Twelve Step Facilitation.com

Stages of an Eating Disorder

Posted by Sparrow on 11th July 2008

Lemberg (1992) proposes a model of development whereby a person moves from voluntary dieting through a number of stages to reach a fully entrenched eating disorder.

Stage 1: Normal, voluntary dieting behaviour.

Unfortunately dieting behaviours have become the “norm”, with

47% of people in Australia having tried to lose weight in the past twelve months.
68% of fifteen year old girls are dieting at any one time,
8% of these are on a severe diet.

While these diets are severe enough to be considered an eating disorder, they are unhealthy and result in rapid weight changes, disrupted metabolism, dehydration, low energy and lack of essential vitamins, minerals and nutrients.

Stage 1B: (in Bulimia Nervosa only).

The hunger associated with dieting and restriction leads to severe and constant cravings, which result in loss of control and overcompensation by bingeing on large amounts of food.

Stage 2: A Diagnosable Disorder.

At this stage the dieting behaviour has become a diagnosable mental illness according to the Diagnostic & Statistical Manual IV-TR (APA, 2000). At this stage there are serious consequences and a morbid fear of fatness, and the dieting is no longer under the person’s control.

However the person is unable to see the negative consequences and is in denial of the eating disorder. In bulimia nervosa the bingeing behaviours, rather than being due to dietary restriction, occur more generally as a result of stress or negative emotional states.

Stage 3A: Autonomous Behaviour.

At this stage the person is generally able to see there is a problem, but as the behaviours are no longer under the person’s control, the disorder does not resolve even if precipitating conditions have been resolved.

Stage 3B: Illness becomes the identity.

At this stage, rather than the eating disorder behaviours being a solution to a problem, the person now identifies him or herself only with the eating disorder and has difficulty separating themselves from the illness. The eating disorder behaviours are now constant rather than used as coping strategies, and the person feels they are nothing without their illness.

They identify with being the illness, i.e. I am anorexic, rather than I have anorexia. The prospect of giving up the disorder can lead to existential fears of nothingness.

Recovery requires not only finding alternative coping strategies, but helping the person address the underlying issues of existential reality.

Overeaters Anonymous may help with any eating disorder.

Brief-TSF manual US$9.95 Buy Now with Paypal, Visa or Mastercard

Subscribe to Twelve Step Facilitation by Email

Posted in 12-Step Groups, Eating Disorders, Recovery, Women, Youth | 2 Comments »

Bulimia Similar to Addiction

Posted by Sparrow on 30th April 2008

Bulimia Nervosa and Substance Use Disorder Similarities and Differences

Abstract

The purpose of this study was to compare bulimia nervosa (BN) and substance use disorders (SUD) in cognitive-motivational terms.

The cognitive orientation theory was used as a framework for testing the hypothesis that the commonality between BN and SUD consists of a similar motivational disposition for eating disorders, rather than for addiction, as was previously claimed.

It was expected that BN and SUD patients would differ from controls but not from each other.

The participants were 31 BN, 20 SUD, and 20 healthy controls. They were administered questionnaires for assessing anxiety, depression, addiction and the cognitive orientation for eating disorders.

On most parameters BN and SUD scored higher than controls but did not differ from each other except in norm beliefs.

Treatment of BN should consider the similarity of BN to SUD in the pathological tendency for eating disorders.

Research; Bulimia Nervosa and Substance Use Disorder Similarities and Differences; A. Ram; D. Stein; S. Sofer; S. Kreitler. Eating Disorders, Volume 16, Issue 3 May 2008 , pages 224 - 240

Some Women Choose Drinking Over Eating to Lose Weight

Posted by Sparrow on 20th March 2008

Some women in the U.S. and U.K. are choosing to skip dinner and drink alcohol instead in hopes of losing weight, but the strategy is flawed because of the high caloric content of alcohol, the Telegraph reported March 19.

In a practice dubbed “drunkorexia,” women may drink a glass or two of wine rather than eating a meal in a pattern that seems to combine two dangerous behaviors: binge drinking and eating disorders.

“They get fully hooked, it is an extremely noxious thing,” said Janet Treasure, head of the eating-disorders unit at the Institute of Psychiatry in London. “It is more common with bulimia than anorexia but you get the combination of empty calories with no nutritional value and the risky behavior that goes with being drunk.”

“You are more likely to be binge drinking,” added Susan Price of the British Dietetic Association. “What you should do is eat a healthy balanced diet and choose low calorie mixers and non-alcohol low calorie soft drinks.”

Diets that focus on limiting daily food intake may unintentionally encourage the problem, but experts note that alcohol has more calories on a gram-for-gram basis than carbohydrates or protein. A 250 ml glass of wine, a standard large pour in pubs, contains more calories than a light lunch, for example. Some beers contain 250 calories per pint.

From Join Together Online