Are you looking for an “eating disorder therapist near me”?
At Bregman Medical Group, our team of professionals specializes in treating a wide array of mental health disorders, including eating disorders. Through our years of experience, we have been helping children, adults, and families in Coral Gables, Florida overcome challenges and develop better ways to manage their mental health.
If you think you or your loved one has an eating disorder, take action and talk with a licensed mental health professional now.
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What Are Eating Disorders?
Eating disorders are a type of mental health disorder that involves severe, unhealthy eating habits and related behaviors because of distressing thoughts and feelings. Eating disorders can pose serious, life-threatening consequences because they negatively affect the physical, mental, and social functioning of a person. A person with an eating disorder is always preoccupied with food, their body weight, and their shape.
Eating Disorder Types
Anorexia Nervosa is one of the most common types of eating disorders.
People with anorexia are extremely fearful of gaining weight and they see themselves as being fat even if they are underweight for their height and age. Because of distortion of their body image, people with anorexia nervosa restrict their food intake, binge-eat, and purge, or exercise excessively in their pursuit of being thin. It may not always be the case but their BMI is typically under 18.5.
Because of being extremely underweight, people with this eating disorder are at risk of developing serious medical complications such as kidney problems and abnormalities in their heart rhythm - and even death.
People with anorexia nervosa can either be the restricting type where they engage in weight-loss activities like fasting, dieting, and exercising; or the purging type where they misuse laxatives, enemas, or diuretics, and self-induce vomiting.
Bulimia nervosa involves recurrent episodes of binge eating that lead to compensatory behaviors afterward in a person's effort to prevent gaining weight. The person's self-evaluation is unduly influenced by their body image. Bulimia nervosa is also another common type of eating disorder.
During a binge-eating episode, a person uncontrollably eats very large amounts of food that is not normal for most individuals at a specific time and situation. After a binge-eating episode, the person feels guilty for eating too much and makes up for it through behaviors preventing weight loss (called purging episodes) such as self-induced vomiting, use of laxatives, excessive exercise, and fasting.
People with bulimia nervosa also fear gaining weight, even if they have a normal BMI.
Binge Eating Disorder
Binge eating disorder has the same symptoms as bulimia nervosa and the binge-eating subtype of anorexia nervosa. People with this mental health disorder also uncontrollably eat unusually large amounts of food, but the difference is that they do not have regular purging episodes after they binge eat. As a result, people diagnosed with this disorder are often overweight and obese.
Being overweight or obese makes them at risk for many health complications like heart disease and diabetes. Other mental health conditions can also co-occur such as depression, anxiety, or substance abuse.
In the US, binge eating disorder is the most common type of eating disorder and affects mostly younger or middle-aged people. To be clinically diagnosed with binge eating disorder, a person must have the eating disorder symptoms at least once a week for three months.
Pica is an eating disorder where a person persistently craves one or more non-nutritive or non-food substances that are inappropriate for their developmental stage. Some examples of these non-food substances include hair, soil, paper, soap, or dirt. Their persistent cravings must last for at least one month.
To be diagnosed with pica, a person’s behavior must not be socially acceptable or part of their cultural or religious norm. Pica can be fatal depending on the substances taken as people are more at risk of being poisoned and having gastrointestinal problems. They are also in danger of nutrient deficiency.
Pica may also be comorbid with other mental health disorders like autism spectrum disorder and intellectual disability.
People with rumination disorder have frequent and repeated behaviors of regurgitating their food after eating. They voluntarily retch so that their swallowed food will be brought back up for them to re-chew the food and spit out, or to re-swallow it.
Their ruminating behavior occurs several times a week or every day, and for over a period of one month.
Avoidant Restrictive Food Intake Disorder
Avoidant restrictive food intake disorder (ARFID) involves an eating disturbance where a person has a lack of interest in eating food, avoidance of sensory stimulation of food, and extreme concern about the negative consequences of eating.
Similar to people with anorexia nervosa, people with ARFID are at risk of malnutrition, however, they do not have an obsession with their body weight.
Other Specified Feeding or Eating Disorder
There are eating or feeding disorders that do not meet the full criteria of the other eating disorder categories as presented in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Psychiatrists classify these as other specified feeding or eating disorders (OSFED).
For example, a person can be diagnosed with bulimia nervosa of low frequency and/or limited duration if they meet all of the criteria for bulimia nervosa, except that the frequency and duration of the binge-eating behaviors are less than 3 months.
Purging disorder is another example where a person usually does purging behaviors to strictly control their body weight, but without binge-eating.
Mental health is part of your overall health. If you or you know someone who needs an eating disorder therapist, our team can help you.
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Causes and Risk Factors of Developing Eating Disorders
Eating disorders can happen to anyone from all backgrounds, races, ethnicity, gender, or age. However, some studies show some people are more prone to developing them.
Many experts believe that there is no one cause for developing an eating disorder. But, eating disorders are caused by a complex combination of psychological, social, and biological factors. These may include:
Genetics - a person with a first-degree relative with an eating disorder or another mental health condition has a higher risk of developing an eating disorder
Temperament and personality traits - people who have neurotic tendencies (emotionally unstable), who are perfectionists, and who are obsessive-compulsive tend to be anxious, depressed, and self-critical, which can contribute to an eating disorder
Gender - a study shows that anorexia nervosa is more common among young women, especially for 15-19-year-olds
Media influence - there is research that shows young people who are exposed to unrealistic and unhealthy body images can influence perceptions of their own body image and body satisfaction.
Negative childhood experiences such as always hearing overcritical comments about their weight and eating
The interplay between genes and the environment
Both genetic and environmental factors that interplay are much more likely the cause for a person developing eating disorders. The development of eating disorders may begin in a very subtle way. Even if a specific event triggered the start of the disorder, there are almost always other factors that also contribute to it.
For example, a person who is already susceptible to developing an eating disorder and also experiences weight-teasing from friends may decide to start dieting that snowballs to disordered eating habits.
Diagnosis of Eating Disorders
The diagnosis of eating disorders involves many healthcare providers. Some of the tools used by doctors to make a diagnosis include:
Administering a physical exam and other lab tests to rule out other medical conditions that may be causing your eating disorder symptoms
Checking your medical history by asking you about your symptoms
Performing a psychological evaluation by asking you about your thoughts, feelings, and eating habits or letting you answer a questionnaire
Other tests may be performed depending on the advice of your healthcare provider and to check if you have other health concerns caused by an eating disorder.
In the USA, mental health professionals use the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) published by the American Psychological Association (APA).
Signs of Eating Disorders
Many people with eating disorders may try to hide it from their family and friends or may not even realize they have a problem. If you think someone you know may have an eating disorder, identifying their symptoms early will be the first step to help them on their road to recovery.
Below are some of the signs that someone may have an eating disorder:
Relentlessly exercising while eating very little because they distortedly think they are overweight even when not
Religiously counting their calorie intake
Drastic weight loss and wearing loose clothing to hide it
Denial of being extremely underweight
Excessively complaining about being “fat”
Refusal to eat during meal times and with others
Signs of binge eating such as taking abnormally large amounts of food in a short period of time
Signs of purging such as going to the bathroom after meals or finding laxatives and diuretics
Finding food storage in strange places
People with a binge-eating disorder may constantly diet, but rarely lose weight
Treatment of Eating Disorders
The treatment of eating disorders may involve a team of health professionals who will help decide what combination of treatments will work best for you. Below are some examples of how eating disorders can be treated:
Since people with eating disorders usually lack nutrients because of unhealthy eating habits, an important part of the treatment is to ensure that they receive proper and adequate nutrition. This is especially true for people diagnosed with anorexia nervosa who are extremely underweight. A dietitian can assist in designing a meal plan to make sure that the person will receive good nutrition and slowly help them develop healthy eating habits so they will get to eat normal foods again.
Treatment Centers for Eating Disorder
For severe cases of eating disorders that would need constant supervision of mental health professionals such as psychologists, psychiatrists, and nutritionists, there are treatment centers that can provide 24/7 care and support to the patient.
Psychotherapy for Eating Disorders
Qualified therapists conduct psychotherapy or counseling individually or in groups such as with family.
Cognitive Behavioral Therapy (CBT) - CBT is widely used in treating mental health disorders, including eating disorders. It is the leading evidence-based intervention for eating disorders. The focus of CBT is to identify your thought patterns, emotions, and behaviors related to food, your body weight, and your appearance. Once you’ve identified them, your counselor will help you develop healthier ways to manage your behavior. Enhanced Cognitive Behavioral Therapy (CBT-E) is a highly-individualized form of psychotherapy that is specific to treating eating disorders like anorexia nervosa, bulimia nervosa, binge eating disorder, and other similar eating disorders.
Family-Based Treatment (FBT) - FBT, also called the Maudsley Method, is usually used for children/ adolescents who are diagnosed with eating disorders. With FBT, parents and other family members are included in the therapy as they are vital to the person’s recovery. Parents are taught the right skills and coaching tips to help their children develop healthier eating habits and maintain normal body weight.
Interpersonal Psychotherapy (IPT) - IPT focuses on your current interpersonal relationships and how they may contribute to your eating disorder. Therapists identify the “problem areas” of the person in the social context, which may include interpersonal deficits, role disputes, role transitions, and complications in grief.
Once the problems are identified, your therapist will then help you develop strategies to improve your interpersonal skills for your recovery. IPT can be very helpful for people with eating disorders comorbid with depression.
Medication for Eating Disorders
It is important to note that the main treatment for eating disorders is nutritional rehabilitation and psychotherapy; however, in some cases, medication can be helpful to make psychotherapy more effective. Antidepressants such as selective serotonin reuptake inhibitors (SSRIs) can be helpful to many people with eating disorders who also struggle with other mental health conditions like anxiety and depression.
An in-depth and complete diagnostic evaluation by your psychiatrist is important before administering medications.
Meet Dr. Arthur Bregman
Dr. Arthur Bregman is the lead psychiatrist of Bregman Medical Group in Coral Gables, FL. With over 40 years of experience, he has helped thousands of patients of all ages overcome and manage their mental health conditions. Dr. Bregman was previously the Chief of Psychiatry of Nicklaus Children’s Hospital and is presently helping patients through his private psychiatric practice of Bregman Medical Group. He is a recipient of the “America’s Best Doctors’ Award” in 2012.
Request an online appointment with Dr. Arthur Bregman today!