Eating Disorders – The Breakdown!

Eating Disorders

Dania Demaurio

Dania Demaurio, LCSW
Behavioral Health Consultant
NOAH Balsz Health Center

Eating disorders affects up to 24 million Americans. There are eight types of feeding and eating disorders in Diagnostic and Statistical Manual of Mental Disorders 5 (DSM 5) including anorexia nervosa, bulimia nervosa, binge eating disorder, pica, rumination disorder, avoidant/restrictive food intake disorder, other specified feeding or eating disorders, and unspecified feeding or eating disorders. Each disorder in the manual has its own criterion and diagnostic symptoms. In this article, we will focus on the diagnostic symptoms, warning signs and treatment recommendations of anorexia nervosa, bulimia nervosa and binge eating disorder.

Anorexia nervosa

Anorexia nervosa symptoms include refusal to maintain body weight at or above minimally normal weight for height, body type and age and an extreme concern with body weight and shape. Loss of menstrual period in females’ post-puberty often can occur.

Warning signs include:
• Sudden weight loss
• Extreme dieting
• Food rituals (taking very small bites, eating foods in certain order)
• Hair loss
• Dry skin or hair
• Brittle nails
• Growth of fine
• Downy hair on the face and body

Treatment recommendations include restoring person to healthy weight, treating psychological disorders related to the condition and reducing or eliminating thoughts and behaviors that lead to disorder eating. The following treatments are recommended:

• Nutritional rehabilitation
• Psychosocial interventions
o Cognitive behavioral therapy (CBT)
o Family based treatments with children and adolescents

Bulimia nervosa

Bulimia nervosa symptoms include recurrent episodes of eating large quantities of food in short periods of time without regard to feelings of hunger or fullness and to the point of feeling out of control and following the binge with a purging or compensatory behavior (self-induced vomiting, laxative or diuretic abuse, fasting or obsessive and compulsive exercise) to make up for excessive calories taken. Individual will have extreme concerns with body weight and shape.

Warning signs include:
• Disappearance of large amounts of food
• Frequent trips to bathroom after meals
• Calluses on knuckles from using fingers to induce vomiting
• Swelling of face, primarily lower cheek and under the chin

Treatment recommendations
• Nutritional rehabilitation
• Psychosocial interventions
o Cognitive behavioral therapy (CBT)
o Dialectical behavior therapy skills training (DBT)
o Family based treatments with children and adolescents
• Antidepressants have shown modest benefit

Binge eating disorder

Binge eating disorder symptoms are similar to bulimia nervosa with eating large quantities of food in short periods of time often secretly without regard to fullness or hunger and feelings of shame, disgust or guilt after binge but no purging or compensatory behaviors.

Warning signs include:
• Sudden weight gain
• Disappearance of large amounts of food

Treatment recommendations
• Nutritional rehabilitation
• Psychosocial interventions
o Cognitive behavioral therapy (CBT)
o Guided self-help cognitive behavioral therapy (CBT-GSH)
o Dialectical behavior therapy skills training (DBT)
o Interpersonal therapy (IPT)

• Medications- not considered first line of treatment as psychotherapeutic interventions have demonstrated to be more effective
o Vyvanse- 1st FDA approved medication for binge eating disorder
o Topomax
o Selective serotonin reuptake inhibitors (SSRIs)- common antidepressants

If you or your loved one is suffering with an eating disorder, our Care Team at NOAH are here to help you create and manage your healthy lifestyle habits. Need help setting or sticking to your goals? Call 480-882-4545 today for an assessment to discuss treatment options. #pediatrics #familypractice #counseling



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