1. WHAT ARE EATING DISORDERS ?
Eating disorders, also known as “eating behavior disorders,” involve eating behaviors that are not appropriate for the individual’s environment. These disorders lead to somatic and psychological issues related to food consumption.
There are various types of eating disorders, with the three major ones being :
Anorexia Nervosa
This disorder is characterized by food restriction or even refusal to eat, with the goal of losing weight. As a result, the individual experiences significant weight loss and takes pleasure in becoming thinner. A person suffering from anorexia nervosa feels the need to lose more weight and will use different methods to achieve this. These methods may include excessive calorie control with intense guilt if control is not maintained and excessive physical activity. Anorexia nervosa is often associated with binge eating episodes, leading to compensatory behaviors such as vomiting or using laxatives.
Additionally, individuals with anorexia nervosa may also exhibit body dysmorphia, an obsession with certain body parts, resulting in a distorted perception of their body.
Bulimia
Bulimia is characterized by urges to consume food and a loss of control. These binge eating episodes are often linked to specific emotional states, such as stress. People with bulimia consume large quantities of food quickly, often high in fat, without the ability to stop and without feeling full. The individual feels a NEED to eat.
This food consumption is often accompanied by feelings of guilt and shame, which is why this behavior is usually done in secret to avoid being seen. To avoid gaining weight, people with bulimia often resort to compensatory behaviors such as vomiting and using laxatives.
Binge Eating Disorder
Binge eating disorder is characterized by the same urges and needs as those experienced by people with bulimia, meaning the significant consumption of food. The difference is that in the case of binge eating disorder, individuals do not engage in compensatory behaviors, and therefore, they gain weight during their episodes.
Other Disorders
Other eating behavior disorders are described, notably in the DSM-5, including:
- Pica: An eating disorder involving the persistent consumption of non-food items. People with pica often experience digestive tract obstructions or poisoning.
- Rumination Disorder: This disorder is characterized by the regurgitation of food, which is then re-chewed, re-swallowed, or spit out.
- Avoidant/Restrictive Food Intake Disorder (ARFID): This disorder is defined by a restriction or complete avoidance of food intake. Various reasons can explain this behavior, such as sensory hypersensitivity or a lack of interest in eating, leading to significant weight loss that may require hospitalization.
- Other Specified or Unspecified Feeding or Eating Disorders: These include any other eating or feeding disorders that do not meet the specific criteria of the aforementioned disorders but still cause significant distress or impairment.
2. WHAT ARE THE CONSEQUENCES OF THESE EATING DISORDERS ?
As previously mentioned, the consequences vary depending on the disorder.
Anorexia nervosa can lead to malnutrition or undernutrition. In such cases, the mortality risk is significantly higher than in the general population.
Binge eating disorder can result in substantial weight gain, leading to overweight and various joint or cardiovascular issues.
Compensatory behaviors present in bulimia can cause digestive disorders, dental problems, and nutritional deficiencies.
3. THERAPEUTIC MANAGEMENT OF EATING DISORDERS WITH CBT
CBT (Cognitive Behavioral Therapy) is one of the most effective treatments for eating disorders. In over 70% of cases, CBT helps reduce various eating crises, with a recovery rate of about 40 to 50%. These outcomes are superior to those achieved with pharmacological treatments.
Practitioners use CBT to address body image, impulse control, meal composition, emotions related to food consumption or deprivation, and automatic thoughts.