Eating Disorders

Navigating the Holidays with an Eating Disorder

Eating disorders have become increasingly common among US teens, especially girls. Understanding how and why eating disorders develop can help teens, parents, and friends alike better gauge how to prevent relapses and flare-ups in symptoms and address some of the root stressors behind increasingly disordered behavior – especially as the holiday season draws closer. To help avoid any setbacks, here are some ways you can navigate the holidays with an eating disorder.

How the Holidays Can Affect Disordered Eating

Perhaps the biggest misconception among adults and teens alike is that an eating disorder is largely external – that things like unrealistic Instagram models and Hollywood superhero bodies heavily contribute to the development of disordered eating habits.

There is an element of influence, yes; the modern beauty standard, even as it evolves and continues to change, can certainly affect and exacerbate some of the anxieties that teens with eating disorders share. But at their root, eating disorders are severe anxiety disorders – often tied to genetic factors, trauma, and a host of environmental causes.

Some people are intrinsically more likely to struggle with body image issues and are more susceptible to disordered eating as a behavioral coping mechanism. The overabundance of sanitized and edited images in our day-to-day – whether on the silver screen or on the smartphone – is making things worse. But eating disorders are too complicated to blame on a single factor.

Stressors play another important role in the severity of an eating disorder and the shape it takes. The more pressure a person is under, the more likely they are to struggle with the compulsions that fuel their eating disorder, such as food binges, purging behavior, overexercising, diuretic abuse, and other forms of unsupervised drug use.

Ironically, the holidays are some of the most stressful days in the year and a source of stress for many people who specifically struggle with food and disordered eating. In most households, the holidays mean joy and cheer and plenty of food. But it takes a lot of preparation and is hectic to get things ready for the celebration, and excessive food can trigger binge eating behavior.

Ways to Handle the Holidays with an Eating Disorder

Whether it’s Thanksgiving or an end-of-the-year celebration, holidays might be some of the toughest times for someone struggling with an eating disorder. But thankfully, there are measures you – and your loved ones – can take to make the best of the situation during the holidays with an eating disorder:

1. Minimizing Incoming Stressors

Like other anxiety disorders, the symptoms of an eating disorder can get a lot worse the more pressure you’re under.

Try to minimize that pressure – if you’re helping your family out over the holidays, see if you can limit your responsibilities and instead devote more time to therapy.

Work with your therapist to identify helpful stress management techniques over the holiday break. Work on relaxation techniques to refocus your attention on the break ahead rather than all the work you’ve yet to finish or the schoolwork you have ahead of you on the first Monday back in school.

Struggling with anxiety isn’t an excuse to get out of running errands or helping around the house. But don’t overdo it out of a sense of guilt or self-deprecation, either.

2. Utilizing Healthier Coping Skills

We can’t lead stress-free lives. We each have our fair share of responsibilities, some of which are unavoidable even in times of “rest.” It’s good to feel important and to serve a function, whether it’s at work, at school, or at home – but we each need our own way of dealing with the mental fatigue and stress that accumulates over time or suffer the consequences.

For teens with anxiety disorders or eating disorders, too much pressure can exacerbate symptoms or, after treatment, lead to an unwanted relapse (such as a food binge). It’s important to develop healthier coping skills, especially as a teen.

These might include taking a long walk through a refreshing park or through nature, reading a nice book, using essential oils in your room, or listening to your relaxation playlist to calm you down.

3. Don’t Make Too Big a Deal Out of the Meal

A lot of holidays ultimately revolve around the big meal – like the Thanksgiving dinner. But if a person in your household struggles with eating disorders and is still in treatment, consider talking your dinner plans over with their therapist.

A big meal can bring the family together, from the arduous prep time to the extensive post-meal cleanup duties. But it’s also putting the focus on something a person with an eating disorder might not be comfortable fixating on, especially for hours on hours on end.

4. Don’t Dwell on the Dishes

Another important tip is to consider moving on from the dinner table as soon as everyone’s done with their meals – or, as an alternative, cleaning up right after eating so dinnertime conversations can continue with some fresh mint tea or a pot of coffee.

One more tip for minimizing some of the stress and anxiety around Thanksgiving meals and other holiday meals is to prepare portioned plates rather than giving everyone a plate and access to a myriad of dishes.

While it isn’t very traditional, taking care of portioning in the kitchen and bringing everyone their meal at the dinner table can help eliminate the urge to go and clean off the rest of the meal – or eat anything barely at all and just pick at the beans for a bit. The structure of consistent portion size – in and outside of the holidays with an eating disorder – can also help with disordered eating.

How A Lack of Structure Challenges Treatment

Both in the context of food and living, structure is important for teens with eating disorders and other anxiety problems. Additional structure can take some of the uncertainty out of day-to-day planning, but it also helps combat rumination and intrusive thinking.

Having a consistent structure for key things – like sleeping, eating, and exercise – also keeps both the mind and body happy, as our own internal clocks are set based on when and how we rest and feed.

Be Patient and Prepared

It can take years for someone with an eating disorder to develop a healthier relationship with their body and food. Consistency is important, but it’s normal to hit speedbumps from time to time.

The holidays are a frequent trigger, and while you can do everything in your power to minimize that risk, it’s also important to accept things when they go wrong. Don’t let that discourage you from your journey in recovery.

For more information on treatment for teen eating disorders, visit Visions Treatment Centers.

ADHD Body Image Eating Disorders Mental Health Substance Abuse

4 Sneaky Mental Illnesses in Teens to Watch Out For

Mental illnesses in teens can be a complicated topic for parents, especially if they have no personal experience with mental disorders. Recognizing and separating symptoms of a mental disorder from regular teenage behavior can be difficult, because many mental health symptoms are subtle, and begin in ways that can be misconstrued as normal teenage behavior.

Nevertheless, recognizing and identifying these symptoms is important. Teens themselves may lack the awareness or the experience to identify their feelings as troublesome and might instead internalize their symptoms as being their own fault.

This guilt can feed and accelerate feelings of anxiety, depression, or other symptoms, and can make treatment more difficult over time. Pressure at home or at school, a history of victimization, or mental health stigma in the community can complicate things even further, making teens less likely to seek help or consider asking for it.

Mental Illnesses in Teens Have Gone Up

The rates at which mental illnesses in teens have also gone up over time. Some of it may stem from awareness, or from societal factors, such as environmental concerns, greater academic pressure, and a poor economic outlook. But by and large, teen stressors are the same as they have always been: relationship problems, grades, fitting in, family environment, and trauma.

Let’s look at a few common yet sneaky mental illnesses that may affect your teen and how to identify them.

1. Body Dysmorphia

Body dysmorphia is a growing issue with the prevalence of social media and doctored Instagram posts, even amid waves of body positivity and messages about self-acceptance.

Also dubbed body dysmorphic disorder, this mental health condition is characterized by an untrue self-image. It isn’t just that a teen with BDD does not like the way they look – in their eyes, they look completely different than what they might look like to others. A teen with BDD might starve themselves or work out excessively to try and conform to their ideal, unattainable self-image. Teens with body dysmorphia may also abuse substances to suppress their appetite or achieve a different figure, such as using anabolic steroids to build muscle quickly. Signs and symptoms of BDD include:

  • An excessive and extreme focus on physical appearance and repeated negative comments about their self-image.
  • Spending inordinate amounts of time checking and rechecking their appearance.
  • Hiding away from others or hiding their body with loose-fitting clothes and baggy clothing.
  • Not listening to affirmations from others, ignoring praise about their physical appearance/continuing to lament their appearance as ugly.

2. Eating Disorders

Eating disorders are often adjacent to body dysmorphia but are characterized primarily by an unhealthy relationship with food. Eating disorders are usually diagnosed as either binge eating disorderanorexiabulimiaavoidant restrictive food intake disorder, other specified eating disorders, or unspecified eating disorders.

Binge eating Disorder 

Binge eating disorder is characterized by a cycle of emotional lows and depressive symptoms culminating in an unhealthy binge eating session, leading to another cycle of low mood. Teens who are binge eating may hide their binges, keep food in their room, or store chocolate bars and snacks in their drawers.

Anorexia Nervosa

Anorexia Nervosa is a disorder characterized by excessively restrictive calorie counting and starvation, including severe body image issues, such as seeing oneself as fat despite being dangerously underweight. Therefore, anorexia can be a life-threatening condition.

Bulima Nervosa

Bulimia nervosa is an eating disorder characterized by a cycle of self-starvation, binging, and purging behavior (through laxatives or self-induced vomiting). Frequent vomiting can also cause throat and dental damage, as well as create callouses on a teen’s index and middle finger knuckles.

Avoidant Restrictive Food Intake Disorder

Avoidant restrictive food intake disorder is characterized by an unhealthily restrictive food intake. Teens with avoidant restrictive food intake are incredibly picky about what they eat, to the point that it causes dramatic weight loss and physical health problems. These problems are progressive, meaning the list of acceptable foods becomes smaller over time. Teens with avoidant restrictive food intake are not necessarily worried about body image, but may be worried about choking on their food, or react nauseously to normal foods for no discernable reason. Choosing to cut out certain foods for health or moral reasons (such as a keto diet or veganism) is not a disorder.

Other Specific or Unspecified Eating Disorders

Other specific or unspecified eating disorders may be applied as a label to teens with disordered eating habits that do not yet fit an established profile, fit into multiple disorders at once, or in cases where more information is needed to determine a teen’s condition.

Eating disorders need to be addressed professionally. They can be life-threatening and can cause lasting physical harm.

3. Attention-Deficit/Hyperactivity Disorder

Attention-deficit/hyperactivity disorder or ADHD is a well-known condition in children and teens, but it can present itself in subtle ways that often evade diagnosis for years. Teens learn to cope with their ADHD symptoms over time, continuing to mask them well into adulthood.

However, untreated ADHD can be a great risk to teens because it is often associated with a much higher risk of comorbid mental health problems, including depression and substance use disorder.

One of the primary symptoms of teen ADHD is recurring disorganization. Being disorganized or clumsy is not just a personality trait – if your teen is consistently bad with time management, constantly misplaces their belongings, dodges, or misses deadlines all the time, and is actively anxious about these things (i.e., they are worried, and trying, but their behavior does not change), they may be struggling with ADHD.

Executive functioning problems are another common sign of ADHD in teens. Executive functioning refers to the ability to utilize one’s working memory, flexibility, and self-control to go about their life, including making and coordinating schedules and plans, prioritizing tasks effectively, demonstrating emotional control, effective self-monitoring, focusing on a task at a time, and being flexible about schedule changes.

Teens with ADHD can still learn to develop and hone these skills, but they may have a harder time doing so than their peers. Executive functioning can also be impacted by other problems, such as depression, abuse, or trauma.

4. Substance Use Disorder

Substance use disorder is another term for addiction. Addiction in teens may occur as a result of comorbid conditions, such as an anxiety disorder, PTSD, or depression, or as a result of a combination of environmental factors (socioeconomics, trouble at home, parental disconnect) and inner factors (genetics, family history, addiction at home).

Signs of a substance use disorder in teens can vary. Drug paraphernalia is one common sign, from hidden bongs to a bottle of vodka under the bed. Consistently coming home too late, coming home drunk or high multiple times, and experiencing physical symptoms of recurring drug use – from bloodshot eyes to memory loss – are also important signs.

When To Get Help

Mental illnesses in teens are treatable, and regardless of what your teen is going through, the first step of that treatment is compassion. Help your teen understand that you are in their corner and want them to feel better. They need to internalize that your goal isn’t to punish them, but to help.

In some cases, it can be difficult to convince your teen that you’re on their side. Some conditions make it harder to help teens get help than others, including addiction, personality disorders, and conduct disorders. Working with a mental health professional beforehand can help you come up with the best way to intervene on your teen’s behalf and get them to see things your way.

For more information, contact Visions Treatment Centers today.

Eating Disorders

Eating Disorders in Teens: How to Talk About It

Eating disorders refer to several mental health conditions revolving around the bingeing and purging of food, obsessions with weight, highly restrictive diets, and other requirements (including the compulsive ingestion of non-food items, known as pica). While eating disorders can, on the surface, sometimes be masked as a “healthy” concern for bodyweight, they are intensely physically and psychologically destructive and continue to have the highest mortality rate among all psychiatric conditions currently recognized by the Diagnostic and Statistical Manual of Mental Disorders.

Characterizing Eating Disorders in Teens

Eating disorders can have a long list of potential symptoms. While there are five major characterized eating disorders (anorexia nervosa, bulimia nervosa, binge eating disorder, rumination disorder, and pica), there are also several behaviors that can be classified as “other specified feeding or eating disorders” (OSFED), as well as “avoidant/restrictive food intake disorders” (ARFID), which are separate but related to eating disorders.

Anorexia Nervosa

Intense fear of weight gain characterizes anorexia, specific “fear foods,” incredibly low daily caloric intake, low body weight, and severe body image issues, to the point that the patient doesn’t recognize their low body weight as being unhealthy or too low. At its worst, teens with anorexia may have various physical symptoms caused by their malnutrition and low body weight, including:

    • Loss of menstrual cycle
    • Dizziness
    • Brittle or thinning bones
    • Dangerous heart health issues
    • Lanugo-like body hair
    • Dental damage due to frequent purges

There is some overlap with obsessive-compulsive disorder (OCD). Teens with anorexia tend to set extreme rules for themselves surrounding food intake and body weight and may punish themselves for breaking these rules (through starvation and excessive exercise).

Bulimia Nervosa

Bulimia is characterized by frequent binge-eating behavior coupled with subsequent purging behavior. It is cyclical, in the sense that teens with bulimia will often obsess over certain foods and be obsessed with eating, binge heartily, then experience extreme guilt, leading to a purge. Purging behavior includes vomiting, taking laxatives, fasting, or excessive exercise.

Teens with bulimia are not usually underweight, but they may still be at risk of malnutrition and other physical ailments because of their frequent binging and purging, including swollen lymph nodes, a weakened immune system, and damage to the throat and teeth caused by stomach acid.

Binge Eating Disorder

Binge eating disorder is characterized by frequent binging and subsequent low mood, but not purging. Teens diagnosed with binge eating disorder will often feel incredibly guilty and self-conscious, reinforcing binging as a coping mechanism, starting a cycle. Unlike teens with anorexia or bulimia, teens with binge eating disorder may be overweight or obese.

Seek Guidance From Parents or Therapists

Eating disorders are severe, and many teens diagnosed with an eating disorder have a warped sense of what is and is not suitable for physical appearance and food. They may be sensitive to specific phrases and sentiments, such as seeing others comment about their health and appearance or seeing them pick up new diets or commit to new kinds of eating.

Start helping your friend by asking their parents or therapist how you can help by learning what sentences and actions to avoid or learning what you should do to model a healthier relationship with food. By better understanding your friend’s diagnosis, you will have an easier time knowing how your behavior and words might affect them emotionally.

Family Support and Care Is Vital

Family and friends can play a significant role in eating disorders in teens through the Maudsley approach. This family-based therapy emphasizes the importance of continuing to provide support outside of inpatient or hospital treatments. The Maudsley approach helps families play a role in the treatment of their teens by coordinating with a therapist providing individual or group therapy and by setting the foundation for healthful living through:

    • Weight restoration.
    • Modeling healthy eating habits.
    • Noting and tracking both physical and mental health improvements.
    • Slowly helping teens take control over their eating habits as they close in on a healthy weight and have made significant progress.

Family therapy may also play an essential role in helping families better understand their teen’s behavior and problems surrounding food and teaching them how to encourage better eating without placing pressure on the teen themselves and blaming them for their behavior. It emphasizes that the disorder is an external actor playing a role in their teen’s behavior and that the focus is on overcoming that disorder together. Therapists will ensure that parents do not criticize their teen’s behavior or make it “their fault.”

Help and Treatment for Eating Disorders in Teens

It is important not to encourage the behavior associated with your friend’s condition, such as skipping meals, exercising way past the point of physical recovery, avoiding certain foods, or obsessing over body image and thinness. Empathy and compassion are essential, recognizing that a friend’s self-image issues may continue to be a sensitive topic for them even after treatment.

They might not be ready to discuss certain things without triggering anxieties and worries about body image or food. Teens struggling with eating disorders often have a long and arduous treatment process ahead of them, one in which both their physical and mental health must be taken into consideration. Many teens with conditions such as anorexia nervosa are treated at the height of their malnourishment and near starvation.

Despite such consequences, many teens diagnosed with an eating disorder do not realize that they are actively harming themselves and harbor extreme and deep-seated fears regarding certain foods and weight gain. Long-term support from friends and family is essential to the proper treatment of eating disorders in teens. By assisting in the critical refeeding process, modeling healthy eating behaviors, working on beneficial coping mechanisms together, and keeping an eye on potential signs of relapse, a teen’s loved ones continue to play an important role long after the initial treatment process.

Eating Disorders

Signs of Anorexia to Watch for in Teens

Anorexia nervosa is one of the most common eating disorders in teens, and a condition that has risen in prevalence over the last few decades. It’s largely characterized by unhealthy and unsustainable weight loss, a consistently below-average body mass index (BMI), and a very low body weight in the absence of any contributing diseases or conditions.

Anorexia is commonly mentioned in contrast to bulimia. Where bulimia is characterized by binge eating and purging behavior (i.e. laxative use, induced vomiting, etc.), anorexia is characterized by controlling and reducing body weight largely via exercise and self-induced starvation. Women are more often affected by anorexia nervosa, but men can also struggle with eating disorders and associated body image issues.

While eating disorders are most often diagnosed among teens and young adults, they can occur (or persist) later in life too. Because teens are learning to take care of themselves and taking concepts such as nutrition and healthy living into their own hands, it’s important for parents and educators to differentiate between healthy lifestyle changes and potential symptoms of an eating disorder.

A Key Characteristic of Anorexia Nervosa

There are several signs and symptoms for anorexia nervosa, the most important being self-induced starvation, physical symptoms of extreme malnutrition, and a fear of gaining weight, particularly fat. However, it often comes back to a central point: The need to always lose more weight.

Teens who struggle with anorexia nervosa constantly perceive themselves as fat in some way, and often suffer from symptoms of body dysmorphia, a compulsive mental health issue wherein someone constantly perceives flaws within themselves even when these flaws aren’t present. More than any other symptom, teens with anorexia nervosa will insist that they need to lose more weight even while they’re unhealthily underweight.

Other Warning Signs of Anorexia

Teens with anorexia nervosa will go through extreme lengths to avoid eating food or making up for meals with excessive and intense exercise. While there is certainly a benefit to intense exercise, the level of exercise that is characteristic for someone with anorexia is destructive and harmful, particularly in the absence of much needed nutrition and critical recovery.

At the very least, a growing teen body needs plenty of sleep and plenty of food. This is doubly important when undergoing training. If your teen is obsessed with sports alongside unrealistic calorie restrictions, they may be struggling with anorexia. Other important signs and symptoms include:

    • Denying hunger
    • Eating in secret to avoid being judged
    • Developing certain rituals during meals (centered around reducing intake, such as excessive chewing)
    • Extreme dietary rulesets (completely avoiding one type of food or nutrient)

Aside from behavioral symptoms, anorexia can lead to the development of serious physical symptoms because of malnutrition and intense physical stress. These symptoms include:

    • Amenorrhea, or the absence of menstruation
    • Signs of osteoporosis, or brittle bones
    • Abnormally dry and flaking skin
    • Acne
    • Hair loss
    • The development of very fine facial and body hair, known as lanugo
    • Frequent fainting spells
    • Low blood pressure

These are not surefire signs of anorexia, and any one of these symptoms should prompt a visit to a doctor. But in the absence of a different medical condition, they may be caused by malnutrition and stress because of an eating disorder – especially in combination with the aforementioned behavioral signs.

What Causes Anorexia?

The causes of anorexia are complex, consisting of both environmental triggers and potential heritable traits that overlap with symptoms of obsessive-compulsive disorder (eating disorders and OCD can cooccur), anxiety, and depression. Psychiatric causes, including abuse and exposure to certain media, also play a large role. Other identified causes range from genetics to bacterial infection.

Given that eating disorders are more common in developed or Western countries, and are rising in prevalence in developing or non-Western countries, one theory is that the growing rate of eating disorders among teens is at least partially a result of Western beauty standards, media, and advertising (from TV to Instagram).

In the age of fitness models and influencer culture, teens are more inundated with unrealistic bodies and beauty standards than ever and may adopt unhealthy diets or exercise regimens not understanding what goes on behind the scenes. They may not be aware of how dangerous it is to remain at a certain low bodyfat outside of competition or aren’t aware of the use of things like fake weights, imperceptible image manipulation, and performance-enhancing drugs.

However, whether these environmental factors simply trigger an innate potential for anorexia or contribute to its development is still unclear. Research into eating disorders has shed a lot of light on just how complex they are, as well as revealing the many internal and external factors that play a role in their origin.

Signs of Anorexia in Boys

When eating disorders are brought up in the context of boys and men, other body image issues – such as muscle dysmorphia – are more commonly talked about. Indeed, “bigorexia” is a more common issue among boys than girls. However, that doesn’t mean anorexia nervosa does not exist in men. An estimated 20 percent of anorexics are male, presenting with all the same symptoms – starvation, a heavily distorted body image, and extremely restrictive dietary habits.

Again, symptoms of anorexia in boys overlap with symptoms of anxiety, depression, and obsessive-compulsive behavior. It’s a disorder that claims lives across gender lines, and while women are more heavily affected than men, the cases of boys with anorexia are rising, or at least becoming more known to clinicians and researchers.

How Anorexia Is Treated?

Some cases are far more severe than others. Because anorexia nervosa can sometimes go untreated until hospitalization occurs (because many teens refuse treatment), one of the most important steps to treating anorexia is first ensuring an anorexic teen’s survival. Teens with anorexia are carefully monitored to ensure that their hydration and electrolyte levels are improved, that their heart health hasn’t deteriorated too much, and they may require a feeding tube if they can’t keep down solid food. In extreme cases, hospitalization plays a vital role in the long road towards recovery and improvement.

Because the causes for anorexia may be neurological as well, treatment differs from individual to individual depending on how effective certain approaches are deemed to be. Teens with anorexia will usually work with a therapist to overcome and deny delusions of fatness and accept that they need help to work towards a healthier bodyweight. Different types of behavioral therapy such as CBT may help teens with anorexia confront their own thought patterns and avoid re-engaging in self-induced starvation.

Sadly, anorexia has the highest mortality rate of any mental disorder, in large part because of the risk of cardiovascular failure and the effects of starvation. Treating this disorder can be difficult, and requires a holistic approach addressing a teen’s psychological and physical symptoms. Family members often work with specialists to provide critical support, and a registered dietitian will help a teen learn to rethink their eating habits and slowly return to a healthier weight.

Eating Disorders

What Are Symptoms of an Eating Disorders?

One of the most common eating disorders we’ve all come to know is anorexia. Most of those accounts portraying anorexia are focused on women and young girls. There are also other eating disorders we may not be aware of looking at someone directly. Other eating disorders are harder to see on the surface, whereas anorexia is characterized by deficient weight that causes the person affected to waste away before our very eyes.

Conditions like these hurt families, and they often feel confused and helpless because they are unaware there’s an issue half of the time. At Visions, our parents and loved ones must learn a little something about every mental health and emotional condition so they can be ready, with eyes wide open, to see the signs. We hope to prepare families everywhere to care for each other, even when the person hurting can’t express themselves in words at that moment.

Most people don’t realize that eating disorders don’t just affect women and girls, unlike what the media continues to show us. Eating disorders affect everyone, no matter their gender. It’s known that over 10 million men in the United States are affected by eating disorders; this number is half of women and girls affected, but the point is that women are not the only people that struggle with weight and body image.

Most Common Eating Disorders

Anorexia Nervosa

As one of the leading, most common eating disorders, anorexia nervosa is a condition that begins with the complete cessation of eating or gaining any nutrition into the body at all. Adolescents affected by anorexia often lose weight rapidly to the point that it can cause serious health issues, possibly even death.

Symptoms of Anorexia

  • Depression
  • Thinning hair
  • Suicidal thoughts
  • Social withdrawal
  • Trouble with digestion
  • Wearing baggy clothes
  • Reduced periods in women
  • Acute fatigue and insomnia
  • Anxiety concerning weight gain
  • Dehydration Jaundice (yellowed skin)
  • Won’t eat in a group setting and often makeup excuses

Bulimia Nervosa

Those affected by bulimia eat, but they won’t allow the food to digest in their system. You’ll notice them take frequent bathroom breaks to vomit up their food to avoid absorption of nutrients so they can avoid gaining any weight. Bulimia is a serious condition that could cause deterioration of the esophagus and other tissues in the body. Those with bulimia could suffer from seizures and irregular heart rhythm.

Symptoms of Bulimia

  • Frequent mood changes
  • Depression and anxiety
  • Their breath will often have an obscure odor
  • Dental deterioration
  • Constipation or inflammation of the intestinal tract
  • Dry skin
  • Devour lots of food and excuse themselves
  • Critical of body weight and shape
  • Muscle cramping
  • Tremors
  • Social withdrawal
  • Fainting

Binge Eating Disorder

People eat with binge eating disorders, and they will eat regularly, but these abnormal eating behaviors occur when they’re alone. Bulimics have periods where they won’t eat, fast, then eat a high amount of food in one sitting. Those with bulimia will often eat fast food alone and hop from one restaurant to another to eat in isolation.

Symptoms of Binge Disorder

    • Lack of self-control
    • Eating significant amounts of food and hiding food away
    • Continually eating until it becomes uncomfortable
    • Social withdrawal
    • Weight gain
    • Feeling guilty eating
    • Excessive exercising
    • Can binge eat and then vomit their foods

Body Image Disorder or Body Dysmorphic Disorder (BDD)

A mental health condition that often comes from anorexia, bulimia, and binge eating disorder often comes from these disorders. It might be the case that your loved one started with a form of extreme dieting or became addicted to exercise, and this body dysmorphic disorder (BDD) manifested, or the other way around. These conditions work off one another.

At Visions, we work with our teens to help them realize the beauty within every one of them. If we’re aware of how our children feel about themselves and how we talk to them as a family or supportive unit, we might notice these changes in eating behaviors and their adverse effects. As always, pay attention and be attentive to your children. If your child or loved one develops an eating disorder, contact us today.

Eating Disorders Mental Health Recovery

Eating Disorder Awareness Week: Insight From Michelle Gross, MA, LMFT

Continuing our week of honoring Eating Disorder Awareness Week, I spoke to Visions’ Michelle Gross, MA, LMFT who has specialized in the treatment of eating disorders for over 18 years. Her passion is in treating the eating disorder community both individuals, and their families. Eating Disorder Awareness is something we encourage and support via groups, individualized therapy, and nutritional support. I asked Michelle for some insight into what she tells families with a loved one who is suffering from an eating disorder or disordered eating behaviors. She says,


“When assisting a family who have just learned that their loved one is suffering from an eating disorder, I want them to know that eating disorders are a coping mechanism that tend to occur in individuals who suffer from anxiety and/or depression. Eating disorders numb pain (overeating), release feelings (purging), and create a feeling of control (counting calories). Eating disorders, although not always identical in form, tend to run in families. Family members need to know that the way in which they respond to their loved one is critical to the recovery process; however, they are not responsible for the development of the eating disorder itself. Eating disorders are an illness. Eating disorders are not about weight.”


Families who are confronted with this issue have to re-learn how to communicate with each other in a non-triggering way. I recently had to have a discussion with someone about their perpetual food talk and how triggering it was. Every meal was punctuated with negative commentary about weight gain, etc. So, eating with this person was becoming treacherous. Michelle Gross has wonderful insight and suggestions for situations just like this:


“It is important for family and friends to know how to be supportive. Unfortunately, the best of intentions to assist the eating disordered individual tend to backfire. Telling an anorexic that recently gained weight: ‘You look so much healthier,’ is easily misconstrued as being told one is ‘fat.’  Attempts to make sure an anorexic eats or a bulimic does not purge, create feelings of powerlessness that intensify the desire to feel in control by minimizing calories or purging.  Innocently mentioning one’s own need to lose weight or recently enjoying a vigorous workout, leave the eating disordered individual feeling inadequate and more dissatisfied with herself.  Loved one’s need to learn the ‘language’ spoken by the eating disordered individuals. Eating disorders are competitive.”


And what about triggers? Remember, what triggers one person may not trigger another, but some things are similar across the board. Michelle provides some salient advice here. If we begin to understand the psychological mechanisms of the eating disorder, our awareness and ability to support someone who is suffering increases. By opening our eyes, we can be supportive without judging the individual.


Michelle tells us that, “Family and friends also need to learn what triggers or intensifies eating disordered thoughts and behaviors.  Shopping for clothes, going to restaurants, exercising to reduce stress, can all intensify the eating disorder.  Eating disorders are reactive. The more one learns how their loved one’s eating triggers them, the more helpful one can be.”


Recovery is a family process, and that includes recovery from substance abuse, mental illness, eating disorders, or processing disorders. Treatment must include all facets of the family system. Learning how to do this is a process and a practice; and as Michelle illustrates, it is not one-sided affair:


“It is extremely valuable for family members to be part of the treatment.  Family sessions in addition to the individual therapy offers all members the opportunity to learn how to be supportive, to share concerns in a controlled environment, and gives the eating disordered individual an opportunity to express their feelings in an appropriate way vs. through the eating disordered behaviors.”


We need to unite as a recovery community, championing Eating Disorder Awareness Week and encouraging others to do the same. We can facilitate supportive environments and spaces for healing so those suffering from an eating disorder can begin to recover and find freedom from the devastating anguish caused by their eating disorders.

Body Image Eating Disorders Events Mental Health Recovery Teen Activism

Eating Disorder Awareness Week: Visions’ Stefanie Boone, MS, RD Shares Insight

It’s National Eating Disorder Association‘s Eating Disorder Awareness Week

often referred to as EDAW. I asked Stefanie Boone, MS, RD, to provide some insights and tips on what an eating disorder is, what is is not, and ways in which you can be supportive. This year’s EDAW theme is “I had no idea.” We are grateful to have Stefanie as part of the Visions family:

When I see parents, friends, or significant others trying to support their loved one with an eating disorder, my heart goes out to them. Besides feeling guilty (is this my fault?), worried (will he or she be OK?), and overwhelmed, they are often at loss around how to be helpful. Friends, family, and community need education around the following concepts:

–       That an eating disorder is really a symptom of deeper underlying issues;

–       That their loved one cannot just simply stop the behavior;

–       Certain things you may think would be supportive can actually make things worse;

–       That their own talk and behavior around food, diet, and being dissatisfied with their own bodies have and will continue to affect  their children or loved one;

–       That the sports team their child is a part of may actually be feeding into their ED.

My top five tips for those who want to be supportive are:

1. If you are trying to get your loved one to seek help, take a loving and non-judgmental stance with your loved one. An eating disorder is a mental illness, and requires professional help. Express your concern from a loving place.  Share how the ED is impacting you and your family.

2. If you are supporting an adult (spouse, parent, adult child) – do not be the food police. This is usually not helpful. With children and teens parents may need to be more involved – your child’s treatment team will guide you.

3. Be a positive role model – even if you do have your own opinions about food and even if you think you are “fat”, you need to stop sharing these thoughts and comments with your loved one.
And NEVER comment on how your loved looks – this is a very sensitive area and often a completely innocent comment such as “you look great” can be twisted into “is she saying I look fat?”

4. If your child is on a team sport, contact the coach – get more information as to what he/she is advising your children around food and exercise. Your child will most likely need to discontinue this sport at least temporarily while in recovery.

5. If you are a teen and have a friend you are worried about, talk to an adult about it immediately– teacher, school counselor, parents. I know this may be hard, but you may be saving your friend’s life.


Eating Disorder Awareness Week begins TODAY: 2/23-3/1. Please share your experience, strength and hope this week, using the hashtag #EDAW14. You never know who you’re helping or who might “hear” you for the first time.

Links to Check out:

How much DO you know? Take the NEDA QUIZ.

Proud2BMe Teen activist guide

Download NEDA’s Key Messages HERE and let others know why you’re participating.


Eating Disorders Mental Health

Orthorexia: When Healthy Becomes an Obsession

Orthorexia Nervosa is a term coined by Dr. Steven Bratman in 1997 and refers to the obsession with the purity and healthfulness of food. Orthorexia hasn’t found its way into the DSM-V, but it is a very real disorder. It falls under the pretense that one is really eating healthfully.  However, the desire to eat well and purely can often provoke an environment of nutritional loss and poor health. Orthorexia presents a conundrum, because eating healthy is a positive attribute; where the issue arises is when eating healthy becomes an unhealthy obsession.


I sought deeper insight into this disorder, and spoke to our nutritionist Stefanie Boone, MS, RD, who frequently works with clients suffering from Orthorexia.  She says,


“When I see clients with orthorexia, what stands out most is the level of stress and anxiety they experience at the idea of eating something they deem as unhealthy, as well as the amount of time and energy spent around their healthy diet. Orthorexia is hard for people to understand as a type of eating disorder, because eating healthy is generally such a positive thing to do. But when it winds up being all-consuming, it is at the expense of other areas of their life (relationships, work, mental health). Health may be compromised if a person winds up eliminating too many foods. Weight can get dangerously low, though it doesn’t always.

With orthorexia, there is an exaggerated perception that eating one food or meal that is unhealthy will have unrealistically negative consequences (similar to Anorexia Nervosa where a person may fear one food or meal will cause them to ‘get fat’).  Sometimes, the person feels as if their goodness or worthiness as a person, or even their spiritual trajectory, depends on their eating.”


The National Eating Disorder Association (NEDA) provides these questions to consider. The more questions you respond to with a “yes,” increase the likelihood of orthorexia:


  • Do you wish that occasionally you could just eat and not worry about food quality?
  • Do you ever wish you could spend less time on food and more time living and loving?
  • Does it seem beyond your ability to eat a meal prepared with love by someone else – one single meal – and not try to control what is served?
  • Are you constantly looking for ways foods are unhealthy for you?
  • Do love, joy, play and creativity take a back seat to following the perfect diet?
  • Do you feel guilt or self-loathing when you stray from your diet?
  • Do you feel in control when you stick to the “correct” diet?
  • Have you put yourself on a nutritional pedestal and wonder how others can possibly eat the foods they eat?


Orthorexics often become isolated, suffer from nutritional deficiencies, lose the ability to eat intuitively, and suffer from significant social issues. The fear of food becomes overwhelming. This is not a sustainable existence; it is one that requires professional help and support.


As a recovered orthorexic client describes, “I basically thought that the cleaner I ate, the better my closeness to the source would be from a spiritual perspective—that I would be able to see and think and feel more clearly. The problem was that at the end of it all when you cross reference the foods that are not OK to eat across the many different philosophies I was trying to follow (ayurveda, Chinese medicine, etc.), I was left with the reality that there was really nothing left I could eat.”


With professional help, a recovered orthorexic will learn to shift their paradigm around food. While they will continue to eat healthy foods, they will have redefined their relationship to it, freeing them to enjoy life more completely.  If you are suffering, please seek help. Recovery is possible.

Helpful sites and articles:

Mayo Clinic

Academy of Nutrition and Diatetics

Orthorexia: Too Much of a Healthy Thing? (Huffington Post)


Eating Disorders Mental Health Recovery

Eating Disorders: Putting Ed in Time Out

It’s been a while since we’ve talked about Ed (Eating Disorders), but it’s summertime, and Ed likes to interject a lot now that it’s bikini season. Oh, and FYI, it’s not uncommon for those in recovery to refer to their eating disorder as Ed. Some may give it another name, but Ed always seems to fit the bill.


Eating disorders are tricky: they are not about food, but food is the weapon of choice. Ed is the one quietly whispering in your ear, nagging you about calories or telling you that you really shouldn’t eat this or that or encouraging you to binge. Frankly, he’s a jerk. He doesn’t have your best interests in mind. Part of recovery is learning how to talk back to Ed, but that is a process. We tend to get so caught up in the lies and dysfunction of the eating disorder itself, we get detached from reality. Ed is a magnificent manipulator and master of ceremonies, and he digs his role.

In the book “Life Without Ed,” Jenni Shaefer declares independence from her eating disorder. She does this after a lot of therapeutic work; so don’t get any crazy ideas! Jenni  Shaefer eventually wrote a declaration of independence from her eating disorder; I’ve shared a more general version with you which was sourced from here. It’s fantastic. Perhaps it will encourage you to talk back to your eating disorder. Perhaps it will encourage you to kick Ed to the curb and declare your own independence.  Enough is enough. There’s no reason to live under the tyranny of Ed any longer. Even when he rears his ugly head, we can talk back. And even if he gets the better of you for a day or two, perhaps you can look at this and know that you can dust off your knees and stand up again. Remember, “fall down seven, stand up eight.” To quote Jenni Shaefer, “Ironically, it is the not-so-fun part of recovery that actually enables life to be so much fun in the end.”

My Declaration of Independence 

When in the course of human events, it becomes necessary for a person to dissolve the bonds which have connected them to Ed, and to assume, among the powers of the earth, the separate and equal station to which the Laws of Nature entitle them, a decent respect to the opinions of humankind requires that they should declare the causes which impel them to the separation.

We hold these truths to be self-evident, that all persons are endowed upon birth with certain unalienable Rights, that among these are Life, Liberty, and the pursuit of happiness.

That whenever Ed becomes destructive of these ends, it is right to abolish Ed and to institute Recovery, laying its foundation on such principles and in such form as shall seem the most likely to effect safety and happiness.

When a long train of abuses, pursuing invariably the same person evinces a design to reduce that person under absolute despotism, it is their right, it is their duty, to throw off Ed, and to provide recovery for their future security.

The history of Ed is a history of repeated absolute Tyranny over this man or woman. To prove this, let facts be submitted.

-Ed has refused for a long time to allow the individual to find happiness

-Ed has erected a multitude of binges and purges

-Ed has ravaged the individual’s life and harmed the lives of the people close to them

-Ed has cut off all emotions

-Ed has suspended the individual’s own mind and declared himself invested with the power to legislate the the individual’s world

-Ed has deprived the individual of food

-Ed has taken away the individual’s feelings, abolished his or her most valuable morals, and altered fundamentally his or her values.

Therefore, I solemnly declare that I am FREE and INDEPENDENT.

I am absolved from all allegiance to Ed.

Any connection between Ed and I will be completely dissolved, and as a free and independent individual, I have the power to eat, live in peace, and find happiness.

Addiction Eating Disorders Recovery Smoking

Eating Disorders: Using Smoking As Weight Control

Smoking cigarettes in adolescence has always been considered a pathway to coolness, or a way to fit in. For a time, smoking began to be considered passé, but amongst teens in recovery, it still holds the mythical status of cool and is often key to fitting in. So much so, kids who want to quit or who don’t really want to smoke may even start smoking E-cigarettes in an attempt to reach the same level of cool. (It is just vapor, right?). I digress. For girls who smoke, there may be another reason behind the nasty habit: presumed thinness, or a path to thinness. Some assume that smoking is also the answer to hunger pains and subconsciously satisfy (albeit temporarily) the desire for food.


In their working paper titled “The Demand for Cigarettes as Derived from the Demand for Weight Control,” Stephanie Von Kinke Kessler Scholder and John Cawley found that “among teenagers who smoke frequently, 46% of girls and 30% of boys are smoking in part to control their weight.” We see this behavior all the time within our recovery community, particular among those suffering from and beginning to recover from eating disorders. For some, the idea is that it’s far easier to go smoke than to eat lunch. We are highly aware of this predilection amongst our eating disorder population and we take great measures to stop these behaviors in their tracks. Some of which include supervised meals and several focus groups dedicated to eating disorder recovery.


But what about someone struggling with an eating disorder who is not in the safe, healing environment of a treatment facility? What if they are on their own, doing the dance of recovery solely through meetings and fellowship? Will they notice their use of cigarettes to stifle hunger pains? More than likely, they will not. I remember being new and bragging that I was surviving on a diet of coffee and cigarettes, ever chasing the goal of “perfection.” At the same time, I also had a raging eating disorder, consuming my thinking and vision. I was clueless. It took me years to learn to recognize that smoking was a key to assisting me in my process of acquiring thinness.  In fact, one of the fears when I quit smoking was the presumed assurance of weight gain.


As always, one of the first steps to recovery is asking for help. This is not a feat that comes naturally to an addict or alcoholic. We are accustomed to “doing it all ourselves.” Still, going to meetings, getting a sponsor, finding a therapist, all of these things can help us begin the healing process. Beginning the process of digging deeply and getting to the root cause of whatever is causing you to harm yourself with addiction, starvation or binging, or binging and purging is crucial. We cannot recover alone, nor can we stop the insanity of our addictions without asking for help.

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