Eating Disorders
Eating Disorders generally develop during adolescence. Binge-eating, common in bulimia and compulsive
overeating, often involves an excessive intake of food, usually high calorie foods, in a short period of time. It can be understood
as an attempt to dull or escape anxious thoughts and feelings by creating a “trance-like” or “mindless”
state. These periods of overeating are usually preceded by a period of fasting, producing excessive cravings for food, and
often followed by purging through excessive exercise, self-induced vomiting or laxative misuse. Many bulimics hold perfectionistic
standards for themselves which produce excessive self-criticism (e.g., “ I’m disgusting”, “No one
will ever want me”). Treatment involves:
- Establishing an appropriate eating plan (three meals and snacks) to reduce the risk of excessive cravings that often lead
to bingeing. A consultation with a licensed nutritionist is strongly recommended.
- Detailed self-monitoring of the frequency, amount, situations, thoughts and emotions associated with bingeing.
- Using response delays (allowing some predetermined amount of time to pass or engaging in an alternate activity - choosing
to wait 20 minutes before bingeing, calling a friend, washing laundry, etc.) or response prevention (trying to tolerate the
urge to binge without bingeing).
- Cognitive thought monitoring to identify and challenge the unpleasant thoughts and feelings you become aware of as binge-eating
decreases (e.g., “I can’t stand feeling so bloated”, “I have to get rid of this feeling immediately”).
- Relaxation and positive body imagery training.
- Assertiveness, communication and problem-solving strategies as needed.
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