7 Invisible Eating Disorders

I recently asked you to tell me what eating disorder topics you wanted covered and so many of you asked me to talk more about the nontypical types things like osfed disordered eating atypical anorexia or bulimia so let's get into it here are seven invisible and often misunderstood Eating [Music] Disorders starting off with what I would call the umbrella diag nosis number seven osfed or other specified feeding or eating disorder almost every eating disorder patient that I've treated over the years at some point meets a criteria for this diagnosis because it's kind of a catchall for any and all eating disorders that doesn't mean it's less serious it just means that we don't quite meet the criteria for the other options like things like anorexia nervosa bulimia or binge eating disorder just to name a few but we still have an eating disorder disorder if you're having a hard time understanding what this could look like let me give you an example let's talk about Lucy she's 28 years old and has been struggling with an eating disorder since she was a teenager she overe exercises restricts and binges her weight goes up and down depending on what Behavior she's engaging with most but it never dips below her body's natural weight therefore she doesn't meet the criteria for anorexia she doesn't binge and Purge regularly enough to be diagnosed bmia and her binges are always followed by some compensatory Behavior so it's not binge eating disorder either Lucy is diagnosed with Ed because her eating disorder behaviors run the gamut and they just aren't consistent which brings me to another important point that Eating Disorders are shape shifters they move between different behaviors depending on how we feel and what's going on in our life because remember eating disorders are coping skills they are ways for us to numb out from our feelings past experiences current stressors you name it and if our trigger for the eating disorder changes or one Behavior becomes harder to engage in well then it will shift to fit the need a terrible side effect of this diagnosis is that it can often cause us to feel like we aren't sick enough which we probably already worried about anyways and it can lead us to increasing our eating disorder behaviors with the hopes of me meeting the criteria of another one of the diagnoses not to mention that insurances here in the states often don't cover the treatment for Ed as well as they cover the other ones and in many ways it's just the worst and I would argue also the most common eating disorder number six atypical anorexia this is one of the options listed under the osfed criteria and can be diagnosed when we have met all the criteria for anorexia like with we have an intense fear of gaining weight and becoming fat and have a disturbed view of our body and our shape except our weight is still in a normal range an example of this would be Greg Greg is 44 years old and he's been struggling with his body image for most of his life unlike typical anorexia nervosa Greg's body weight is not significantly below what is considered normal for his age and height however he has an intense fear of gaining weight and and engages in restrictive eating behaviors Greg maintains a diet that's extremely low in calories avoiding certain food groups and carefully monitoring what he eats despite being at a weight that falls within the normal range Greg is constantly dissatisfied with his body and feels compelled to lose more weight he has a distorted body image perceives himself as overweight even when others see him as thin or at a healthy weight exercise is also a significant part of his life and he engages in intense physical activity regularly as a way to burn calories and control his weight friends and family have expressed concerns about his eating habits and excessive exercise but he dismisses them insisting that he's just trying to be healthy Greg's atypical anorexia nervosa is characterized by the restrictive eating patterns intense fear of weight gain and a distorted body image despite not meeting the typical low weight criteria associated with anorexia nervosa this atypical presentation underscores the importance of considering a range of factors beyond just weight when assessing and diagnosing Eating Disorders this could happen for a bunch of reasons but the most common is BMI or body mass index it's outdated archaic yet many medical models still use it today why I have no idea but here we are another reason could be that we used to struggle with binge eating and that caus us to gain a bunch of weight so even though our behaviors are now in line with the anorexia nervosa criteria our weight hasn't caught up yet it could also be due to PCOS or polycystic ovarian syndrome or many other illnesses or even medications that make weight loss difficult if not impossible number five atypical bulimia in this case it has to do with the frequency or duration of our behaviors this is because much of the bulimia criteria has to do with how often we binge and Purge and how long it's been going on if we haven't been engaging in the behavior for at least 3 months and acting on it at least once a week we don't meet the criteria for Bia nervosa we fall into this category here's an example of what atypical bulimia can look like Sarah is a 32-year-old woman who has struggled with her body image for several years she occasionally experiences episodes of binge eating eating during which she consumes large amounts of food in a short period unlike typical buim nervosas Sarah doesn't consistently engage in self-induced vomiting or excessive exercise after these binge eating episodes instead she tends to compensate for her perceived overeating by fasting or severely restricting her caloric intake for a day or two afterward she might use laxatives on occasion when she feels particularly guilty about her eating habits however these compens behaviors are not as regular as those seen in typical cases of bulimia nervosa Sarah's relationship with food is marked by periods of strict dieting followed by episodes of overeating and subsequent attempts to you know quote unquote make up for it she is preoccupied with her weight and appearance and these concerns impact her self-esteem and overall well-being while Sarah's behaviors do not fit the classic criteria for bulimia nervosa her struggles with binge eating and some compensatory actions indicate an atypical pattern that still warrants attention and intervention from mental health professionals number four atypical binge eating disorder this eating disorder is similar to the last one however an important distinction to be made is that when we struggle with binge eating disorder of any kind this means that we eat an amount of food that's larger than what most people would eat in a similar period of time and under similar circumstance and we feel out of control when we eat and this is a big and we aren't doing any compensatory behaviors to try and make up for our binge take Alex for example Alex is 30 years old and has struggled with what she thought was emotional eating for a number of years she does not experience binge eating episodes frequently and they sort of come and go just depending on what's going on in her life Alex tends to engage in sporadic episodes of overeating often triggered by stress or emotional turmoil during these episodes she consumes larger amounts of food than normal and feels completely out of control when she's doing it there's also a sense of guilt and discomfort afterward but it's not as Intense or pervasive as in typical binge eating disorder Alex's relationship with food is marked by occasional episodes of emotional eating which serve as a coping mechanism during challenging times while these episodes may not meet the frequency or Varity criteria for a traditional diagnosis of bch eating disorder they still interfere with her overall well-being and contribute to feelings of guilt and shame number three purging disorder sure we've heard of purging after a binge but someone with this disorder uses purging Behavior things like inducing vomit abusing laxatives or diuretics without binging first again I just want to mention that many of this these Eating Disorders are things that my patients have found themselves engaging in while on their path to recovery if we know we need to eat and we're trying not to binge we can still engage in parts of our eating disorder by purging anyway here's an example of what this could look like let's take Jamie ja's 26 years old and has struggled with body image and weight concerns for several years unlike bulimia nervosa Jaimie does not engage in regular episodes of binge eating however they've developed a pattern of purgan behaviors as a means of controlling their weight Jamie maintains a very restrictive diet often avoiding certain food groups and severely limiting calorie intake after consuming even a small meal Jamie feels intense guilt and anxiety about potential weight gain in response to these feelings Jamie engages in purging behaviors to rid the body of the consumed calories purging behaviors in this case may include self-induced vomiting misuse of laxatives or excessive exercise these behaviors are driven by by a fear of weight gain and a distorted body image even though Jamie may be at a normal or underweight for their height despite not fitting the criteria for bulimia nervosa Jaime's purging behaviors are a concerning aspect of their relationship with food and Body Image the focus on weight control through purging poses health risks and is indicative of a disordered eating pattern number two night eating syndrome night eating syndrome is when we have recur current episodes of eating excessive amounts of food after our evening meal or snack or after we wake up from sleeping like we're eating in the middle of the night the important pieces here are that we're aware of our eating and we remember doing it so this isn't part of sleepwalking or any other sleep disorder this also isn't induced by medication because I've had a ton of patients over the years who were on a certain medication like cakil and they would find themselves never satiated and eating a lot in the evenings this also can't be better explained by binge eating disorder so it only happens at night imagine Taylor a 32-year-old lawyer who's been grappling with night eating syndrome for the past few years unlike typical Eating Disorders Taylor struggles are specifically related to eating during the nighttime hours Taylor often finds it difficult to fall asleep without first eating a substantial amount of food during these nighttime eating episodes Taylor will eat more food than she ate all day even if she's already had her regular dinner her eating is driven by an overwhelming urge to eat during the night and she often feels a sense of loss of control during these episodes she tells me that she can't relax until she does this but then when she does she hates herself for doing it it feels like a vicious cycle that she's stuck in not to mention that the these nighttime eating episodes disrupt her sleep leading to feelings of fatigue and grogginess during the day number one rumination disorder someone struggling with this will find themselves repeatedly regurgitating their food and this Behavior has been going on for at least a month this means that previously swallowed food is brought back up into our mouth without nausea vomiting or involuntary wretching then we can Rew it spit it out or swallow it again and I know I know this is hard to understand and is why many of my patients have struggled to even talk about it but in my experience this is usually done as a way of self- soothing many of my patients who have a history of purging Behavior find this to be a stop along their path to recovery it's important to know that this Behavior cannot be better explained by a gastrointestinal or other medical issue and it's not part of another eating disorder like we meet all the criteria for bulimia nervosa and then we also do this as part of our bulimia it also cannot happen as a result of a disability or other mental condition we engage in this Behavior almost every day and it's another way of coping to better understand this disorder let's talk about faith faith is 40 years old and has a successful career as a marketing executive growing up she struggled with her body image and for about a year she engaged in Bic behaviors although she was never diagnosed at the time she never sought therapy until recently because she's in a serious relationship and they're talking about moving in together faith has never told someone about her rumination disorder in fact she didn't even know it was a diagnosable thing but after every meal she regurgitates her food and swallows it again for about a half an hour for this reason she prefers to have lunch in her office and doesn't like eating with other people that often she's horribly embarrassed about about this and assumes that no one will understand she tells me that she doesn't know how to stop because if she doesn't get to do it her anxiety starts building it goes through the roof a few months ago to work dinner she had a panic attack because she didn't get a chance to do it she's worried that if her girlfriend moves in she's she'll have to stop and either have panic attacks around the clock or her girlfriend's going to notice and dump her the important thing to remember with each of these is that just because because they aren't talked about as much or don't meet the criteria for what we consider a quote unquote worse eating disorder that doesn't make them any less serious or painful I know our Eating Disorders can be really competitive and try to tell us that we aren't sick enough but trust me you deserve to get help and have access to the care that you need our Eating Disorders will always tell us that we aren't doing it enough or aren't skinny enough for help but that's because it's trying to keep doing its job of pulling our Focus onto it if we thought we had made it or were in fact Sick Enough then we wouldn't have to keep using it right and the entire reason that our Eating Disorders exist is to help us cope with something bigger or more uncomfortable like we can't think about our past trauma if we're focused on how uncomfortable we feel after binging or I can't experience the discomfort from my grief if I'm constantly thinking about food and exercise our eating disorder's whole job is to keep us focused on it at the cost of our relationships and potentially our life so remember that you are worthy of care and Recovery no matter what eating issues you have I hope this was helpful and at the very least helped you see your struggles for what they really are an eating disorder that with professional help can be [Music] overcome

Channel: Kati Morton

Views: 114,331

Keywords: eating disorder therapist, what are the different types of eating disorders, EDNOS, OSFED, Anorexia, Bulimia, Binge Eating Disorder, Binge and Purge, Atypical Eating Disorders, Night Eating Syndrome, Atypical Anorexia, Purging disorder, BMI and eating disorders, disordered eating, Emotional eating, trauma coping skills, rumination disorder, eating disorder, eating disorders, ed recovery, eating disorder recovery, do I have an eating disorder, ed youtube, ed youtube channel

Id: xjDofzdRTCk

Length: 15min 57sec (957 seconds)

Published: Tue Feb 27 2024