Therapy

Eating Disorders are complex problems that can evolve out of a person’s effort to cope with feelings and social pressures. The person uses food or restricts food intake as a way to communicate and manage anxiety and internal conflicts. Disordered Eating can take a number of different forms.

At ABC, we offer help for anorexia, bulimia, and compulsive eating/binge eating disorders.

Anorexia Nervosa

Individuals struggling with anorexia may be sensitive about being perceived as fat or have a fear of becoming fat. Marked by a preoccupation with food, calories, and nutrition, anorexics desire to control their emotions and reaction to their emotions through food restriction. In many cases, they continue to diet and/or exercise in order to feel in control and this leads to either starvation or food binges. An anorexic will continue to diet or restrict food intake until they lose 15% or more of their body weight and often become dangerously thin. The weight loss is often accompanied by feelings of irritability, depressed mood, poor concentration, and a loss of menstrual cycle.

Even more important than the weight loss itself, those who suffer from anorexia put themselves at risk for very serious medical problems, including amenorrhea, osteoporosis, insomnia, anemia, metabolic disturbances, heart problems and, in some cases, death. Anorexics typically try to maintain an extreme degree of control over their food intake and may feel a loss of control even when eating very small amounts of food. When this occurs, they may resort to self-induced vomiting, laxative abuse, or extreme exercise to help them regain a sense of control. This desire for control usually extends into other parts of their lives as well, and they tend to become more socially isolated and uninvolved in productive or pleasurable activities.

Bulimia Nervosa

While bulimics often suffer from the same kind of intense fear of “becoming fat” that characterizes anorexia nervosa, the outstanding characteristic of bulimia is the binge-purge behavior. Those who struggle with bulimia may be of normal weight, but they engage in a persistent pattern of binge eating followed by self-induced vomiting, laxative abuse, starvation, or extreme exercise. Bulimia may be associated with depression and loss of self-esteem, esophageal ruptures, dental erosion, acute stomach pain and digestive disorders, as well as heart arrhythmias.

As with anorexia, bulimia usually has its onset in adolescence. While the mortality rate from bulimia is not nearly that of anorexia, it, too, can be associated with long-term and irreversible medical consequences. Men and women with bulimia often feel overwhelmed in coping with their emotions and seek out episodes of binge eating (eating large amounts of food in a short period of time) and purging to avoid feelings such as anger, depression, stress, and anxiety. Bulimics will often use exercise, rather than vomiting, as a means of purging and, when this happens, exercise takes on a compulsive quality as it gets used more to restore a sense of emotional control rather than to promote feelings of fitness and well-being.

Compulsive Eating/Binge Eating Disorder

Problems of compulsive eating are now recognized as serious eating disorders as well. As with anorexia and bulimia, compulsive eaters use food as a way of coping with their feelings and the problems and stresses of daily living. While many compulsive eaters will sometimes engage in food restriction or purging behavior, the primary characteristic of binge eating disorder is a repeated pattern of often-secretive food binges in which large amounts of food are consumed in a short period of time. These food binges are then typically followed by feelings of guilt and shame and, of course, weight gain, which can bring about even more intense feelings of guilt and self-depreciation. Such feelings then help to perpetuate further binge episodes and the compulsive eater can begin to feel trapped in a cycle of social isolation, loss of self-esteem, depression, and weight gain.

The long-term effects of compulsive eating include severe obesity and related health problems, including Type II diabetes, high blood pressure, arthritis, and heart disease. After years of compulsive eating and the associated weight gain, loss of weight by dieting can be extremely difficult and frustrating. Recently, people suffering from compulsive overeating have been seeking surgical solutions to control their weight, leading to the increasing popularity of the procedure known as gastric bypass surgery. At ABC Hawaii, we recognize that such surgery alone cannot treat the underlying psychological issues and we have developed a special program for the treatment of compulsive eating disorders that seeks to help the severely obese and those considering gastric bypass surgery resolve their eating disorders and maintain long-term weight loss success.