Don’t Oversimplify the Cause of Eating Disorders

Common Misunderstandings about the Cause of an Eating Disorder Dismiss Important Factors

We humans can be a simple-minded breed. In order to make sense of difficult or challenging issues in our lives we seek ways to make quick and easy assessments, avoiding the work involved in plumbing the layers of complexity to get to the real root of a problem. This tendency to find a simple explanation for a serious condition applies all too often when trying to understand eating disorders. When a loved one is in the grips of an eating disorder, there is a desire to explain it away. The usual default most people turn to is that he or she is so obsessed with emulating the svelte, toned bodies of their favorite celebrities that they are willing to starve themselves to look like them. Or, that the images they have grown up with—the Barbie dolls with the microscopic waistlines, the emaciated fashion models teetering on the brink of collapse on the catwalk, or overly airbrushed images in the print media—are what’s really to blame for the unhealthy desire to be stick thin. No one wants to face the music, to dig below the trite superficial reasons for disordered eating and expose the often-complicated psychological underpinnings to the disorder. Why is that? It’s because looking under the hood may reveal damage that is unsettling and difficult to accept—like ignoring a funny sound your car is making thinking it’s just in need of a simple tune-up, when in reality the transmission is going out. Who wants to deal with that?

The BioPsychoSocial Roots of an Eating Disorder

The harsh reality is that deep psychological disorders, personality traits, or even genetics can be the causes of a serious mental health condition manifesting itself in disordered eating habits. Addressing these uncomfortable possibilities is difficult for the parents, spouses, or friends of the person suffering from an ED. There may be feelings of guilt, shame, or confusion after uncovering the painful truths that may be at the root of their loved one’s problem; it is much easier to simply blame the media or culture for it. The different types of eating disorders (anorexia nervosa, bulimia nervosa, binge eating disorder) each have their own unique set of factors that may have contributed to the ED. For instance, someone with anorexia may be a perfectionist where someone with bulimia may have an impulsive nature. Some common underlying factors across the ED spectrum may include:

– Anxiety and/or depression
– Sensitivity to reward and punishment
– Excessive persistence (especial in anorexia nervosa)
– Perfectionism
– Sense of having no control over one’s life
– Coping skill deficits
– Trauma, such as physical or sexual abuse or the death of a loved one
– General feelings of inadequacy
– Genetic predisposition if close family members have ED
– Altered brain circuitry in anterior insula, striatal region, and anterior ventral striatal pathways
– Disruption in serotonin pathway
– Low self-esteem
– Family dysfunction or disruption such as divorce
– Impulsivity (especially in bulimia nervosa)

While it is true that an eating disorder results in the obsession with food, appearance, weight, and size, what drives the individual to become so obsessed is a complex and varied set of factors. If eating disorders were simply the result of a culture obsessed with thinness, why is it that only about 3% of the American public struggle with one? Wouldn’t the effects of the societal pressures to conform to an idealized physical size or shape affect everyone in the same way? Since this is not the case, it points to the certainty that the development of an eating disorder has its underpinnings in factors other than simply cultural influences.

Casa Serena can help

The compassionate professionals at Casa Serena are trained to identify which set of factors is contributing to an individual’s eating disorder. Understanding that the reasons are varied and unique to each individual, our program is successful because we get to the root cause of the disorder and will guide the individual to a path of recovery based on their own individualized treatment plan. At Casa Serena we place understand the importance of a support system, so family involvement is considered a key component in the individual’s long-term recovery. Call us today at (925) 682-8252

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Calling Binge Eating what it is…a Real Disorder

Understanding the Very Real Dangers of BED

When people hear the terms ‘anorexia’ or ‘bulimia,’ most understand these words to represent complex mental health disorders that result in disordered eating.  For decades now, public awareness of the serious emotional issues that underlie anorexia and bulimia have helped people understand the validity of these dangerous psychiatric conditions.  However, upon hearing the term ‘binge eating disorder,’ many may wrongly associate it with simply a lack of self-control or a character flaw rather than as a bona fide disorder.

On the contrary, binge eating disorder, or BED, was recently added to the revised Diagnostic and Statistical Manual (DSM 5), recognizing it as a valid, diagnosable illness.  By adding BED to the DSM it gives health professionals specific diagnostic criteria that will aid clinicians in identifying and assessing the disorder, leading to effective treatment decisions for those struggling with BED.

What is Binge Eating Disorder?

Because the word “binge” has been used loosely to describe compulsive behaviors such as binge-watching a TV series, or “binging out” on ice cream after a break-up, there is a tendency to dismiss a binge eating disorder as just a reckless overindulgence in food that has resulted in weight gain; just as binge-watching on Netflix results in lost productivity.  It is a misnomer though, as BED usually has co-occurring mental health conditions that drive the disordered eating, which can result in dire health and psychological outcomes.  These comorbid mental health conditions include:

  • Anxiety
  • Bi-polar disorder
  • Depression
  • Substance abuse

Binge eating disorders affect about 2.8 million adults, according to a 2007 national survey by Biological Psychiatry.  Of those who suffer from BED, 5.2% will die from health complications that resulted from the disorder.  Shockingly, BED is more prevalent in adults in the U.S. than both anorexia and bulimia combined.

Those who suffer from BED use food to manage emotions they do not want to experience.  These unwanted emotions include anger, boredom, guilt, stress, sadness, or a sense of being out of control.  Someone with a BED will attempt to offset these emotions with the pleasure they anticipate they’ll feel by consuming vast quantities of comfort food on a recurrent basis.

BED is also accompanied by a fixation on body image, leading to compensatory behaviors after over-indulging in the food, such as vomiting (although purging is not a common trait in BED), using diuretics or laxatives, or over-exercise.  Despite the serious psychological and sociological issues that underlie BED, the disorder is often misdiagnosed as simply an issue with weight.

Diagnostic Criteria for BED

The DSM-5, published in 2013, lists the diagnostic criteria for binge eating disorder as such:

 Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:

  • Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than what most people would eat in a similar period of time under similar circumstances
  • Eating much more rapidly than normal
  • The binge eating episodes are associated with three (or more) of the following:
  • A sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating)
  • Eating until feeling uncomfortably full
  • Eating large amounts of food when not feeling physically hungry
  • Eating alone because of feeling embarrassed by how much one is eating
  • Feeling disgusted with oneself, depressed, or very guilty afterward
  • Marked distress regarding binge eating is present
  • The binge eating occurs, on average, at least once a week for 3 months
  • The binge eating is not associated with the recurrent use of inappropriate compensatory behaviors (e.g., purging) as in bulimia nervosa and does not occur exclusively during the course of bulimia nervosa or anorexia nervosa

 Signs and Symptoms of BED

Although there are a multitude of variations of BED, there are certain signs and symptoms that someone may be suffering from this serious disorder.   By being aware of these signs, the chance for successful treatment of the disorder is made possible.  Some behaviors are displayed that may be predispositions for developing an eventual BED, but not necessarily.  Regardless, awareness is key in helping a loved one with a mental health condition such as BED.

Emotional characteristics of BED

  • Depression, social isolation, and moodiness
  • Feelings of anger, shame, anxiety and worthlessness preceding the binge
  • Negative or distorted body image
  • Rigid thinking
  • Perfectionist tendencies
  • Need to be in control
  • Conflict avoidance

Behavioral characteristics of BED

  • Eating secretly, hiding, stealing, or hoarding food
  • Disappearance of large amounts of food, empty wrappers or containers indicating large quantities of food consumed
  • Periods of impulsive or continuous eating beyond the point of feeling full, but does not purge. Eating fast, or eating large amounts of food when not hungry
  • Creating rituals allowing for binge sessions
  • Extreme rigidity with food, with periodic dieting/fasting

Effects of BED

A binge eating disorder can put someone at risk for developing several serious health conditions, including heart disease, type 2 diabetes, or high blood pressure, mostly due to obesity or radical weight fluctuations.  Because of the comorbid psychiatric conditions, a BED can also lead to a substance abuse disorder, which in itself can lead to death.

In addition to the physical effects, a BED can cause the sufferer to become disengaged from their normal responsibilities, eventually becoming unable to keep up with their obligations.  A BED can also affect relationships, due to the secretive behaviors and shame that may cause the sufferer to withdraw from loved ones.

Because BED is often a misunderstood condition, it is important to seek help from a provider who is an expert in the field of treating eating disorders.  At Casa Serena, our specialized professionals use evidence-based treatment methods in a caring and supportive environment to effectively treat BED.   Allow our compassionate staff to restore you or your loved one to good health and renewed quality of life.  Call us today (925) 682-8252!

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