I use a *Health at Every Size (HAES)®/Non-Diet approach to therapy.
What are Eating Disorders?
Eating disorders are complex, serious mental illnesses that can lead to serious long-term mental and physical problems and illness. Eating disorders significantly disrupt peoples lives in every way – e.g., physically, emotionally, socially and occupationally. People with eating disorders usually require multi-dimensional treatment and support, such as a psychologist, GP, dietitian and psychiatrist. This is mandatory when they are medically compromised due to anorexia nervosa. Families and carers of people with eating disorders also require support and assistance.
You cannot tell whether a person has an eating disorder based on body size, shape and weight. Eating disorders can occur in people of all body types. Weight restoration is a goal of treatment for people who are medically compromised due to dangerously low weight. This is managed by medical practitioners and dietitians. I focus on supporting people of all sizes, shapes and weights with healthy behaviour enhancement- thoughts, emotions, actions – including self-acceptance, self-compassion and letting go of harmful weight prejudiced and biased diet culture that promotes eating disorders.
“Overweight” and “Obesity” are medical terms based on body mass index (BMI), to describe people with larger bodies. BMI is NOT a reliable indicator of health status, health behaviour, eating disorders or diseases. I will not accept referrals to “treat” overweight or obesity. I will not encourage people with larger bodies to lose weight. I am aware that many people with larger bodies say they developed their eating disorder due to trying to lose weight and unfortunately this was encouraged by medical and health professionals, despite over 50 years of research confirming that pursuing weight loss is ineffective and potentially harmful.
Who is at Risk of Developing an Eating Disorder?
Eating disorders affect about 9% of Australians. They are caused by complex genetic, environmental, psychological, social and cultural factors that are different for each person. HOWEVER, people who follow restrictive diets, exercise excessively and are preoccupied with “health” (beliefs about what health is are often misconceptions), are particularly vulnerable to developing an eating disorder. Psychological risk factors include perfectionistic, obsessive-compulsive, rigid and avoidant personality and thinking styles, a high need for control, body image and appearance being central to self worth and low self esteem making one sensitive to absorbing cultural standards and ideals. Women and girls have traditionally been a lot more vulnerable to developing eating disorders but they are now increasingly being diagnosed in males.
Anorexia Nervosa involves persistent dietary restriction, intense fear of gaining weight and body image distortion or disturbance. It can also involve excessive exercising. It can manifest as a way of exerting control and/or dealing with painful or frightening emotions. There is a restricting subtype and binge eating/purging subtype. There are serious health risks associated with anorexia nervosa due to weight loss and malnutrition, such as anaemia, infertility, intestinal problems, compromised immune system, kidney failure, osteoporosis, heart problems and death.
Bulimia Nervosa involves frequent episodes of binge eating followed by purging/compensatory behaviour such as vomiting, excessive exercising, fasting or laxative abuse, and body size, shape and weight being central to self worth and identity. You do not have to be under or over weight to have bulimia nervosa. There are serious health risks associated with bulimia nervosa, such as, chronic sore throat, heartburn, reflux, indigestion, inflammations and rupture of stomach/oesophagus, stomach & intestinal ulcers, chronic bowel problems, osteoporosis, fertility problems and heart problems.
Binge Eating Disorder involves eating a large amount of food in a short period of time and feeling out of control around food and while eating. People with binge eating disorder tend to be classified as overweight or obese. There are serious health risks such as osteoarthritis, kidney failure, high blood pressure and high cholesterol, which can increase risk of diabetes, stroke and heart disease.
Eating Disorders Not Otherwise Specified (EDNOS) or Other Specified Feeding and Eating Disorders (OSFED) are diagnoses for people who have some symptoms of the above but don’t reach full criteria. They are still serious mental illnesses and require treatment.
Orthorexia is not an official diagnosis yet but medical and health professionals are increasingly observing this disorder. It involves an obsession with healthy eating and lifestyle that leads to distress and impairment of functioning. It can be characterised as an unhealthy obsession with health and involves beliefs about food and health that are often not realistic.
*Health at Every Size and HAES are registered trademarks of the Association for Size Diversity and Health (ASDAH) and used with permission.