Eating to the Limit
When Controlling Food Becomes your own Cheer-Leader
Eating disorders are serious emotional and physical problems that can have life-threatening consequences for females and males. Eating disorders such as anorexia nervosa, bulimia nervosa, and binge eating disorder involve problems around eating behaviour, attitudes and beliefs about body shape and body image, unrealistic weight expectationsand unhealthy weight management. They also include extreme emotions, attitudes, beliefs and behaviors in relation to weight and food.
Sometimes people with eating disorders engage in compensatory behaviours aimed at compensating overeating. These behaviours may include: extreme dieting, fasting, use of laxative and diuretics, self-induced vomiting or excessive exercise.
These behaviours become a problem when people realize that they are starting to affect their physical health, their mental health, their work performance, their academic achievement or any engagement in their social activities.
There are many factors causing eating disorders and there is no single consensus among researchers or clinicians as to what the cause is. The development of an eating disorder may involve a combination of different factors.
They may include: the cultural ideal to be thin, problematic family relationships, transition periods across the life span, genetic vulnerability and neurochemical imbalance implying lack of serotonin.
Mental health conditions such as depression, anxiety disorders (Obsessive Compulsive Personality Disorder, Social Phobia, Social Anxiety, Agoraphobia and Generalised Anxiety Disorder),
The transition period between childhood and adolescence, as well as between adolescence and adulthood place young people more at risk of developing an eating disorder.
In addition, the pressures by the media and society to look ageless and beautiful indeed may exert body dissatisfaction and contribute to expose individuals to disordered patternsof eating.
Developmental transitions or life crises experiences that may trigger eating disorders include: the death of loved one, divorce or widowhood, marital difficulties, pregnancy, loss of youthfulness, menopause, physical signs of aging and medical illness. Unfortunately, these transition periods across the lifespan that may trigger the onset or relapse of eating disorderstend to be underdiagnosed in midlife and beyond.
Having awareness about signs of an eating disorder can make a huge difference to the duration and severity of the illness.
An individual suffering from an eating disorder may reveal one or any combination of the following warning signs:
- Preoccupation with eating, food, weight
- Having a distorted body image
- Extreme body image dissatisfaction
- Radical changes in food preferences
- Obsessive rituals around food preparation and eating
- Feeling anxious and/or irritable around meal times
- Intense fear of gaining weight
- Unable to maintain a normal body weight for their age and height
- Reduced capacity for thinking
- Increased difficulty in concentrating
- ‘Black and white’ thinking (rigid thoughts about food being ‘good’ or ‘bad’)
- Low self-esteem and perfectionism
- Increased sensitivity to comments relating to food, weight, body shape, exercise
- Dieting behaviour
- Deliberate misuse of laxatives, appetite suppressants, enemas and diuretics
- Repetitive or obsessive behaviours relating to body shape and weight
(CBT-E) for adults and adolescents suffering from bulimia nervosa, and individual and Family-Based Treatment for anorexia nervosa (FBT) for children and adolescents.
Beside addressing the issue directly, through the symptoms, the psychotherapy process revolves around at targeting the underlying causes of the eating disorder and focusing on the factors that maintain the eating disorder psychopathology.
By identifying, monitoring, and untangling maladaptive patterns of thoughts and perceptions, cognitive behavioural therapy (CBT) has demonstrated to be effective in enabling healthy schemas and leading to effective behavioural changes.
Dialectical Behavioral Therapy (DBT) is progressively being integrated into eating disorders treatment for identifying triggers, improving responses to stress, increasing self-awareness, applying mindful eating, adjusting rigid thoughts and improving coping strategies in dealing with conflicts.
Psychotherapy sessions mainly conducted one to one often involve family therapy sessions and educational programmes.
Usually they cover the follow issues:
- Establishing healthy patterns of eating
- Education around realistic weight expectations
- Education of appropriate exercise
- Identifying distortions in thoughts and beliefs
- Identifying factors that cause and aspects maintain disordered eating
- Challenging distorted assumptions
- Changing behaviour that maintains the eating disorder
- Identifying and addressing interpersonal difficulties
- Gaining insight and addressing issues around role transitions, grief and loss, unresolved relationship issues
- Learning emotion regulation skills
- Improving self-esteem, self-acceptance and self-worth
- Improving communication skills
childhood sexual abuse, self-harming and suicidal ideation or substance use disorders are often key factors involved in eating disorders as well as psychological and social difficulties.
Moreover, interpersonal dependency, non-assertive communication style, avoidance of interpersonal conflict, competition and rivalry, difficulties in recognising and controlling emotions, feelings of inadequacy or loneliness are further aspects involved in eating disorders.
People in these circumstances deal with their painful emotions by means of gaining a sense of control and by adopting perfectionistic attitudes to cope with their low self-esteem, self-acceptance, self-worth and their sense of insecurity.
Therefore, eating disorders become a coping mechanism for people attempting to gain control of their situations when they feel helpless in the face of other aspects of their life. When this quest for control goes too far, the risk of developing an eating disorder can dramatically increase.
Sometimes psychological issues start before eating disorders develop and at other times emotional difficulties can be the result of eating disorders.
In both cases they are factors that maintain them.
There are many symptoms that are common to eating disorders. They may include: dieting or avoiding food, eating rituals, playing with food rather than eating it, distorted body image, preoccupation about food and body weight.
Although eating disorders are typically thought to occur in adolescent girlsor young adulthood females, they also occur in young boys, young adulthood males, children, middle aged people and the elderly.
- Spending more and more time alone
- Eating in private and avoiding meals with other people
- Secrecy around eating
- Compulsive or excessive exercising and distress if exercise is not possible
Many people with eating disorders do not seek for help. However, it is imperative that people struggling with these issues receive treatment sooner rather than later, especially in childhood and in adolescence.
Research has demonstrated that seeking help at the first warning sign is much more effective than waiting until the illness is in full swing. It is vital to seek help and support as early as possible: the longer these difficulties are present the more entrenched the thoughts and behaviour becomes, the harder it is to make changes.
The most effective treatment for curing an eating disorder generally includes a team approach with different clinicians with multi-disciplinary specialties: a general practitioner, a psychiatrist, a clinical psychologist, a dietician and a nutritionist.
Visiting any of these professionals to discuss and assess disordered eating is a good start in identifying the eating disorder and the more appropriate treatment plan. In fact,symptoms of eating disorders are unique to every patient.
The clinical treatment depends on the specific type of eating disorder. But in general, it typically includes psychotherapy, nutrition education and medication.
In case of serious health problems, such as anorexia nervosa that has resulted in severe malnutrition, hospitalization on a medical or psychiatric ward may be also recommend.
Psychological treatment includes Motivational Interview (MI), Dialectical Behavioral Therapy (DBT) techniques,Cognitive-Behavioural Therapy Enhanced
- Managing conflicted relationships
- Developing coping strategies
- Developing problem-solving skills
- Building autonomy
- Preventing relapse
Eating disorder recovery consists of different transitions and levels of care, relapse included.The experience of relapse is a natural aspect of the recovery until the remission of the symptoms is fully achieved.
The highest risk for relapse for individuals recovering from Anorexia and Bulimia has been identified in the 6-7 months following partial symptom remission.Understanding that relapse may be part of the recovery journey, it is important to identify ways to continue to support the healing process.
Some important factors to make the transition through treatment levels towards an eating disorder recovery are:
- Following the guidance of the treatment team in establishing psychological stability in order to maintain the recovery outside treatment.
- Learning about situations, circumstances, and emotions that trigger eating disorders.
- Establishing healthier coping skills to work through triggers rather than engaging in eating disorder patterns.
- Envisaging a plan for any type of “emergency” through the recovery
- Keeping on truck by means of continuing support.
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- Who is a psychiatrist? Psychiatry is the branch of medicine that is concerned with the diagnosis, treatment, and prevention of mental, emotional and behavioral disorders. A psychiatrist is a physician who specializes in mental health, including substance and other addictions.
- When should I see a psychiatrist? You should see a psychiatrist suffering from:
- What are the major diseases that psychiatrists treat?
Psychiatrist treat disorders like anxiety disorders, depressive disorders, obsessive-compulsive and related disorders, trauma- and stressor-related disorder, sexual dysfunctions and gender dysphoria, substance-related and addictive disorders, and schizophrenia. - Difference between a psychologist and a psychiatrist?
Psychologists focus on psychotherapy and treating emotional and mental suffering with behavioral intervention. Psychologists are also qualified to conduct psychological testing but in most cases, cannot prescribe medications to their patients. - What happens in your first appointment with a psychiatrist?
The first appointment with a psychiatrist is usually one hour long. During your meeting, your psychiatrist listens to you talk about your concerns and symptoms, asks questions about your general health, asks about your family history, takes your blood pressure and do a basic physical check-up and might asks you to fill out a questionnaire. - Depression
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Eating disorders are so challenging with their unique needs and concerns. Long term commitment in therapy is a fundamental requisite for a comprehensive treatment involving a multi-disciplinary team engaging deeply both patients and their relatives to cope with their devastating illnesses and restore their lives.
If you would like to talk, feel free to reach out to us. An LifeWorks therapist would be able to help.
I’m Dr. Saba Aslam, Licensed Clinical Psychologist at LifeWorks. I have more than seven years of experience working in this field with all age groups as children, adolescents, adults and older.
I have worked with the patients having diverse mental health issues as stress, depression, anxiety, emotional behavioral problems, anger issues, intellectual disability, attention deficit hyperactivity disorder, autism spectrum disorder, obsessive compulsive disorder, interpersonal relationship problems, self-esteem issues, decreased self-confidence, or trust issues, adjustment problems, stress and coping related to developmental changes and physical or sexual abuse in children or adolescents.
I am proficient in using protective techniques, IQ tests, personality tests and other psychological and neurodevelopmental assessment protocols. I prefer to combine elements of various approaches, including humanistic, psychoanalytic/ psycho dynamic, gestalt, cognitive behavioral therapy, behavior modification, social skills trainings, dialectical behavior therapy and applied behavior analysis.
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Raised and educated in Italy, Dr. Lorena is a highly experienced Cognitive Behavioural Clinical Psychologist-Psychotherapist. She achieved her 5 years Bachelor/Master Degree in Clinical Psychology at Padua University (Italy) and further she completed her professional profile with a 4 Years Master Specialization in Como (Italy) at the Post Bachelor Specialization School in Cognitive Therapy.
She also has a Master in Counselling at Brescia University (Italy) and completed level 1 and 2 training in EMDR.
She has been working as a Psychologist /Psychotherapist for 20 years in both Public, Private Hospitals and outpatients clinics.
In addition to her clinical skills experience, Dr Lorena has had an extensive involvement in teaching, clinical research and publications in different fields such as Binge Eating Disorders and Psychological Rehabilitation after heart attack.
After moving to Dubai in 2012 Dr. Lorena got a DHA Licence as Clinical Psychologist and provides psychological treatments in a wide range of mental health and emotional issues.
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Maryam has master’s degree in Relationship therapist and has been working in the Mental Health field since 2009. She believes that therapy is a collaborative process and she kindly guides clients to increase self-awareness, gain new perspectives, decrease symptoms, and increase personal strengths to have a more meaningful life experience.
Throughout her career, Maryam has worked with adults, adolescents, and children, across various settings, including private practice and outpatient primary care clinics, in Netherlands and UAE. She has been working as a psychologist in UAE since 2013.
Maryam has extensive experience in applying various Social worker including Neurofeedback therapy, ABA (behavior) therapy, Counseling and relationship therapy.
In her clinical practice, Maryam helps the individuals t
Maryam uses a warm, empathetic approach to create a safe and nonjudgmental space where clients can learn, grow, and achieve their goals. She makes sure to offer flexibility, meet the individuals where they are, and have patience to help each individual feel secure throughout the process. She always encourages open communication regarding the course of therapy and goal achievement.
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Ritasha Varsani is a CDA licensed Psychologist practicing in Dubai. She has an experience of over ten years in providing psychotherapy to a diverse population in a mental health settings in India and United States. She has been professionally trained from USA and her expertise lies in Marriage, Family and Child Therapy. She offers problem solving insights with evidence based therapies to clients giving them the strength to express themselves and promotes equal privilege is what she believes in.
“Empathy and sensitivity is key to connecting with people on a human level”. I support my clients by cultivating the ability and demonstrating with authenticity, vulnerability and honesty and increase their sense of their own well being. As a result of her approachable, non-judgmental and compassionate attitude her clients feel safe in addressing and overcoming developmental challenges, psychological obstacles and traumatic life experiences.
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Ritasha uses an integrative approach by incorporating interpersonal and psychodynamic principles and evidence based therapies such as Cognitive behavior therapy, motivational interviewing, narrative therapy, compassion focused therapy, solution focused therapy, family therapy. She takes a client centered and culturally competent approach to facilitate progress and change by quality of care and moving through the journey of recovery. Her age range of clients varies from preschool kids to adolescents, individuals and couples/ families providing therapeutic interventions in individual and group settings.
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Safia Ali Malik is DHA licensed Clinical Psychologist with comprehensive knowledge and understanding on different therapeutic techniques. Compassionate, dedicated and empathetic with clients. Experience of working with clients with different needs and nationalities with utmost cultural sensitivity. Excel at providing adolescents and adults with individual psychotherapy to help them facilitate their social and personal growth and allow them to lead more meaningful and fulfilling lives.
She specializes in psychological and educational assessments and provides individual, family and group therapies.
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Psychometric and Psychological assessment, Cognitive therapy, Group therapy, individual therapy, Management, Dialectic Behaviour therapy, Solution Focused and Problem solving Approaches depending on the need of the client.
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Corina has her master’s degree in Cognitive Behavioral Therapy and has been working in the Mental Health field since 2007. She believes that therapy is a collaborative process and she kindly guides clients to increase self-awareness, gain new perspectives, decrease symptoms, and increase personal strengths to have a more meaningful life experience.
Throughout her career, Corina has worked with adults, adolescents, and children, across various settings, including private practice and outpatient primary care clinics, in Romania, Spain and UAE. She has been working as a psychologist in the Emirates since 2017, in Abu Dhabi and Dubai. Her last position was in a children’s medical center, where she had helped families overcome various challenges, such as anxiety, depression, challenging behaviors and OCD, to name a few.
Corina has extensive experience in applying various empirically-supported Cognitive Behavioral Therapies (CBT), including Acceptance and Commitment Therapy (ACT), Exposure and Response Prevention (ERP), Solution Focused Brief therapy (SFBT), Trauma Focused CBT (TF-CBT) and Motivational Interviewing (MI).
In her clinical practice, Corina delivers evidence-based treatments to individuals facing a wide range of emotional, behavioral and adjustment problems, such as:
Corina uses a warm, empathetic approach to create a safe and nonjudgmental space where clients can learn, grow, and achieve their goals. She makes sure to offer flexibility, meet the individuals where they are, and have patience to help each individual feel secure throughout the process. She always encourages open communication regarding the course of therapy and goal achievement.
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Dr.Marwa Abd El Hamid is a certified and trained psychologist with over 16 years of experience working in different countries in a variety of settings. She Specializes in Clinical and Educational Psychology. She has been associated with large hospitals, schools and corporate clients in UAE, Saudi Arabia, and Egypt in conducting sessions on various mental health issues including stress management, parenting and child development, and mindfulness for holistic wellbeing.
As a professional psychologist, she is continually inspired by people’s ability especially she believes deeply that the people themselves are the real experts in their own lives.
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Cognitive behavioral therapy, Dialectic behavior therapy, Rational Emotive Behavior Therapy, Solution Focused on compassion based therapy, Gestalt Therapy, Psychoanalysis, Existential therapy as well as Psychodrama and group therapy based on the needs of the client.
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Dr. Sravani Behara, is Specialist Psychiatrist, MBBS ; MD, MRCPsych (UK) and Medical Director at LifeWorks Holistic Counselling Centre. She is experienced in managing mental health conditions across all age groups in both OP, IP settings using various pharmacological and psychological approaches.
She has also worked as an Asst. Professor in a 650 bedded tertiary care teaching hospital (Nimra Institute of Medical Sciences, India) for more than three years and one year in a Government Medical College (Siddhartha Medical college, India). He has extensive experience in handling child guidance, geriatric, de-addiction, general adult clinics.
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– Finding it hard to cope with the death of a loved one.
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Dr. Bassem Hamed Mohamed Badr is an Egyptian Consultant Psychiatrist and Fellow of American Psychiatric Association, with 25 years of experience. He graduated from Alexandria University in 1993 with MBBch in Medicine, he then went to on to complete further education with a Diploma of Psychiatry and Addiction Practice, Master of Science in Neuropsychiatry, Diploma in Mental Health, Diploma in Hospital Administration and then ultimately received his Medical Doctorate in Psychiatry in 2008 at the University of Suez Canal in Egypt. He is also licensed as Aeromedical examiner: GCAA, General Civil Aviation Authority
Dr Bassem Badr provides comprehensive care for patients of all ages. He believes that the best outcomes are achieved through a combination of professional excellence and an empathic approach. As an expert in the field of general and adult psychiatry, he adopts an approach that is based on a combination of the psyche, the soma, and the spirit through both scientific and philosophical overviews.
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Not only has Dr. Bassem worked in Senior Roles in Hospitals in Dubai, Kuwait, and Egypt but he has also been a Lecturer and Professor at several Educational Institutes, a peer to peer speaker and a coordinator for various addiction treatment programs. He has contributed to scientific research in a number of medical journals. He is also a talented writer in the field of social and psychological problems and has had many publications in reputable newspapers and magazines.
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