Getting Help For Someone Else
It can be difficult to know what to do if you’re worried that someone has an eating disorder.
They may not realise they have an eating disorder. They may also deny it, or be secretive and defensive about their eating or weight.
Let them know you’re worried about them and encourage them to see a GP. You could offer to go along with them.
From Sporadic Observations To Nosography
The evolution of the empirical method and positivism led to new approaches in the field of medicine, psychiatry, and in particular also in the way eating disorders were conceptualized. For example, the first complete pathological nosography was proposed by Erasmus Darwin in 1794. Later, Darwin categorized a voluntary fasting practice that would eventually lead to death, caused in young women by the obsessive idea of being too fat. The French physician Luis Victor Marcé author of Traité de la Folie des Femmes Enceintes, des Nouvelles Accouchées et de Nourices, published in 1858, and of Traité Pratique des maladies Mentales published in 1862 wrote a paper in 1860 that could be recognized as one of the first attempts to describe, from a proper psychiatric point of view, the nosography of what is currently defined as AN. In this work, he reported two clinical cases, outlining the delusional beliefs which led to food-refusal. In the second half of the 19th century, food-refusal was progressively described from a clinical point of view.
Dr Pierre Janet Noted Bulimic Behaviors In Patients
When bulimia behaviors were observed in patients of Dr. Pierre Janet, the spectrum of eating disorders expanded. Eating disorders were starting to be observed in a new light. Rather than being strictly tied to a medical model, these newly observed behaviors shed light on other possible explanations.
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How Have Eating Disorders Have Changed In The Past Decade
- Categorized Anorexia Nervosa
Anorexia nervosa and bulimia nervosa are eating disorders that have dated back to the Middle Ages. These disorders were considered wasting diseases and it was not until the 1980s that published papers and studies were written that centered on these disorders. Over the past decade, awareness has increased about eating disorders and the stigma associated with these mental health disorders has decreased however there are still a lot of barriers to treatment. National Eating Disorder Awareness Week is a national initiative to raise awareness about eating disorders. National Eating Disorder Awareness Week is February 26th-March 4th 2018 and is sponsored by the National Eating Disorder Association . This years theme is Lets Get Real. The goal is to expand the conversation and share stories that are not often heard in the media stories about the reality of eating disorders and personal experiences centered on treatment. NEDA is a well-known and recognized eating disorder organization that began in 2001. Since its time of inception, hundreds of other eating disorder advocates and non-profit organizations have been established in order to raise awareness, eliminate the stigma, provide resources and educate the public on the importance of seeking professional treatment for eating disorders.
Treatment For Negative Body Image
Research shows that body image is often one of the last symptoms of an eating disorder to improve during treatment. Even accounting for different treatments and symptoms between patients, the stages of recovery from an eating disorder follow a fairly similar pattern. Almost universally, weight recovery and behavioral changes appear to precede psychological recovery. And some degree of body image distress and preoccupation may persist after recovery of an eating disorder since it is not normal for people in our society to be entirely free of body image concerns.
A variety of interventions have been designed to target a negative body image. These interventions fall into several broad categories including
- cognitive-behavioral therapy
- psychoeducation
- gratitude
In many cases, treatments incorporate more than one category of intervention. For example, cognitive-behavioral treatments and media literacy programs often include psychoeducation.
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Robert Willans Case Description
Robert Willan was an English physician in London who is credited with founding dermatology as a medical speciality. He is one of the first to describe the symptoms of extreme weight loss in males, in his paper A Remarkable Case of Abstinence, published in Medical Communications in 1790. This describes the case of a young Englishman who died in 1786 after fasting for 78 days. He wrote:
The duration of this young gentleman’s fast is, I believe, longer than any recorded in the annals of Physic.
How Long Do Eating Disorders Last
Research carried out in Australia suggests that the average duration of anorexia is eight years and five years for bulimia. However, these illnesses can also become severe and enduring, lasting for many years and having a hugely debilitating effect on the sufferers and their families. The sooner someone gets the treatment they need, the more likely they are to make a full recovery.
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What Are The Types Of Eating Disorders
There are several different types of eating disorders that people may experience. The most common include anorexia nervosa, bulimia nervosa and binge-eating disorder .
All three conditions fall under the general heading of eating disorders because they share a few important characteristics:
- Involve disordered eating patterns, such as not eating enough or overeating
- Can hurt physical and mental health
- Maybe difficult to overcome without support
However, the main difference between each condition is how the person experiences their symptoms. Below is a list and description of common eating disorders for you to refer to:
What Causes Eating Disorders
We do not know exactly what causes eating disorders.
You may be more likely to get an eating disorder if:
- you or a member of your family has a history of eating disorders, depression, or alcohol or drug misuse
- you’ve been criticised for your eating habits, body shape or weight
- you’re really worried about being slim, particularly if you also feel pressure from society or your job, for example, ballet dancers, models or athletes
- you have anxiety, low self-esteem, an obsessive personality or are a perfectionist
- you’ve been sexually abused
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New Service: Western Australia Eating Disorders Outreach & Consultation Service
Dr. Anthea Fursland, Director of the new Western Australia Eating Disorders Outreach & Consultation Service , provides insight into this exciting state-wide service being launched in May. Dr Fursland is also a Consultant Clinical Psychologist and A/Director of the Centre for Clinical Interventions . In addition to her clinical work, Dr Fursland is involved in applied clinical research, service development, supervision, consultation, training and education.
The Western Australia Eating Disorders Outreach & Consultation Service has been created to facilitate the provision of standardised, best-practice, compassionate care for youth and adults with eating disorders in WA.
In the WA public sector, Princess Margaret Hospital has a well-developed service, providing outpatient, day patient and inpatient treatment for children and adolescents. However, for youth aged 16+ and adults, the only treatment available is specialist outpatient psychological treatment at the Centre for Clinical Interventions in the Perth metropolitan area.
There is a strong need for upskilling clinicians working in inpatient settings. WAEDOCS focus is on inpatient care, since this offers the greatest challenges. We will be available for consulting, mentoring, supporting and educating clinicians throughout the state in all settings: metropolitan and rural, public and private, community and hospital-based, mental and physical health.
Help With Eating Disorders: How To Deal With Them
Eating disorders are a serious problem that affects millions of people worldwide. They are not something that can be cured overnight. But it is possible to feel better with the help of psychotherapy and other coping strategies. Psychotherapists specializing in eating disorders offer many different treatments for their patients. This blog post will discuss the different types of eating disorders, how they manifest themselves, and what you can do to help with eating disorders.
Contents
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What Is Binge Eating Disorder
Binge eating disorder is the most common eating disorder in the United States, and its diagnosed in all age groups. Its most prevalent, though, among teens and adults. People with BED eat unusually large amounts of food in a short period of time and feel a loss of control and guilt over these bingeing episodes.
Researchers estimate that up to 60 percent of people who struggle with BED are women. The cause for the disorder is unknown, but there are likely social, biological, and psychological factors. Without help, the long-term consequences of binge eating include:
- weight gain
What Insurance Does The Hospital Take
If you are being admitted to one of our hospital-based programs, both Inpatient and Partial Hospitalization, our business office will verify your benefits beforehand, and the admissions coordinator will contact you with information about your coverage. Admission to our program in the Johns Hopkins Hospital Department of Psychiatry qualifies as a mental health hospitalization and will be authorized under the mental health portion of your insurance, not the medical portion. Please see the Admissions page for more information.
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Does Our Program Have Published Treatment Outcomes
You can read about patient satisfaction with our treatment program for anorexia nervosa. Reference: Guarda AS, Cooper M, Pletch A, Laddaran L, Redgrave GW, Schreyer CC. Acceptability and tolerability of a meal-based, rapid refeeding, behavioral weight restoration protocol for anorexia nervosa. Int J Eat Diord. 2020 online ahead of print.
You can read about our treatment outcomes for anorexia nervosa in Hopkins BrainWise: A Weighty Approach to Anorexia Nervosa.Reference: Redgrave GW, Coughlin JW, Schreyer CC, Martin LM, Leonpacher AK, Seide M, Verdi AM, Pletch A, Guarda AS. Refeeding and weight restoration outcomes in anorexia nervosa: Challenging current guidelines. Int J Eat Disord. 2015 48:866-73. Pubmed link:
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History Of Binge Eating Disorder
Binge eating disorder was even later on the scene. Binge eating disorder was first described in 1959 by psychiatrist Albert Stunkard, who coined the term Night Eating Syndrome. He later specified that binge eating could occur without the nocturnal component of that disorder. Binge eating disorder was first studied in weight loss populations.
In 1993 a cognitive behavioral therapy manual for binge eating and bulimia nervosa was published by Fairburn, Marcus, and Wilson. This manual described how cognitive behavioral therapy could effectively treat bulimia nervosa and binge eating disorder. It went on to become the most studied manual for the treatment of eating disorders
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Sir William Gulls Anorexia Nervosa Paper
By 1873, Sir William Gull had been made a Baronet and was one of four Physicians-in-Ordinary to Queen Victoria. In that year, he published his seminal work Anorexia Nervosa “, in which he describes the three cases of Miss A, Miss B, and a third unnamed case. In 1887, he also recorded the case of Miss K, in what was to be the last of his medical papers to be published.
Sir William Gull writes that Miss A was referred to him on 17 January 1866. She was aged 17 and was greatly emaciated, having lost 33 pounds. Her weight at this time was 5 stone 12 pounds her height was 5 ft 5 inches. Gull records that most of her physical condition was normal, with healthy respiration, heart sounds and pulse no vomiting nor diarrhoea clean tongue and normal urine. The condition was that of simple starvation, with total refusal of animal food and almost total refusal of everything else.
Gull prescribed various remedies and variations in diet without noticeable success. He noted occasional voracious appetite for very brief periods, but states that these were very rare and exceptional. He also records that she was frequently restless and active and notes that this was a “striking expression of the nervous state, for it seemed hardly possible that a body so wasted could undergo the exercise which seemed agreeable”.
In Gull’s published medical papers, images of Miss A are shown that depict her appearance before and after treatment . Gull notes her aged appearance at age 17:
Death Of Karen Carpenter
Karen Carpenter was a popular American vocal and drummer musician. Her death on February 4, 1983, was attributed to heart failure as a consequence of anorexia nervosa.
Public awareness of anorexia nervosa and other eating disorders was transformed by Karen Carpenter’s death. Her young age coupled with her fame as an entertainer captured public attention and received extensive media coverage. The sympathetic reporting of her illness prompted other celebrities, such as and Lynn Redgrave, to come forward and share their experiences.
Karen Carpenter’s brother and singing partner, Richard Carpenter, established a fund dedicated to his sister’s memory for research into anorexia nervosa.
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History Of Eating Disorders And Treatment
Eating disorders are sometimes represented as culturally-bound syndromes of the post-modern era, however research finds that eating patterns commonly associated with eating disorders, such as bingeing, purging and fasting, date back to Roman and Christian eras, respectively . It wasnt until the late 17th Century that these eating behaviours were interpreted within a medical framework and acquired associated remedies .
The Medicalisation of Eating Disorders
Anorexia Nervosa , Bulimia Nervosa and Binge Eating Disorder have become recognised as psychiatric disorders at different times throughout the 19th and 20th Centuries.
Anorexia Nervosa
Bulimia Nervosa
Although records of bulimic symptoms, such as overeating and purging, pre-date symptoms associated with AN, BN was not recognised as a separate disorder until its addition to the Diagnostic Statistical Manual III in 1987. Its recognition as a disorder can arguably be accredited to the work of feminist and cultural scholars of the 1970s who framed binge-purge behaviours among normal-weight women as bulimarexia. In these accounts, BN was conceptualised as a culture-bound syndrome resulting from the obsession with thinness in modern Western culture . Although socio-cultural ideals around gender and body shape continue to be recognised in the aetiology of eating disorders, they are now seen as only one of several contributing factors .
Binge Eating Disorder
Latest developments in the treatment of eating disorders
Other Specified Feeding Or Eating Disorder
According to the DSM-5, the category of other specified feeding or eating disorder is applicable to individuals who are experiencing significant distress due to symptoms that are similar to disorders such as anorexia, bulimia, and binge-eating disorder, but who do not meet the full criteria for a diagnosis of one of these disorders.
Examples of experiences that fall within the OSFED category include:
- Atypical anorexia nervosa The individual meets the criteria for anorexia and has sustained significant weight loss as a result, but they remain within or above the weight range that is considered normal for their height and gender.
- Bulimia nervosa The individual meets the criteria for bulimia, with the exception that they engage in bingeing and compensatory behaviors less than one time per week or for a duration of fewer than three months.
- Binge-eating disorder The individual meets the criteria for BED, except that they average no more than one bingeing episode per week or have been experiencing symptoms for fewer than three months.
- Purging disorder The individual engages in purging behaviors such as self-induced vomiting or laxative misuse, but they do not experience eating binges.
- Night eating syndrome The individual experiences recurring episodes of eating after awakening at night, or of eating excessively after their evening meal. These episodes cause significant distress or impaired functioning.
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Ways To Help With Body Image And Eating Disorders In Men
If your loved one is struggling with an eating disorder, the following are ways in which you can offer support to the male in your life:
Th Century: Parentectomy Considered An Appropriate Treatment
In the 1900s, parentectomy was considered a useful treatment option for minors with eating disorders. The logic behind this came from a belief that an adolescents eating disorder was caused by their parents. The parental blame for eating disorders in adolescents was damaging and inflicted unnecessary pain on children and parents alike.
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Awareness Of Eating Disorders In Men
Eating disorders in Men have been around for many years and until recently were typically viewed as a female issue. Not anymore. Today, anorexia, bulimia, and especially binge-eating disorder are on the rise in the male population. Anorexia is now diagnosed in boys as young as eight and a full 40% of those with binge-eating disorders are male.
Andrew Walen provides fascinating insight and understanding about males dealing with disordered eating. A must watch for all loved ones and guys seeking to understand the male experience of eating disorders. Learn more about Andrew & The Body Image Therapy Center