Madison Counseling Services
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Eating Disorders

Eating disorders involve a serious disturbance in eating habits, including:

  • not eating enough
  • repeatedly eating too much in a short period of time
  • taking drastic measures to rid the body of calories consumed (purging through vomiting; overuse of diuretics or laxatives; excessive exercise; or fasting)
  • being constantly concerned over body size and shape
  • compulsive overeating

All eating disorders usually have an underlying emotional cause that is expressed through an unhealthy relationship with food. An eating disorder is not a 'diet'. While most people consider a diet as a means to get healthier, people with eating disorders see losing weight as a way to improve one's life, relationships, and self-image. Controlling food and weight becomes a means of hiding pain, anger, fear and other troubling emotions.

The different types of eating disorders

Anorexia Nervosa

Anorexia is characterized by:

  • Refusal to maintain a normal weight for one's height, body type, age, and activity level
  • Intense fear of gaining weight or becoming 'fat'; extreme concern with body weight and shape
  • Body image misperception; for example, feeling 'fat' despite being underweight
  • Loss of menstrual periods


Bulimia Nervosa
Bulimia is characterized by:

  • Preoccupation with food and weight
  • Binges (the consumption of a very large amount of food in a short period of time)
  • Compensation for binges with one or more of the following unhealthy measures:
    • self-induced vomiting (purging)
    • misuse of laxatives, water pills, or diet pills (another type of purging)
    • excessive exercise
    • fasting
    • Secretiveness and shamefulness about the bingeing and purging

Binge Eating
Binge Eating is characterized by:

  • Periods of uncontrolled, impulsive, or continuous eating to the point of being uncomfortably full (binges)
  • Feelings of shame and self-hatred about the bingeing
  • No compensatory behavior (such as purging) after bingeing
  • Warning signs and symptoms of eating disorders
  • Eating disorders are secretive by nature - people will attempt to hide the symptoms and effects of the disorder (like covering up drastic weight loss with layers of clothing, or hiding 'binge' foods under a bed or in some other hiding place).
  • The symptoms can also be hard to recognize until the problem has gotten out of control. Symptoms in teenagers can be even harder to detect because some warning signs (like moodiness) look like normal adolescent behavior. Some people exhibit many of the following warning signs and symptoms, while others may exhibit only a few.

Compulsive Overeating

Mental and Emotional symptoms of eating disorders:

  • preoccupation with body appearance or weight
  • moodiness, irritability, confusion or shakiness
  • reduced concentration, memory, and thinking ability
  • depression or suicidal thoughts
  • anxiety, especially around meal times
  • Behavioral symptoms of eating disorders
  • dieting or making frequent excuses not to eat
    overeating or hoarding food
  • obsessive rituals such as drinking only out of a certain cup, or eating certain foods
  • wearing baggy clothes, or a change in clothing style
  • trips to the bathroom after meals
  • Social symptoms of eating disorders
  • social withdrawal or isolation
  • avoidance of social situations involving food
  • decreased interest in hobbies
  • Physical symptoms of eating disorders

Warning signs for Anorexia include:

  • Dramatic recent weight loss unrelated to an illness
  • In women, missing three consecutive menstrual periods
  • No energy or complaints about feeling cold all the time
  • Dry, lifeless hair; brittle nails, poor skin tone

Therapy Solutions

Individual therapy

Forming a trusting relationship with a therapist allows complex issues to be addressed, such as anxiety, depression, low self-esteem, low self-confidence, difficulties with interpersonal relationships, body image concerns, and identity formation. Practitioners may use a particular type of therapy, or a combination of several different approaches.

Family therapy

Family therapy usually involves those who live with the person with the eating disorder, such as parents, siblings, and partner or spouse. The family therapist encourages the family, as a unit, to develop ways to cope with issues that may be causing concern, including the eating disorder. The success of this treatment is dependent on the family's being willing to participate and make changes in their behaviors.

Group therapy

Group therapy provides a supportive network of people who have similar eating disorders. Groups can address many issues ranging from alternative coping strategies, exploration of underlying issues, ways to change behaviors, and long-term goals. Group therapy for people with eating disorders is generally formed for a specific period of time, such as eight weeks.


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