Posts Tagged ‘ED Q&A’

There is likely no topic more on the minds of clients than weight. While the degree of preoccupation with weight varies—some clients admittedly experiencing little to none—weight is a construct that carries extraordinary meaning within and outside of the eating disorder experience. For those with and without these disorders, weight is a common source of concern and is often given disproportionate influence as a vital sign measure.

We live in a society that obsesses over weight. It erroneously conflates weight with health, attaching both social and moral significance to our body size. Weight bias is pervasive, and people who live in larger bodies face discrimination in settings from the workplace to the doctor’s office.

Eating disorders often compound the significance of weight even more. When we have these illnesses, the number on the scale can operate as a definition of who we fundamentally are. Our essential value as a person becomes attached to that numeric value. While we may know rationally that weight should not hold so much power, eating disorders are not rational illnesses. Therefore, the topic of weighing in eating disorder treatment is not simple at all.

Can you be born with an eating disorder?

While research does show a strong genetic component to these mental illnesses, there is not a single “eating disorder gene” detectable at birth or otherwise. Instead, it is believed that some people are born with a genetic predisposition to eating disorder development. That is, they are born with specific personality and psychological traits that make them particularly vulnerable to developing an eating disorder at some point in their lives. Perfectionism, rigidity, neuroticism, and cautiousness are among the aspects of personality that have been associated with a higher risk of eating disorders. The presence of these traits doesn’t necessarily cause an eating disorder, however; they can and do exist in people without these disorders as well.

There is more to these biopsychosocial illnesses than biology and psychology. A saying used in many illness contexts, “genetics loads the gun, and environment pulls the trigger,” is also sometimes used to describe the etiological role of social factors in eating disorders. Sociocultural influences including family, peers, and media interact with genetics in complex ways to trigger the onset of an eating disorder. Though we cannot change the genetic component, we can challenge our culture’s obsession with diet, weight, and appearance to offset these social risk factors.

CBT, CBT-E, DBT… Have you ever wondered what all those letters stand for and why they are so often talked about at The Emily Program and by other eating disorder professionals? If so, this is the post for you. Let’s dissect these terms, help you understand them, and explain why they are important to the work clients and clinicians do every day.

Cognitive Behavioral Therapy (CBT)

“By correcting erroneous beliefs we can lower excessive reactions.” – Aaron Beck, M.D.

Cognitive behavioral therapy (CBT) was developed by Dr. Aaron Beck in the 1960s. His work focused on how the conscious mind plays a role in how people interact with the world around them. Prior to his work, most therapeutic models focused on the unconscious mind—concepts like impulses, analyzing unconscious thoughts, conditioning, and “uncontrollable thoughts.” Dr. Beck changed mental health by introducing the belief that our thoughts are fundamental to how we interpret our experiences and consequently behave or respond. Dr. Beck and many other researchers have discovered that by identifying, monitoring, and effectively changing our thoughts, we can change or alter our maladaptive perceptions, leading to positive behavioral change.

Starting eating disorder treatment can be scary for the individual affected—but it can also be a stressful time for parents. When your child experiences a negative food/body relationship, you may struggle to understand why. Their behaviors may seem perplexing and leave you feeling frustrated, afraid, and sad. The Emily Program understands that it’s difficult to watch someone you love struggle with an eating disorder. It’s also difficult to know how to comfort them.

What Will Happen When My Child Starts Treatment?

Eating disorder treatment is a new experience, and like all new things, it can be scary at first. Prior to starting treatment, your child’s eating disorder behaviors may increase due to the stress and fear of starting treatment and confronting the eating disorder. Your child may experience dread, anger, anxiety, or depression. They may also experience relief upon knowing that they are on the road to recovery. All of these feelings are normal. 

For parents, it’s important to be aware and present in the days or weeks before treatment. Make sure to check in with your child about how they are feeling or if they could use any specific support. Reassure them that treatment is a good idea because it will help them to live their best life. Be vocal about your support and be present when they share with you.

Eating disorders are hard to spot, especially when disordered eating behaviors are extremely common. From the prevalence of dieting to the glorification of excessive exercise, it can be tricky to understand when disordered behaviors spiral into a full-blown eating disorder.

What is Disordered Eating?

Disordered eating includes unhealthy food and body behaviors, usually undertaken for the purpose of weight loss or health promotion, but that may put the person at risk for significant harm.  Disordered eating is serious and can lead to severe complications in one’s life, so it is important to stay vigilant of the warning signs and symptoms. Unfortunately, disordered eating is extremely common due to the normalization of many disordered behaviors in primarily Western cultures. Common examples of disordered eating include:

• Fad diets
• Cleanses
• Heightened focus on appearance
• Skipping meals
• Supplement misuse
• Diet pills
• Extreme social media focused on appearance or food
• Undereating or overeating

Eating disorders are complex and serious illnesses that can cause serious harm to the individual afflicted. Characterized by a disturbance in an individual’s self-perception and food behaviors, eating disorders are biologically-based brain illnesses that are affected by environmental, cultural, and psychological factors. A key aspect of eating disorders is their complexity and the questions surrounding them—what caused my eating disorder? Will I get better? Do other people experience this?

Environmental Factors

There are certain environmental factors that may contribute to the development of an eating disorder including diet culture, the media, and peer judgment. Diet culture is a series of beliefs that idolize thinness and equate it to health and wellbeing. Diet culture manifests in less obvious ways, too, and can be seen in the way that menus portray “healthy” options as superior or how the typical chair size is made for someone thin. These diet culture consequences can plant the idea, at a young age, that thinner is “normal” and something to strive for, which can lead to disordered eating later in life.

The media is largely problematic in its portrayal of the idea that thin is superior. From the majority of celebrities and actors being thin to weight-centric TV shows like “Biggest Loser,” it’s no surprise that society gets the message that skinny is better. This media messaging infiltrates daily lives. There’s billboards of new diets, commercials promoting gym memberships to get you in beach body shape, and reality TV featuring only the thinnest of stars. When faced with this negative messaging daily, individuals can feel intense pressure to “fit in,” leading to dieting, appearance dissatisfaction, and eating disorders.