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Eating Disorders 101


The term “eating disorders” refers to a group of disorders that are characterized by eating or eating-related behavior and significantly impairs someone’s physical health and/or psychosocial functioning. It is important to note that obesity is not considered to be an eating disorder, though it is associated with other mental disorders such as depression and binge-eating disorder. 

The main eating disorders outlined in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) are anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED). AN is characterized by restriction of energy intake, intense fear of weight gain or becoming fat, and disturbance in one’s experience of body weight or shape. BN is characterized by binge eating, inappropriate compensatory behaviors (e.g., vomiting), and self-evaluation that is influenced by body shape and weight. BED is primarily characterized by binge eating (without compensatory behaviors) as well as distress regarding the amount, frequency, and/or pace of eating. 

There are many factors that can contribute to developing an eating disorder. These include genetic, biological, psychological, and sociocultural factors. Treatment of eating disorders must therefore address the factors that contribute to or help maintain symptomatology. Treatment modalities include individual, group, and/or family therapy. There are also various levels of care based on severity of symptoms. Inpatient treatment tends to be effective for medically and psychiatrically unstable individuals. Residential is suitable for individuals who are medically stable but psychiatrically impaired. Partial hospitalization is helpful for individuals who are medically stable but need daily assessment of their physiological status as well as those who are psychiatrically stable but are engaging in disordered eating behaviors (e.g., restricted eating). Lastly, outpatient or intensive outpatient is an option for individuals who are stable and do not need daily monitoring. It is also effective for those who are psychiatrically stable and can function in day-to-day situations.

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With regard to treatment options and theoretical orientations, clinicians, therapists, etc. have used the spectrum of options, from acceptance and commitment therapy (ACT) to psychodynamic therapy. There are some, however, that are shown to be particularly beneficial for individuals with specific symptomatology. For example, eye movement desensitization and reprocessing (EMDR) has been effective for individuals with a trauma history. Cognitive remediation therapy targets rigid thinking processes usually associated with individuals with AN.If you or someone you know is engaging in disordered eating behaviors or meets full criteria for one of the specific eating disorders in the DSM-5, it is beneficial to meet with a qualified health professional to address symptoms. Please feel free to contact us at 312-573-8860 to meet with one of our therapists or to receive additional resources for treatment.

Come As You Are: Examining Our Own Narratives Around Food, Health, and Body Image


Common assumptions around eating disorders often narrowly focus on an individual’s food intake and exercise. It’s time to examine how cultural norms directly impact all of us. A leading factor in the development of disordered eating is a cultural emphasis on being thin (Culbert, Racine, & Klump, 2015). When thinness is celebrated and equated with health, anyone outside of thinness is subjected to weight stigma and bias. One’s “discipline” and even morality is questioned. Weight stigma is a subsequent threat in and of itself as a risk factor for depression and anxiety (Andreyeva, Puhl, & Brownell, 2008). Rather than investing our time, money, and energy into a narrow and often impossible standard, what if our focus is to work against weight stigma and the idealization of thinness? 

This work begins with ourselves, in identifying the ways we have internalized messages of shame for our bodies, or perhaps in how we have pursued and been devoted to this standard of thinness. For parents and caregivers there is a compelling obligation to consider one’s own beliefs and actions around health, wellness, and eating patterns for the sake of their children. All children are currently composing their own narrative of what it means to “be healthy” and are modeling behaviors from those around them, for better or for worse. (Andreyeva, Puhl, & Brownell, 2008). 

This work is individual and collective. National Eating Disorders Awareness Week is from February 24th-March 1st. The National Eating Disorders Association (NEDA) theme for this year is “Come As You Are, Hindsight is 2020.” Let us take time, be it in conversations, prayer, or in counseling to reflect about our own narratives around food, health, and body image. Let us work toward a culture in our families and communities that speaks to each and every one: “Come as you are.”

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Andreyeva, T., Puhl, R. M. and Brownell, K. D. (2008), Changes in Perceived Weight Discrimination Among Americans, 1995–1996 Through 2004–2006. Obesity, 16: 1129–1134. doi:10.1038/oby.2008.35

Culbert, K. M., Racine, S. E., & Klump, K. L. (2015). Research Review: What we have learned about the causes of eating disorders – a synthesis of sociocultural, psychological, and biological research. J Child Psychol Psychiatry, 56(11), 1141-1164. 

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