Eating disorders involve abnormal eating or dieting behaviors. These can include starving or eating huge amounts of food (binge eating). People with eating disorders think too much about food, eating, body shape or weight. They may be normal weight, overweight, or underweight. In this section, we list several different eating disorders. If you're not sure which one you are looking for, read the brief description of each one. Where possible, we provide a link to other websites that have more information about each disorder. We also briefly discuss psychological treatments that have been evaluated by scientists. Although some medications are also helpful for these disorders, we do not cover them. Eating disorders can cause serious medical problems. Therefore, it is important to see a physician or mental health professional who is a specialist in eating disorders to get an accurate diagnosis and discuss treatment. Be sure to work together to decide treatment goals and how to measure progress. Feel free to print this information and take it with you when you meet with your doctor or therapist.
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Many people feel that they sometimes eat more than they should. Binge eating disorder involves frequently eating an abnormally large amount of food. During a binge, there is a feeling of being unable to control the eating. The person often feels ashamed, disgusted, depressed, or guilty after a binge.
Cognitive behavior therapy and interpersonal therapy are helpful for treatment of binge eating disorder. While other approaches may be helpful for treatment of binge eating disorder, they have not been evaluated scientifically in the same way as the treatments listed here.
For more information on Binge Eating Disorder, please see the Healthtouch - Binge Eating Disorder site. This site contains facts about symptoms, causes, and complications of binge eating disorder. Another good site for information on symptoms, risk factors, and treatment is the Binge Eating Disorder site from the National Institutes of Health.
Bulimia nervosa involves frequent binge eating (uncontrolled overeating) and efforts to undo the effects of binge eating. These efforts can include vomiting, starving, exercising very intensely, or taking medications such as laxatives.
Cognitive behavior therapy is a beneficial treatment for bulimia nervosa. There is some evidence that interpersonal therapy is also helpful for treatment of bulimia nervosa. While other approaches may be helpful for treatment of bulimia nervosa, they have not been evaluated scientifically in the same way as the treatments listed here.
For more information on bulimia nervosa, please see the Healthtouch page on Eating Disorders. This page gives information on both anorexia nervosa and bulimia nervosa, including facts, warning signs, and associated physical problems.
An individual is obese if she or he has too much body fat. Obesity commonly is defined as being 20% or more over recommended body weight for a given height. Obesity is an established health hazard. Researchers have documented a high rate of obesity among American adults, and more children and adolescents are becoming overweight.
Behavior therapy is a useful treatment for adult and childhood obesity. There is some evidence that hypnosis plus cognitive behavior therapy is useful for treatment of obesity in adults. While other approaches may be helpful for treatment of obesity, they have not been evaluated scientifically in the same way as the treatments listed here.
The following website provides excellent information on the health risks associated with obesity, as well as information on the definition and symptoms of obesity: National Institute of Health Weight Control Information Network
Anorexia nervosa is a serious disorder characterized by a persistent refusal to maintain a normal body weight, extreme fear of gaining weight, disturbance in the experience of shape and weight, denial of the seriousness of oneís low body weight, and, in post-pubertal females, sustained absence of menstrual cycles. Anorexia nervosa carries significant medical risk as well as the highest risk of death of the psychological disorders. Individuals with anorexia nervosa frequently experience co-occurring depression, and half the deaths in anorexia nervosa result from suicide. In most cases, the fear of weight gain is sufficiently strong to deter people with this problem from engaging in treatment. There are two subtypes of anorexia nervosa: restricting type, in which individuals achieve and maintain their low weight exclusively via dieting, fasting, and/or excessive exercise, and binge eating/purging type, in which individuals also engage in one or both of these problematic behaviors.
Note: Other psychological treatments may also be effective in treating Anorexia, but they have not been evaluated with the same scientific rigor as the treatments above. Many medications may also be helpful for Anorexia, but we do not cover medications in this website. Of course, we recommend a consultation with a mental health professional for an accurate diagnosis and discussion of various treatment options. When you meet with a professional, be sure to work together to establish clear treatment goals and to monitor progress toward those goals. Feel free to print this information and take it with you to discuss your treatment plan with your therapist.
Cognitive Behavioral Therapy (CBT) as a post-hospitalization outpatient intervention for anorexia nervosa is designed to prevent relapse once a patient has gained weight in the context of inpatient treatment. CBT for acute weight gain is designed to restore weight on an outpatient basis. CBT for anorexia nervosa, designed for late adolescents and adults with this disorder, is typically conducted on an individual basis over the course of one year. Biweekly session are recommended initially while weekly sessions are sufficient once weight is stable. This treatment is explicitly focused on the achievement and maintenance of a healthy weight, particularly one at which (for females) return of menses is possible. CBT for anorexia nervosa employs behavioral strategies including the establishment of a regular pattern of eating and systematic exposure to forbidden foods, while simultaneously addressing cognitive aspects of the disorder such as motivation for change and disturbance in the experience of shape and weight. CBT for anorexia nervosa also emphasizes schema-level change and challenges the seemingly inextricable tie between personal identity and the illness.
Family-Based Treatment (FBT) for anorexia nervosa is an outpatient intervention for adolescents designed to restore weight without hospitalization; however, if a patient is medically unstable, a brief stay in an inpatient unit to resolve the medical concerns may be warranted, followed by a course of FBT. While there are many types of family therapy, FBT specifically refers to a treatment modality developed at the Maudsley Hospital in London, England or its adaptations. FBT is typically conducted in 20 sessions over 12 months, although a shorter course is sufficient for many cases while additional sessions may be necessary for others. FBT consists of three phases. In the first phase, parents are placed in charge of the process of nutritional rehabilitation and weight restoration with the help of the therapist. The adolescent’s autonomy in other domains (friendships, school) is kept intact, at a level consistent with the patient’s stage of development. In the second phase of treatment, once the acute starvation is reversed, control over eating is returned to the adolescent. The third phase of treatment addresses termination and issues of family structure and normal adolescent development. FBT views the parents of adolescents with anorexia nervosa as a resource for resolving the problem, and corrects misperceptions of blame directed to the parents and to the ill adolescent. Siblings play a supportive role in treatment, and are protected from the job assigned to the parents. The focus of FBT is not on what caused the anorexia nervosa, but on what can be done to treat it with as little reliance on hospitalization as possible.