Eating Disorders
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WHAT IS DISORDERED EATING?
- restricting one’s intake to small amounts of food or avoiding particular food or food groups
- weighing oneself frequently and becoming preoccupied with weight changes
- obsessive body checking and scrutiny OR avoidance of looking at one’s body
- overvaluing dietary restraint
- overeating that feels out of control
- engaging in unhealthy ways of regulating weight such as over-exercising, laxatives, and vomiting
When should I seek help?
Some clients display disordered eating behaviours but do not meet DSM-5 criteria for a diagnosable eating disorder. At the Firestone CBT Clinic, we treat both subthreshold and diagnosable eating conditions. You do not need to meet criteria for a diagnosable eating disorder to benefit from our psychological services. If your concerns about food, weight, body shape or eating behaviours are causing you psychological distress, our practitioners can help you to understand your symptoms and change how you are thinking about, perceiving, and behaving with regards to your eating and body image.
ANOREXIA NERVOSA
Anorexia Nervosa is a serious mental health condition that involves not eating enough food, exercising too much, taking laxatives and/ or purging. People with anorexia are underweight and have an intense fear of gaining weight. Anorexia is often associated with a distorted body image, a tendency to base one’s self-worth on weight or shape, obsessive thoughts about food and weight, disturbances in menstruation, and/or physical symptoms such as feeling dizzy, hair loss or dry skin. The starvation and purging behaviours sometimes associated with this condition can result in significant and potentially life-threatening medical conditions. Although many of the clients at the Firestone CBT Clinic are able to recover with our services, with support from their general medical practitioner and a registered dietician, some clients require more intensive services such as being hospitalized or residential treatment.
BULIMIA NERVOSA
Bulimia Nervosa is a serious mental health condition that involves recurrent episodes of eating a lot of food in a short amount of time in an out-of-control fashion (binge eating) and using recurrent inappropriate compensatory mechanisms to eliminate food from the body to try to stop themselves from gaining weight (purging). Compensatory mechanisms can include vomiting, laxatives, diuretics, medications, fasting, or excessive exercise. A tendency to base one’s self-worth on weight or shape is also present in this condition.
Binge-eating disorder is a serious mental health condition that involves recurrent episodes of eating a lot of food in a short amount of time in an out-of-control fashion (binge eating) without using compensatory mechanisms. Binges usually happen when alone, and may include "special" binge foods. People with binge-eating disorder often feel guilty, ashamed or disgusted after binge eating.
BINGE-EATING DISORDER
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WHAT IS AN EATING DISORDER?
The most common eating disorders that are treated at our Clinic are Anorexia Nervosa, Bulimia Nervosa, and Binge-Eating Disorder. An eating disorder is a complex condition caused by an interaction of biological, psychological and social factors.
Cognitive Interventions in CBT
Cognitive interventions involve learning how to examine and change unhelpful thoughts and beliefs that play a role in the onset and maintenance of the eating disorder. Typical thoughts that are targeted are overconcern with weight and shape, unhelpful beliefs related to emotions, self-esteem, perfectionism, and interpersonal issues. Various strategies can be used to tackle unhelpful thoughts including psycho-education about healthy eating, cognitive restructuring or thought challenging, distress tolerance skills, acceptance and mindfulness strategies, amongst others.
Behavioural Interventions in CBT
Behavioural strategies for working with eating disorders include modifying dysfunctional eating behaviours including restrictive eating, meal skipping, avoiding foods, and compensatory behaviours such as vomiting, laxative use and excessive exercise. Regulating food intake, completion of food records, exposure to feared foods, reduction of body checking or body avoidance, as well as behavioural experiments, exposure therapy, distress tolerance training and relaxation and mindfulness strategies are just some of the many interventions used at the Firestone CBT Clinic.
COGNITIVE-BEHAVIOURAL THERAPY (CBT) FOR DISORDERED EATING / EATING DISORDERS
Cognitive Behavioural Therapy (CBT) is an evidence-based psychological therapy that is used to treat various mental health disorders including eating disorders. CBT aims to change maladaptive emotional responses by altering thoughts and behaviours and using a variety of other techniques. CBT is the first-line treatment for eating disorders. It has been extensively studied and shown to be highly effective for treating eating disorders.
How is CBT different than other approaches?
CBT is different than other therapeutic approaches in its emphasis on the ways that a person’s cognitions, emotions and behaviours are linked. Unhelpful emotions are related to our perception of ourselves, others and the world, and how we behave in accordance with these beliefs. CBT practitioners help clients uncover their unhelpful beliefs and behaviours and work on overriding these when they are not functional. At the Firestone CBT Clinic, we use a model based on CBT but also incorporate other approaches when clinically indicated, including techniques from Dialectical Behaviour Therapy (DBT), Metacognitive Therapy (MCT), Acceptance and Commitment Therapy (ACT), Emotion Focused Therapy (EFT), amongst others.
How many CBT sessions are required?
A typical course of CBT therapy for eating disorders is somewhere around 20 weekly sessions. We recommend having regular visits with your general medical practitioner as well as a registered dietician in addition to outpatient visits with your psychologist. The Clinical Director will assess you during your first meeting and make a recommendation about the number of sessions for your specific concerns.