The post Medications to Treat Binge Eating Disorder appeared first on Talkspace.

While these may be signs of an eating disorder, these conditions don’t always present in these ways. For instance, you may find yourself constantly consuming large quantities of food and feeling like you’re unable to stop. Many people have periods when they overeat, such as during the holidays, but if you experience a loss of control with food regularly, it may be a sign of an eating disorder called binge eating disorder.

What Is Binge Eating Disorder?

You may have heard about eating disorders like anorexia and bulimia, but, although it’s one of the most common eating disorders, binge eating disorder isn’t as frequently discussed. 

People with binge eating disorder may frequently ingest large amounts of food in a short time, and feel unable to stop eating. The loss of control is usually triggered by stress-inducing situations, and it may lead them to binge even when they aren’t hungry. These episodes are usually followed by a feeling of guilt or unhappiness afterwards.

Binge eating disorder commonly affects young people in their late teens or early 20s. Although the common view is that this eating disorder mainly affects women, men can also be affected. According to the US Department of Health and Human Services, about 1.6%of adolescents, 3.5%of adult women, and 2%of adult men are dealing with binge eating disorder. For men, it mostly occurs in midlife, between the ages of 45 to 59.

Some people who deal with binge eating disorder maintain a normal weight. But for many other people, binge eating causes rapid weight gain and can bring other associated health issues such as high blood pressure, type 2 diabetes, and heart disease. Although most people with obesity do not have binge eating disorder, over two-thirds of people dealing with this disorder do become obese. Binge eating disorder often also leads to depression, anxiety, and other mental health conditions.

What Are the Signs of Binge Eating Disorder?

Binge eating disorder was officially recognized as an eating disorder diagnosis in the DSM-5 manual in 2013. Before then, it was categorized under the non-specific “EDNOS” (Eating Disorder Not Otherwise Specified).

According to the current diagnostic criteria, you may have binge eating disorder if:

• You have recurrent and persistent episodes of binge eating
• You eat much more rapidly than normal
• You eat until you feel uncomfortably full
• You eat large amounts of food even when you don’t feel physically hungry
• You eat alone because you feel embarrassed by how much you’re eating
• You feel depressed or very guilty after overeating
• You experience marked distress regarding your eating habits

Binge eating disorder is often mistaken for bulimia nervosa, another common eating disorder. But unlike bulimia, binge eating disorder doesn’t involve regular compensatory behaviors after an episode, such as vomiting or other methods to get rid of calories or prevent weight gain. However, with binge eating disorder, you might try to control the amount of food you eat between binges.

What Causes Binge Eating Disorder?

Experts are still unsure of the exact cause of binge eating disorder, but it can generally be traced to a range of risk factors. For instance, painful or traumatic childhood experiences — such as critical comments about your weight — are associated with developing binge eating disorder. This eating disorder also runs in some families, and some experts believe that there may be a genetic link to it.

Certain psychological factors are also believed to contribute to binge eating disorder, such as increased sensitivity to dopamine (the brain chemical that’s responsible for feelings of pleasure and reward), changes in the brain structure that results in a higher response level to food, or other mental health conditions like depression, anxiety, or post-traumatic stress disorder that influence a person’s eating habits.

For many people dealing with binge eating disorder, these episodes bring a temporary feeling of comfort and calm that they become used to. Sometimes, they may plan a binge episode in anticipation of the feeling it brings. These episodes tend to bring regret in the long run, and the condition may last for years if left untreated. It’s best to seek professional help as soon as possible, if you’re experiencing any of the signs of binge eating disorder.

How Is Binge Eating Disorder Treated?

Making the decision to get treatment for binge eating disorder is the first step to recovery. Research shows that over 65%of people are successfully able to control binge eating after going through treatment.

The treatment options for binge eating disorder may target eating habits, weight gain, low self-esteem, mental health issues, or a combination of these. Your doctor may also screen you for any condition related to binge eating, such as depression or anxiety, or other health issues such as high blood pressure.

There are several therapy options for people with binge eating disorder, such as cognitive behavioral therapy (CBT) which helps you identify the causes of negative emotions relating to your eating habits or weight, and how to develop positive emotions to replace them. 

Interpersonal psychotherapy also helps those dealing with binge eating disorder by identifying the specific personal problem that led one to adopt binge eating as a coping mechanism, and make changes to these behaviors over the course of 12-16 weeks. Some types of medication such as antidepressants, can also be helpful in treating binge eating.

Weight loss therapy can also help control binge eating disorder by boosting your self-esteem and promoting a positive body image. However, it’s important to avoid worrying about your weight or going on a diet, as depriving yourself of food can often actually increase the likelihood of binge eating.

As you work on a suitable treatment plan with the help of your provider, certain strategies can also help you manage your triggers. These include practicing mindfulness, exercising, choosing healthy foods, keeping track of your food habits and your moods, and getting enough sleep. It’s also important to get support from family, friends, a partner, online therapy, or a support group with others who are also dealing with binge eating disorder, and can understand what you’re going through.

What Can I Do To Help a Loved One With Binge Eating Disorder?

A person dealing with binge eating disorder may come up with effective ways of masking the behavior, often making it difficult to detect. If you suspect that someone you know may be struggling with binge eating disorder, you can encourage them to have an open discussion about it by sharing your concerns and providing the necessary support. You can also help them reach out to a professional and go with them to therapy sessions or doctors’ appointments.

Dealing with binge eating disorder isn’t a character flaw. Overall, it’s important to promote a healthy body image, regardless of body shape or size. An eating disorder also won’t necessarily go away with mere willpower. Treatment from a licensed mental health provider can help prevent health problems, increase your self-esteem, and improve your quality of life. Talkspace online therapy is an inexpensive and convenient way to get the help you need — reach out today. 

The post What Are the Signs, Symptoms, and Treatment of Binge Eating Disorder? appeared first on Talkspace.

Unfortunately, research suggests that feeling not so great about the way you look or a negative body image can have a big impact on our mental health — it can even lead to eating disorders. It’s hard for all of us to figure out what’s normal and what’s not, but especially during these years when we’re changing so rapidly. Maybe even more importantly, what can you do about poor body image?

What Affects Body Image?

Everyone has things about their bodies they’d like to change, but we’re usually too hard on ourselves. We want to fit in and be “normal,” attractive to ourselves and others.

People with a persistently negative body image often misread, or distort, their features in a way that other people don’t see. In other words, you don’t see yourself realistically compared to how other people see you. What you see in the mirror might not correspond with what’s actually there.

Distortions are a common problem with body image, and we tend to judge ourselves unfairly based on many things. Consider the following issues that influence how you think about your body image:

Cultural expectations

“Ideal” body type varies considerably depending on background. Some cultures value thin people, for example, while others favor a fuller figure.

Peer differences

If you feel you look different from most of the people you hang out with or go to school with, your body image might suffer.

Overall self-image

People who tend to have a general negative opinion of themselves, who suffer from low self-esteem in many other areas, may also feel unattractive or uncomfortable in their bodies.

Gender

Gender expectations pose challenges. Whereas girls are often expected to be thin and lithe, boys are expected to be muscular and strong. Society’s distorted expectations for your gender can cause body image worries.

How Does Body Image Relate to Eating Disorders?

If you’re not happy with something specific about how you look, naturally you might try to change things. You may buy new clothes or color your hair, perhaps add some new accessories to your look. If you’re not happy with overall appearance, however, you might try changing through diet and exercise.

Because body image concerns can reflect distortions in your thinking — say, you might think you look overweight when you’re actually within a healthy range for your height — then sometimes the changes you’d like to make also might not actually be healthy.

When your body image isn’t based in reality, you’re at risk for using extreme measures to take control. What starts as a simple diet or a plan to hit the gym a couple of times a week can develop into obsessive eating restrictions or extreme exercise.

As your body image gets less realistic, so do your thoughts about diet and exercise. People who suffer from eating disorders often view extreme eating or exercise habits as “normal,” because their view of themselves has gotten skewed. It’s as if they’re looking at themselves in a fun-house mirror, but they believe the warped unrealistic image they see. It doesn’t help that our culture is so focused on appearance and provides so many negative messages through TV and the media.

Keys to Positive Body Image

Good body image is key to good health, so don’t let inaccurate assumptions about yourself and your body lead you down a path toward an eating disorder. Consider these tips to feel better about your body.

Keep it realistic.

Be aware we’re prone to seeing our bodies a bit inaccurately. It can be hard to get an objective view from friends or family. But, if your doctor says you’re healthy, then you might have a self-esteem problem, rather than a body problem.

Focus on healthy, not artificial

Remember, advertising images and celebrities’ perfect selfies are often exaggerated, edited, or enhanced. Find legitimate ways to be healthy instead of striving to meet artificial standards.

Practice positive self-statements

If you’re constantly criticizing your body, in time you’ll believe those messages. Find things you like about yourself and think about those often. Practicing the positive will improve your confidence.

Find some support

Friends and family can be great supports, but sometimes they have their own unrealistic body image standards. If you consistently feel worse about your body rather than better when talking to them, consider talking to a trained and licenced therapist instead.

The majority of teens who struggle to feel good in their bodies will not develop eating disorders, but we know that most people who develop eating disorders struggle with distorted, negative body image. We also know that teens are particularly vulnerable to eating disorders. Developing a positive body image during this time of physical change can really protect you from a difficult road — so don’t be afraid to reach out for help from a professional if you have any questions.

The post What Every Teen Should Know About Body Image and Eating Disorders appeared first on Talkspace.

In middle school, one of my best friends stopped eating. Though she was a notoriously picky eater, suddenly her penchant for munching on trail mix for every meal became less quirky and more concerning as the ziplock baggies of nuts grew smaller and smaller.

Exacerbating the issue, she competed in an image-based performance sport, in which size and appearance were paramount. One day, we were sitting in my living watching the movie Center Stage for the millionth time, when we reached a scene in which an aspiring ballerina battling bulimia throws up a meal in a bathroom stall. I tensed up, wanting to pause the movie and say something, anything, but I didn’t know how.

Therapy as Preventative Measure for Eating Disorders

With time, I found a way to help her (more on that below), but to this day I still wish I had acted sooner. My 13-year-old self hadn’t been equipped with the knowledge I now have about the many benefits of therapy.

I have been fortunate to have never struggled with an eating disorder, but like many other women I’m not impervious to difficulties involving body image. At times, this has manifested itself into unhealthy or disordered eating patterns. From dabbling in the occasional fad diet and extreme calorie counting, to bouts of restrictive eating, my relationship with food has been fraught.

When I first started going to therapy for depression and anxiety, I discovered it helped alleviate long-held negative thought patterns connected to my body and self esteem. Therapy has helped me confront issues that, left unchecked, could have the potential to materialize into more serious conditions.

It also helped me feel less alone. Eating disorders, as with many other mental illnesses, can be incredibly isolating. According to Talkspace therapist Jill Daino, LCSW-R and director at The Center For The Study of Anorexia and Bulimia, it is this sense of isolation that often prevents people from getting help in the first place.

“Many patients feel like they’re odd and the only one struggling in their particular way,” Daino said. “This sense of isolation increases their shame around their disorder and makes it even harder to initially seek help. It takes great strength to ask for help and is an amazing first step in healing.”

Therapy’s Role in Eating Disorder Recovery

In the United States, 30 million people suffer from an eating disorder, a condition that has the highest mortality rate of any mental illness. Eating disorders take many forms — including anorexia, bulimia, binge eating, and restrictive food intake disorder — and span across gender, age, race, and body size.

According to Daino, while treatment is typically a multi-step process, talk therapy is an instrumental first step to seeking help for an eating disorder.

“Oftentimes patients enter talk therapy not ready to address their eating disorder. Being able to safely explore and discuss concerns with a knowledgeable therapist, who also keeps their medical safety at the forefront, is crucial at all stages of treatment,” she said.

A good therapist can also assist a patient in finding additional resources they may need — including medical doctors, nutritionists, treatment centers, and psychiatrists in cases where medication for binge eating may be beneficial. 

“A common example of how talk therapy integrates with the treatment team is when the patient is working with a nutritionist on a meal plan and the patient is really struggling with the food choices,” Daino said. “The nutritionist can focus on the food and the patient can have the time and safe space with the therapist to explore all the concerns that are coming up around the meal plan and expectations.”

Helping a Loved One Seek Therapy for an ED

When it comes to helping a friend or loved one seek therapy for an eating disorder, Daino said the key is to be sensitive and compassionate, but also not to delay.

“It is important to remember that eating disorders can have very serious — and at times life threatening — medical consequences, so you should not hesitate to speak up if you are worried,” she said. “Keep it simple and express that you are concerned about a possible eating disorder and have noticed changes or that she seems more stressed, worried, and/or depressed.”

In the case of my friend, a few weeks after I almost confronted her while watching Center Stage, I finally gathered the courage to sit her down to express my concern and encourage her to get help. It was an incredibly challenging conversation, filled with tears and heartache, but it served as the catalyst to helping her get the treatment she needed.

Daino said not to get discouraged if the person becomes visibly frustrated of they refuse to admit there’s a problem. She added that it’s important to recognize you don’t have all the answers, and to explain the importance of working with a therapist trained in treating eating disorders and body image.

“An example of what to say could be ‘I want you to know how much I care about you and our friendship, and you can talk to me about anything. I also think it would be important to talk with a therapist who knows about these complicated topics,’” Daino said.

How Therapy Helps Long Term Recovery

Daino emphasized the importance of ongoing talk therapy appointments to stave off negative thought patterns, and avoid returning to old behaviors.

“Just as talk therapy is vital at the outset and throughout eating disorder treatment it certainly has a crucial role in maintaining recovery,” she said. “It continues to provide a safe space for the patient to explore and consolidate her new skills and get support around challenges as they arise. Many patients describe that the eating disorder symptoms go away long before the eating disorder mindset does, so to have talk therapy over time strengthens long term recovery.”

Similar to most mental illness, there’s no magic cure for an eating disorder. Even after a patient has made visible strides toward recovery, there is still a long road ahead to maintain the progress made during treatment and prevent relapse.

The post How Therapy Helps With Eating Disorders appeared first on Talkspace.

If you’re familiar with EDs, you know they can result in chaotic outcomes for the individual: drastic weight loss, binge eating, or obsessive exercising are just a few possibilities. What you might not know is this chaos often has a very different starting place — control.

Illusions of Control

We usually think of control as a good thing. When our lives are “under control,” everything is ok, right? Our habits, goals, and accomplishments drive our sense of who we are. Unfortunately, trying for too much control can have the opposite effect, wreaking havoc instead of bringing peace.

Unhealthy controlling habits often come from childhood experiences with caregivers. Research suggests controlling parenting styles are more strongly associated with EDs. When children believe their parents only love them for achievements such as grades, or external factors such as appearance, they learn that they themselves aren’t valuable as people. Only outward factors matter.

Not only do overly controlling parents make children question their self-worth, they dominate kids with rigid rules. They discourage the independent thinking and self-reliance kids need to manage life’s challenges.

As a result, kids in these situations often lack coping skills, which can make them anxious or depressed. They rely instead on rigid control over things such as grades, sports achievements, or even diet and exercise, to feel competent or loveable.

We all need goals and routines, but when control leads to perfectionism, worry, and self-doubt, the risk for eating disorders rises. In fact, studies have shown perfectionism is not only associated with higher risk for EDs, but it also makes EDs harder to treat.

Underlying Chaos

Unfortunately, with EDs, the harder people try to control their lives, the more things fall apart. The following factors add to this brewing storm.

Rumination

Thinking about negative things over and over, or obsessing over certain ideas is common for those suffering from EDs. Those thoughts often revolve around low self-worth and failure. It’s hard to contain this type of thinking, which grows more scattered and disruptive as the illness progresses.

Eating and exercise behaviors

Rituals around food or exercise become more rigid as the person adopts unrealistic, unattainable standards. Trying harder to control exercise and eating, they find it difficult to eat any meal without elaborate planning. Similarly, excessive exercise takes time away from other activities, so important tasks fall by the wayside. Life gets so out of balance that chaos sets in.

Self-esteem/perfectionism cycling

Low self-esteem leads to perfectionism, which, of course, dooms us to fail. The ruminating mind magnifies those failures, further damaging self-esteem. It becomes a cycle: self-esteem plummets, perfectionism takes over. Behaviors and emotions become unmanageable. Food and exercise choices grow more rigid and obsessive, making it harder for the person to see their choices realistically.

Reigning in the Chaos of Eating Disorders

Eating disorders are serious medical conditions; people with EDs need professional help tailored to their individual circumstances, especially physical health. Still, research suggests several strategies that might be helpful when working with professionals.

Reduce rumination and perfectionism

Understanding the link between these two symptoms can make people more aware of these habits. One study says therapy targeting perfectionistic tendencies directly may provide additional help.

Increase self-esteem to prevent perfectionism

Another study suggests that building self-acceptance and reducing approval-seeking could reduce perfectionistic behaviors, which may be hard to let go of when people don’t feel good about themselves.

Improve ability to regulate emotions

Some research indicates that difficulty coping with strong feelings can be a risk factor for ED, especially when paired with perfectionistic tendencies. Learning to deal effectively with difficult emotions may reduce ED risk.

Treat perfectionism early in children and teens

Perfectionism often starts young and poses a risk for EDs later in life. Individuals with perfectionistic tendencies may benefit from learning ways to keep such habits from taking over.

Understand the role of controlling family

Just like many other studies before, a 2016 study found parenting style has a clear impact on ED risk. If you are a parent who struggles with controlling behaviors, or if you grew up in a controlling home, getting help for these problems could reduce that risk.

Therapy Can Help With Eating Disorders

While EDs are complicated problems with many contributing factors, it’s easy to see how the concept of control actually facilitates chaos for sufferers and their loved ones.

If you think you have ED symptoms, consider contacting a therapist experienced in treating EDs. The therapist will need to work closely with your physician to treat the complex physical outcomes of EDs as you work on your mental health. With good treatment, peace is possible.

The post Understanding Eating Disorders: From Control to Dysfunction appeared first on Talkspace.

“As a plus-size black woman, summer time always made me nervous,” said Christian Simone, a blogger and content creator. “Being someone who developed early, wearing shorts and a tank that looks so comfy was always a struggle…As an adult, I feel like a magnifying glass is over me when I opt to wear things like a bikini or shorts.”

“I was the girl who ‘got fat’ when I went away to college and my body anxiety was at an all-time high,” Jaclyn DiGregorio, founder of the digital wellness community Cuspit, said. “I would go into the dressing room with a few bikinis and stare at my fat and ugly body, telling myself that I really needed to step it up and eat less to lose weight before summer began.”

What Is Body Anxiety

It’s normal to feel self-conscious about how we look, especially as we peel off extra layers of clothing during the hot summer months. But body anxiety can also be debilitating.

“I feel I am missing out on my most festive summer nights because I don’t feel comfortable,” says Christian Simone. “People who don’t deal with body issues can’t understand the intensity of someone who has been cat-called or told to sit the summer out as there is no place for hippos.”

While some people “can continue with ‘normal’ activities,” according to Dr. Ariane Machin, a clinical psychologist and co-founder of the Conscious Coaching Collective, they may “be very distracted by thoughts related to their body size/shape, perceptions that they are typically much larger than they are in reality, or constantly comparing themselves to those around them.”

Sometimes a little reassurance from loved ones, and traveling with people who make us feel loved and comfortable, is enough to keep the worry at bay — even on the beach or poolside. At other times, body anxiety is tied to deeper issues.

“[Others] may begin to isolate and/or reduce the activities that they are involved in,” Machin said. “Someone who once loved to do group workouts now feels too self-conscious and isolates, which in turn may enhance feelings of depression and anxiety.”

When To Seek Help

Body anxiety at the stronger end of the spectrum may lead to low self-esteem, other mental health issues, and eating disorders. Those who have also experienced trauma will likely have a complicated relationship with their body.

“Sometimes the anxiety has nothing to do with the body at all,” Philadelphia-based licensed psychologist Robin Hornstein said. “It [could] be some trauma that happened [or] you’re waiting for test results from a medical test, and you’re scared, and so it’s so much easier to fight a part of your body at that moment then to just say, ‘Damn, I’m grieving,’ or, ‘I’m scared,’ or, ‘I don’t know how to handle this stress for too long.’”

If body anxiety starts to take over by exhibiting symptoms such as not eating right, poor sleep, isolation, avoidance of previously enjoyed activities, or trouble keeping up with obligations like work, it may be time to reach out to a mental health professional.

“If you can’t do it on your own, reach out to somebody else,” Hornstein advised. “Whether that’s a therapist, or whether that’s somebody you trust — a mentor, a family member, a friend, a partner, a spouse — and say, ‘Hey, help.’”

Ways To Combat Body Anxiety

In the meantime, we have a few ideas to help reduce body anxiety as we head into the dog days of summer.

1. Reduce Media Consumption

Hornstein asks clients to reduce the amount of media they consume. These unrealistic portrayals of bodies and beauty aren’t realistic (and are often a work of camera and editing magic). In addition, Hornstein helps clients identify favorite activities, like swimming, they no longer enjoy due to anxiety about their body and figure out how to work those back into their life.

2. Reframe How Your View Your Body

Teaching clients to reframe how they view their body is one of the first steps Machin takes, by using mantras such as, “My body is an instrument, not an ornament.” From there, Machin finds clients regain their power and confidence through body movement by taking up walking, yoga, weight lifting, or any other activity that “brings you joy in moving your body and reaffirms that your body is strong.”

3. Focus On The Positives of Summer Skin

New York-based clinical psychologist Dr. Sanam Hafeez suggests refocusing our energy on the benefits of showing more skin, a cognitive shift that can help mitigate the impact of anxiety. She recommends asking questions such as, “How would it feel to savor the sensation of warm sun on my skin?” or “How might swimming help me relax or exercise more?” Take this a step further, she said, and try: “What three things can I appreciate about my body right now?”

How Others Empower Themselves

In addition to these practical strategies, find creative ways to reduce body anxiety that work for you. Sometimes these pursuits are the most empowering.

Start a Blog or Journal to Tell Your Story

For example, Christian Simone took hold of her anxiety by creating a body positivity blog, The Christian Simone, where she posts about her journey to health and acceptance.

“Last year I created a post that showcased me in a bikini. I did this again this year because I feel if I own who and what I am then I can move forward,” Simone said. “I still have moments of anxiety but I just tell myself that these moments are temporary and who cares if someone doesn’t like it? What has been more important is to allow myself the mental flow to accept me at my size and to not stop living because of anxiety.”

Create Clothes That Fit Your Unique Style and Body

Erin Weisbart, owner of the sewing and pattern company Tuesday Stitches, uses another creative outlet to overcome body anxiety — sewing. Weisbart encourages others to bring clothing to life that flatters their favorite features through customizable patterns. By sewing her own clothing, she’s found a path to confidence, and she shares that message with others through her company.

“I sew pretty much all my own clothes at this point,” Weisbart said. “Sewing empowers people to love their bodies because you learn that with any sewing pattern, you’re going to make changes to it to fit your body perfectly.…If you learn to sew your own clothes, then you can learn to embrace, accept, and celebrate your unique body.”

Above All, Self-Love is a Key Component

Regardless of the journey, with self-love and support from loved ones and a therapist as needed, self-acceptance can replace body anxiety.

“I loved the stretch marks on my legs because they signified the transition from child body to adult body,” Jaclyn DiGregorio said, on where she is now, “No one has the perfect body, but turning your imperfections into gratitude for the many blessings in your life can truly make a huge difference in finding body positivity in a world of body anxiety.”

This summer, we’ll leave you with these final bits of advice:

“A beach body is a body that puts on a bathing suit and goes to the beach,” Robin Hornstein said.

Christian Simone tells it frankly. “Wear whatever you want and live your most festive life!”

The post Summer Body Anxiety is Real, Here’s How to Work Through It appeared first on Talkspace.

Unfortunately, as Western society increasingly prioritizes clean eating, physical exercise, and other forms of “healthy living,” clinicians have seen another trend: orthorexia.

A relatively new term, orthorexia is still taking shape as a concept, and is not yet mentioned in the Diagnostic and Statistical Manual of Mental Disorders. The original definition by doctor Steven Bratman and writer David Knight described orthorexia as an obsession with proper nutrition, dietary restrictions, and specific food preparation methods.

Other research suggests we should include preoccupation with exercise as a component of the definition as well. In short: we’re still trying to figure out exactly what it means. Not only does orthorexia overlap other disorders, but it’s also hard to tell when a specific diet becomes a problem.

Orthorexia, Anorexia, and Anxiety

According to authors Nancy S. Koven and Alexandra W. Abry, orthorexia appears to mimic other disorders such as anorexia (an eating disorder) and obsessive-compulsive disorder (or OCD, an anxiety disorder). Like anorexia and OCD, individuals with orthorexia have a few traits in common: perfectionistic tendencies, an anxious outlook, and difficulty being flexible in how they see the world.

On the other hand, orthorexia has some distinct differences. What sets it apart from anxiety and OCD?

1. Orthorexia is more specific. First, in orthorexia, we see greater emphasis on food quality, along with unrealistic beliefs about food and an overall desire to maximize health.
2. Orthorexia is not often a secret. In addition, people with anorexia and OCD tend to be secretive about their behaviors and symptoms, fearing other people will judge them or try to intervene. In contrast, people with orthorexia appear to flaunt their healthy choices, making their beliefs and habits well-known to those around them. They’re excited about their healthy lifestyle.

Although clinicians now understand more about orthorexia as a unique problem, distinct from disorders with similar symptoms, we still have no official diagnostic criteria. Scant research and flawed measures make diagnosis tricky.

Diet or Disorder?

Even the man who coined the term orthorexia carefully distinguishes between a strict diet and a clinical disorder. In fact, Bratman recently clarified his thoughts about it, pointing out that a healthy diet isn’t a problem unless it intensifies into an obsession.

While he and other researchers are still working on exact diagnostic criteria, we have to do the best we can with what we’ve learned so far. Just because a person adheres to a strict or unusual diet doesn’t mean they have a disorder.

Fortunately, clinicians are accustomed to working in gray areas. Most only worry about a behavior when it becomes severe enough to disrupt daily life. In my practice, for example, I’m most interested in how well my clients are functioning. I can still help people who want to change problem behaviors, even if those behaviors don’t exactly fit a diagnostic pigeonhole.

For Bratman, the patients who raised concern were those whose “exuberant pursuit of physical health had spawned a rigid, fearful, and self-punishing lifestyle that caused more harm than good.” Using this mindset, along with the general diagnostic framework’s researchers propose, we can recognize signs of possible orthorexia.

Warning Signs

When considering the following warning signs, remember we’re looking at an overall pattern of behavior that gets in the way of daily life, not just one or two habits or beliefs. These clues suggest a person may have taken a healthy lifestyle to an unhealthy extreme:

• Excessive time spent thinking about, planning, and preparing food. Likely, the time spent doing these things limits time available for other activities.
• Anxiety regarding health, types of foods, or food contamination. Severe food-related anxiety and perfectionism makes it hard to be flexible about food — in social settings and otherwise.
• “Healthy habits” begin to interfere with social life. People avoid social situations because unpredictable settings might keep them from meeting their strict food standards.
• Excessive exercise. A person works out too long, too hard, or too often.
• Significant weight loss or negative changes in health. Rigid eating habits persist even when the person’s health suffers.
• Excessive focus on moral implications of food choices. The person worries more about what a food choice means for their moral standing than whether that choice actually supports health.
• Excessive focus on body image. Anxiety about appearance or unrealistic opinions of body image remain, despite evidence to the contrary.

Getting Help

If you or loved one has signs of disordered eating or exercise, there are good treatment options. Because eating disorders affect both physical and mental health, they must be treated using a whole-person approach.

Although working with multiple providers can be overwhelming, each person plays an important role in recovery. This team effort includes mental health, medical, and nutrition professionals, each of which brings unique expertise.

Physicians will assess and monitor your physical health, recommending a pace of change that is healthy for you. A nutritionist can teach you about required nutrition, identify food misconceptions, and plan a recovery diet that meets your nutritional needs. Finally, a mental health professional can use cognitive behavioral therapy and behavior modification to change unhealthy thoughts and habits into more functional ways of thinking and behaving.

We’re still working to pin down orthorexia’s specifics, but we can help when healthy habits go awry. By consulting with specialists trained in eating disorders, you can have a truly healthy lifestyle.

The post Orthorexia: When Healthy Eating Gets Unhealthy appeared first on Talkspace.

My eyes feast on the meal, but inside my anxiety starts to edge its way into my mind. How much can I put on my plate this Thanksgiving and still feel like I won’t be judged for how much or what I am eating? Can I afford to eat two slices of pie, or do I need to stick with just one to keep up appearances? Am I making enough of a show of restraint in comparison to my BMI for the extended family members at the table so I won’t feel judged?

If you take one look at me, it’s not going to be a secret that I eat a lot of food, and unhealthy food at that. I have an uncomfortable relationship with my body, not the least of which is my anxiety around how others perceive what I look like, which is overweight. I try to joke about it — rebranding french fries as “health potatoes” to make everyone laugh instead of watch me eat more unhealthy food I don’t need — but nothing other than practicing extreme restraint around others eases the anxiety about how my body is perceived, especially when I am eating.

In the end I stick with a moderate plate of food, skip seconds on the stuffing, and have only one piece of pie, even though the national food indulgence holiday could serve as an excuse to eat a little extra. But in front of other people, the anxiety about what I consume is too great to override my fear about what my body looks like and what I imagine people think when they see a fat girl eating too much food.

Anxiety Around Social Eating

It turns out anxiety around eating and body issues is not uncommon, for people of all shapes and sizes. Much of it can be linked to social anxiety disorder. According to the psychology diagnosis bible, the Diagnostic and Statistical Manual of Mental Disorders, social phobia is marked by a fear or anxiety in social situations where you are “exposed to possible scrutiny by others,” including being observed while eating or drinking. This can make eating in social situations very uncomfortable.

“Concerns about what others are thinking can fuel anxiety and make it very difficult to eat,” writes Lesley Williams, MD. “My patients who struggle with eating in front of others describe physical symptoms of anxiety such as a fast heart rate, sweaty palms, a sensation of a lump in their throat, nausea, and stomach pain.”

The chief cause of anxiety comes directly from the fear of how others perceive you. This can result from past bad experiences around your body and food, whether that’s because someone commented on how much you ate, what you ate, or what your body looked like. This breeds a sense of self-consciousness and low self-esteem around one’s body that can easily turn into full-blown anxiety in future outings where food is involved.

“It may be that there has been a direct incident in the person’s past where they have had a negative experience of eating in front of others, [whether it’s] being told that they eat in an antisocial manner, [or one bad] comment or an event,” said Click For Therapy’s Rebecca McCann. “It may also be linked with low self esteem, a feeling of not being good enough that adds to feelings of anxiety.”

Anxiety and Disordered Eating

The relationship between eating, anxiety, and body issues can be even more complex than social anxiety disorder. Anxiety around food, and the fear of how others view you, can lead to disordered eating.

“Having a difficult time eating in front of others can also be a warning sign of developing an eating disorder in the future,” writes Williams.

A 2012 eating behaviors study on the correlation between social anxiety and eating disorders, for example, found that the fear of being viewed poorly in social situations, especially while eating, predicted “body dissatisfaction, bulimic symptoms, shape concern, weight concern, and eating concern.” A “fear of negative evaluation” often led directly to a desire for thinness and restraint around eating. This makes eating and body image perception even more complicated, especially with other people around.

“It takes a great deal of mental energy to quiet the constant eating disorder voices that are saying things like, ‘You shouldn’t eat that,’ ‘That has too many calories,’” said Williams. And this is where things get really difficult. “Those eating disorder voices get even louder when you add worries regarding about how others are perceiving you.”

Eating to Ease Anxiety

On another side of the equation, eating can be used as a way to relieve anxiety, feeding into a vicious cycle between food issues and body image discomfort.

“Anxiety symptoms and disorders frequently co-occur with overeating,” writes psychologist Jennifer Pells. “The hoped-for effect of this coping strategy may be to suppress, numb, distract, soothe, avoid, or mask the original anxiety.”

Overeating to soothe anxiety can happen for a number of reasons. Food can be used as an escape from self-awareness, and therefore hard feelings, because of the concentration on an alternative, yet immediate stimuli: food.

Food also works as an emotional regulation tool through binging, though often this can make people feel depressed, guilty, or shameful afterward. However, these negative emotions serve as a “trade-off” to minimize the heightened discomfort of an anxiety response, creating a complicated relationship between eating and how we view our body after overindulging.

Help for Food Anxiety

Taken together, if anxiety around food and body image are taking their toll, know you are not alone. Reach out for support from trusted loved ones or your therapist if you’re feeling anxious about eating or struggling with your body image. At the end of the day, we all deserve to feel good in our body no matter our shape, and eat in a way that nourishes our body, mind, and soul, whatever that means for each of us.

“There is one golden rule to normal eating, and it is this,” writes registered dietitian Michelle Allison. “No one decides what or how much goes in your mouth but you.”

And remember: there’s no wrong way to have a body.

The post My Holiday Anxiety Around Eating and Body Issues appeared first on Talkspace.

To illustrate this point, I am going to share two different client scenarios below. Each of them may seem like a typical case of anxiety, mild depression and struggles with self-confidence and lack of happiness. With a closer look through the lens of an eating disorder therapist, these two stories take on different meanings.

Client Scenario 1: Depression and Anxiety with Subtle Signs of an Eating Disorder

A client and therapist have been meeting for several sessions. The client’s initial reason for therapy was to deal with anxiety and depression that seem to come and go.

In the sessions, the client talks about how anxious she becomes when people invite her to a social event. In these discussions she also mentions the idea of eating in front of others is difficult. Her anxiety increases and she cannot focus on what is happening.

She loses her train of thought when talking or finds it difficult to engage in any meaningful conversation with others. After she departs from the social event, she is left feeling disconnected and depressed.

Client Scenario 2: Confusing a ‘Lifestyle Change’ with Something Else

Another client comes into therapy because she is struggling with feeling confident in herself. She says she needs to make a few changes that will help her feel more positive.

From the start she is talking about how she has tried many diets, but they don’t seem to work long-term. She feels good when she is working the diet. At some point, however, she blows the diet and is back to feeling like she will never be able to lose the weight and feel good.

She is currently trying a “lifestyle” change and is working with an online healthy living coach. She has lost some weight and is feeling good about this. During her sessions she reports to you how well she is doing with following her diet and how good this makes her feel.

She also shares that she has been to several social events. Each time she has brought her own food because the thought of not knowing what foods will be there makes her really anxious. If there are any “bad” foods being served, she couldn’t take the chance of ruining her day by eating these foods.

Looking Past the Surface

If you are not looking for eating disorder red flags, you would likely see the first client only as someone who is struggling with anxiety that can lead to feelings of depression. The second client could be seen as a woman who has been struggling with having confidence and simply did not find a diet that “worked.”

If you are looking through the lens of an eating disorder therapist, however, this anxiety/depression and struggle to find confidence and happiness looks much different.

The unspoken signs with the first client could sound like this:

• “My days are spent thinking about food, what foods I can eat, which foods are off limits.”
• “If I eat that food I am going to feel like such a bad person.”
• “I don’t deserve to eat anything.”
• “When I am in a social event that involves food, I feel so overwhelmed, anxious and scared I can’t concentrate on anything except all the food thoughts and food rules that are going through my head.”

With the second client the thoughts might be:

• “I hate my body”
• “I will never be thin enough or pretty enough for anyone or good enough for anyone or anything.”
• “I can’t eat any foods that are not on my food ‘rules’ list.
• “If I do eat any bad foods, I am such a failure.”

When you look at each client through the lens of an eating disorder therapist, the stories become different. Eating disorders are deceptive. It is easy to miss their unspoken signs.

Remember, these signs don’t guarantee the client has an eating disorder. They are, however, always worth discussing.

Going Beyond the Stereotypes of an Eating Disorder

Both of these clients could be of average, above average or somewhat below average weight for a person their size. Unless a client is severely under or overweight, a therapist cannot look at a client and determine from their size if they do or do not have an eating disorder. With the exception of the client deciding on their own that they need help with their eating disorder, it is going to take the skills of the therapist to discover and bring into discussion the unspoken signs.

We often think of people with eating disorders as having some sort of extreme weight or symptom such as binging or purging. People with eating disorders can look or act much different than that, though.

An eating disorder can be anything that includes “extreme emotions, attitudes and behaviors surrounding weight and food issues,” according to the National Eating Disorders Association [NEDA]. If anything related to food, weight or body image prevents you from living a full and happy life, it is a mental health issue — maybe something a therapist can help you with.

The post How Therapy Subtly Reveals Whether You Have an Eating Disorder appeared first on Talkspace.

I had the opportunity to work at a clinical research lab with a young woman who suffered from bulimia nervosa. She said no one close to her knew she had an eating disorder because she had an average body weight and only binged or purged when she was alone.

She was happy no one knew about her disorder but simultaneously hoped someone would notice what she was going through and try to help. She felt both proud and ashamed of what she was doing to her body and had trouble admitting she had a problem.

Her symptoms emerged at the end of her freshman year of college because she was overwhelmed by schoolwork and gained weight suddenly.

Although no one made comments about her size, she felt like people were looking at her “fat” and silently scrutinizing her body all the time. She interpreted unrelated comments as evidence she was “overweight.” She felt uncomfortable being a “larger size” than the rest of her friends.

Beyond her body image concerns, she also suffered from depression due to low self-esteem about her academic ability. She felt like various aspects of her life were “falling apart” — her grades, her body and her social life.

She binged when she felt depressed or anxious and purged when she felt “fat” or “out of control.” She wished she “had more self-control” like her friends who were “skinny” and “academically successful.”

Bulimia nervosa is a serious, potentially life-threatening condition that affects 1-2% of adolescent and young adult women, according to The National Eating Disorders Association. Approximately 80% of sufferers are female.

Individuals usually appear to have an average body weight and often suffer from depression and low self-esteem. It’s important to recognize these common signs and symptoms of bulimia nervosa if someone you know needs help.

This young woman felt ashamed of her illness and afraid to open up about her experience. Although I wasn’t her therapist, she was relieved to tell me about her symptoms and became motivated to tell others and get the help she needed. This is typical of many women dealing with an eating disorder who end up suffering in silence out of fear of rejection and being “found out.”

Eventually she was able to open up to her sister and a close friend about her condition. Telling her story and receiving supportive feedback allowed her to accept her symptoms and seek therapy.

In honor of National Eating Disorder Day, let’s become aware of these stories and support people on their path toward recovery. Their experiences are rich and nuanced. They deserve our attention. By understanding and empathizing with individuals who have struggled with an eating disorder, we can aid sufferers in overcoming internalized stigma and feeling safe enough to come forward.

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