With the holidays here, many people have asked me questions about eating disorders: how to recognize warning behaviors, how to handle a person believed to be struggling with an eating disorder, and a few other concerns. The following is a short list of frequently asked questions and answers which are intended to be only an overview. Please visit my website: www.simpleserenity.com for additional information and a current list of resources.
It is important to understand that not all behaviors are created equal – meaning each behavior has a different meaning for each individual. One person may be counting calories to become more aware and intentional in the face of food portions and calorie content. Another person may be caught in food restricting and dangerously controlling behavior involving calorie counting and specific food groups. It is important to use your intuition and trust yourself in observing other people, such as a family member or a friend. Above all, bring patience, compassion and love to the situation before making any decisions or forming any opinions.
The world of eating disorders is large and complex – the following questions are only a start. Hopefully, this information will be helpful.
What are some of the behavioral changes seen in those with eating disorders in general?
The most frequent signs I have seen in my practice include:
- Restricting food, feeling guilty about eating, counting calories, avoiding eating
- Labeling foods “good or bad”, “safe or unsafe”
- Weight loss from restricting calories
- Weight gain from overeating
- Binging on foods
- Weighing often
- Wearing baggy clothing to cover up low weight
- Excessive exercising or exercising when tired or ill
- Cooking for others and not eating herself or himself
- Appearing frail and being cold – having a low body temperature
- Using substances for weight control such as laxatives, diuretics, diet pills, etc.
- Constantly eating and feeling incapable of stopping
- Eating in isolation
What are some different ways you have used to treat an individual with an eating disorder? Are there specific medications involved as well as behavioral changes?
Since I am not an M.D., I do not prescribe medications. There are some medications that have been proven to reduce the symptoms of bulimia – and some that treat depression with a side effect of improving the symptoms of an eating disorder. This is clearly the responsibility of a person’s physician to prescribe and monitor. I work with people so they can grow and develop as the strong person they are capable of being – and therefore, do not need their disordered ways of behaving anymore. I introduce and teach mindfulness based stress reduction and mindful practices to assist a person to become aware – of thoughts, feelings, sensations and ultimately choices. All healing starts with mindful awareness. I teach the skills of mindfulness and assist the client to “grow” more expansive than their disorder – so the disorder can be “put out of a job” and not needed anymore.
How would you advise a family member to approach a loved one they suspect has an eating disorder?
- With love and compassion above all
- Accept the eating disorder as serious, an illness, that needs treatment
- Go to therapy with a loved one
- Educate yourself about the illness
- Listen and seek to understand before reacting
- Pay attention to signs and symptoms
- Be honest with yourself about what you see and feel without judgment
- Be patient – there are many stages and steps in treatment and recovery
How successful has treatment been for those who have sought assistance?
I have had a 100% success rate with clients who take personal responsibility for their health, do their homework and attend each session and work with me until they are behaving in a healthy manner – making choices to affirm their health on a daily, hourly and moment to moment basis.
What are some common physical characteristics to look for if you suspect someone is anorexic?
- Low body weight
- Wearing excess layers of clothing for warmth
- Calorie and food category restriction
- Appearance of lanugo: soft hair growing on face and other parts of the body
- Frail and gaunt – bones often showing
- Low body temperature – feeling cold most of the time
What are some common physical characteristics to look for if you suspect someone is bulimic?
- Swollen glands on either side of the lower face
- Uses language: “Binge and purge”
- Uses language: “getting rid” of food
- Often disappears following a meal or snack
- Uses laxatives, diuretics or other substances inappropriately
- May restrict calories
- Regulates mood by binging and purging
This is a very difficult disorder to “see” and diagnose. I added a couple of additional (to physical) symptoms to know about. Many times these individuals are highly successful and creative, often hiding the disorder and appearing “normal” to family and friends.
Which eating disorder do you yourself encounter most frequently, and why do you believe this disorder occurs more frequently than others?
I see a wide variety of disorders, no one being the most common in my experience.
The most frequent behavior is “control” or wanting a sense of control over one’s life (in the arena of food). This sense of control could be from restricting and losing weight (anorexia) or from some other consequence of attempting to have a feeling of authority and power over one’s life and circumstances. I personally believe our society contributes highly to eating disorders by encouraging a need to achieve and be desirable, according to external standards. The media is a powerful inspiration to many vulnerable individuals.
What is the average amount of time an individual has an eating disorder before seeking professional help? What seems to be the motivation for seeking treatment, other than to restore health (i.e. relationships, psychologically, family members insist, etc…)
This varies so widely, there is no ‘average’. Sadly, many people wait until they are quite ill – or “controlled by” the behavior established and feel desperate. All of your suggestions for reasons are valid and I see it all as contributing, on some level, to eating disorders
Are you aware of any hormone deficiencies or imbalances that may predispose an individual to an eating disorder?
Yes. Being poorly nourished is a state the body does not do well with. The brain is affected, the entire psycho-physiological balance and stability is affected and hormones are thrown off as well. Starvation is a very serious state and leads to serious deficiencies. Currently, there is research being done on this topic: predisposing factors. It is a topic that we will be seeing more frequently in the literature. Stress is a precursor, as many hormones and substances in the body become abnormal, leaving a person vulnerable to a “fight or flight” response that may not be healthy. Once the body is on “alert status” from a fight, flight or freeze response, all bodily systems are impacted and symptoms may develop, such as high blood pressure, headaches, etc., which can soon lead to lessened health and well – being. Eventually, the body begins to breakdown and serious illness may result.
From your encounters, what are some of the reasons an individual develops an eating disorder?
Family pressures and dysfunction; school and social pressures (to be thin); sports or dance pressures; need for control; to escape life and create a pseudo-life that gives the sense of power or control; to numb feelings; to avoid the challenges and/or rewards of growing up and maturing. These are a few contributing factors, none of which are to blame entirely for eating disorder behavior. Most of the time, an eating disorder begins as a means to ‘cope’ – somehow – with a life that is different from one that is wanted or wished for. Sadly, in our culture, we are not often taught to be happy with who we are and to trust ourselves. Rather, we are taught to trust authority (as the last word), to strive, to progress, achieve, etc. We become further and further from ‘ourselves’, our inner self that has wisdom and intuitive strength. In my work, I bring mindfulness into the lives of each client I work with. Becoming aware – mindfully aware – is where we start.
In closing, I want to emphasize that these questions and answers are only a beginning and meant as a brief overview. I urge you to seek more information by visiting:
You may also arrange for an affordable telephone or Skype consultation with me if you have concerns, questions or are interested in learning more about one-on-one treatment. Please don’t hesitate to take action if you know you need help or if you suspect someone you love and care about has an eating disorder. I welcome your call and I am here to help.