The vast majority of women, and many men, are unsatisfied or excessively worried about their bodies or weight. At the same time as we have an epidemic of obesity in our society, we also have an epidemic of anorexia and bulimia - the two go hand in hand. Binge eating, restricting food intake, and purging or over-exercising can become a very serious and even life-threatening problem right under our noses. Eating disorders are one of the most serious of the mental illnesses, and almost always involve a great deal of denial on the part of the affected individual and their family. It is crucial to consult a professional as soon as possible if you notice any of these behaviors in your child or loved one, or in yourself. The sooner treatment can begin, the better the prognosis.
Anorexia nervosa is a pattern of restricting food intake, leading to weight loss beyond what is healthy for the individual. At the same time, the person with anorexia becomes preoccupied with food and obsesses about what to eat and often about how to loose weight. Anorexia can involve severe distortions in body image, where looking in the mirror, the person sees an overweight body despite in reality being underweight or dangerously under weight. The preoccupation with food and restricting food intake creates a closed mental system, where the person often feels that if they can control what they eat, than they can have a sense of control in their lives. This actually comes from feeling OUT of control - and the pattern is extremely difficult to break because it is so hard to deal with the feelings of being out of control, and so seductive to enter the restrictive world of not eating.
The personality of the person with bulimia is often more volatile and can be explosive/expansive. There is often a pattern of relational closeness followed by retreat from closeness with others. People with bulimia are not typically underweight. However, there are serious health and medical consequences to binging and purging that often require medical supervision or residential treatment.
Many people struggle with binge eating disorder, which is actually a new disorder in the DSM-V, and can range from emotional eating to a disorder with serious health consequences. Binge eating can be a very difficult pattern to break, and can often be ameliorated by increasing a sense of efficacy in ones life and increasing assertiveness. Consultation with a nutritionist and implementation of a sustainable exercise plan can also be important elements of recovery.
Eating disorder treatment often requires a team approach, with a nutritionist or dietician and medical specialists working together with the psychotherapist.