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Eating Disorder Treatment

People often have complicated relationships with food, eating, and their bodies. In Western Europe and North America especially, the media and marketing have aggressively promoted an unhealthy ideal of weight and body image. At the same time we have become a very sedentary culture that eats a lot of high-calorie food. The result is a near epidemic of feeding and eating disorders as well as an epidemic of obesity. At CBT Associates, we provide evidence-based treatment for eating disorders as well as cognitive behavioural therapy (CBT) for weight management.

Feeding and eating disorders are characterized by eating habits that involve either too little or too much food intake. People with feeding and eating disorders are preoccupied with their weight and body image. In addition to restricting intake, they often engage in compulsive behaviour (counting calories, exercising, weighing) that results in serious problems with physical and mental health. Although there are three main types of eating disorders, including anorexia nervosa, bulimia nervosa, and binge-eating disorder, many people with feeding and eating disorders do not fit neatly into any one category.

Anorexia nervosa

Anorexia nervosa is characterized by extreme restriction of food intake to the point of excessive weight loss and self-starvation. The essential features of anorexia include:

  • Overvaluation, judging one’s self-worth based on weight and shape;
  • Intense desire to be thin and fear of gaining weight and being fat; and
  • Working actively to engage in behaviours to maintain a low body weight that is less than 85% of what would be expected for that person or a Body Mass Index of less than 17.5.

The diagnosis of anorexia nervosa can be further broken down into two subtypes – the restricting type and the binge/purge type. People with the restricting type lose weight by restricting food intake and engaging in compulsive activity such as over-exercising. People with the binge/purge type may engage in binge eating and/or compensate by purging.

The extreme weight loss from anorexia nervosa often causes amenorrhea, a condition in which women to stop having menstrual periods.

Bulimia nervosa

Bulimia nervosa is characterized by binge eating and purging. The essential features of bulimia nervosa anorexia include:

  • Overvaluation, judging one’s self-worth based on weight and shape;
  • Binging that involves eating a large amount of food with a sense of a loss of control;
  • Purging that can include strict food restriction, self-induced vomiting, over-exercising, and the misuse of diuretics, enemas, and laxatives.

Although anorexia and bulimia may sound very similar, the big difference between the two disorders is body weight. People cannot be diagnosed with bulimia if they meet the criteria for anorexia nervosa (body weight that is less than 85% of what would be expected for that person or a Body Mass Index of less than 17.5).

Binge-eating disorder

Binge eating is characterized by recurrent binging in the absence of the compulsive compensatory or purging behaviours associated with anorexia nervosa and bulimia nervosa.

Treatment

Eating disorders are endemic in western society, and women are especially at risk, however rates of male eating disorders are on the rise. Eating disorders are often serious problems that result in serious medical complications and severe consequences, including death. People with eating disorders often suffer from the cognitive symptoms of starvation and are “not thinking straight.” Eating disorders often occur with other problems, including mood and anxiety disorders and substance use problems. CBT is a proven treatment for several eating disorders in adulthood and can be highly effective.

Although evidence-based treatment can be highly effective in treating eating disorders, it is important that people with eating disorders receive an adequate amount of treatment. People with severe eating disorders usually need medical management and intensive day treatment or a residential program to achieve wellness. People with more moderate symptoms and those who have successfully completed a more intensive day treatment or inpatient treatment program can be treated successfully in an outpatient setting. At CBT Associates, comprehensive assessment and treatment for eating disorders involves working with the other professionals in your circle of care. Consistent with the Academy of Eating Disorders Guidelines, we know that optimal care includes a multidisciplinary team approach by eating disorder specialists, including medical, psychological, nutritional, and psychopharmacologic services. Families and spouses should also be included whenever possible.

Eating disorders are often difficult to diagnose and treat effectively. They are also often serious problems that require medical management and intensive treatment. Because of these complexities, the first step towards appropriate and effective treatment is a thorough and proper diagnostic assessment from a physician or psychologist.

Weight management

If you struggle with your weight and body image, you are not alone. Most people have complicated relationships with food, eating, and their bodies. In Western Europe and North America especially, the media and marketing have aggressively promoted an unhealthy ideal of weight and body image. At the same time we have become a very sedentary culture that eats a lot of high calorie food. The result is an epidemic of obesity.

Losing weight is often the easy part; maintaining weight loss almost never is. Sustained healthy weight control is a “head game” that requires a lot of courage, knowledge, insight, tools and effort. Certainly diet and nutrition, as well as exercise and fitness, are important. As for other weight management programs, CBT for weight management includes personalized plans for eating and exercise. However, CBT for weight management also helps people to acquire the thinking (cognitive) and behavioural skills that are essential for success including how to:

  • Use CBT techniques to prepare for successful behaviour change;
  • Use CBT techniques to recognize and challenge unhelpful thinking;
  • Design and select a personalized healthy eating and exercise plan;
  • Set realistic goals;
  • Motivate themselves to stick to their plan and eat well even when they don’t feel like it;
  • Resist urges;
  • Deal with setbacks and relapse and get back on track;
  • Manage craving, desire, hunger, and emotional eating;
  • Predict and plan for setbacks due to common triggers such as stress, special occasions, vacations, travel, and unsupportive people;
  • Understand and manage alcohol consumption; and
  • Develop healthy relationships with their bodies.

Sustained healthy weight management is a challenge and CBT techniques can be an important part of the solution. However, because obesity often occurs with other common problems such as mood, anxiety and substance use disorders and often results in a number of serious medical conditions, the first step towards effective weight loss and management is thorough and proper assessment from a physician or psychologist.


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FAQ
Why choose CBT Associates?

CBT Associates is a large, well-established and rapidly-growing network of clinics that provides evidence-based psychological services to children, adolescents, adults of all ages, and couples.

We are a highly-qualified group of over 50 psychologists and psychological associates who provide personalized, compassionate, respectful and discreet treatment with the highest level of... Read More

What is the policy for cancelled or missed appointments?

To help us reliably meet the needs of all our clients, we must ask you to provide 24 hours’ notice when cancelling or rescheduling an appointment. Appointments without sufficient notice will be charged the full fee.

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What is a psychologist?

Psychologists:

  • Are registered healthcare professionals who are regulated like physicians, surgeons, and dentists.
  • Work with individuals, groups and organizations to promote positive change by assessing and treating psychological problems.
  • Are trained to assess problems accurately using psychological tests and semi-structured interviews.... Read More
What is the difference between a psychologist and a psychiatrist?

Psychologists are closely aligned with psychiatrists as both are highly-trained professionals. Psychiatrists are oriented toward pharmaceutical solutions (some illnesses in fact lend themselves to medication versus talk therapy, such as severe depression or schizophrenia); while psychologists are oriented toward talk therapy as a solution.

Psychologists and psychiatrists both undertake... Read More

What is the difference between a psychotherapist and a psychologist?

The first important difference between psychotherapists and psychologists is the number of years of education and training required to register by each college. The College of Registered Psychotherapists of Ontario requires members to complete an undergraduate degree that includes 360 hours (total) of training and education. In contrast, to become a psychologist in Ontario the... Read More

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