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LGBTQ Youth & Eating Disorders - River Centre Clinic

Why Are Eating Disorders More Common in the LGBTQ Community?

Eating disorders have long been a problem in the United States. These disorders have been part of the psychiatric literature for many years. In recent decades, psychiatrists and other healthcare professionals have allocated more time and resources towards the study, treatment and prevention of these disorders. Recent studies are attempting to explain a particular pattern of eating disorders in U.S. society. Researchers have found that more than half of young LGBTQ people between the ages of 13 and 24 have been diagnosed with an eating disorder.

Both the National Eating Disorder Association (NEDA),  and The Trevor Project, (LGBTQ suicide prevention organization) state that the report is based on online surveys of 1,034 young people. Among the 46 percent of LGBTQ youth who were surveyed and had never been diagnosed with an eating disorder, 54 percent reported that they at some point suspected they suffered from an undiagnosed eating disorder. Out of all the survey’s respondents, 75 percent said they had either been diagnosed with an eating disorder or suspected they had one at some point in their life. This research displays the need for additional studies in this area.

The most common disordered eating behavior from the survey was skipping meals and eating very little food in general. Not surprisingly, anorexia nervosa was the most prevalent eating disorder. The data also displayed a correlation between young LGBTQ individuals with eating disorders and suicide. Out of the individuals who had been diagnosed with bulimia, a shocking 96 percent had considered suicide. On a similar note, 66 percent of survey respondents who had stated that they had considered suicide already had been diagnosed with an eating disorder.

An earlier study in 2007 had explored at the prevalence of eating disorders in lesbian, gay and bisexual men and women. Part of the research examined associations between participation in the LGBTQ community and eating disorder prevalence in gay and bisexual men. The research was not clear as to why there was a high prevalence of eating disorders among gay and bisexual men. Researchers in this study found that gay and bisexual men had a significantly higher incidence of eating disorders when compared to heterosexual men.

Studies in 2007 were the first to assess DSM diagnostic categories, gay and bisexual men had a significantly higher prevalence of lifetime full syndrome bulimia, subclinical bulimia, and any subclinical eating disorder. At the time, gay men are thought to only represent 5 percent of the total male population in the United States. Yet, for males who have been diagnosed with an eating disorder, 42 percent of them identify as gay. For people who identified as gay, lesbian, bisexual or mostly heterosexual, they possessed binge eating, purging and laxative abuse rates that were much higher than their heterosexual peers. Data shows that for LGBTQ youth, as early as age 12, they are at a higher risk of engaging in disordered eating behavior.

So why is there a higher occurrence of eating disorders in the LGBTQ community?

Some researchers argue that because of stress from living as a minority, unhealthy eating habits are more common in the LGBTQ community. Eating behaviors such as binge eating and anorexia nervosa are symptoms of the general social stress that LGBTQ individuals experience as minorities. Thankfully, new studies and technology are making it easier to understand the physical impulses that surround unhealthy eating behaviors. Also, a broader acceptance of LGBTQ people in American culture should hopefully lower this statistic. The election of the first openly gay governor in Colorado shows that U.S. society is changing.

However, there are still unique stressors that people in the LGBTQ community are forced to face every day. These stressors create higher levels of anxiety and depression. This, in turn, can encourage unhealthy coping mechanisms that creates eating disorders and/or substance abuse. Some of the stressors that may encourage the development of eating disorders include:

  • Internalizing negative messages.
  • Living in fear from being harassed which can develop into PTSD.
  • Stress from discrimination.
  • Living as a runaway and/or experiencing homelessness.

Healthcare professionals who have direct experience with diagnosing and treating eating disorders can help people successfully recover from an eating disorder infliction. For additional information or questions about bulimia and anorexia, please contact the staff at River Centre Clinic (RCC). Their Eating Disorders Programs provide a full range of treatment options for both adolescents and adults. Their facility is located Northwest Ohio in the town of Sylvania, OH.

Follow on Twitter:  @River_Centre

LGBTQ, Eating Disorders, Anorexia Nervosa
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Binge Eating Study, Apple and Smartwatches

In 2014, the New York Times published an article that explored the ever-growing presence of smartwatches in healthcare. The article argued that watches in the future will not only track time in increasingly complex ways, but will also play a more critical role in helping people stay healthy. These new watches which mimic the nomenclature of the smartphone are collectively known as smartwatches. The article predicted that in the near future, these devices would go beyond simply transferring app usability from a smartphone to your wrist.

The long-term goal of these devices was to solve problems and deliver benefits to the user in a fundamentally new way that was unique to the smartwatch. These high-tech wristbands would track a person’s fitness level while simultaneously helping with the treatment and management of chronic health conditions. Since 2014, smartwatches have expanded in their functionality and popularity. Many smartwatches can help monitor heart conditions and sleep issues, but now these devices will assist in treating eating disorders.

For readers who are not familiar with smartwatches, here is a brief summary of these newer devices. Basically, a smartwatch is a small computer that is worn on the wrist. They can associate with a smartphone and are extensively used for long-term biomonitoring or telemetry. More recent smartwatches have smartphone functionality and utilize Bluetooth and LTE technology.

Reflecting current medical industry trends, many technology companies have been expanding there presence in the healthcare industry. The tech giant Apple has a number of rumored healthcare-themed projects. For example, a recent patent application that was made public suggests that the company may soon offer a wearable device that accurately monitors blood pressure. In a different healthcare specialty, Apple is donating smartwatches for a new research on eating disorders. The tech company will donate Apple Watches to a binge eating disorder (BED) and bulimia nervosa (BN) study.

The term eating disorder is a broad medical term. The diagnostic system in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) classifies eating disorders into four basic diagnostic categories: anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED) and Other Specified Feeding or Eating Disorder (OSFED). The most notable change in the DSM-5 over the previous editions was the recognition of binge eating disorder as a separate eating disorder category. In recent years illnesses like bulimia have gained public attention. Entrepreneur, actor and political activist Jane Fonda recently spoke publicly about her battles with bulimia.

The goal of the binge eating study is to discover whether this illness is biological or behavioral in origin. More precisely, the study is hoping to better understand the genetic factors that may be associated with binge eating disorder (BED) and bulimia nervosa (BN) in order to develop better treatments for the millions of people who suffer from these illnesses.

The creator of the iPhone is donating 1,000 of its Apple Watches to this study. The company itself is not conducting the study or analyzing any of the data. However, researchers believe that Apple’s smartwatch technology could help to greatly expand the medical understanding of how and why eating disorders occur. Participants in this study will wear the Apple Watch in order to monitor their heart rates over an entire month. They will use a mobile app on the smartwatch to record their thoughts and emotions during periods of binge eating activity. The researchers are investigating whether there are specific biological changes that occur in the body before a binge eating episode. Examples of biological changes that the study hopes to detect are changes in a person’s heart rate before each episode. This kind of data is something that the Apple Watch should readily detect and record.

A long-term goal is to use this data to predict binge eating episodes before they happen. In this way, medical professionals could specifically understand what happens to the human body in the time period leading up to binge and purging behavior. Ultimately, researchers hope to gain the ability to anticipate and change the course of these episodes.

Binge Eating Disorder (BED) and Bulimia Nervosa (BN) are dangerous conditions that require medical help. An individual suffering from bulimia nervosa may reveal several signs and symptoms, many which are the direct result of self-induced vomiting or other forms of purging, especially if the binge/purge cycle is repeated several times a week and/or day.

Physical signs and symptoms of this eating disorder include:

  • Constant weight fluctuations
  • Electrolyte imbalances, which can result in cardiac arrhythmia, cardiac arrest, or ultimately death
  • Broken blood vessels within the eyes
  • Enlarged glands in the neck and under the jawline
  • Oral trauma, such as lacerations in the lining of the mouth or throat from repetitive vomiting
  • Chronic dehydration
  • Inflammation of the esophagus
  • Chronic gastric reflux after eating or peptic ulcers

Other signs and symptoms of binge eating and purging are:

  • The disappearance of large amounts of food
  • Eating in secrecy
  • Lack of control when eating
  • Switching between periods of overeating and fasting
  • Frequent use of the bathroom after meals
  • Having the smell of vomit

Only experienced healthcare professionals can properly diagnosis eating disorders and provide crucial help. For additional information about binge eating and bulimia, please contact the staff at River Centre Clinic (RCC). Their Eating Disorders Programs provide a full range of treatment options for both adolescents and adults. The River Centre Clinic is located in the tranquil setting of Sylvania, Ohio – a historic suburb of Toledo, Ohio.

The EAT-26 (Eating Attitudes Test) assessment provides anonymous and quick feedback for a variety of eating-related health conditions.

Follow on Twitter:  @River_Centre

Binge Eating, Bulimia Nervosa, Apple, Smartwatches

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Orthorexia Nervosa versus Anorexia Nervosa?

Anorexia nervosa is a well-known eating disorder that afflicts both women and men. The disease creates an extreme fear of weight gain in people who suffer from it. Symptoms include not eating, binge eating and purging, also known as bulimia. However, there is a lesser known eating disorder that shares similarities to anorexia, but is still different. This disorder is known as orthorexia nervosa and was first described in 1998.

Orthorexia means an obsession with proper or healthy eating. Having a concern with the nutritional quality of the food is a healthy behavior, but problems occur when this concern becomes excessive, damaging and disruptive. Individuals with orthorexia become so fixated on what they perceive as healthy eating that they actually damage their own physical and emotional well-being.

Is Orthorexia Nervosa the same as Anorexia Nervosa?

Many of the symptoms and behaviors surrounding orthorexia tend to overlap with anorexia. Yet, in cases of anorexia, people tend to focus more on severely restricting the quantity of food (calorie count). There is a clear and forceful desire to not gain weight. This, in turn, creates behavior that focuses on excessive exercising in order to lose unwanted weight. However, these are separate inflictions.

Since orthorexia is a newer diagnosis, it still possesses varying levels of acceptance among eating disorder treatment professionals. Some eating disorder specialists regard orthorexia as a discrete diagnosis like anorexia nervosa or bulimia nervosa. There are reports that signs of orthorexia are perhaps increasing due to the use of social media to popularize extreme diets and other food-related behavior. Other health professionals, believe that patients with orthorexia symptoms are actually suffering from anorexia nervosa. The symptoms for orthorexia and anorexia have similarities such as:

  • A desire to maintain control of life by severely controlling daily food consumption.
  • Seeking self-esteem and fulfillment through controlling food intake.
  • Citing undiagnosed food allergies as a rationale for avoiding food.
  • Co-occurring disorders such as OCD or obsessive-compulsive personality disorder.
  • Elaborate rituals about food that may result in social isolation

What Is Orthorexia Nervosa?

There are still very few studies on the Orthorexia, but theories suggest that it is based on anxiety and/or depression much like other eating disorders. It is for this reason that the occurrence of orthorexia is typically accompanied by other eating disorders such as anorexia, bulimia, or binge eating disorder (BED). Which means a person’s orthorexia can co-exist with a bulimia disorder. This means an individual could binge on seemingly healthy foods (vegetables) and then purge the food in order to get rid of the calories.

Unlike bulimia though, people with orthorexia can hide their disease by displaying their symptoms in plain sight. At initial glance, people suffering from orthorexia appear to be simply taking care of their physical body. Individuals with orthorexia may even talk about how they are about their eating habits. But, this healthiness is an illusion. There is a difference between conscious, healthy eating and having orthorexia nervosa. Orthorexia is similar to obsessive-compulsive disorder (OCD), in the fact that people must create rules and engage in specific rituals around food.

Some trendy or extreme diets can trigger behavior that resembles orthorexia. However, simply adopting an alternative diet, whether based on science or pseudoscience, does not mean someone has orthorexia. For example, some people adopt a trendy diet that restricts certain food groups: Vegan, gluten-free, Paleo diets, etc. The adoption of these diets does not automatically create an orthorexia diagnosis.

Orthorexia turns eating into a pathological activity that becomes entangled with obsessive thinking, compulsive and ritualistic behavior and self-punishment. Individuals with orthorexia often use a diet to achieve a feeling of perfection, purity or superiority. They may feel judgmental towards people who do not follow their perfect, healthful diet. This means they often spend excessive amounts of time planning and researching “pure” foods, which interferes with participation in normal social activities and interactions. These symptoms are what turns a trendy diet into orthorexia nervosa.

How are Orthorexia Nervosa and Anorexia Nervosa Different?

Obsession with weight is one of the primary signs of anorexia, bulimia, and other eating disorders. But this is not a symptom of orthorexia. Instead, the focus for people with orthorexia is an excessive obsession with the health implications of their dietary choices.

People with anorexia will severely restrict their food intake in order to lose weight. People with orthorexia, however, strive to feel pure, healthy and natural. The focus is on quality of foods consumed instead of the quantity. In the end, it is critical that people with eating disorder signs and symptoms seek appropriate clinical advice from a professional with experience treating orthorexia, anorexia as well as other conditions. The obsessive tendencies associated with orthorexia can indicate a co-occurring disorder that should be diagnosed and treated by a psychiatrist.

There are definite similarities as well as differences between anorexia and orthorexia. Both of these eating disorders tend to provide a sense of control and stability around the consumption of food. Again, both eating disorders are dangerous mental illnesses that require professional treatment from a skilled clinician.

For additional information or questions about anorexia and orthorexia, please contact the experienced staff at River Centre Clinic (RCC). Their Eating Disorders Programs provide a full range of treatment options for both adolescents and adults. The clinic is located in a modern, spacious and tranquil setting in Sylvania, Ohio.

Eating Attitudes Test (EAT-26)

The EAT-26 is the most widely cited standardized self-report screening measure that may be able to help you determine if you have an eating disorder that needs professional attention. Take the EAT-26 now and get immediate and anonymous feedback.

Follow on Twitter:  @River_Centre

Orthorexia Nervosa, Anorexia Nervosa,

Contributor: ABCS RCM

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DBT For Eating Disorders

When people are struggling with binge eating behavior or weight management issues, they are sometimes told to simply eat less and exercise more. This advice, perhaps well intended, will potentially make the situation worse and create an unhealthy diet cycle that focuses on a negative body image and deprivation. People need a sound treatment plan that addresses the complexity of the behaviors, thinking patterns, and relationship with food. This is where a type of treatment known as Dialectical Behavior Therapy (DBT) is helpful. DBT is a type of therapy that combines elements of cognitive behavioral therapy with principles of from Zen Buddhism. DBT has been proven an effective theoretical framework that helps promotes changes that are necessary to treat binge eating as well as other eating disorders.

What is DBT?

Dialectical behavior therapy is a specific type of cognitive-behavioral psychotherapy developed in the late 1980s by psychologist Dr. Marsha M. Linehan. The original goal of DBT was to find better treatment options for people suffering from borderline personality disorder. Dr. Linehan, who is currently a professor at the University of Washington actually developed DBT as a response to her own borderline personality disorder, which had previously not been properly treated. However, since the development of this therapy, it has been used to treat other kinds of mental health disorders.

Dialectical behavior therapy is a type of psychotherapy (talk therapy) that utilizes a cognitive-behavioral approach that emphasizes the psychosocial aspects of treatment. The main concept behind DBT is the view that some people are prone to react in a more intense and out-of-the-ordinary manner toward certain emotional situations. These emotional situations are primarily triggered by romantic, family and friend relationships. DBT theory advocates that some people’s arousal levels in such situations can increase far more quickly than the average person’s, attain a higher level of emotional stimulation and thereby take significantly more time to return to baseline arousal levels.

Dialectical behavior therapy understands that there are times when people act on emotions that do not match a social situation. This is when a skill from dialectical behavior therapy (DBT) called “opposite action” is invaluable. It’s a skill that helps us to manage our emotions, enhance our relationships and enhance our lives. It’s a skill that helps us make more healthful decisions. DBT would advocate that an opposite action is required in these situations, because it allows people to recognize that their thoughts are not facts. Individuals learn how to experience emotional urges, but take the opposite action and not act on these urges. This provides a level of self-regulation and allows people to have more control over their thoughts, feelings and actions. Not surprisingly, dialectical behavior therapy is an effective treatment approach for people struggling with eating disorders.

A summary of how DBT works:

The term dialectical is based on the principle of blending two key ideas together, acceptance and change. In therapy, both of these ideas produce better results when they are combined together. DBT has patients focus on accepting their experiences, but simultaneously working on changing unhealthy behaviors. A major goal is to provide patients with the necessary skills that allow them to cope with, and change, these unhealthy behaviors. This form of therapy was initially designed to treat people with suicidal behavior and borderline personality disorder. But, DBT has been successfully adapted to treat other mental health problems that threaten a person’s safety, relationships, work, and emotional well-being.

Traditional dialectical behavior therapy focuses on behavioral skills for four domains:

  1. Emotion regulation: Recognizing, labeling, and adjusting emotions.
  2. Interpersonal effectiveness: Navigating conflict and interacting assertively.
  3. Distress tolerance: Feeling intense emotions like anger without reacting impulsively or using self-injury or substance abuse to dampen distress.
  4. Mindfulness: Becoming more aware of self and others and attentive to the present moment.

DBT takes these four domains and applies them in a linear, multistep approach. The first step is to treat the most self-destructive behavior (suicide or self-injury). The next step is to control behavioral response such as emotional regulation, distress tolerance, and interpersonal effectiveness. The third and fourth steps promote better personal relationships and self-esteem while encouraging a sense of happiness and connection.

For additional information or questions about dialectical behavior therapy for eating disorders, contact the staff at River Centre Clinic (RCC). Their programs provide a full range of treatment options for both adolescents and adults. River Centre Clinic is located in Sylvania, Ohio.

Follow us on Twitter:  @River_Centre

DBT, Eating Disorders,

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Body image and shame

Fat Shaming, Low Body Esteem & Body Positivity

The topic of girls and women’s perception of their bodies, as well as how this topic is portrayed by the society, has long been a subject of discussion. An individual’s perception of her (or his) body has long played a critical role in understanding how to treat eating disorders. Much of this understanding is increasingly looking at the role of media and societal pressures on people’s perceptions. Popular media and the fashion industry appear to actually encourage a culture of fat-shaming and weight stigma. This history of shame and stigma has created devastating consequences.

Low Body Esteem:

According to studies performed by the Dove (Unilever Corporation), feelings of low body esteem impact the majority of both women and girls. The report states that 85% of women and 79% of girls say that they purposely skip major life activities and events due to the fact that they do not feel good about the way they look. Shockingly, 69% of Women and 65% of girls state that pressure from advertising and mass media pushes them to reach an unrealistic standard of beauty. On a worldwide scale, the report states that out of the 13 countries in the study, Japan ranked lowest, with only 8% body confidence among respondents, followed by the UK and Canada at 20%, the US at 24%, and South Africa topping the list at a modest 64% of women who feel confident in their bodies.

The Body Positivity Movement:

Reports like these have inspired a growing empowerment trend known as body positivity movement. This movement is quickly gaining popularity on the internet and in mass media. The concept of body positivity evolved as a way to counteract feelings of poor body image in society at large. Generally, body positivity asserts that all bodies are good bodies. How people’s bodies physically appear should not determine their worth as a person. “In Western society, this idea fights against long-held valuations of physical appearance, primarily as portrayed (or conspicuously not portrayed) in the media. Body positivity proponents across social media, therefore, seek to make diverse body types more visible, partly as a reminder to rethink our cultural conceptions of what it means to be beautiful, and that such concepts are not fixed.”

Fat Shaming as Entertainment:

Whether the body positivity movement able to create permeant societal change is still unclear. The entertainment industry still produces shows that seem to send the opposite message. For example, for the last few months controversy has been swirling around the new Netflix show Insatiable. Described as a dark comedy set in the Southern world of beauty pageants, the show is labeled as a “coming of rage” story. The series follows the actions of a vengeful teenager who was called “Fatty Patty” by school bullies. However, this character loses a substantial amount of weight, after having her jaw wired shut; and then teams up with a disgraced pageant coach in order to seek revenge against the people who once tormented her. The show’s creator argues that the Netflix series draws from her own experiences dealing with bullies and an eating disorder while growing up in the suburbs. Critics have called the show “an offensive mess,” “almost unwatchable” and “obscenely cruel” for perceived fat shaming.

One of the actors from the series, Alyssa Milano, defended the series arguing that the show is not engaging in fat-shaming behavior. “We are addressing (through comedy) the damage that occurs from fat shaming.” Milano explains that she hopes the show is a conversation starter, since the series explores body images issues, rather than sweeping it “under the carpet.” Insatiable’s main star Debby Ryan agreed with Milano and argues that the subject matter is difficult, but she hopes that the show serves a purpose by “stirring conversation” about fat shaming and low body esteem.

Critics of the show have not agreed with Ryan and Milano’s analysis. As of August 31st, 2018, a Change.org petition has garnered more than 200,000 signatures to have the show canceled. The originators of the petition state that the shows central plot is not an isolated case, but part of a much larger problem every single woman has faced in her life. The Netflix series “perpetuates not only the toxicity of diet culture but the objectification of women’s bodies.”

Other critics have agreed with this analysis and have called the show dangerous. Behavioral health professionals have noted that the U.S. society has made significant improvements in advancing the body positivity movement. However, fat-shaming and body weight stigmas are still a problem. Netflix’s show Insatiable only proves there’s still a lot about the way body image is portrayed in the media that needs to improve. The show’s core premise displays a plotline that is based on some ugly body image ideas. Body Positivity activists have pointed out that series shows that “a fat girl could never stand up for herself while fat and of course she has to be assaulted and have her mouth wired shut before she becomes her best self, her skinny self.” Other news sources have raised the question that perhaps the series is just misunderstood.

Whether the show is deemed offensive or is actually secretly progressive, the judgment that people feel about their physical appearance will continue. As a social trend and topic of conversation, River Centre Clinic will monitor this story as it unfolds. Our trained staff understands the complexity and sensitivity surrounding these issues. For additional questions or comments about this or other related topics – please contact us.

The River Centre Clinic’s primary purpose is to provide high quality, cost-effective, specialized care for patients with eating disorders in a state-of-the-art treatment environment. The clinic follows a treatment philosophy designed to provide an affordable treatment alternative to inpatient care. Our innovative approach to treatment is designed to reduce costs without compromising our high quality of care. The River Centre Clinic provides state-of-the-art treatment located in a modern, spacious and tranquil setting in Sylvania, Ohio — an historic suburb of Toledo, Ohio. The facility was designed to provide an attractive, and safe alternative to hospital or hospital-based programs. Living facilities are located in the main building to comfortably accommodate adults and adolescents in separate units.

Follow on Twitter:  @River_Centre

Body positivity, Body Image, Weight Stigma, Low Body Esteem

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What is Emotional Eating and How to Stop It?

The occasional food craving is a normal behavior for many people. But when these cravings become something more, they could suggest larger underlying problems. This is where the term emotional eating enters the conversation. Emotional eating is not initial harmful, due to the fact that it satisfies a person’s immediate emotional impulse. However, a regular pattern of emotional eating can create various health problems.

What is emotional eating?

This eating behavior is a way for people to suppress negative feelings like stress, anger, fear, boredom, sadness or even loneliness. Major life events can trigger emotional eating such as problems with personal relationships, work, health or even financial pressures. When some people are in emotional distress, their food consumption patterns may become more impulsive and began to resemble binge eating behavior. The act of eating serves as a distraction with the focus on eating a “comfort food” providing momentary relief, versus dealing with a serious problem or painful situation.

In other words, consuming comfort food during times of stress can provide temporary gratification. But, this food consumption will not fulfill a person’s actual emotional needs or solve ongoing problems.

 

Why do people engage in emotional eating?

The reasons as to why people may engage in emotional eating are complex. Part of this behavior is likely due to our evolutionary roots. In ancient hunting and gathering societies, stress was a signal to the body to consume more calories for survival purposes. This behavior may have helped 100,000 years ago, but is now ill-suited to our sedentary lifestyle.

The physical sensation of hunger is based on how the human body reacts to stress by telling the adrenal glands to release a burst of adrenaline. This in turn increases the heart rate and supplies energy that is intended to be used for fight or flight situations. Next, the adrenal glands release cortisol, which instructs the body to replenish energy by stimulating an appetite for high-energy (calorie) foods. Cortisol can stay in the body for many hours, which will create hunger pains. Oddly, this same hormone also tells the body to store any unburned calories as fat. Again, this evolutionary and physical response to stress, as well as the associated storage of body fat, is not healthy in the modern age.

 

Ways to control emotional eating?

Here are 4 influencers that tend to encourage emotional eating behaviors.

[1] Food as a main pleasure:

People experience a real soothing effect when they eat certain foods like ice cream, potato chips or cookie dough. Consumption of certain comfort foods delivers a burst of short-term pleasure. These foods are addictive, so not eating them when the urge strikes is a challenge. A possible solution is for people to discover other ways to soothe their emotions besides eating food. They need to explore other (non-destructive) behaviors that bring them pleasure.

[2] Not aware of the behavior:

Sometimes people are not aware that they are eating. This is sometimes known as unconscious eating by therapists. In these cases, individuals seem to almost operate as if they are in a trance. In many ways, this behavior may resemble binge eating. Mindlessly eating or grazing while watching television or movies can easily encourage this behavior. A solution is for people to stop putting food into their mouth simply because it is available. The best prevention is to always be mindful of what and when they are eating.

[3] Difficulty Coping with Negative Feelings:

It is human nature to avoid thoughts and experiences that make a person feel bad. Sometimes this is tough, so the only way some people can avoid negative feelings is to engage in self-destructive eating behaviors. In the short-term, this will distract a person from feeling negative thoughts. However, this not a healthy long-term solution. Ideally, individuals should learn to let themselves experience negative or difficult feelings. A trained, certified and experienced behavioral health professional is helpful in this situation.

[4] Negative Body Image

People hating their own physical body and possessing an overall negative body image is a critical factor for triggering emotional eating. A downward spiral of negativity and shame makes it challenging for people to implement long-lasting healthy eating changes. Again, a skilled mental health specialist is helpful in this situation. People need to stop hating their own body before they can successfully stop their self-destructive emotional eating behaviors – and this is tough to do alone.

 

When should an individual seek professional help?

If individuals have tried to use self-help options but they still have no control over their emotional eating behavior, they should consider seeking help from an eating disorder specialist. An experienced mental health professional can help a person understand the origins of this behavior, whether it is an eating disorder as well as acquire coping skills.

For additional information or questions about emotional eating, please contact the staff at River Centre Clinic (RCC). Their Eating Disorders Programs provide a full range of treatment options for both adolescents and adults. The clinic’s main phone number is 1.877.212.5457.

The River Centre Clinic is located in a modern, spacious and tranquil setting in Sylvania, Ohio – a suburb of Toledo, OH.

Follow on Twitter:  @River_Centre

Emotional Eating, Eating Disorders,

 

Contributor: ABCS RCM

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Childhood Eating Problems & Adolescents Eating Disorders

Many parents are familiar with children who are picky eaters. In fact, for babies, this is often a normal eating behavior. As children age, they start to develop their own personal food preferences. However, as children grow older an overly selective eating behavior could be a sign of deeper health concerns. Many people are not aware that eating disorders are the third most common chronic illness in adolescents according to the American Academy of Pediatrics (AAP). Since the 1950s, there has been a steady increase in the incidence and prevalence of anorexia nervosa, bulimia nervosa as well as other eating disorders in both children and adolescents.

Data from the National Institute of Mental Health (NIMH) estimates that out of 800 public high school students, approximately 20-22 students will be impacted by eating disorders and even more will experience subclinical (not detectable) symptoms of the disease. Adolescents who have suffered from eating disorders are more likely to experience medical co-morbidities such as depression, anxiety, substance abuse and suicide.

During a person’s adolescence is when many of these diseases first occur. Adolescence is a time in people’s life when a great deal of change is occurring. Body changes, confusion, social anxiety only accelerate feelings of self-consciousness and low self-esteem. The onset of eating disorders often appears during this period, but these diseases can develop at a later time in a person’s life.

Not all of these eating disorders directly develop due to body image issues. Among children, they may struggle to eat certain foods because they feel physically nauseous. This can create a lack of appetite for food, which will make it more difficult to eat. A fear of vomiting or choking makes a child avoid certain foods, which can gradually become more restrictive over time. According to the National Eating Disorder Association, this restrictive eating behavior is a possible sign of what was previously identified as selective eating disorder, but is now referred to as ARFID or Avoidant Restrictive Food Intake Disorder.

ARFID is similar to anorexia in that both disorders involve limitations in the amount and/or types of food consumed, but unlike anorexia, ARFID does not involve any distress about body shape or size, or fears of fatness. Although many children go through phases of picky or selective eating, a person with ARFID does not consume enough calories to grow and develop properly. In children, this results in stalled weight gain and vertical growth. ARFID can also result in problems at school, due to difficulties eating with others and extended times needed to eat. As with all eating disorders, the risk factors for ARFID involve a range of biological, psychological, and sociocultural issues. These factors may interact differently with different people, which means two individuals with the same eating disorder can have very diverse perspectives, experiences, and symptoms.  

Eating disturbances are considered problematic when it causes the child to become upset or worry and when he or she is not eating enough to sustain proper nutrition and facilitate proper growth. Complications around eating can take many forms including but not limited to:

  • Trouble with food textures/sensory issues
  • Temper tantrums during meals
  • Refusing to eat
  • Limiting food groups
  • Choking, gagging, or vomiting after eating
  • Body image concerns
  • Anxiety/OCD

Due to the concern over the growth of eating disorders among children and adolescents, the Centers for Disease Control and Prevention (CDC) has researched this modern health concern. The CDC made the following recommendations during their 2008 national initiative. Their screening of high school students for eating disorders found that almost 15% of girls and 4% of boys scored at or above the threshold of 20 on the EAT-26, which indicated the possible existence of an eating disorder. The CDC recommended regular health screenings for high school students in order to identify at-risk students who could benefit from early intervention. Early identification and treatment of disordered eating and weight control behaviors can prevent progression of the disease and reduce the overall chronic health risk. To complicate matters, pedestrians have pointed out that some obesity prevention efforts may actually encourage the development of an eating disorder. The majority of adolescents who develop these disorders were not previously obese, but some teenagers, in a mistaken attempt to lose weight, can develop an eating disorder.

For additional information about childhood and adolescent eating disorders, please contact River Centre Clinic. Their Childhood Eating Problems Program director is Anna Lippisch, MSW, LSW. She can be reached at 419-885-8800 or by email. The EAT-26 (Eating Attitudes Test) assessment provides anonymous and instant feedback for a variety of eating-related health conditions.

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Childhood eating problems, Adolescents eating disorders, ARFID

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Outside Yoga Class (River Centre Clinic)

Can Yoga Help Treat Eating Disorders?

Yoga, Eating Disorders,

Are there links between body image, physical activity and eating disorders? Stories and research from decades ago have shown that competitive sports can encourage the development of eating disorders. In the 1990s, Sports Illustrated articles openly discussed the deadly impact of anorexia on women athletes. Yet, roughly twenty years later, this problem still exists in U.S. culture. As of 2011, according to the Huffington Post and the National Eating Disorder Association, approximately 33 percent of male athletes are affected by eating disorders who participate in aesthetic sports and weight-class sports. But what if some physical activities actually decreased the occurrence or actually provided effective treatment for eating disorders?

Newer research is studying whether certain physical activities such as yoga, provide effective treatment for eating disorder related illnesses. Yoga, originally a Hindu spiritual and ascetic discipline from India, as an activity is increasingly popular around the world. Yoga is popular in the United States as a hobby that promotes health and relaxation. The activity incorporates movement, body postures, breath control as well as meditation. The popularity of yoga has raised questions as to whether different styles of yoga can provide complementary therapy for patients who are receiving treatment for eating disorders.

A randomized controlled clinical trial study in 2009 attempted to discover what effects individualized yoga practice had on adolescent patients. These individuals were receiving outpatient treatment for diagnosed eating disorders (anorexia nervosa, bulimia nervosa, or eating disorder not otherwise specified). In this randomized study, out of 50 girls and 4 boys, the group that was participating in yoga experienced a greater decrease in eating disorders. The participates who were receiving non-yoga activities showed some initial decline, but then returned to baseline levels after 12 weeks. In this study, the yoga treatment did not have a negative effect on BMI, but the overall therapeutic approach was seen as holding promise as an adjunctive therapy to standard care.

Research in 2016 also asked the question as to whether the practice of yoga provided positive results in an outpatient setting. Specifically, in treating anxiety, depression and body image disturbances among adolescents with eating disorders. In this study, researchers concluded that outpatients eating disorder therapies combined with yoga practice showed decrease levels of anxiety, depression, and body image disturbances. Like the earlier 2009 study, the practice of yoga was seen as a beneficial treatment strategy when blended with multidisciplinary care. However, researchers did add that further study was needed on treatments approaches that presented yoga as a standard element of outpatient eating disorder therapy.

More recent studies from 2018 are continuing to research the application of yoga as a treatment strategy.  A small randomized control trial investigated the impact of an 11- week yoga program for women who were diagnosed with bulimia nervosa or other not specified eating disorders. Interestingly, this small study found that the women experienced benefits from yoga for months after the original research. A more detailed and larger study is planned in collaboration with the University of Buffalo. Like earlier research, this study will document the impact of regular yoga practice as a viable eating disorder treatment. Researchers in this study did note that examining eating disorders is challenging due to the fact that most yoga-eating disorder studies have few participants, short duration window as well as other design challenges. This two-year study will provide eating disorder researchers with an opportunity to collect data on an established, manualized yoga program that serves hundreds of individuals in community, educational and medical settings.

For additional questions about the use of yoga practice to supplement the treatment of eating disorders, please contact the staff at River Centre Clinic. The clinic’s mission is to provide specialized and cost-effective treatment for individuals suffering from eating disorders (anorexia nervosa, bulimia nervosa, binge-eating disorder, and other eating disorders). An innovative approach to treatment is designed to reduce costs without compromising a high quality of care. They follow a well-established therapy model for treating eating disorders that integrates individual, group, and family therapy. For real-time feedback, their EAT-26 (Eating Attitudes Test) assessment provides anonymous and instant feedback about a variety of eating-related health conditions.

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Yoga, Eating Disorders

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image - military helmet - Eating Disorders Among Active-Duty Military Personnel

Eating Disorders Among Active Duty Military Personnel

The United States has one of the best militaries in the world, with just over 1.34 million active-duty troops in 2015. They are prepared to meet any threat or challenge facing the country. However, many Americans are unaware of the personal and mental health challenges facing members of the nation’s armed forces. One of these challenges is the prevention and treatment of eating disorders among the ranks of U.S. military service personnel. Recent studies by the U.S. military indicate that eating disorder diagnoses for members of the armed forces have increased by 26 percent over a period of five years. The same study hints that the actual incidence of these illnesses is likely even greater.

According to research, it is estimated that roughly 30 million Americans will experience some type of eating disorder. Similar studies have shown that there are elevated rates of this disease among the nation’s active duty military members. In particular, the disease appears at higher proportions for women who are enlisted for active duty in the military. This data is not a new phenomenon. Back in 1999, researchers at the Mayo Clinic studied the eating behaviors of 423 women on active duty at Madigan Army Medical Center in Fort Lewis, Washington. This study reported that 8 percent of the women were diagnosed with an eating disorder. For comparison, the incidence of this disease for non-military women is estimated at only 1 to 3 percent of the total population. Active duty service members, including West Point graduates, reported that they feeling pressure from family, school and peers to “make the uniform look good.” This pressure can create a cycle of binging and purging with soldiers feeling like they can never be thin or in shape enough. The same disease also occurs among male active duty service members.

In all of the armed forces, more women than men are diagnosed with diseases like anorexia, bulimia and binge eating. More than two-thirds of cases involved female troops and the overall incidence rate among women, at 11.9 cases per 10,000, was more than 11 times that of males. Interestingly, the overall incidence rate of eating disorders among female Marine Corps members was nearly twice the amount when compared to women Army members. For male active duty service members, the rates were highest in the Army and Marines. Potential reasons for the increased risk for developing an eating disorder while in the military is likely due to exposure to trauma, as well as the need to routinely meet physical fitness and body weight requirements. These factors likely elevate the risk of eating disorders developing among both women and men. Children of military families also reported similar conditions at a significantly higher rate than the civilian population.

Research published in the U.S. Military’s Defense Health Agency’s Medical Surveillance Monthly Report found that incidence rates had risen steadily from 2013 to 2016 before decreasing slightly in 2017. Diagnoses for eating disorders increased from 2.3 per 10,000 to 3 per 10,000 in 2016, before dropping to 2.9 per 10,000 in 2017. “Results of the current study suggest that service members likely experience eating disorders at rates that are comparable to rates in the general population, and that rates of these disorders are potentially rising among service members,” the report states. “These findings underscore the need for appropriate prevention and treatment efforts in this population.”

The need for prevention and treatment of military members and their families suffering eating disorders has not been unnoticed. The U.S. Department of Defense’s (DOD) Peer Reviewed Medical Research Program (PRMRP) has allocated funding for eating disorders research, intervention and treatment programs. Congress first made the topic of eating disorders eligible for funding in 2017. In 2018 Congress is expected to allocate $5 million towards the prevention and treatment of eating disorders. However, federal funding for research on eating disorders is limited, with only $0.93 per person affected by eating disorders compared to other diseases such as autism receiving $44 per person affected.

To complicate matters, there is still a stigma surrounding the reporting of diseases such as eating disorders. Members of the Armed Forces are less likely to seek treatment, making prevention programs and access to treatment an imperative need across all branches. The occurrence of these diseases may, in fact, be much greater among active duty military members.

For additional questions about this topic, contact the staff at River Centre Clinic. Their programs provide a full range of treatment options for women and men with a primary diagnosis of an eating disorder. For immediate and confidential feedback, take River Centre Clinic’s EAT-26 (Eating Attitudes Test) assessment.

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Active-Duty Military Personnel, Eating Disorders

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Scale and tape (RCC)

Body Weight and the Diet Cycle

According to research from Harvard Medical School, eating disorders such as anorexia, bulimia and binge eating, afflict more than 30 million Americans, while millions more experience disordered eating and weight control behaviors. This statistic is even more sobering when one considers the fact that eating disorders have the highest mortality rate of any psychiatric disorder in the United States. Numbers like these have real consequences on people’s health and overall quality of life. Often people are trapped in a vicious cycle of weight gain and severe dieting. In many instances, dieting does not produce permanent weight loss. Instead, it creates an unhealthy diet cycle where a person’s body weight quickly cycles up and down. What is needed is a holistic understanding of health that does not stigmatize body weight. People should focus on healthy behaviors and physical well-being instead of body weight.

The central idea behind the act of dieting tends to create problems. Extreme diets can actually damage people’s metabolism as well as their mental perception of food and eating. This means that individuals can end up in a worse place versus when they started the diet. The diet cycle can start here, with people’s weight gain and loss having a yo-yo appearance. The rise and fall of body weight creates the appearance that people are actually at war with their food (and weight). What is more beneficial for people is an active and healthy lifestyle, as well as an acceptance of their physical appearance and body weight.

When people are informed that they are overweight, there are unintended consequences. This information can reduce people’s satisfaction with their body and create other negative emotions and behavior. This is due to the fact that modern society tends to reinforce the message that “thin” is beautiful and good. People who struggle with their weight tend to also have lower self-esteem. The stigma of being overweight can help to set up a cycle for additional weight gain or the development of eating disorders like bulimia or anorexia. Individuals at all body weights often respond to stress and anxiety by eating. This emotional-induced eating will likely only encourage more weight gain. An increase in body weight can create a feeling of lower self-esteem and anxiety in a person. People quickly become trapped in an unhealthy feed back loop of weight gain and dieting.

More has to be done in order to make it safe to be a larger-bodied person. Most eating disorders are often accompanied by trauma, but body shaming and fat loathing only make these diseases worse. Actions from the fashion and food industry, as well as pop culture, almost seem to encourage eating disorders. However, attempts have been made to address the issues surrounding perceptions of physical imperfections, body weight and fat shaming. A few examples from fashion and marketing are from lingerie retailer Aerie and the increasing popularity of plus-size models. Since 2014, the ad campaigns of lingerie retailer Aerie (American Eagle) reportedly uses non-airbrushed photos of women of various body shapes and colors. Successful Fashion designer Chris Siriano has stated that there have “always been customers of different sizes since day one.” Currently, one half of Siriano’s fashion collection is made in extended sizes. These are positive steps in the right direction, but body weight fears and stigma surrounding fat is still a common occurrence.

For additional questions about the connection between body image, body weight and the diet cycle, contact the staff at River Centre Clinic. Their programs provide a full range of treatment options for children and adults with a primary diagnosis of an eating disorder. For immediate and confidential feedback, take River Centre Clinic’s EAT-26 (Eating Attitudes Test) assessment.

Follow us on Twitter:  @River_Centre

Body Weight, Diet Cycle

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