorders are serious, biologically influenced illnesses — not personal choices. Recovery from an eating disorder is possible.

Approximately, 1 million1 Canadians have a diagnosis of an Eating Disorder, such as Anorexia Nervosa (AN), Bulimia Nervosa (BN), Binge Eating Disorder (BED), Avoidance Restrictive Food Intake Disorder (ARFID)2 and Otherwise Specified Feeding and Eating Disorder (OSFED)3.

In Canada, between 12% and 30% of girls and 9% and 25% of boys aged 10-14 report dieting to lose weight13. Moreover, the incidence of Eating Disorders in Canadian children is estimated to be 2 to 4 times greater than Type 2 Diabetes.14

How are Eating Disorders diagnosed?

Although there are formal guidelines that health care professionals use to diagnose Eating Disorders (DSM-5), unhealthy eating behaviors exist on a continuum. Even if a person does not meet the formal criteria for an eating disorder, he or she may be experiencing unhealthy eating behaviors that cause substantial distress and may be damaging to both physical and psychological health.

How are Eating Disorders Treated?

Getting a diagnosis is only the first step towards recovery from an eating disorder. Treating an eating disorder generally involves a combination of psychological and nutritional counseling, along with medical and psychiatric monitoring. Treatment must address the eating disorder symptoms and medical consequences, as well as psychological, biological, interpersonal, and cultural forces that contribute to or maintain the eating disorder.  

Treatment should address psychological, behavioral, nutritional and other medical complications. The latter can include consequences of malnutrition or of purging behaviors including, heart and gastrointestinal problems as well as other potentially fatal conditions. Ambivalence towards treatment, denial of a problem with eating and weight, or anxiety about changing eating patterns is not uncommon. With proper medical care, however, those with eating disorders can resume healthy eating habits, and recover their emotional and psychological health.

Eating Disorders Program at Lotus:

The Eating Disorders Program treats individuals suffering from an eating disorder who can make independent change to their eating, activity and eating symptoms. You will receive support and guidance, but you must believe you can make changes without supervision to succeed in an outpatient setting.

You must be aged 16 or over to participate in this program. If you are under 18, living at home and going to school, you may want to contact the Children’s Hospital Eating Disorders Program (Hamilton Health Sciences).

You will need more intensive treatment than we can provide if your weight is dangerously low (below a BMI of 16).  If you feel that you require a higher level of care, such as an inpatient treatment program, we suggest you seek a referral to an inpatient program through your family physician.

We do not offer treatment for obesity, as this is not a weight loss program.  We do however, offer treatment for individuals suffering from Binge Eating Disorder. If you are regularly binging on large quantities of food and feel out of control at these times, you can be referred to our program for assessment and treatment.

If you are currently abusing substances or engage in significant self-harming behaviours, you may not be eligible for treatment until these issues are resolved.

A thorough assessment is conducted to ensure attention to:

• Your specific eating disorder symptoms

• Other psychiatric problems that may make recovery more difficult

• Your eating and activity patterns

• Your physical well-being

• Life circumstances in which you find yourself

The information obtained in the assessment helps us work more effectively with you and tailor our treatment recommendations to your specific needs.

CBT-based therapy that takes you through the steps necessary to overcome the symptoms of your eating disorder.  For the first weeks of therapy, you will receive information about factors that maintain eating disorders, the personal and medical consequences of eating disorders, and information about weight regulation. 

you will work to change the thoughts and behaviours that are part of an eating disorder. You will set goals and work to normalize your eating and activity. You will track your symptoms to identify practical, emotional, and interpersonal triggers for disordered eating and learn strategies for managing these triggers.

Eating Disorder Treatment Phases:

First phase is assessment and considering what is maintaining the eating disorder (history, onset, current contributing factors)

This phase also includes psychoeducation on weight science and weight regulation

Second phase focuses on current diet and lifestyle (daily intake and activity) and symptom interruption as well as working towards normalizing eating and activity

Third phase is to identify practical, emotional and interpersonal triggers for disordered eating and learning strategies for managing

Recovery maintenance and relapse prevention is also a key aspect of therapy. This is for individuals completing therapy and for those individuals leaving an inpatient or residential eating disorder program and transitioning to outpatient care.

This part of the therapeutic process will include creating a plan for coping with relapse in symptoms and will focus on a plan for coping with everyday challenges and consider problems that an individual will be likely to face while reintegrating into life after eating disorder treatment. This includes..

• Harnessing areas of strength and support

• Identifying potential triggers

• Creating support systems and connecting with other helpful resources

• How to implement the skills and strategies learned in treatment to stay on track.

Source: St. Joseph’s Healthcare Hamilton website

Source: American Psychiatric Association

Source: NIED