Eating Disorders
What are Eating Disorders?
Eating disorders are complex, serious mental illnesses that can lead to serious long-term mental and physical problems and illness. They have one of the highest mortality rates of any mental illness. They can involve restrictive eating; fasting; over-eating; binge eating; feeling out of control while eating; obsessive eating behaviour: purging (vomiting); laxative or diuretic misuse; excessive exercise; yo-yo weight loss/gain; body image distortion & body dysmorphia; preoccupation and obsession with size, shape, weight, diet and health; body size, shape and weight being central to self-worth and identity; body dissatisfaction or hatred (especially of body fat), and intense fear of particular foods (e.g. sugar, carbs, fat) and weight gain.
Read more..
Eating disorders can significantly impair functioning and disrupt peoples’ lives in every way – e.g. physically, emotionally, relationally, socially, academically and occupationally.
Eating disorders occur in people of all body sizes, shapes and weights.
Eating disorders occur in many varied ways. They can be formally classified primarily as binge eating disorder, bulimia nervosa, anorexia nervosa and other specified feeding or eating disorder (OSFED). The most common eating disorders are binge eating disorder and OSFED. “Underweight”, “Overweight” and “Obesity” are NOT eating disorders. They are terms that describe body mass index (BMI), which is a population statistic. BMI is NOT a reliable indicator of health status, health behaviour, eating disorders or diseases. BMI should not be used to classify people as “healthy” or “unhealthy” and to make stereotypical assumptions about their eating and exercise behaviour. People with so-called “healthy BMI’s”, or attractive, ideal body types, can have eating disorders, other illnesses and poor health. Many people are naturally thin/small or fat/large and are quite healthy. A thorough assessment is required to form accurate impressions about an individual’s health, lifestyle and treatment needs. Even when weight is associated with health problems, attempts to change weight can harm overall health.
Who is at Risk of Developing an Eating Disorder?
About 1.1 million Australians (4.5% of the population), are living with a clinical eating disorder, and many more live with disordered eating. Eating disorders are caused by complex genetic, environmental, psychological, social and cultural factors, that are different for each person. HOWEVER, restrictive dieting is the single biggest predictor of developing an eating disorder.
Read more..
People who follow restrictive diets (or lifestyles that involve following strict rules about eating, including people with food allergies, diabetes and other medical conditions), exercise excessively, have internalised weight stigma/prejudice, and are preoccupied with “health” (beliefs about what health is are often misconceptions), are particularly vulnerable to developing an eating disorder.
People with larger bodies receive high pressure from society, health and medical professionals and the mass media to shrink their bodies so are very vulnerable to harmful restrictive dieting. Psychological risk factors include perfectionistic, obsessive-compulsive, rigid and avoidant personality and thinking styles, a high need for control, history of trauma, 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 men and boys.
Treatment of Eating Disorders
People with eating disorders usually require multi-dimensional treatment and support, such as a GP, psychologist, dietitian and psychiatrist. This is essential when they are medically unstable, e.g., due to significant weight loss, nutritional deficit and risk of death, as in anorexia nervosa. Weight restoration is a goal of treatment for these people. Medical monitoring and dietitian support is essential for them, and for those who frequently purge (vomit), abuse laxatives and over-exercise. They may also require inpatient treatment. Families and carers of people with eating disorders also require support and assistance. Family based therapy is recommended for adolescents with eating disorders. The frequency and intensity of treatment required depends on the severity of the disorder and motivation/ability to participate in therapy. This can range from weekly consultations to more intensive outpatient or inpatient treatment programs.
What I Offer – Psychological Therapy to Adults
As eating disorders present in many varied ways, I only offer therapy to adults, and when I assess that I have capacity to meet individual needs using evidence-based therapy. I work most effectively with individuals, who initiate their own therapy and are motivated to participate in therapy. You may be referred by your GP or psychiatrist with and Eating Disorder Plan, or a Mental Health Treatment Plan.
Read more..
I focus on supporting people of all sizes, shapes and weights with healthy behaviour enhancement, including cultivating cognitive and behavioural flexibility, helpful self-talk, body acceptance, self-acceptance and self-compassion; promoting flexible, individualised eating based on hunger, satiety, nutritional needs, and pleasure, (rather than any externally regulated eating plan focused on weight control); encouraging enjoyable physical activities; and letting go of unhelpful beliefs, behaviours and harmful weight prejudiced diet culture.
Weight restoration would be a goal of treatment for people with restrictive eating disorders who have nutritional deficits and are medically compromised due to weight loss. Medical practitioners (GP, psychiatrist) and a dietitian primarily manage this aspect of treatment.
I am a Credentialed Eating Disorder Clinician and use evidence-based treatment approaches including cognitive behaviour therapy for eating disorders, dialectical behaviour therapy and Interpersonal therapy. I adapt therapy to individual needs.
I provide supportive counselling for carers of people with eating disorders.
What I Am Unable To Offer
I am not able to offer therapy to adolescents with eating disorders. I recommend intensive family-based or Maudlsey treatment.
I am not able to offer therapy to adults with serious restrictive eating disorders, such as anorexia nervosa, when they require more intensive treatment than I can provide and when they are not capable of engaging in therapy due to medical/cognitive instability.
Read more..
I don’t “treat obesity”, as “obesity” is not a disorder, it is a body size. I will not encourage people with larger bodies to “lose weight”. Many people with larger bodies say they developed their eating disorders due to restricting their eating to try to lose weight and often after being told to “lose weight” by medical and health professionals. This is despite over 50 years of research confirming that pursuing weight loss with restrictive eating is ineffective for the vast majority of people and potentially physically, mentally and emotionally harmful.
In fact, restrictive eating and dieting is the single biggest predictor of developing an eating disorder. Therefore, research does not support a weight loss focus as a goal of therapy. Healthy behaviour enhancement is a realistic, achievable, ethical and compassionate goal of therapy.
Weight loss may be a consequence of healthy behaviour enhancement for some people. However, it is not possible to accurately predict whether an individual will lose weight and how much weight can be lost, AND, mental and physical health can improve significantly as a consequence of healthy behaviour enhancement without weight loss.
To discuss your therapy needs for Eating Disorders and counselling support for carers, contact Lesley Russell on 0412 638 749, email lesley@lesleyrussell.com.au or complete my enquiry form.
Endorsement
Endorsement by the Australian Health
Practitioner Regulation Agency (AHPRA)
Area of Practice: Clinical Psychology
Registrations:
> Psychology Board of Australia
> Health Insurance Commission (Medicare)
Credentialed Eating Disorder Clinician
Contact Me
8/294 Sydney Rd, Balgowlah NSW 2093
P: 0412 638 749
Email me:
or complete my enquiry form.
Professional Memberships
> The Australian Psychological Society (APS)
> The APS College of Clinical Psychologists
> Australia & New Zealand Academy for
Eating Disorders (ANZAED); National Eating Disorders Collaboration (NEDC)
© Copyright Lesley Russell 2024.