Eating Disorders are serious illnesses that affect life quality and can have lethal consequences. They include bulimia nervosa, anorexia nervosa, binge eating disorder, and related conditions. Bulimia nervosa occurs in 1% to 8% and anorexia nervosa in 0.4% to 1% of Canadians.

    Bulimia nervosa typically occurs in people of normal weight, and involves a cyclical pattern of bingeing and use of compensatory strategies. Bingeing means eating a large amount of food with feelings of a loss of control. Compensatory behaviours are strategies to get rid of unwanted calories, and may involve self-induced vomiting, abuse of laxatives, diuretics, or enemas, excessive exercise, and/or fasting. The self-esteem of individuals with bulimia nervosa is strongly influenced by their body shape and weight.

    Symptoms of anorexia nervosa include extreme weight loss due to restriction of food intake, an extreme fear of gaining weight/becoming fat, and a strong influence of body shape and weight on self-esteem. Weight loss is severe enough to involve absence of menstruation in females. Some individuals with anorexia nervosa also experience episodes of bingeing and/or use of compensatory behaviours.

    Eating Disorders Not Otherwise Specified (EDNOS) is a final category of eating disorder that allows for the diagnosis of people not fitting the strict criteria for anorexia or bulimia nervosa, yet still exhibiting serious symptoms. Binge eating disorder is an example of an EDNOS, and involves similar criteria to bulimia nervosa, but does not include the use of compensatory behaviours.

What psychological approaches are used to treat the eating disorders?

    In cognitive behavioural therapy (CBT), individuals learn to challenge thoughts, feelings, and behaviours that maintain eating disorder symptoms.

    Interpersonal therapy (IPT) focuses on understanding links between eating disorder episodes and relationship issues. For instance, therapy might focus on difficulties in forming or maintaining relationships, unresolved grief, and disputes with friends or relatives.

    Psychoeducation is typically delivered in group format, and provides factual information about the causes of eating disorders as well as strategies for overcoming an eating disorder.

    Family therapy focuses on assisting the family to work together in overcoming the eating disorder.

    Motivational enhancement therapy (MET) focuses on helping individuals work through their ambivalence about giving up their symptoms, and making life choices that are congruent with their higher goals.

How effective are psychological methods of treating eating disorders?

    Research has shown that psychoeducation is a useful first intervention for individuals with mild to moderate bulimia nervosa. For individuals with more severe bulimia symptoms, interpersonal therapy and cognitive behaviour therapy have been shown to be highly effective, and identified as the treatments of choice.

    Although research is still investigating the best treatments for anorexia nervosa, a comprehensive approach that addresses motivational issues, weight restoration, and underlying psychological issues is recommended. Family therapy has been shown to be a critical treatment component for younger clients.