Five ways to manage eating disorder behaviors
What is an eating disorder?
An eating disorder consists of any behaviors involving eating, food, weight, body shape or body size that impact a person’s ability to function normally on a daily basis. The behaviors associated with a person’s eating disorder may fit a variety of specific diagnoses.
The DSM-5 describes three of the most common eating disorders as follows:
Anorexia Nervosa: Anorexia involves having significant restriction of food intake that results in significantly low body weight. A person with anorexia can experience intense fear around gaining weight or feel disturbed by their current weight, shape, or size.
Bulimia Nervosa: Bulimia involves an individual having a period of binge eating, which consists of eating a significantly large amount of food for one sitting, or feeling out of control of one’s intake of food. Following binge eating episodes are periods of engaging in compensatory behaviors such as of vomiting, laxative use, diuretic use, fasting, or excessive exercise.
Binge Eating Disorder: Bing eating disorder is when someone eats a significant amount of food that would be more than an average person would eat during the same period of time. These periods are followed by feelings of embarrassment or guilt for how much the person has eaten.
Five ways to begin to manage eating disorders:
Normalize regular eating throughout the day. Depending on the diagnosis, the focus when eating these regular meals and snacks may look different. When struggling with significant restriction, it is key to increase nutrition in order to reduce negative physical side effects associated with restriction. Those binging often restrict their eating before a binge, so normalizing throughout the day can reduce episodes of binge eating. For many, this means eating three meals and three snacks, which results in eating every three hours. Someone who is significantly underweight should be monitored by a medical professional due to potential physical side effects of the refeeding process. It is also recommended to meet with an eating disorder informed dietician to learn appropriate portion sizes and nutritional needs.
Identify thoughts associated with an eating disorder and begin to challenge them. When in an active eating disorder, individuals often struggle with labeling foods as “good foods” or “bad foods.” Instead, it is healthier to see foods as fuel for the body. Individuals might also struggle with thoughts around having rapid weight gain because they ate certain foods, and it can be helpful to recognize that no one meal or snack is going to change weight shape and size. These are a few examples, but individuals may struggle with many more distorted thoughts. One way to challenge this kind of pattern is to ask, “If your friend shared with this thought with you, what would you say to them?”
Reduce distress around eating, meals, and snacks. Often individuals struggle with high anxiety around eating and fear of weight gain. Learning skills to reduce the distress can help individuals be able to eat enough to fuel their body and reduce eating disorder behaviors. One skill can be to use distractions such as crosswords, watching TV, talking to a friend, taking up a craft, reading etc. Anything that helps to get your mind off the feared situation can be a helpful distraction. Another technique can be to hold ice, an ice pack, or a frozen orange when distressed. This can help to provide individuals with a sensation to focus on and help to calm the central nervous system.
Find new ways to fill your time. Often for those struggling with an eating disorder, their eating disorder tends to take up majority of their time and their thoughts. Beginning to identify what you enjoy doing or what bring you joy can help to fill your time in constructive ways and reduce the amount of time spent on your eating disorder.
Reduce focus on your body. Individuals working to reduce their focus on their body can sometimes experience even more distress because their view of their body is distorted. To reducing checking your body in the mirror, it may be useful to cover mirrors with a towel, sheet, or collage of quotes and positive pictures so that you can only see your face. Remove access to scales because fixating on weight will only cause more distress and lead to more disordered eating behaviors. Finally, wear clothes that are lose fitting and comfortable in to reduce fixation on body throughout the day.
Final Thoughts:
These are only a few starting points to begin to address eating disorder behaviors and diagnoses. However, for many eating disorder behaviors it is helpful to learn how to apply these skills effectively with the support of a therapist, a dietician, and a medical professional. It should be noted that many eating disorder diagnoses have a significant impact on physical health in addition to mental health, and including medical monitoring can often be key in supporting a successful recovery.
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Erin Smith, MEd, LPCC is a therapist at Cleveland Health and Wellness Center who specializes in the treatment of eating disorders and additions. She is accepting new clients. Request an appointment today.