Eating Disorder 101: A Mental Health Therapist Answers Your Most-Asked Questions -Part II

Part II - Effects & Finding a Dietitian

Note: There are two parts to this article. For “Part I - Getting Familiar with Eating Disorders,” click here.

I’m Limor Weinstein, founder of Bespoke Wellness Partners, and I am going to answer some of your most-asked questions about eating disorders (ED). My background, experience, and education as a licensed mental health therapist are centered on personal and family well-being. As a mother, wife, and psychotherapist, my goal has always been to provide emotional support and knowledge that may be absent due to a variety of variables. I myself am an ED survivor. I am also an Eating Disorder Specialist who works with clients to help them find their way to better health.

What health risks are related to ED?

There are many health risks related to eating disorders. Each eating disorder has its own health consequences due to the nature of the disorders. As Anorexia Nervosa is characterized by self-starvation, the body is forced to live without the essential nutrients it needs for normal functioning. Anorexia can lead to abnormally slow heart rate and low blood pressure, which increases the risk for heart failure, reduction of bone density, muscle loss and weakness, and severe dehydration, which can result in kidney failure, fainting, fatigue, overall weakness, dry hair and skin (hair loss is common). It is also possible that there is a growth of a “downy layer of hair called lanugo” all over the body to keep the body warm (NEDA).

With the binge-and-purge cycle of Bulimia Nervosa, the entire digestive system becomes affected, which leads to electrolyte and chemical imbalances of the body. These electrolyte imbalances “can lead to irregular heartbeats and possibly heart failure and death” (NEDA). This is because electrolyte imbalance is caused by “dehydration and loss of potassium, sodium and chloride” from the body each time the individual purges (NEDA). Gastric rupture can occur during binging. Frequent vomiting can lead to inflammation and possible rupture of the esophagus, tooth decay, and staining from stomach acids. Abuse of laxatives can lead to “chronic irregular bowel movements and constipation” (NEDA).

The consequences of Binge Eating Disorder are similar to the health risks associated with clinical obesity. These include high blood pressure, high cholesterol levels, heart disease due to elevated triglyceride levels, type II diabetes mellitus, and gallbladder disease (NEDA).

Are there any ED withdrawal symptoms? What are they?

Withdrawal from an eating disorder is similar to withdrawal from other addictions. According to a study done by Indiana University, symptoms of withdrawal typically include irritability, cravings, and general restlessness.

Why do people fear overcoming ED?

Fear comes with this decision to recover from an eating disorder because until this point, the eating disorder has helped the individual to feel safe and secure. The eating disorder has given this individual a sense of control and identity. This is why it becomes difficult to stop an eating disorder. But, it is possible. The person affected by the eating disorder must overcome their feelings of helplessness, guilt, shame, and self-disgust to seek help. Once they do this, they will still fear letting go of their eating disorder and going through a change. These fears should be acknowledged and discussed to help in the road to recovery.

There is, of course, always the fear of relapse. The final stage of recovery, maintenance, is about new experiences and adjusting to new developments. With this there is the chance of relapse, but this cannot be the focus of recovery. This is why recovery is an ongoing process, involving asking for help and communicating through thoughts and feelings.

You’ve said that, “While it might not be easy to stop ED, it can be enjoyable.” Can you elaborate?

Although it is not easy to stop an eating disorder, it can be enjoyable. Depending on the type of treatment that one goes through, he or she will likely be surrounded by other people in treatment, which can be both good and bad. By being surrounded by like-minded individuals, one can see that they are not alone, that there are people out there going through the same thing as them who are also looking to get help.

As August McLaughlin discusses in “The Silver Lining: 5 Happy Truths About Eating Disorder Recovery,” there are positive aspects in the road to recovery. Recovery leaves people “feeling lovelier, inside and out.” Individuals with eating disorders have distorted views of themselves both physically and mentally. They want to lose weight to fix their physical appearance and they take these drastic measures to make them feel better internally. Treatment, however, teaches people how to appreciate themselves for who they are and to love each and every part of themselves. Treatment leads to greater energy. Eating disorders take an extreme amount of physical and emotional energy to sustain. By letting go of an eating disorder people will gain back this energy to do things they love physically and to think about something other than the eating disorder.

Treatment also brings enjoyment back to food. Food is no longer as scary as it once may have seemed. By mending one’s relationship with food, he or she can enjoy their favorite foods without feeling the extreme guilt before, during, and after. Treatment leads to freedom. Eating disorders have such control over people’s lives. By not letting the eating disorder dictate every life decision, individuals are surprised to see how much they can freely live their life by their own rules.

Lastly, treatment leads to gratitude. Living with an eating disorder can be extremely challenging and detrimental. People in recovery, living without an eating disorder, will learn to be thankful for their bodies and minds. It may be scary to think about what one’s life would be like giving up this eating disorder that has had so much control, but there is nothing to lose by giving up an eating disorder, just a beautiful life to gain.

I’m sick of people focusing on why I shouldn’t maintain my ED (health risks, etc.)! Can you tell me why people do continue their ED?

It is easy to list all of the reasons why clients should try and get rid of their eating disorders. There are health risks involved, the eating disorders take over the individual’s life, there’s dramatic weight loss as well as damage to the digestive system and potential organ damage. Sometimes it is not enough to express to the client the negative effects that an eating disorder can have. Rather, we should focus on why people maintain their eating disorders. People become comfortable with their eating disorders. They begin living a lie and don’t know how to get out of it or if they even want to. As stated earlier, the eating disorder that has such control over their life becomes a sense of security and control. The eating disorder begins making life decisions that the individual does not have to make. Furthermore, the eating disorder becomes his or her release. The willpower not to eat, the binging, purging, or excessive exercise gives the individual a way to relieve stress.

By teaching clients alternative ways to have control in their daily lives or new ways to cope and calm themselves, clients can hopefully give up the detrimental ways in which they achieve this through their eating disorders. If a client can begin to enjoy these alternatives they may be more likely to give up the harmful techniques they were using and transition into recovery.

Is it a myth that the ED person "sacrifices” something or deprives themself when they stop their ED?

Many people believe that when they quit something they are addicted to they will be sacrificing something. In the case of eating disorders a client may feel that they are missing out on something by giving up their eating disorder. To help with recovery we must show how positive it can be to live a life without an eating disorder. There should be “nothing to fear, nothing to ‘give up’ and absolutely everything to gain” (Carr, 2011).

Why do eating disorders provide people with a feeling of safety and security?

Life with an eating disorder provides people with a feeling of safety and security. This is because eating disorders are started out of instability, with the hope that the eating disorder will create stability or some kind of control. Eating disorders hold great control over individuals lives that they grow accustomed to over time. It can be scary to let go of this sense of control and comfort that they have been living with.

Is there a link between boredom and ED?

Yes, many people eat out of sheer boredom. It is important to differentiate between biological hunger and boredom. When we develop negative eating habits, we become unaware of why we are eating. An individual may try to fill themselves up with food when they do not feel like their lives are full. Eating becomes a mindless activity, similar to when one emotionally eats.

What is going on in the brain of an eating disorder client?

In addition to the other emotional, physical, and social effects that eating disorders have on an individual, eating disorders can lead to neurological damage (Emilyprogram.com). A client’s nervous system is negatively impacted when they engage in restrictive behavior. This leads to disruptions in neurotransmitter behavior, structural changes, and abnormal activity during anorexic states, a weakened response in the reward regions of the brain, and potential shrinking of the brain. Nerve-related conditions such as seizures, disordered thinking, and numbness or odd nerve sensations in the hands or feet are also possible effects. Eating disorder clients may become depressed, irritable, or isolated due to the adverse effects on the emotional centers of the brain. An individual also could have difficulty thinking, switching tasks, and setting priorities due to the disruption in the brain’s normal functioning.

Is it an illusion that I can overcome my eating disorder?

In some cases, body dissatisfaction does not change once an individual has “recovered” from an eating disorder. Even when the physiological and behavioral aspects return to status quo, mentally a client may still feel negatively about their body. This is why recovery from an eating disorder is an ongoing process that involves overcoming daily triggers that an individual may encounter. However, it is not an illusion. There can be a light at the end of the tunnel.

How do I stop?

Unfortunately, this is not as simple as reading a response. However, I’ve put a list of things I have my clients ask themselves:

1. What does the ED really do for me?

2. What purpose does it serve?

3. Do I really enjoy it?

4. Do I really need to go through life playing with my health just to maintain my eating disorder?

5. What am I getting out of maintaining this eating disorder?

6. Would my life be incomplete without it?

7. How could I make my life more complete so I can get rid of my eating disorder?

8. How can I use the resources and people around me to help?

Where can I find a dietitian?

If you are trying to figure out where to find a dietitian, chances are, there is someone not far from you. There are fabulous nutritionists, dietitians, and eating disorder therapists all around the country who are qualified and ready to help you. Your doctor may have some good recommendations if you want to find a local dietitian. Do you want someone who is uniquely matched with you? Contact us. We will learn about you - from your personality, your history, your health past, your struggles, and your goals - and we will find someone in your area who fits you best. We have many fantastic providers whom we trust and adore to help guide our clients on their path to recovery.

If you or someone you know is struggling with an ED, it’s time to take the necessary steps to change life for the better. You can grow into the best version of yourself, starting right now.

If you would like me to connect you with one of our expert therapists or coaches, contact me. I look forward to hearing from you!