Istana’s Clinical Director, DrJeremy Alford, is the Founder and President of the non-profit organisation The Middle East Eating Disorders Association www.meeda.me which is a Partner Chapter of the Academy of Eating Disorders for the Middle East. Jeremy is also a Senior Trainer for the National Centre Of Eating Disorders in the UK.
Holistic treatment for eating disorders is an area that Istana specialises and excels in. Please contact us if you would like to have a conversation with Jeremy to discuss how Istana can help you resolve your eating disorder.
Eating disorders and unhealthy eating behaviours are complex mental health conditions that require specialist guidance and treatment intervention. According to the WHO, an estimated 70 million people are affected by eating disorders worldwide, and have the highest mortality rate of all mental health conditions.
Eating disorders and severe unhealthy eating behaviours affect people of every age, race, size, gender identity, sexual orientation and background. Athletes and veterans are also at risk of screening for an eating disorder.
The commonly known eating disorders are anorexia nervosa, bulimia nervosa and binge eating disorder; which are characterized by restrictive, avoidant or binge-purge subtypes.
However, there are many other types, from orthorexia to night eating syndrome, reverse anorexia which is also called bigorexia or muscle dysmorphia which is a kind of body dysmorphic disorder (BDD) that affects men primarily who work out and bodybuilders.
Eating disorders are accompanied by comorbid mental health conditions such as anxiety, depression, obsessive compulsive disorder, substance abuse as well as personality disorders that need to be carefully assessed and addressed and can only be treated by specialist mental health professionals. Failure to recognize comorbidities may place an individual at greater risk of relapse when faced with acute stress later on. It may also lead to development of other destructive coping behaviors if the fundamental issues of fear, trauma, shame and control are not addressed under the guidance of a team of mental health professionals experienced in treating eating disorders.
The eating disorder behaviour itself is just the tip of the iceberg. Its purpose is to defend against insecurities in which the person has felt out of control. It is a coping mechanism that provides a false sense of control and a temporary relief. However, the factors that cause eating disorders are complex and not clearly understood. Current research suggests that approximately 40 to 60% of the risk for anorexia nervosa, bulimia nervosa, and binge eating disorder is genetically influenced. Chance and ‘bad luck’ appear to play a role and every person varies in their genetic risk. This isn’t something that can simply be stopped suddenly on one’s own by simply eradicating unhealthy eating behaviours, because of the addictive nature of the behaviour.
Diets are the number one risk factor for developing an eating disorder, especially in those that have a high genetic predisposition. The food restricting mentality behind diets sends a maladapted message that often leads to body dissatisfaction, and although a majority of people will be able to go off the diet, a small percentage of people will begin to enter into the pitfalls of eating disorders. However, not all diets will lead to developing an eating disorder, neither than they be guaranteed to bring about sustained healthy eating behaviours or return to a healthy weight.
It is often misconceived that people with eating disorders could easily stop it, achieve a healthy weight and adopt a more helpful coping mechanism instead, however this is not possible without expert eating disorder treatment. It is critical to understand that there are many perpetuating factors that maintain an eating disorder behaviour in place. In the world of eating disorders treatment we use the ‘biopsychosocial model’ term to explain that all eating disorders have several precipitating factors, from genetic, to biochemical, nutritional, psychological, emotional and even social factors that make the process of recovery for some, long and arduous. However, what must be noted is recovery from eating disorders is possible with the right qualified approach, the right team and more importantly a personalized method.
Many people with eating disorders are unable to recognize that they are ill, nor are they able to realize the severity of their condition. Similar to that of a substance or alcohol user, a person with eating disorders will go through what are known as ‘stages of change’, which represents where a person is at with respect to their readiness, willingness, ability and active participation in their process of recovery. Many people with eating disorders will be afraid of changing although they might be desperate to change. Ambivalence is common and is something that a person has to learn how to work through.
Although expressing a readiness to recover and adopt healthy eating behaviours is a positive sign, eating disorder treatment doesn’t have to wait until your loved one is ready. If the person in question is an adult; both family and friends must express their concerns about the negative impact of the eating disorder behaviour on their loved one’s life and encourage them to seek help.
People with an eating disorder may present with a combination of symptoms and some may not show any signs, even healthy weight. They may go through great efforts to hide their behaviour or they may not be aware that their behaviour is a problem. This can make it difficult to identify the warning signs and the necessity of treating eating disorders may be missed completely.
Below are signs and symptoms that can be observed and when treating eating disorders should be considered.
- Changes in weight or rapid weight loss
- Loss of menstruation in women
- Looking pale and lethargic
- Feeling cold even when warm outside
- Preoccupation with food, body weight and shape
- Anxious around food
- Rigid thinking
- Refusing to eat because of emotional reasons
- Dieting behaviours such as calorie counting, fasting, avoiding certain foods
- Avoiding meals with others
- Evidence of hoarding of food
- Using laxatives, diuretics, appetite suppressants
- Excessive exercising
- Changes in food preferences
- Obsessional rituals around food such as cutting food into small pieces
- Very sensitive to others comments around food, shape, weight or exercise habits
Early intervention is key to a faster recovery, with a multidisciplinary team of experts in the specialised field of treating eating disorders