Eating Disorders and Body Image Concerns
Eating Disorders and Body Image Concerns
Eating disorders are characterised by ongoing concerns regarding eating or eating related behaviours, which can cause clinically significant concerns with physical health, psychological and social functioning (American Psychological Association, 2022). Body image issues can result from concerns regarding shape, shape checking and avoidance, feeling fat and having a disordered eating mindset (Fairburn, 2008).
Common eating disorders may include:
- Anorexia Nervosa (e.g., restriction of energy intake leading to significantly low body weight; intense fear of gaining weight)
- Bulimia Nervosa (e.g., episodes of eating a large amount of food; loss of control overeating; purging behaviour to compensate for overeating)
- Binge Eating Disorder (e.g., eating large amounts of food in a short period of time; loss of control with eating quantity)
- Other Specified Feeding and Eating Disorder (e.g., Atypical Anorexia, Night Eating Syndrome)
What you may be able to gain from psychological therapy:
- Understanding of your eating, weight and body image concerns
- Reduction in disordered eating behaviours and body image concerns
- Reduction in eating disorder cognitions (thoughts)
Cognitive Behaviour Therapy – Enhanced (CBT-E) (Fairburn, 2008):
Cognitive Behaviour Therapy – Enhanced (CBT-E) is an enhanced form of Cognitive Behaviour Therapy, which focuses on exploring the thoughts and behaviours that maintain disordered eating and body image concerns. It has been shown to be effective in treating adults and older adolescents for a range of eating disorder diagnoses (Atwood & Friedman, 2020).
CBT-E consists of 4 stages in therapy:
Stage 1: Starting Well – Understanding disordered eating and modifying and stabilising eating behaviours and weight
Stage 2: Taking Stock – Review of progress made in therapy so far and further therapy planning
Stage 3: Understanding the processes that maintain the eating concerns, such as concerns about shape and eating, dealing with daily moods and events, and addressing dietary restraint
Stage 4: Ending Well – Review of progress in therapy and future planning following treatment ending
Therapy will involve:
- Thorough intake assessment, including risk assessment
- Psychoeducation about eating, weight and body image
- Self-monitoring activities
- Development of regular eating behaviours
- Monitoring of weight
- Challenging eating disorder and body image cognitions (thoughts) and behaviours
- Collaboration with your clinicians involved in your care (e.g., General Practitioner, Psychiatrist, Dietician)
- Collaboration with others involved in your care (e.g., carers, family or friends)
How to access help:
- Consult your General Practitioner (GP) to discuss your eating and body image concerns
- Consider a referral to a Psychologist with experience in eating and body image concerns
- You may be eligible for a Mental Health Care Plan (MHCP) or an Eating Disorder Plan (EDP) for Medicare rebated psychological therapy sessions
Article written by Jocelyn Clarke, Psychologist
Support Services
Eating Disorders Victoria
https://eatingdisorders.org.au/
Recommended Resources
Centre for Clinical Interventions – Eating Disorder handouts
https://www.cci.health.wa.gov.au/Resources/For-Clinicians/Eating-Disorders
American Psychiatric Association (2022). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision. American Psychiatric Association, Washington, DC: USA.
Atwood, M. E. & Friedman, A. (2022). A systematic review of enhanced cognitive behavioral therapy (CBT-E) for eating disorders, International Journal of Eating Disorders, 53, 311-330, https://doi.org/10.1002/eat.23206
Fairburn, C. G. (2008). Cognitive Behaviour Therapy and Eating Disorders. The Guilford Press, New York: USA.