Category Archives: Bulimia Nervosa

Must-Ask Questions When Looking For An Eating Disorder Therapist

Must-Ask Questions When Looking For An Eating Disorder Therapist

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Let’s face it, finding the right eating disorder therapist for your eating disorder can be daunting. It can feel downright overwhelming. You may be ambivalent about getting treatment. Maybe you are worried that your eating disorder isn’t “bad enough” to warrant treatment (trust me, it is). Or perhaps you are feeling hopeless about finding another therapist after being treated in the past.

Whether you are an individual with an eating disorder or a loved one of a person with an eating disorder, looking for a qualified therapist can be tough.

This post will give you tips on what to look for in a treatment provider, and questions to ask to help you determine the right eating disorder therapist for you.

Most therapists are willing to talk with you on the phone before you set an initial appointment. They will help assess goodness of fit in regards to scheduling, payment, and issues you may want to address in therapy.

If the therapist doesn’t offer a phone consultation, then these questions can be asked in the initial face-to-face appointment.

You can use the following questions and talking points when interviewing a potential therapist:

How do you help clients with eating disorders?

If a therapist has a lot of experience treating eating disorders, they should have a concise and clear answer. Many well-meaning therapists indicate on their website, referral site, or insurance websites that eating disorders are their specialty, but really don’t have experience treating eating disorders.

Because of the complex nature of eating disorders, try to get a therapist with extensive experience with eating disorders if possible.

Do you have a network of other professionals who have experience treating an eating disorder to whom you can refer me?

The gold standard of care in eating disorder treatment is to have a multidisciplinary team. An eating disorder treatment team usually consists of a therapist, registered dietitian, medical doctor, psychiatrist, family therapist, and possibly other specialists.

If the therapist has experience treating eating disorders, they should have a relationship with other treatment providers in your community. To learn more about eating disorder treatment teams click here.

What hours do you see clients and what are the payment options?

The course of eating disorder treatment can be long. Having a conversation up front with a potential eating disorder therapist about finances and scheduling is important. Be sure that the scheduling and payment options work for you over the longer -term.

Here are a few resources to help you find a qualified eating disorder therapist in your area:

Finding an eating disorder therapist can take time.  Consider breaking down your search into smaller pieces and chip away at it each day.

Additionally, if you feel overwhelmed trying to find an eating disorder therapist, ask a friend or family member to help you in your search.

Please call for a free 15-minute phone consultation to learn how I work with clients with eating disorders.

Don’t live in the Austin Area, but want tips about how to improve your relationship with food and your body? Subscribe to my newsletter here.

Must-Ask Questions When Looking For An Eating Disorder Therapist
Must-Ask Questions When Looking For An Eating Disorder Therapist


Reduce Binge Eating

5 Ways a Dietitian Can Help Reduce Binge Eating

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Whether you are struggling with binge eating disorder or bulimia nervosa, a dietitian who specializes in eating disorders on your treatment team is a must.

If you have an eating disorder, you probably already know a lot about food.  You probably know how many calories, how much fat and how many sugar grams are in different foods.  You probably are an expert on the latest diets.   You may be asking yourself, “Why do I need to see a dietitian for my recovery if I already know so much about food?”.

Remember, eating disorders are not really about food.  Food and eating disorder behaviors are used to cope with stress, relationship struggles, worry, and other uncomfortable feelings.

Therefore, knowledge about food is not the issue, but rather how you relate to food.

5 ways that a dietitian can help in binge eating disorder and bulimia nervosa recovery:

1. Reduce chaotic eating associated with binge eating.

Binge eating can cause chaotic eating patterns in several ways.  After a binge, you may find yourself not wanting to eat for several hours or skip the next meal.  This turns into a nasty cycle because skipping meals can then lead to more binge eating.   If you tend to binge (or binge-purge) at a certain time of the day, let’s say in the evening, then you may tend to restrict food during the day in order to “make-up” for binge eating later on in the evening.  Again, restricting calories can exacerbate the binge eating.  A registered dietitian will help set-up a meal plan to reduce the food chaos.

2. Ensure that you are eating enough at meals and snacks.

Studies show that food restriction leads to binge eating.   Our bodies want to ensure that we get enough food.  If we chronically underfeed it at certain times of the day then when we have access to food, we will eat more than we made need at that moment.  Along with helping manage your chaotic eating style, a dietitian can help ensure that you are eating enough throughout the day with enough variety to help reduce binge eating.

3.  Challenge mistaken beliefs about food.

A dietitian can help you sort out science from fad when it comes to eating, food, weight, and shape.  There are a million messages about food on TV and social media and from well-meaning friends, family members, and co-workers.  On any given day, it seems like the messages about which foods are “good” and which foods are “bad” to eat are moving targets.  During the 90s, fat was the culprit.   Now gluten and carbohydrates have a bullet on their head.  Not only do we get messages about which foods to eat, but also how to eat them—eat these foods;  not these foods; eat 6 small meals a day;  don’t eat in between meals.  You get the point.  There are so many messages out there, it’s no wonder America is plagued with eating problems.

Challenging mistaken beliefs about food can reduce feelings of guilt and increase your confidence about food choices, which ultimately help reduce binge eating and the binge-purge cycle.

4. Learn how to eat “binge foods” without fear.

A dietitian can help you feel more confident around foods that on which historically binged.  Once your eating pattern has become less chaotic and you are feeding yourself more regularly throughout the day with foods you enjoy, you will work with your dietitian on “challenge foods.”  Challenge foods are foods that you avoid (due to fear of binge or binge-purge), foods that you regularly binge on, and/or foods that cause a lot of anxiety before or after eating them.

A dietitian can work with you several ways to do this, such as doing an in-the-office food challenge (yep, eating your challenge food during the appointment) and practicing eating the foods with others.

5.  Intuitive eating.

One of the last steps of nutritional therapy for binge eating and bulimia nervosa is learning how to listen and respond to the internal cues your body provides.  In other words, you will learn how to trust your body, not some diet, when it comes to feeding yourself.

Note:  Consulting with a registered dietitian who has experience treating eating disorders is a must.  While a registered dietitian is one member of the treatment team, a medical doctor, counselor, and a psychiatrist are also needed.

reduce binge eating infographic
reduce binge eating
reduce binge eating

 

Eating disorders in midlife

Not Your Teens Eating Disorder: What you need to know about eating disorders in midlife.

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Unfortunately, eating disorders in midlife are on the rise.  Many eating disorders in adult women may go undiagnosed because of the mistaken belief that older women don’t develop eating disorders.   It is true that adolescent girls are at a higher risk, but women of all ages are at risk for developing and maintaining an eating disorder.

Adult women usually present with eating disorders in the three following ways:

  1. An eating disorder was developed earlier in their life. That is, as an adolescent or young adult the individual developed her eating disorder, but never fully recovered.  Adequate treatment, motivation to change, social & family support, etc. are all necessary for a full recovery.
  2. The second scenario is similar to the first, an eating disorder developed in adolescence or early adulthood and the individual fully recovered through treatment.  But, then in midlife, a relapse took place either in response to environmental, social, psychological and/or physical stressors and the eating disorder returned.
  3. In this last scenario, which is the least common, is that the onset of the eating disorder first occurred in midlife. That is to say, the individual had no pre-existing eating disorder. The most common type of eating disorder that starts in mid-life is binge eating disorder (click here to learn more about binge eating disorder).

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Dieting increases risk for an eating disorder

Why Dieting is Hazardous to your Health

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We are knee-deep in the diet culture.   Messages about what we should and shouldn’t eat are everywhere: social & print media, TV, on food labels and even well-meaning friends and family.

We forget that food is necessary to survive. Food is not optional. Dieting makes us think we can go without carbohydrates, fats or other food groups. But, we just can’t. Food and eating are not about willpower, it is about biology.

Dieting leads to food preoccupation

The most basic function of our brain is to keep us alive. When our basic needs are not being met, our bodies experience stress. Our brain sends us alerts to get us what we need. Most diets aren’t sufficient in energy (calories) or macronutrients (carbohydrates, protein & fat). Therefore, our brains alert us that we need to eat.
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food addiction

Feeling Out of Control with Food? Could it be Food Addiction?

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There is a lot of controversy around food addiction…

Among clinicians, there is much debate if food addiction is a bonafide diagnosis. Some believe absolutely food can be addictive. In fact, science shows that our brains are activated in the same way it is with drugs when we eat highly palatable, good tasting food.

People who describe themselves as food addicts have a compulsive drive to eat, even when they are not hungry.  Eating, perhaps, to soothe emotions or to “check-out”.  Short-term overeating feels good. But, long-term it can feel pretty uncomfortable.  There is a sense of loss of control described by people who feel like they are food addicts. Furthermore, attempts to stop overeating are made, but with little success. Sounds similar to drug or alcohol addiction, right?

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