Eating and Food Issues ©

Eating disorders, such as an unhealthy reduction of food intake or extreme overeating are severe disturbances that lead to poor physical or psychological health. These unhealthy patterns can be caused by feelings of distress or concern about body weight or shape that can in turn harm normal body function and composition. When a person’s relationship to food spirals out of control, a diagnosable eating disorder has occurred.  A person with an eating disorder may start out eating larger or smaller amounts of food than usual and at some point, the urge to eat less or more can spiral out of control. Eating disorders include anorexia nervosa, avoidant/restrictive food intake disorder, binge-eating disorder, bulimia nervosa, pica, and rumination disorder.


Eating disorders frequently develop during adolescence, or early adulthood. However, reports have indicated their onset can occur during childhood or later in adulthood. Many adolescents are capable of hiding their eating disorder from their family for months, or even years. Eating issues generally occur because people develop complicated relationships with food, or their bodies that may result in overeating or under-eating and compulsive exercising, rather than allowing their appetite and hunger to dictate their eating cycles.

 

Anorexia Nervosa ©

This disorder is characterised by extreme food restriction, an intense fear of gaining weight or of becoming fat, that leads to dangerously low body weight and possibly malnutrition or starvation, among other detrimental physical effects. A person with anorexia is likely to have a distorted body image, a fear of gaining weight and experiences obsessive thoughts about food and weight. The person will maintain a body weight that is below a minimally normal level for their age, sex, and physical health.


The restricting type of anorexia is most common and occurs when people lose weight by dieting, exercising excessively, extremely low caloric intake, or fasting. The binge-eating or purging anorexia includes severe food restriction interspersed with periods of binge-eating or purging that may include compulsive exercising, using diuretics or enemas, self-induced vomiting or misusing laxatives. The emotional symptoms of anorexia nervosa are, a lack of emotion, depressed mood, irritability, social withdrawal, reduced interest in sex and thoughts of suicide.


Warning signs of Anorexia Nervosa include:

  • Bingeing

  • Brittle hair or nails

  • Compulsive exercise

  • Continual dieting

  • Depression

  • Drop in internal body temperature, causing a person to feel cold all the time

  • Growth of fine hair over body

  • Infrequent or absent menstrual periods (in females who have reached puberty)

  • Intense fear of gaining weight or becoming fat, even if underweight

  • Lethargy

  • Low blood pressure

  • Muscle weakness and loss

  • Preference to eat alone

  • Preoccupation with calories or nutrition

  • Purging

  • Severe constipation

  • Significant weight loss

  • Slowed breathing and pulse

  • Undue influence of body weight or shape on self-evaluation

Therapy

Eating disorders are a person’s way of coping with difficult emotions and feelings. Because sufferers of an eating disorder feel ashamed and guilty it is difficult for them to talk about their problem. The therapist is an independent, objective person ready to guide and support their client through their process of recognising why their eating disorder came about. They will work together on changing how the client can deal with their emotions and emotional events.

 

Binge Eating 

Binge eating is where a person feels compelled to overeat on a regular basis, often eating when they are not hungry. It usually takes place in private with the person feeling that they have no control over their eating and will result in the person having feelings of guilt or disgust. It is like bulimia in that a person will consume excessive amounts of food in a brief period.


Binge eating will lead to a surge in blood sugar and cause the pancreas to produce insulin, which is a hormone that helps to break down fat and carbohydrate in the body. This insulin will cause the blood sugar levels to fall rapidly, resulting in a false message being sent to the brain that more food is needed to top up the person’s glucose levels. Cravings for sugary foods will follow to provide a quick glucose fix. The person will then eat large quantities of food even if they are not hungry. Following the person’s consumption of these large amounts of sugary foods, the cycle will repeat itself with a rapid increase in blood sugar levels and the production of insulin.


Purging, is absent from binge-eating though the person may engage in periodic dieting or fasting to compensate for the binge-eating episode. Binges are frequently planned and can involve the person buying specific binge foods. Both depression and anxiety may be a cause, and an effect of binge eating. The emotional symptoms of binge eating are, anxiety, depression,

disgust or self-hatred, shame and a lack of control once one begins to eat.


Warning signs of Binge Eating include:

  • Avoiding social situations involving food

  • Continually eating even when full

  • Eating in secret

  • Eating large amounts of food when not feeling hungry

  • Eating much more rapidly than normal

  • Eating 'normal' quantities in social settings, and bingeing when alone

  • Embarrassment over physical appearance

  • Depressed after overeating

  • Disgust after overeating

  • Feeling ashamed after eating

  • Feelings of anxiety that can only be relieved by eating

  • Feelings of stress that can only be relieved by eating

  • Frequently dieting

  • Frequently eating alone or in secret

  • Guilt after overeating

  • Inability to stop eating or to control what is eaten

  • Lack of sensation while bingeing

  • Numbness while binging

  • Secretly stockpiling food

  • Self-harm 

  • Suicide attempts

Therapy

Eating disorders are a person’s way of coping with difficult emotions and feelings. Because sufferers of an eating disorder feel ashamed and guilty it is difficult for them to talk about their problem. The therapist is an independent, objective person ready to guide and support their client through their process of recognising why their eating disorder came about. They will work together on changing how the client can deal with their emotions and emotional events.

 

Avoidant/Restrictive Food Intake Disorder

ARFID, previously classified as a feeding disorder of infancy or early childhood, include adults who limited their eating. It is an eating or feeding disturbance characterised by a routine failure to consume adequate nutritional daily energy needs. This results in significant nutritional deficiency and a reliance on oral supplements or enteral feeding, significant weight loss, or poor weight gain in youth, or severely impaired psychological and social functioning. The person has fears regarding the negative consequences of eating like an allergic reaction, choking and vomiting, lacks an interest in food and has a poor appetite.

People with ARFID, whether child, adolescent or adult will typically have an inability to eat certain foods. This may be due to a specific colour, smell, taste, texture or temperature of the food, and sufferers may avoid certain food types or groups, such as meats, fruits and vegetables. They may have adverse reactions to foods that gastrointestinal upsets are triggered, such as choking, gagging or vomiting.

Warning signs of ARFID include:

  • Abdominal pain

  • Avoids particular types of texture or colours of food

  • Cold intolerance

  • Complaining of having no appetite without a reason

  • Consistent, vague gastrointestinal complaints

  • Consistently eating very slowly

  • Constipation

  • Difficulty eating meals with family or friends

  • Difficulty maintaining relationships

  • Dramatic weight loss

  • Dressing in layers to hide weight loss

  • Fear of choking or vomiting

  • Limited range of preferred foods becomes narrower

  • Loss of menstrual period

  • No longer eating food that were previously eaten

  • No appetite for no known reason

  • Picky eating

  • Refusing certain foods for fear you choke or vomit

  • Sudden refusal to eat food

  • Unable to finish what is served

  • Very slow eater

Therapy

Eating disorders are a person’s way of coping with difficult emotions and feelings. Because sufferers of an eating disorder feel ashamed and guilty it is difficult for them to talk about their problem. The therapist is an independent, objective person ready to guide and support their client through their process of recognising why their eating disorder came about. They will work together on changing how the client can deal with their emotions and emotional events.

 

Rumination Disorder 

Rumination Disorder is a condition in which a person keeps bringing up food from the stomach into the mouth (regurgitation) and re-chewing the food and the cause is unknown. It is the compulsive regurgitation of food, usually by an infant or young child followed by either spitting, re-chewing, or re-swallowing of the food.  Rumination Disorder is rare in children and teenagers.


The person brings back up and re-chews partially digested food that has already been swallowed. In most cases, the re-chewed food is then swallowed again, with the infant/child occasionally spitting it out. Symptoms must go on for at least 1 month to fit the definition of Rumination Disorder.



​Other Specified Feeding or Eating Disorder (OSFED)

When an eating or feeding behaviour does not fall into one of the six main types, but does demonstrate psychological distress and impairment, the behaviour may be classified as OSFED.


Examples of OSFED include:

  • Atypical anorexia nervosa (weight is not below normal)

  • Bulimia nervosa (with less frequent behaviours)

  • Binge-eating disorder (with less frequent occurrences)

  • Purging disorder (purging without binge eating)

  • Night eating syndrome (excessive night-time food consumption)


Therapy

Eating disorders are a person’s way of coping with difficult emotions and feelings. Because sufferers of an eating disorder feel ashamed and guilty it is difficult for them to talk about their problem. The therapist is an independent, objective person ready to guide and support their client through their process of recognising why their eating disorder came about. They will work together on changing how the client can deal with their emotions and emotional events.

 

Pica

Pica is the persistent eating of substances such as dirt or paint that have no nutritional value, for at least 1 month. It is a relatively rare eating disorder characterised by eating substances, such as buttons, chalk, cigarette ashes, clay, faeces, glass, glue, hair, metal, mud, paint, paper, soap, stones, or washing powder. A person may be drawn to consume such substances due to the texture or flavour of the item, and the action of eating the substance may be self-soothing. It is most commonly seen in small children, institutionalised people, pregnant women and people with development disabilities such as autism.


The word Pica is Latin for magpie; a bird known for its indiscriminate appetite and will eat nearly anything. 


Warning signs of Pica;

  • An obstruction or perforation in the intestines that may be caused by non-food substances building up in or perforating the intestines

  • Bowel problems

  • Constipation

  • Severe tooth abrasion and surface tooth loss

  • Eating or swallowing substances that are not food

  • Heavy metal poisoning, caused by the ingestion of metal-based substances

  • Infection or parasitic infestation

  • Intestinal obstructions

  • Toxic ingestion such as lead poisoning

  • Ulcerations


A person with Pica needs to consult a psychologist.

 

Bulimia Nervosa

Bulimia nervosa is described as a cycle of binge eating that results in feelings of guilt, shame, and remorse, which further compel a person to compensate for the binge by purging or over exercising. With this guilt and shame the person judges herself/himself harshly for any perceived flaw. It is characterised by recurrent and frequent episodes of eating unusually large amounts of food and feeling a lack of control over the eating, and can be followed by excessive exercise, purging (excessive use of laxatives or diuretics, vomiting) and/or fasting. Self-induced vomiting is the most prevalent form of purging.

The physical effects of Bulimia include abdominal pain, bowel problems, chronic sore throat or inflammation of the esophagus, dehydration, and among others. Bulimia does not generally result in significantly low body weight, and sometimes a person’s weight may be slightly above average. Emotional symptoms of bulimia include, anxiety, changes in personality, depression, fear, emotional outbursts, erratic behaviour, guilt, loneliness, low self-esteem, mood swings, reluctance to develop personal relationships, self-harm, self-disgust, self-loathing, substance abuse.

Warning signs of Bulimia Nervosa include:

  • Abuse of laxatives or diuretics to lose weight

  • Bloating or fullness

  • Dental problems, like tooth decay

  • Depression or mood swings

  • Discoloured teeth from exposure to stomach acid when vomiting

  • Frequent use of bathroom after meals

  • Heartburn or bloating

  • Intestinal distress and irritation from laxative abuse

  • Irregular menstrual periods

  • Kidney problems from diuretic abuse

  • Loose skin

  • Marks on the backs of the hands and knuckles from self-induced vomiting

  • Purging by strict dieting, fasting, vigorous exercise, or vomiting

  • Recurrent episodes of binge eating

  • Reddened fingers

  • Self-evaluation that is unduly influenced by body shape and weight

  • Severe dehydration from purging of fluids

  • Sore gums or mouth sores

  • Swollen cheeks caused by repeated vomiting

  • Swollen salivary glands

  • Thin or dull hair

Therapy

Eating disorders are a person’s way of coping with difficult emotions and feelings. Because sufferers of an eating disorder feel ashamed and guilty it is difficult for them to talk about their problem. The therapist is an independent, objective person ready to guide and support their client through their process of recognising why their eating disorder came about. They will work together on changing how the client can deal with their emotions and emotional events.

 

Gene Barry Psychotherapist

© Gene Barry