Thread: Eating disorders therapy?

I have successfully and unsuccessfully lost weight over the years but I feel I definitely have some form of eating disorder, I occasionally have small binges and sometimes purge too, but its more than that.
I can trace my whole life of eating, from being a baby that wouldnt eat at all, (with a distraught mother forcing me to eat) to a fat 10 year old on a diet already building huge issues with food and it just continued from there.
I feel my eating can best be described as OCD which is a term commonly used by people (often who dont realise its true meaning) it simply stands for obsessive-compulsive disorder; an obsession -recurring thought that cant escape my mind (food) compulsion -behaviour or action that relieves the obsession (eating) disorder -the thoughts and actions being out of the ordinary, I believe they are, waking up every day worrying and thinking about what I will eat, it must be tasty and satisfying but will it make me fat, will it be too healthy and I have to eat something else?


Anyway I waffled on a bit there, but basically has anyone been to therapy or a clinic or something for eating disorders? Do you think its worth trying?
I did Lighterlife and I need something more personalised than that as they had so many assumptions like "your parents told you to clear your plate" and I often had different things to say and ask that my counsellor couldnt answer.

A copy of my post I put on the other board, may be of interest, Em x

Eating disorders and eating disorder therapy:

I am sure that on the minimins site there are many people with diagnosed and undiagnosed eating disorders and I think its so important to discuss this issue and the need for professional eating disorder therapy.

I know from personal experience that eating disorder therapy is extremely useful, now when I say that I don't mean some diet counsellor who works with something like LL or such I mean a properly trained therapist who specializes in eating disorders be that anorexia, bulimia, binge eating , compulsive eating etc. It is important to see a "proper" therapist not some Joe Bloggs who has done a short course in it as eating disorders are serious and have often taken over a persons life for years, the wrong help can be at best not useful and worst bordering on dangerous.

VLCDs should not be used if you have a diagnosed eating disorder :-

If you have been diagnosed with an eating disorder you would not be advised ever to do any VLCD as it makes things ten times worse, VLCDs can of course work for many people I know but for someone with an actual eating disorder and the obsessive thoughts around food and weight etc that go with that eating disorder, a VLCD just leads to those thoughts increasing and getting worse in the long run, even those people who are used to eating lots of food can go the other way to getting obsessed with the feeling of having very little inside them, I did that prior to getting proper help!.

My story :

I have been diagnosed with a binge eating disorder myself which began as a young child, I have almost no memories of my childhood that aren't food connected, for me it was a source of comfort, a friend I could rely on but eating disorders have a way of getting out of control and years on when I ended up being sexually abused by a man I knew over a two year period my binge eating got way out of hand and has resulted in me weighing a massive amount and feeling horrid about myself. My days were basically complete starvation for most of the day and then a massive binge in the evening.

An eating disorder is not about food!

Far too often people think eating disorders are about food, food is not really the issue, we all concentrate with eating disorders on eating too much or too little but again I say its nothing to do with food, its purely a way of dealing with unwanted emotions, its a way of self soothing, you could use food or lack of it, alcohol, drugs anything really its all about avoidance of emotions and being able to avoid those emotions / feelings by doing what is termed maladaptive behaviours now for me thats binge eating and severe OCD for others it could be binge eating and making themselves sick or drugs and alcohol etc etc. The key to recovering from an eating disorder is first getting the right help, secondly the realisation that its your emotions that you need to face and thirdly that you need to learn new ways of coping with those emotions rather than relying on avoidance behaviours.

Therapy :

I am going through intense eating disorder therapy at the moment and its so hard, it drains me emotionally but you know what for the first time in years I am not having to binge as I am facing those difficult emotions and learning other ways of handling them, its not easy and its a very long process but it is so rewarding and anyone with a true eating disorder needs this help.

Think about looking into DBT (dialectical behaviour therapy) on eating disorder grounds?, its not an easy form of therapy to get or complete but its often used to deal with things like eating disorders and well worth looking into. I know you would need a full diagnosis and full assessment to get such a service, I had to have both but if you then get it on the NHS or through an eating disorder charity organisation etc it will be your saving grace.

Also DBT is a very practical therapy which often is better for those with eating disorders than purely talking therapy , talking therapy alone can help but is often not enough if you have a serious eating disorder you need to learn new skills as well and that is where DBT really comes into its own.

I am sorry to have written so much its just something I have quite a lot of insight into and experience of and thought it might help to point people in the right direction. I am having help from an eating disorder charity who run DBT individual therapy and group sessions and its helping me so much.

Em x

thanks for a great reply, how do you go about getting the therapy? perhaps its worth speaking to people so I can find out if there is a serious problem or not?

Hi there, its def worth talking with someone about it, I guess your first point of call could be a gp, of course I know not everyone has a good gp but if you do have you could ask about possible eating disorder services in your area, if there are any then they always do their own thorough assessment and they will of course specialize in eating disorders. The problem sometimes can be getting past the gp stage as sadly many gps have limited knowledge re eating disorders and tend to think of them in terms of either bulimia and anorexia and sadly if you battle with your weight and binge not every gp has a great understanding of the link with emotions and use of food or food restriction and you can end up with a lecture on healthy eating and exercise which for someone with an eating disorder just isn't good enough! I have a fab gp now who is so supportive but I have had my fair share of bad ones!

Also it would be worth looking up on say google or something eating disorder services both on a national and local level if you can't find the local ones I am sure some of the national eating disorder services could hopefully point you in the right direction.

I am not sure of course if you have a psychiatrist, I know thats a very personal thing, but I was seeing one for my mental health issues and my eating disorder and he was the one who told me about the eating disorder service in my area and made a referral on my behalf but in most cases you can self refer as well and they take that just as seriously.

I really think from what you have said on here that you def have issues around eating / body etc and whilst I am not qualified to diagnose I would say it would truly be of benefit to you to look into this further.

I am losing weight now and so having an eating disorder doesn't mean you can't ever lose weight or that it is putting it off, its purely about getting the support you need to deal with your personal situation and make it easier for you in the long run to change your lifestyle and tackle your issues around food / body etc.

I am sorry if that hasn't answered your question, I really hope you get the help you require as I know it can be so awful battling with an eating disorder especially without the right help. Emma xx

Thanks again, you have answered my question! I'll look into it definitely, I dont want to carry on struggling by myself and will take any help I can find!
Good point about the GP, ive not seen mine for ages but I can imagine he might not give me the answer I want. when I felt depressed I spoke to him and he just told me to eat turkey and didnt want to make a big deal out of anything but I do think my eating is a big deal and now ive lost some weight its almost more painful that I cant lose any more weight because I know ive done it before.

I know what you mean re gps, I was told once to just eat lettuce, I thought what ??? ha ha sadly some gps just haven't a clue. I know for me having an eating disorder means the way I think re food / weight etc is not "normal" , for example even being on a diet plays with my mind which is why I am having to look at my plan as a lifestyle change as if I call it a diet as such I immediately react in either feeling like I need to restrict everything to the point of basic starvation or I need food so much more that I eat more than should be possible. I am finding the key is the support from my eating disorder therapist, obviously you have to put alot of work in yourself but just having that person who understands how your brain works due to your eating disorder really helps. I am the kind of person who wants to lose weight more than anything but if I see a big weight loss sometimes can go straight out and buy loads of food to eat for comfort as I'm scared of losing weight as well. I know people without eating disorders who think its as simple as eat less and exercise more but sadly that doesn't allow room for the ways you think when you have an ed, I went down to a much lower weight years back by starving myself, I got used to feeling empty and became addicted to that then I went big as I am now and did that because I couldn't give up the binge eating to comfort myself, it seems rational at the time but I now know it isn't but it doesn't mean that my ed still doesn't mess with my head, it still does, it feels like a daily battle but that said getting the right support can be essential and I really hope you get that asap. Em xx

Im going to be lazy and c&p something I wrote on another thread but I feel it is relevant. Laura X

Have you gone to your GP about the compulsive eating? In my PCT there is a group called Life Morph who are a 3rd party company employed by the nhs, I am on a 6 month waiting list to be seen but it sounds like the kind of thing you need. It is intensive one to one therapy addressing your personal issues with food. You work with trained psychologists and nutritionists to get to the root of your problems with food, use cbt to combat the problems and create an eating plan which works for you and aids loss. I think there are also personal trainers for exercise too. Basically it seems like the 360 approach you need, so worth looking into! I cant wait to start.

Originally Posted by 1978Emma

A copy of my post I put on the other board, may be of interest, Em x

Eating disorders and eating disorder therapy:

I am sure that on the minimins site there are many people with diagnosed and undiagnosed eating disorders and I think its so important to discuss this issue and the need for professional eating disorder therapy.

I know from personal experience that eating disorder therapy is extremely useful, now when I say that I don't mean some diet counsellor who works with something like LL or such I mean a properly trained therapist who specializes in eating disorders be that anorexia, bulimia, binge eating , compulsive eating etc. It is important to see a "proper" therapist not some Joe Bloggs who has done a short course in it as eating disorders are serious and have often taken over a persons life for years, the wrong help can be at best not useful and worst bordering on dangerous.

VLCDs should not be used if you have a diagnosed eating disorder :-

If you have been diagnosed with an eating disorder you would not be advised ever to do any VLCD as it makes things ten times worse, VLCDs can of course work for many people I know but for someone with an actual eating disorder and the obsessive thoughts around food and weight etc that go with that eating disorder, a VLCD just leads to those thoughts increasing and getting worse in the long run, even those people who are used to eating lots of food can go the other way to getting obsessed with the feeling of having very little inside them, I did that prior to getting proper help!.

My story :

I have been diagnosed with a binge eating disorder myself which began as a young child, I have almost no memories of my childhood that aren't food connected, for me it was a source of comfort, a friend I could rely on but eating disorders have a way of getting out of control and years on when I ended up being sexually abused by a man I knew over a two year period my binge eating got way out of hand and has resulted in me weighing a massive amount and feeling horrid about myself. My days were basically complete starvation for most of the day and then a massive binge in the evening.

An eating disorder is not about food!

Far too often people think eating disorders are about food, food is not really the issue, we all concentrate with eating disorders on eating too much or too little but again I say its nothing to do with food, its purely a way of dealing with unwanted emotions, its a way of self soothing, you could use food or lack of it, alcohol, drugs anything really its all about avoidance of emotions and being able to avoid those emotions / feelings by doing what is termed maladaptive behaviours now for me thats binge eating and severe OCD for others it could be binge eating and making themselves sick or drugs and alcohol etc etc. The key to recovering from an eating disorder is first getting the right help, secondly the realisation that its your emotions that you need to face and thirdly that you need to learn new ways of coping with those emotions rather than relying on avoidance behaviours.

Therapy :

I am going through intense eating disorder therapy at the moment and its so hard, it drains me emotionally but you know what for the first time in years I am not having to binge as I am facing those difficult emotions and learning other ways of handling them, its not easy and its a very long process but it is so rewarding and anyone with a true eating disorder needs this help.

Think about looking into DBT (dialectical behaviour therapy) on eating disorder grounds?, its not an easy form of therapy to get or complete but its often used to deal with things like eating disorders and well worth looking into. I know you would need a full diagnosis and full assessment to get such a service, I had to have both but if you then get it on the NHS or through an eating disorder charity organisation etc it will be your saving grace.

Also DBT is a very practical therapy which often is better for those with eating disorders than purely talking therapy , talking therapy alone can help but is often not enough if you have a serious eating disorder you need to learn new skills as well and that is where DBT really comes into its own.

I am sorry to have written so much its just something I have quite a lot of insight into and experience of and thought it might help to point people in the right direction. I am having help from an eating disorder charity who run DBT individual therapy and group sessions and its helping me so much.

Em x

Hi Em,

Thanks for this! I used to have EDNOS and now have OCD (v severe) which I see a psychologist for, and issues with binge eating. Even though I know it is not appropriate I've been considering doing a VLCD or reducing my calories to 900ish per day but I know I shouldn't, thanks for reminding me!

Good luck everyone & hope therapy helps

xx

Hi Amelie24, I know how tempting doing a VLCD can be and they are even more tempting to people with eating disorders who work best in extremes and obsessive routines, I have done them myself before I got the help and whilst they work for some people for those with eating disorders it tends to make us even more obsessive than usual and this can be very dangerous. I mean I weighed in recently at 22 stone 5 lbs as for years I have been a massive binge eater, so ashamed by this but stuck in a cycle of starvation and then massive binges. I did a VLCD way back and because I have an ed which means I tend to work well in extremes, the feeling of hardly taking anything in to my body became an addiction in itself, I lost shed loads of weight but I was starting to go the other way ed wise , I am an all or nothing person, very typical of people with eating disorders. I now know thanks to specialist eating disorder help that the only way for me to work on the eating disorder is regular , healthy eating so no long gaps of starvation, drinking enough fluid and allowing myself treats because as soon as everything is off limits I want it so much more but if I say to myself no food in bad its about moderation then I can have a treat or leave it. The difficult thing is getting to the moderation part as like I said I am an all or nothing person, every day I battle the urge to starve or binge yet everyday at the moment I'm winning by waking up and eating healthy regular meals, its far from easy but its allowing me to not live in the cycle of starve / binge. I have to say that eating disorder support is key, without that I don't think I would have ever got to this stage and also I am now realising just how linked my binges were with avoidance, avoidance of my painful emotions really and so part of the therapy has been to address these emotions, basically sit with them however painful they are rather than trying to push them down with food.

I am sure you are already aware of this but there is a very strong link between eating disorders and OCD, almost everyone I know with an eating disorder also has OCD to some degree, mine like yours is severe which I know is a nightmare in itself. OCD is just another level of avoidance, it helps us to avoid dealing with what is really bothering us as we focus on the routines the problem is OCD grows and grows until in some cases it can take over your life and the reason it started can have long gone but you are left trapped in the cycle of these OCD obsessions and compulsions which can be devastating to your life.

I really wish you well as I know how difficult it can be battling an ed as well as severe OCD, Em xx

Originally Posted by 1978Emma

Hi Amelie24, I know how tempting doing a VLCD can be and they are even more tempting to people with eating disorders who work best in extremes and obsessive routines, I have done them myself before I got the help and whilst they work for some people for those with eating disorders it tends to make us even more obsessive than usual and this can be very dangerous. I mean I weighed in recently at 22 stone 5 lbs as for years I have been a massive binge eater, so ashamed by this but stuck in a cycle of starvation and then massive binges. I did a VLCD way back and because I have an ed which means I tend to work well in extremes, the feeling of hardly taking anything in to my body became an addiction in itself, I lost shed loads of weight but I was starting to go the other way ed wise , I am an all or nothing person, very typical of people with eating disorders. I now know thanks to specialist eating disorder help that the only way for me to work on the eating disorder is regular , healthy eating so no long gaps of starvation, drinking enough fluid and allowing myself treats because as soon as everything is off limits I want it so much more but if I say to myself no food in bad its about moderation then I can have a treat or leave it. The difficult thing is getting to the moderation part as like I said I am an all or nothing person, every day I battle the urge to starve or binge yet everyday at the moment I'm winning by waking up and eating healthy regular meals, its far from easy but its allowing me to not live in the cycle of starve / binge. I have to say that eating disorder support is key, without that I don't think I would have ever got to this stage and also I am now realising just how linked my binges were with avoidance, avoidance of my painful emotions really and so part of the therapy has been to address these emotions, basically sit with them however painful they are rather than trying to push them down with food.

I am sure you are already aware of this but there is a very strong link between eating disorders and OCD, almost everyone I know with an eating disorder also has OCD to some degree, mine like yours is severe which I know is a nightmare in itself. OCD is just another level of avoidance, it helps us to avoid dealing with what is really bothering us as we focus on the routines the problem is OCD grows and grows until in some cases it can take over your life and the reason it started can have long gone but you are left trapped in the cycle of these OCD obsessions and compulsions which can be devastating to your life.

I really wish you well as I know how difficult it can be battling an ed as well as severe OCD, Em xx

Thank you Em! it's good to know I'm not alone in this. Even on a reasonable eating regime (slimming world) I'm finding it very hard to resist binging and did binge last night.
I just feel empty a lot. You're right that VLCD goes with the black and white / all-or-nothing thinking side of OCD and it's helpful to hear your experience of VLCD with a disorder- I'm definitely going to stay away from them.

It's interesting that you say binging is avoidance, I wonder if that's the case for me- I do often go straight from feeling stressed/anxious to losing control and binge eating. I sometimes binge eat as a sort of self-harm and have OCD about how many items to eat.

I hope you're okay & get lots of help to get better. Your weight loss is very impressive so far!
xx

Amelie24, I know what you mean, I am not on a set diet plan but I guess it would be pretty similar to say ww as its basically healthy eating but even when I know physically I have had enough to eat I can still be starving and whilst I know this is down to emotional hunger sometimes knowing that isn't enough to stop me having a binge. The problem is though many of us binge as we feel so empty inside, I sometimes feel like there is this huge hole inside of me and it doesn't matter how much food I put into my body it always seems to be empty. I heard that with an eating disorder especially if its a binge one that a switch is like flicked in the brain when in binge mode so that you just never feel full during this period and you can eat more than you ever could when not in binge mode.

I didn't want to come over as anti VLCD just I'm against them if you are trying to use them whilst dealing with an eating disorder as sadly I think it works against our recovery, it increases our obsessive relationship with food. I mean its hard to imagine that someone who got as big as I did could get addicted to the feeling of starvation / hunger but I did and when I told my eating disorder therapist she wasn't shocked at all,she said all eating disorders are very similar in many ways and that I have the binge element but also the starvation element from other eating disorders, its just that our brains work in a different way as you said very black and white / all or nothing!

I have to admit that before therapy I just thought I binge ate as I was hungry or worse greedy, its only in therapy that we looked into issues in my past that had made my binges worse and then looked at how and when I felt the urge to binge and it was always as a response to some sort of emotion, this could be sadness, anger even feeling happy, but the binges always came about after a strong emotional feeling, the thing is when you are feeling immense sadness or anger in particular these feelings are uncomfortable to say the least and that is where the avoidance element comes in, so for me for example when I binge I get this cotton wool type feeling, all fuzzy inside, all dreamy and sleepy and its like an anaesthetic now thats a much better feeling than the sadness or anger so I keep doing the binge thing the problem is as time goes on all you are doing is delaying dealing with that emotion and the nice feelings after a binge last for shorter periods and the you get longer periods of disgust and hatred towards yourself because of what you have just done.

My therapist explained it to me that the only way to give up the binges which are due to avoidance of emotions is to deal with those uncomfortable emotions, so when you are sad, let yourself cry let yourself scream even, if you are angry let it out in a safe place, beat your pillow whatever you need to do to stay with that emotion and it passes eventually as the binge eating only works to put off the dealing with it, the emotion never truly goes away. I had a history of abuse which was one of the reasons why my eating disorder got so bad and I found and still do find dealing with that head on in therapy is helping me not to binge, its absolutely hard going and so distressing at times but something I think I needed to do.

The only issue is for me is my OCD and binge eating have always been my two main ways of coping so at the moment if one gets better the other remains the same at best or starts to get worse, I'm trying to resist the urges with the OCD as well but you will know all too well how hard that is to do. Em xx

I would just like to add something to this if that is ok. I have been under the eating disorder services myself, but sadly in my area they were a bit of a let-down. That life morph service sounds perfect for the kind of problems we face, why can't they have something like that everywhere?

For me, the eating disorder service was really, really awful. The assessment was carried out in the inpatient building, so while I was waiting to be seen (they were running late like most nhs clinics) there were patients going in and out past me who suffered from severe anorexia and made me look and feel like the back end of a bus. I am sure it was probably just as distressing for them, as I was probably the incarnation of their terror of being fat! A friend of mine suffered from anorexia and had to use the inpatient and outpatient services there, and I think her experience wasn't great either. But I don't think they were really set up to help people on the opposite end of the weight spectrum.

I am now having having therapy privately (there are several types of therapy though, so it would definitely be useful to get advice from your gp or eating disorder charity if you want to go to a therapist privately.) I know that a lot of therapists are willing to charge less if you don't have a very high income.


Its mind-boggling how many people there are struggling with their weight who possibly have some form of eating disorder or mental health problem. Surely the nhs must see that would be a good area to focus some resources? It makes me mad!

I can understand where you are coming from, I have had eating disorder help in the past and its been shocking to say the least, especially when in a hospital environment and I also had help on a one to one counselling basis but really my issues were beyond her sadly. In the case of the hospital one the guy was just plain nasty to me, I said I had tried everything to lose weight and he looked me up and down like a piece of crap and said "well its obviously worked" in a sarcastic way, what an idiot hey! The one to one eating disorder therapist I originally had was lovely but my issues were just so severe that it went beyond what she could help me with.

I now have a lovely specialist who is doing DBT (dialectical behaviour therapy) with me which is extremely intense but is working wonders for me as not only does DBT in particular really help when it comes to eating disorders, its seen as far more helpful in the treatment of eating disorders than basic CBT for example, she has an amazing level of insight into eating disorders to boot. I am now getting this help not on the NHS or private but from an eating disorder charity and they are amazing and best of all the therapy is free due to my low income, I couldn't sing their praises enough. The therapy is much harder than anything I have done before but it really works if you put the effort in, the thing is the therapy is only as good as the therapist, if you end up with someone who isn't up to the job it will really effect your ability to recover from an eating disorder.

It can be difficult at first being around others with other eating disorders especially if its say anorexia or bulimia more when the people can be so much slimmer, at first this worried me greatly. I now have individual DBT therapy and group DBT therapy each week and the groups are made up of six people myself included, we all tend to binge eat to varying degrees, three inc me are very overweight due to the eating disorder and three are very slim due to the eating disorder, the weird thing is as time has gone on I am realising its got little to do with the size of someones body, I can totally relate to what say the really slim people are saying and vice versa, an eating disorder is an eating disorder and it means that you can be shocked by just how much you have in common with someone who ultimately looks completely different body wise to you.

Sadly many NHS run places tend to focus on anorexia and bulimia and not so much on binge eating and compulsive eating disorders yet the charity I now have therapy with does focus on all eating disorders which really helps and doesn't run down my experiences because I am obese, its seen as just as serious as it has its own health issues.

I think sadly as far as the NHS is concerned they tend to look at it as purely a weight issue on the whole and that really misses the point, like with weight loss surgery granted for some its the only option but for many it doesn't help the person to deal with why they got so big in the first place, there are often emotional issues that need to be addressed. I so wish more was done to help people with eating disorders on the NHS and those who have an ed which leads to incredible weight gain not just loss but the sad fact is many people go to their gps as a first port of call and they can all too often be far from sympathetic, I have a lovely female gp now but in the past I have seen some nasty pieces of work, people treat them as if they are an all knowing being, a God and sadly most of the time they have little insight into such issues, you really need specialist help for those issues.

Em xx