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With very few exceptions, we do not treat anorexia at the clinic. We strongly encourage sufferers to contact the Douglas Hospital Eating Disorders Program at (514) 761-6131 ext. 2895.

According to a 2004 Canadian Community Health Survey (CCHS), 23% of Canadians are obese and another 36% are overweight. Even amongst those who are able to maintain a healthy weight, many are concerned with their weight or eating, and some suffer from bulimia nervosa. In fact, although their weight fluctuates over time, most bulimics are within the normal range for weight.

Symptoms of Bulimia Nervosa

Recurrent episodes of binge eating, defined as eating within a discrete period of time (e.g., 2 hours) an amount of food definitely larger than most people would eat within that same period, with a sense of lack of control.

Recurrent inappropriate compensatory behavior to regulate weight (vomiting, use of laxatives or diuretics or enemas or other mediation, fasting or excessive exercise).

The binge eating and compensatory behavior(s) occur on average at least twice a week for at least three months.

Self-evaluation is unduly influenced by weight.

There are 2 types:

Purging: The person engages in self-induced vomiting or uses laxatives, diuretics or enemas.

Non-Purging: The person does not purge, but instead exercises excessively or fasts.

Symptoms of an Eating Disorder (Other)

One can have an eating disorder without meeting the criteria for Bulemia Nervosa. For instance, some people binge-eat but do not engage in compensatory behaviors, or feel that their eating is out of their control in some other way.

 

Statistics

1-3% of women and 0.1 to 0.3% of men suffer from bulimia.

Many more individuals who do not meet full criteria for bulimia suffer from an eating disorder not specified.

Treatment

Changing thoughts:

Poor body image/self-esteem and erroneous beliefs about eating most often play a role.

Examples include “I must be thin, otherwise I am worthless” or “I must have perfect control over my eating: never eat junk or one mouthful too much”.  Thoughts about eating are typically excessively rigid, and thinking errors (e.g., “all-or-none”) need to be modified.

In eating disorders, people tend to engage in “emotional eating”, using eating to manage their emotions. The learning of alternative healthy emotion management techniques is essential.

Changing behaviors:

As part of the treatment, the individual, with help from a mental health professional, needs to identify rewarding behaviors that the individual may engage in instead of overeating. For instance, exercising or meditating is a wonderful way to get in touch with one’s body, which is important since during binges one is “disconnected” from it.

The client also needs to learn effective behavioral strategies to cope with impulses (e.g., using relaxation strategies while waiting to have more) and to eat better generally (e.g., have healthy snacks, eat mindfully, drink water, allow for occasional treats, etc).

Selected Book References

Overcoming binge eating.
Dr. Christopher G. Fairburn (1995).
Guilford Press. ISBN-13 978-0-89862-179-2.

Eating disorders and obesity.

Dr. Christopher G. Fairburn (1995).
Guilford Press. ISBN-1  57230-688-2.


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