Understanding Eating Disorders

Today approximately three percent of the population in Canada and the United States of America suffer from one form of eating disorder or another. Eating disorders are far more common among females; only 10-15 % of those afflicted are men. Even though these disorders revolve around controlling food intake, they are not really about food. Instead, they most often are the result of untreated emotional issues such as neglect, abuse, or abandonment. The seriousness of eating disorders is often underestimated; many people believe it is just a more intense form of dieting. Nothing could be further from the truth; more people die from eating disorders than from any other mental illness.

Types of Eating Disorder

Eating disorders can take on a variety of forms; the two most commonly known are anorexia nervosa and bulimia nervosa. These disorders can manifest themselves at any stage of life. However, they typically develop during early adolescence or the early stages of adulthood. The evidence suggests that childhood trauma or abuse drastically increases the risk of developing an eating disorder.

Anorexia nervosa is the most lethal psychiatric disorder, with a mortality rate nearing 20%. Individuals affected by this disorder restrict their food intake and are willing to go to extreme measures to keep from gaining what they perceive to be unwanted weight. These behaviors can include fasting, excessive exercise, self-induced vomiting, misuse of diuretics and weight loss supplements, and frequent use of laxatives. Individuals with a long history of this disorder can experience life-threatening physical changes including mild anemia, extreme weight loss, lethargy, muscle weakness, and low blood pressure. The rate of death for females ages 15 and 24 who suffer from anorexia nervosa is twelve times higher than the death rate due to all other causes. These deaths are attributed to complications brought about by the disorder.

Bulimia nervosa seems to be experienced mostly by those who have undergone some form of physical trauma and who may be experiencing PTSD as a result. Many persons suffering from bulimia appear to have a normal body weight; however, they share some of the same behaviors as anorexia nervosa. The disorder is characterized by frequent consumption of unusually large amounts of food, followed by purging in an attempt to maintain body weight. Purging can consist of self-induced vomiting or using diuretics or laxatives. Periods of extreme exercise may also follow binge eating episodes.

Physically, individuals with bulimia nervosa often exhibit swollen cheeks, dental problems characterized by abnormal tooth decay, intestinal distress, heartburn, severe dehydration, and kidney problems. Frequent vomiting can cause bleeding or ulceration of the esophagus and dangerous electrolyte imbalances.

Treatment of Eating Disorder

Treatment of eating disorders such as anorexia and bulimia should ideally include four key areas: 1) Medical intervention and nutritional counseling; 2) Counselling in the form of individual, group or family-based therapy; 3) Medication for the treatment of secondary conditions such as anxiety or depression; and 4) Some type of spiritual therapy designed around the individual’s prior spiritual belief system.

Medical intervention can range from basic nutritional counseling to the extreme of hospital-based care in order to bring the individual’s body weight back up to a healthy level. In extreme cases, additional medical care may be needed to address the damage the disorder has done to the body and to help restore healthy function.

Counseling, in some form, is always necessary for identifying the underlying causes of the eating disorder. An unhealthy self-image regarding body weight and shape, troubled interpersonal relationships, physical or sexual abuse, and cultural pressures and norms, are just a few of the underlying causes that must be explored. All experts agree that the sooner the treatment starts, the better the outcome will be.

Spirituality and Eating Disorder

In recent years, experts have started to acknowledge that, in addition to considering the affected individual’s physical nourishment and psychological health, they also need to address the individual’s spirituality when treating eating disorders. A shift in a person’s perceived spiritual state could be at the root of the eating disorder. For example, feelings of guilt which makes a person feel hopelessly unworthy of God’s love could lead to a preoccupation with physical appearance as a way of trying to feel better and shift the focus to a realm they can control. Similarly, a person who feels unworthy of love from a father or other parental figure who criticized their weight, leading to the eating disorder and self-rejection, may also see themselves as not being worthy of God’s mercy and forgiveness. Another example is a person who feel that God did not protect them from the person who abused them and carry unresolved anger towards God as a result. They may ask, “where was God? If He is all powerful, why didn’t he prevent it from happening?” Eating disorders in these cases have a spiritual component that should be addressed by a skilled Christian Counsellor who knows, not only psychotherapy but also how to resolve the spiritual crisis that is often a factor in eating disorders.

When discussing their negative images of God, eating disorder clients tend to describe God in the same way they describe their parents. If they perceive their parents as distant or unavailable, they often feel that God is also distant as well. If they see their parents as rejecting, critical, controlling, angry, devaluing, shaming, etc., they often project these characteristics onto God. As the eating disorder progresses, these negative images of God play a significant role in their disconnection from spiritually -based relationships. This disconnection leaves them without the support system of their faith group and makes them more vulnerable to distorted thinking, depression, and even death. Encouraging them to reconnect with their faith-group can help to ensure that any progress made in the other areas of treatment have a better chance of succeeding.

Treating eating disorders should involve more than controlling food intake or correcting a person’s distorted view of their body. Treatment of eating disorders should include looking at the trauma, neglect, abuse or other negative factors that have entered the person’s life. Similarly, treating eating disorders should not only involve the physical realm but the spiritual as well.