Managing an Adult Eating Disorder: Steps to Success
Our society is on guard for signs of teen and child eating disorders. Children today have manifested signs of anorexia nervosa, bulimia nervosa, and binge eating disorder. What we as leaders have not done is give parents and professionals the tools to recognize eating disorders in children so that they can manage them as adults. It is a sad fact, that an adult eating disorder is harder to control because these disorders become habits during youth.
As in all things, recognition and acceptance are the first step. Once you know there is a problem, you absolutely should consult a doctor and/or mental health professional to get a definitive diagnosis. After that, your medical team can hook you up with a nutritionist and therapist. Finally, the patient needs to take responsibility for the disorder and learn to recognize him or herself as a whole person. These are critical steps to handling an adult eating disorder.
Recognizing and Accepting the Disorder
There are multiple eating disorders that can begin in childhood and carry on into adulthood: anorexia nervosa, bulimia nervosa, and binge eating. Each of these adult eating disorders can be fatal.
Anorexia nervosa is the unnecessary and extreme restriction of calories to maintain an overly thin physique. Anorexics are also often prone to over exercising for fear of gaining weight. They have a form of body dysmorphia, meaning they don’t see a true reflection of themselves in a mirror. When they look, they don’t see a 98-lb skeleton – they see a fat person.
Anorexia nervosa is a mental health condition. It is driven by an intense fear of gaining weight – not being fat. They already see parts of themselves as fat. They fear taking in calories and as a result, severely restrict their eating. They may compulsively weight and portion their food, weigh themselves every day (even multiple times a day), and abuse laxatives or diuretics.
Bulimia nervosa is the process of eating or overeating and then regurgitating the food to avoid absorption of calories – also known as bingeing and purging. The bulimic gets the pleasure of eating but experiences so much guilt from the consumption of food that he or she simply cannot allow the food to be digested. This manifestation is a fear of becoming an overeater and feeling guilting for enjoying food.
Bulimics can alternatively binge and purge tens of thousands of calories every day. The primary disorder is the inability to stop eating when full. Unlike anorexics, whose bodies are frail and thin, bulimics are often of normal weight. The bingeing and purging are often done in secret because the bulimic is ashamed of the behavior.
Binge eating is an emotional disorder where patients eat to avoid coping with negative experiences and traumatic events. This type of eating disorder leads to morbid obesity rather than being underweight, like in anorexia and bulimia. A binge eater can easily put away 20,000 calories per day – ten times the recommended daily allowance for adults. I most instances, binge eaters who become morbidly obese are trying the only way they know how to deal with emotional trauma. They lack the requisite coping mechanisms to deal with their issues in a healthy way.
In all three adult eating disorders, many patients die from the abuse of their bodies. Anorexics who die from the disease usually pass away from heart failure or starvation. Bulimics can rupture their esophagus from repeated self-induced vomiting, lose the enamel on their teeth, or they can cause dangerous hormone imbalances. Binge eaters who reach weights over 300 pounds are at risk of heart failure, stroke, diabetes, high cholesterol, and a variety of other conditions related to obesity. These dangerous conditions must get under control if a person is going to manage an adult eating disorder.
Getting a patient to accept that there is a problem can be extremely difficult because they are not mentally stable. They either have a medical condition or psychological condition that requires treatment. It is virtually unheard of that a person with an eating disorder is able to handle it alone. In addition to medical and psychological treatment, there are support groups and recovery programs that help people with eating disorders accept their conditions and work on taking care of themselves in a healthy way.
Getting a Diagnosis
To get a diagnosis of the adult eating disorder, begin with a trip to your family physician. The doctor will ask you a series of questions regarding your eating habits, the types of foods you eat, how often you eat, what your exercise habits are, and how you view yourself when you look in the mirror.
Based on the answers provided, the doctor can diagnose the adult eating disorder. Some patients can be in serious to critical condition by the time they see a doctor, and many have to be admitted directly to the hospital for life-saving treatment.
Anorexics often need IV nutrition, electrolytes, and medications to regulate their body systems. Without the proper intake of calories and appropriate nutrition, all organ systems can begin to fail. The cardiovascular system needs proper balances of electrolytes, fluids, and enzymes to operate the heart and lungs. The endocrine system needs complex carbohydrates, fluids, and salt to properly flush the kidneys and liver. The nervous system needs proper vitamins and minerals to continue producing spinal fluid and cerebrospinal fluid (fluids in the spinal column and brain).
Bulimics may need surgery for ruptures or may have to have their teeth worked on by a dental specialist. The constant bingeing and purging put an unnecessary amount of strain on the esophagus and diaphragm. The stomach acids that are expelled during a purge are corrosive and will eat away at the soft tissue of the esophagus as well as damage the enamel on teeth. Additionally, because bulimics often don’t digest a significant number of nutrients daily, they may also need IV nutrition for malnourishment.
Binge eaters may need hospitalization to address cardiovascular and hormonal problems or they may need to be admitted to the hospital for restricted calorie diets to lose weight as fast as possible. The more weight you carry on your body, the more strain you are putting on your heart, lungs, muscles, feet, back, and joints. The human heart can only take so much strain and chronic obesity wears out the heart very quickly. It is not unusual for morbidly obese patients to die at a very young age (30s to 40s).
In all of these instances, the adult eating disorder has become a condition that can be life-threatening without treatment and proper nutritional management.
Meeting with a Nutritionist
One of the medical professionals most helpful to patients trying to manage adult eating disorders is a nutritionist. For many patients, they were never taught as children what healthy eating is. They may have been from a family that could not afford to eat healthily. Their parents and/or guardians may not have had the knowledge to teach them healthy eating. Or, they simply became addicted to sweets and unhealthy foods that led to their adult eating disorder.
A nutritionist will teach the patient how their adult eating disorder is affecting his or her body. Each body system, organ, and cell has specific nutritional needs. If your body is low in water, your kidneys can start failing. If you don’t have enough salt, your blood pressure is affected. If you have too much sugar, your pancreas will be overworked.
Nutritionists can teach patients about macro and micro-nutrients; how fast food and junk food contain dangerous levels of fat, salt, and sugar.; and how fresh, natural foods are much more helpful to the body and allow it to perform at maximum potential. The best foods to put in the body are those you cook yourself – pre-packaged foods, fast foods, and even some restaurant foods are never going to be as healthy as what you can cook for yourself at home.
A nutritionist can also come up with a healthy diet that contains everything the patient needs to fight the adult eating disorder and lead them to healthier ways of shopping for food and cooking it to maximize nutrition (for example, baking chicken instead of frying it) and reduce loss of nutrients during the cooking process. Once a person begins shopping, cooking, and eating in a healthy manner, they are ready to start working on the mental health issues revolving around the adult eating disorder.
Seek Psychological Treatment
Once a patient is physically stable, the next step in management is seeking psychological treatment for the adult eating disorder. You can seek out a psychiatrist, family therapist, counselor, or psychologist. You may have to try multiple professionals and different types of therapy before you find the one that’s right for you. Don’t be discouraged by this. You must be comfortable with your team if you are going to succeed in managing an adult eating disorder.
During psychological treatment, your mental health professional will ask you what types of things trigger your eating behavior; what events in your childhood could contribute to your disorder; do you recall any traumas that could affect your eating. These unresolved issues can all lead to a dysfunction in eating habits. It is not unusual for patients to want to avoid dealing with the pain of past events, so eating is their way to avoid facing these memories.
In some cases, a mental health professional will prescribe anti-depressants or anti-anxiety medications to help the patient with focus. Oftentimes, once the medications have reached therapeutic levels, the patient is calmer, more focused, and more prepared to handle the pain that will come from discussing hurts and pains from the past. These medications can be used on a temporary basis to get through a single traumatic event, or they can be lifelong regimens to help the patient establish a level of normalcy.
To goal of psychological treatment is to help patients identify the events and things that trigger unhealthy eating and create adult eating disorders. But, in order to be successful, you have to accept everything about yourself and what has led you to this unhealthy behavior.
Look at Yourself as a Whole Person
There is so much more to a person than what he or she eats, or how one looks. Identifying and addressing triggers that cause a person to either not eat, purge, or overeat gives them the power to control the issue. Each of us is more than our outward appearance – so much more. We are a mind full of ideas and curiosity; we are a heart that loves and seeks to be loved; we are a spirit that connects with nature, God, or the universe in powerful ways.
While there is no such thing as being cured from an adult eating disorder, you must look at yourself as not just the physical – the mental, the emotional, the spiritual, and the physical are all equally important to maintain a healthy life and control an adult eating disorder.
Find the things in your life that are overwhelmingly positive. What can you achieve with your mind? Are your emotions all over the place, or do you have a sense of emotional control? Do you have a spiritual life that gives you peace and connection to the universe or a deity? How have you changed your physical life to bring balance and health to your existence?
These are questions that must be answered so you can act in your own best interest, control your eating, and create a balanced, healthy life.
When we start disordered eating behavior as children or teens, those habits will follow us into adulthood. Whether it was family issues or bullies in school, those with adult eating disorders have lots to unravel in their minds and bodies.
Fighting an adult eating disorder is difficult under any circumstance. The habits that we develop in childhood can be so hard to break as adults. But with the proper diagnosis, treatment, and mental health counseling, adult eating disorders can be managed, and lives can be saved.