Eating Disorders

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Living free from eating disorders

Tens of millions of Americans currently struggle with eating disorders, and the problem appears to be growing. Teenage girls and young women are the most commonly affected, but eating disorders occur in both genders, all ages and all ethnic backgrounds worldwide. Many people go undiagnosed because they conceal their illness.

Eating disorders are life-threatening. Untreated, eating disorders can lead to malnutrition, organ damage and death. The psychiatric effects and impact on relationships are also severe, causing some people with eating disorders to turn to drugs or alcohol to numb their feelings of shame, depression, anxiety and fear.

Major symptoms of eating disorders include undereating, overeating, binging, and/or purging. Sometimes people with eating disorders overexercise, take laxatives or use drugs to suppress their appetites. Though the causes and symptoms differ, most people with an eating disorder share one common problem: a negative body image.

Body image

Body image distortions are part of the diagnostic criteria for eating disorders. The American Psychiatric Association’s 2012 Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), defines body image distortions as a “disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or persistent lack of recognition of the seriousness of the current low body weight.”

Body image distortion is a dislike of one’s own physical characteristics. A negative body image leads to low self-esteem and poor mental and physical health. No one likes everything about his or her body, but when thoughts become obsessive and the resulting behaviors interfere with daily activities, body image distortion becomes a problem.

According to the DSM-5, there are different ways eating disorders can manifest. The following are the most common. Descriptions are quoted from the DSM-5.

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Anorexia nervosa

Anorexia nervosa is self-starvation, or the “restriction of energy intake relative to requirements, leading to a significantly low body weight in the context of age, sex, developmental trajectory, and physical health.” There is an “intense fear of gaining weight or of becoming fat, or persistent behavior that interferes with weight gain, even though at a significantly low weight.” Severity is based on calculation of the body mass index being below 15 percent of minimum expected weight for height.

Other signs and symptoms of anorexia include:

  • Elaborate food preparation and eating rituals
  • Excessive exercise
  • ­Amenorrhea (absence of menstruation)
  • Cold intolerance
  • Constipation, bloating
  • Fatigue, weakness
  • Cognitive impairment
  • Hair loss or thinning
  • Growth of lanugo (soft, fine newborn-like hair) on extremities, face and trunk
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Bulimia nervosa

Bulimia nervosa includes both eating large amounts of food within a short period of time and feeling out of control while doing so. Bulimia is the “recurrent inappropriate compensatory behaviors in order to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, or other medications; fasting; or excessive exercise. The binge eating and compensatory behaviors both occur, on average, at least once a week for 3 months.” Severity is graded by number of episodes per week.

Other symptoms of bulimia include:

  • Sore throat
  • Tooth sensitivity
  • Eroded tooth enamel
  • Gum disease
  • Calluses, abrasions, bruising on hand and thumb
  • Swollen but non-tender parotid glands (large salivary glands in front of the ears)
  • Abdominal tenderness
  • Ankle swelling

Binge-eating disorder

Binge-eating disorder is characterized by “recurrent episodes of binge eating a large amount of food within a 2-hour period.” Those with binge-eating disorder feel a loss of self-control over what and how much they consume. During an episode, they eat “very rapidly, eating until uncomfortably full, eating when not physically hungry, and eating alone due to embarrassment over the large quantity being eaten, and feeling disgusted, depressed, or very guilty afterward. Marked distress is present. The binge eating occurs at least once a week for 3 months.” Severity is graded according to the number of binges per week.

Other symptoms of binge-eating disorder include:

  • Weight gain or fluctuations in weight
  • Depression
  • Anxiety
  • Compulsive self-harm behaviors, which may or may not be present, such as hair-pulling or skin-picking
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Mental and physical costs of eating disorders

Mental and physical costs of eating disorders depend on the causes, symptoms, duration and severity of the illness. Problems not only affect the person with the disorder, but all of the people in his or her life. Some examples include:

  • Infertility
  • Tooth and gum disease
  • Gastrointestinal disorders
  • Neurological damage
  • Multisystem organ failure
  • Type 2 diabetes mellitus
  • Impaired functioning in family, school, work and social roles
  • Damaged relationships with family and friends
  • Death from heart failure, organ failure, malnutrition and suicide

Co-occurring disorders

Eating disorders rarely occur in the absence of other emotional disturbances or mental illnesses. Whether other illnesses cause or result from eating disorders is unclear, but each can exacerbate the other. The most common underlying or co-occurring disorders are as follows:

  • Depression
  • Anxiety
  • Post-traumatic stress disorder
  • Substance use disorder
  • Bipolar disorder
  • Other mental illness
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Treatment at Sovereign Health

Only 1 in 10 people suffering from eating disorders receives any treatment at all, and only 35 percent of those who receive treatment are managed in a specialized facility. Since eating disorders have one of the highest mortality rates of all mental health disorders, prompt diagnosis and treatment is essential.

The Sovereign Health Eating Disorder Programs are located in Sothern California at the following locations:

  • San Clemente, California (women age 18 and older)
  • Rancho San Diego, California (girls age 12 to 17)

Both facilities offer cognitive behavioral therapy and dialectical behavior therapy, two forms of evidence-based treatment that have been found to reduce the symptoms associated with eating disorders. Our patients develop healthy lifestyle habits by also participating in:

  • Nutritional education
  • Daily exercise
  • Process groups
  • Body image therapy
  • Stress management
  • Empowerment workshops
  • Experiential therapy (art, yoga, music and equine therapy)
  • Group outings, which occur on a regular basis

Our specially trained, onsite dietitian helps patients plan out their meals. These individualized meal plans are designed to help our patients understand their personal nutritional needs and accept food as a welcome part of living. Our clinicians also help patients shop for food and participate in dining excursions.

About Sovereign Health

The Sovereign Health Eating Disorder Programs provide residential, partial hospitalization and intensive outpatient levels of care. We provide individualized care plans tailored to each individual’s specific needs. We use state-of-the-art techniques to treat underlying and co-occurring illnesses. Medically supervised detoxification is available to those who are also chemically dependent. Our treatment team works together with teens, women and their families to find a solution that works for them. For more information about eating disorders or our program, please call our 24/7 helpline.