Dawn Cox Counselling

In Victoria BC where I have my private practice we have hundreds of counsellors who advertise a specialty in eating disorders. There is a great demand for support in this area. One of the more interesting phenomena that I observe when working with individuals who have had success at, essentially, starving themselves for periods of time to reduce their weight is that they often have vast amounts of knowledge about food and exercise but they do not have knowledge about the multitude of ways one’s body is affected by this deliberate starvation.

The body has a delicate system called homeostasis that keeps all of the body’s many complex systems operating at maximum efficiency and keeping the machine of our body as far away from “death” as possible. One of those main functions begins with food consumption to bring energy and building blocks into the body to be used to run the system. Like gas in a car, if the fuel runs out the car will not move but unlike fuel in a car the nutrients from food are not just the energy that propels the car/body forward. It is also the substance with which the machine is lubricated, replacement parts are built, air in the tires, a shiny/waterproof exterior and in the case of a human being, hormones that regulate all bodily functions including mood. Low energy for many often equates to a feeling of low mood that is often interpreted as a feeling of sadness, anxiety or depression.

In addition, the anxiety that often accompanies, precipitates and exacerbates a dysfunctional relationship with food and body is very depleting, like having holes in your gas tank that are constantly leaking one’s precious fuel leaving them feeling low again.

Below is a segment of a Mayo Clinic Staff article that lists many of the complications that accompany both “under-eating” and overeating in some cases as well as a link to an independent Bulimia Support Website. I would also add that anorexia and/or purging can brings with them swollen glands in the cheeks and behind the ears, a result of malnutrition and possibly irritation from stomach bile (various sources suggest one cause or the other). This is reported to be both painful and create an appearance change that is exactly the opposite of what the client was originally trying to achieve, which is generally to improve their attractiveness so they could feel more comfortable (less anxious) in their own skin by believing that they would be generally more likeable.

A change in one’s voice to a lower or raspier sound is also common. Again, this seems due to the acid from the stomach coming in contact with the throat tissues and/or vocal chords. I have had clients tell me that if they only knew they would have these symptoms as well as greatly increased anxiety they never would have taken the starvation path.

The often seen progression from anorexia to binging and purging brings with it another set of emotional issues as well, as my clients have reported that any food in their stomach that feels filling triggers an uncontrollable need to purge so they can “feel better” or “not guilty”. The client then feels guilty for purging, which is a behavior that seems to bring large amounts of shame. This cycle continues repeatedly for the client over and over again ratcheting up their anxiety levels, which they continue to try and soothe by focusing on their appearance and hence starving themselves until their body’s cry out. They tell me they “break down” and binge continuing the very painful cycle of “diet/binge/guilt/ diet/binge/guilt”.

In my work I address all areas of a client’s life including the behaviours around food and body but, essentially, we work to help the individual meet all of their needs in life enhancing ways. As normal life needs are met, like feeling “liked” or that you have a community the need to cope with negative strategies like over-focusing on food and body are no longer needed. Check out these other common complications of eating disorders:

Complications of Eating Disorders

By Mayo Clinic Staff

Eating disorders cause a wide variety of complications, some of them life-threatening. The more severe or long lasting the eating disorder, the more likely you are to experience serious complications. Complications may include:

• Death
• Heart problems
• Multiple organ failure
• Depression
• Suicidal thoughts or behavior
• Absence of menstruation (amenorrhea)
• Bone loss
• Stunted growth
• Digestive problems
• Kidney damage
• Severe tooth decay and tooth loss
• High or low blood pressure

Another webpage link with fairly graphic descriptions and images of Bulimia symptoms

Eating Disorders

1) Who is at Risk?

Recently I was asked who I find are the most common people to experience eating disorders. In my practice I see people from all walks of life that are experiencing a dysfunctional focus on food or body image. “Eating Disorders” include those who under-eat (e.g., anorexia, bulimia) and those who over-eat (binge eating, over-eating, night eating). Having said that, I thought I would comment on what groups, statistically, fall into the highest risk categories. The following (below) is a clip from a Mayo Clinic staff article and quite clearly shows who is found to be at greatest risk. If you or someone you know falls into more than one of these categories it would be wise to keep an eye out for some of the common types of thinking and behaving that accompany “disordered eating” or an unhealthy focus on body image. Some personal learning or counselling can help curb these thoughts and behaviours before they become ingrained and very difficult to dislodge.

I think most practitioners who work in this field would agree that the longer an eating disorder persists the more difficult it is to change. And remember, hunger/food is something you have to deal with 3-5 times a day, on average, and your body is with you all day everyday so, if these two things become stressors then that represents a lot of repetitive stress that can really wear you down and very quickly start to affect other areas of your life.

Risk factors

By Mayo Clinic Staff

Certain situations and events might increase the risk of developing an eating disorder. These risk factors may include:

• Being female. Teenage girls and young women are more likely than are teenage boys and young men to have eating disorders.
• Age. Although eating disorders can occur across a broad age range — from pre-adolescents to older adults — they are much more common during the teens and early 20s.
• Family history. Eating disorders are significantly more likely to occur in people who have parents or siblings who’ve had an eating disorder.
• Emotional disorders. People with depression, anxiety disorders and obsessive-compulsive disorder are more likely to have an eating disorder.
• Dieting. People who lose weight are often reinforced by positive comments from others and by their changing appearance. This may cause some people to take dieting too far, leading to an eating disorder.
• Transitions. Whether it’s heading off to college, moving, landing a new job or a relationship breakup, change can bring emotional distress, which may increase your susceptibility to an eating disorder.
• Sports, work and artistic activities. Athletes, actors and television personalities, dancers, and models are at higher risk of eating disorders. Eating disorders are particularly common among ballerinas, gymnasts, runners and wrestlers. Coaches and parents may unwittingly contribute to eating disorders by encouraging young athletes to lose weight.

(Mayo Clinic article link)