Anorexia Bulimia EDNOS Binge-eating

Disorder

What every parent should know about:

Brief anorexia description.

Eating Disorders

Anorexia NervosaAnorexia Nervosa Bulimia NervosaBulimia Nervosa

Eating Disorder Not Eating Disorder Not Otherwise Specified Otherwise Specified

(EDNOS)(EDNOS)

Binge-Eating Binge-Eating DisorderDisorder

In this module, you will learn about the following types of eating disorders:

Click on a type of eating disorder for a brief description. After reviewing the descriptions, click the next arrow to continue.

Brief bulimia description.

Brief EDNOS description. Brief BED description.

Rebecca, age 12Rebecca, age 12

Rebecca, age 12

Let’s meet Rebecca, 12, daughter of John and Susan Williams. Rebecca’s parents describe her as a cheerful, social and intelligent child with a bright imagination. She has always been a straight-A student and just finished her 6th grade year at Lincoln Elementary. Rebecca loves to paint, ride horses and spend time with her friends. She has a younger sister, Emily, who is 7, and a baby brother, Nathan, who just turned a year.

During the last month of school, Rebecca intermittently complained of headaches and fatigue and twice requested to stay home from school. Rebecca has always been a good student and rarely missed classes, so Susan agreed to let her stay home. Susan wanted to make an appointment for Rebecca with her pediatrician, but Rebecca insisted that the symptoms were a result of the intense running program she had recently started in preparation for joining the cross-country team in middle school. Rebecca runs nearly every evening before dinnertime, but often doesn’t return home until after the rest of the family has finished eating.

Case Study

Rebecca, age 12

Yesterday, Susan received a note in the mail from one of Rebecca’s favorite teachers, Mrs. Warren. It read:

Dear Mr. and Mrs. Williams,

I have thoroughly enjoyed having Rebecca in my 6th grade science class this year. She is a bright, inquisitive child and is always willing to answer questions and help other students with their work. However, I have been particularly concerned about her lately since she was much quieter in class and did not seem to interact as much with her friends and classmates during the last several weeks of school. I know she missed a few days of classes due to illness, so I hope she is feeling much better by now!

I hope you all have a wonderful summer!

Kind regards,

Mrs. Warren

Rebecca, age 12Later that evening, Susan was emptying the trash and noticed the plate of food she had made for Rebecca to eat after her run had been scraped into the trash can. She asked Rebecca why she hadn’t eaten and she just shrugged and said she had eaten a snack before her run and hadn’t been hungry for dinner.

After the kids are in bed, Susan tells John she needs to talk to him about Rebecca.

Susan: I’ve been really concerned about Rebecca. She hasn’t seemed to be herself these days, even her teacher

was concerned enough to send us a note. She’s also fighting more with Emily and she turned down an invitation

to go camping with Kate’s family this weekend.

John: I’m worried, too; she has seemed pale and tired lately. I talked to her about reducing the intensity of her

running program, but she insisted that it is something she has to do to be ready for the team next year. Do you

remember last week when it started pouring rain and asked us if she could run anyway? Like we would let her

run outside during a thunderstorm!

Susan: I remember – I found her doing sit-ups in her room later that night. I think she’s exercising way too

much. And tonight she didn’t eat any dinner. Come to think of it, lately she’s been trying to leave the house in

the mornings without breakfast.

John: Wait, what? She didn’t eat tonight? And she’s been skipping breakfast? A few days ago when we were

out running errands and I offered to stop at the Sweet Shop for ice cream. She turned me down. That kid has

never once turned down ice cream!

Susan [tearfully]: I am so worried for her! I think Rebecca has developed an eating disorder. We should make

an appointment with Dr. Thompson first thing tomorrow.

John [comforting tone]: It’s going to be okay, Honey. Let’s talk to Rebecca. Then we’ll make the appointment

with her doctor and get treatment for her right away if that’s what she needs.

We’ll work through this…

Rebecca, age 12 Convert to audio with still photos of Rebecca’s parents

Rebecca, age 12

Recognize the problem.

John and Susan have taken an important first step in helping their daughter – after observing Rebecca’s behavior and discussing it together, they have come to the realization that she may be suffering from an eating disorder.

What should I be looking for?

General symptoms of eating disorders include:

•Dramatic reduction of food intake or excessive overeating•Preoccupation with weight or body shape•Sudden weight loss or gain (may be dramatic)•Evidence of purging behaviors (vomiting, fasting, laxative or diuretic use, over-exercising)

Nonspecific symptoms may include: irritability, mood swings, isolation from friends or family, fatigue, difficulty concentrating, depression, anxiety or sleep disturbances.

Rebecca, age 12John and Susan agree to talk to Rebecca together first thing in the morning. The next morning, Rebecca is surprised when her Dad hasn’t left for work as usual.

Susan: Rebecca, your father and I would like to talk to you about something, okay?.

Rebecca: [hesitating] All right….what’s up?

John: Well, we’re worried about you, Sweetie. We’ve noticed you’ve been skipping meals and we feel like you’ve been exercising way too much. You’ve seemed tired lately, too.

Rebecca: But I’m fine! I’ve just been trying to get ready to run cross-country next year. That’s all!

Susan: Becca, we think it’s more than that – we think you have an eating disorder. We’re concerned enough that we’ve made an appointment for you today with Dr. Thompson. We’re getting a babysitter for Emily and Nathan. Dad and I will take you in an hour. We love you so much and we want what’s best for you.

Rebecca: Wait, what? I’m really fine! I don’t want to go to the doctor! I won’t go! [starting to cry]

John: [puts his arm around Rebecca] We are taking you, Rebecca. We can’t ignore this. We would do anything in the world for you and this is what we need to do for you now.

Susan: Go get ready, Honey. Things are going to be okay.

Rebecca, age 12

Address the issue.John and Susan were firm, but gentle in confronting Rebecca about their observations. They expressed love and concern for her, but did not waver in their resolve to get help for Rebecca even though she insisted everything was fine.

I love my daughter, but right now I’m so frustrated and angry with her. What then?

If you feel angry or upset, take whatever measures you need to take to calm down before you talk to your daughter about your concerns. Talk to your spouse or a friend. Try writing down how you feel. Do something relaxing. Take some deep breaths. Your daughter needs to feel of your love and concern for her. Expressing anger will likely make her feel more anxious and confused.

What if my daughter denies there’s a problem?

Restate your observations and tell her again why you’re concerned. Give her time to respond to your concerns and listen attentively. Avoid jumping to conclusions, but also keep that most peoplewith eating disorders try very hard to keep their behavior hidden and may not always be completely honest about their behavior.

Rebecca, age 12John and Susan take Rebecca to the doctor. Rebecca has lost 15 pounds since her last doctor’s visit 2 months ago. After talking more to Rebecca, Dr. Thompson performs a physical exam and administers the Eating Disorder Inventory. Rebecca is now underweight with low blood pressure (84/48 mmHg) and slow heart rate (42 bpm). Her temperature is 97.0⁰F. With symptoms of pallor and fatigue, Dr. Thompson suspects Rebecca has also developed anemia; a quick blood test in the office confirms mild anemia with a hemoglobin level of 10.2 mg/dL. After evaluating all of the available information, Dr. Thompson determines Rebecca meets the diagnostic criteria for anorexia nervosa.

Dr. Thompson is concerned enough the changes in Rebecca’s vital signs that he recommends inpatient hospitalization for medical monitoring and stabilization, followed by intensive outpatient treatment (IOP) for 15 hours/week for at least 8 weeks. After completion of IOP, continued outpatient therapy is recommended.

Insert slide here on anorexia symptomsWill include diagnostic criteria.

Rebecca, age 12

Seek treatment.

John and Susan are shocked to learn of the changes in Rebecca’s physical health. She had been dressing in baggy clothes that disguised her weight loss. They are frightened and confused as they drive Rebecca to a nearby Children’s Hospital for admission.

Rebecca currently requires the highest level of care, inpatient hospitalization, for medical stabilization. Many other options are available depending on your child’s specific circumstances. Treatment options include: [descriptions still needed]

•Inpatient Hospitalization

•Residential Treatment

•Day Treatment

•Intensive Outpatient Therapy

•Outpatient Therapy

Rebecca, age 12After a week of hospitalization, Rebecca’s physical symptoms improve enough to be discharged to the adolescent IOP program. John and Susan are still extremely concerned, but hopeful for Rebecca’s complete recovery.

What does treatment for anorexia consist of?[Discuss 3 main goals of anorexia treatment here]

Where can I learn more about treatment options in our area?

Your child’s physician can provide information and referrals to local treatment facilities or you can research treatment options online. Be sure to check with your insurance company to determine what services are available to you. Some insurance companies exclude certain types of treatment or may have specific requirements that need to be met before they will pay for your child’s treatment.

You might find these websites helpful for locating treatment:

www.something-fishy.org/treatmentfinder

www.edreferral.com

Rebecca, age 12

Support recovery.After 8 weeks, Rebecca has completed her intensive outpatient program and is ready to step down to outpatient therapy consisting of weekly counseling sessions and twice monthly visits with a dietician. Dr. Thompson will handle weekly vital sign and weight checks, as well as monthly lab work. John and Susan make sure Rebecca keeps all of her appointments. One night they have the following conversation:

Rebecca: Mom and Dad, I’m really sorry I’ve caused you to worry so much lately!

John: Rebecca, we love you so much and would do anything to help you be well and happy.

Susan: We’re just happy you’re doing better, Sweetie. We were really worried for awhile, but we can see you’re really trying. We’re proud of the progress you’ve made.

Rebecca: It’s still really hard, but I’ve learned how to deal with things better.

John: And we’re glad for that! We love you so much, Becca!

My daughter is really trying to recover, but sometimes she struggles and has setbacks. Two days last week she hardly ate anything at all. Should I try to force her to eat?

It’s best to be supportive and encouraging, without being controlling or overbearing. If you can see she’s struggling, ask her if she’d like to talk and then just listen. Ask her what she thinks she needs to continue in her recovery. Don’t bargain with her or impose punishments for setbacks. Let her know that you love her and care about her happiness and well-being. Of course, if she’s refusing to eat at all or continues to lose weight despite treatment, you need to intervene and seek a higher level of treatment for her.

My daughter is over 18 and won’t commit to any treatment at all. What can I do?

[Paragraph needed here.]

Rebecca, age 12

Recognize the problem.

Address the issue.

Seek treatment.

Let’s review the steps…

Support recovery.

Anna, age 19Imagine you have a 19 year-old daughter, Anna, who is a freshman at the University of Texas, 8 hours from where you live. Anna had been about 10 pounds overweight before leaving for college. When she returns home for Thanksgiving break, you notice she has lost some weight. On Thanksgiving, Anna seems distracted, but she is helpful in the kitchen and spends most of the day cooking with you. When it’s time for dinner, Anna announces she has plans with a friend. You protest, but Anna insists on leaving and returns home long after dinner is over. When you ask her if she’d like some leftovers or pie, she refuses. The next day, you overhear her on the phone complaining about her weight to a friend. Later you tell Anna you’d like to talk to her.

You: Anna, you’re looking really great. It looks like you’ve been getting quite a bit of exercise.

Anna: Yep, it’s been easier to be active at school. My classes are all spread out, so I walk quite a bit and I’ve really enjoyed playing intramural volleyball. Next semester I’m registered for a contemporary dance class, too.

You: That’s really great, but I’ve been a little worried about you. You didn’t eat Thanksgiving dinner with us and, now that I think about it, I haven’t seen you each much since you’ve been home.

Anna: Oh Mom, all that food is so bad for you!

You: Just make sure you’re eating, Anna. Good nutrition is so important and you don’t need to lose any more weight.

When Anna returns home at Christmas, she seems to have lost even more weight. You bring it up, but Anna quickly dismisses your comment and tells you she’s just been stressed with final exams. Anna spends a lot of time with her friends over the break and never seems to be home for meals. The few times she has been home for dinner, she eats with the family, but doesn’t touch any high-calorie foods. Otherwise, Anna is pleasant and seems to be enjoying her vacation, so you try not to worry too much.

In late March, you receive a call from the Student Health Center. They tell you Anna is now dangerously underweight and needs to withdraw from school to receive treatment for anorexia.

Give some thought to what you could’ve done differently to recognize the problem before it spiraled out of control.

Anna, age 19

Anna, age 19Were you able to identify any warning signs that may have warranted further attention?

You were right to take note of her weight loss and eating patterns. You even expressed your concerns and encouraged healthy behavior. However, it may have been helpful to have had a more in depth discussion with Anna during her Christmas break – by this point she was displaying some typical behaviors associated with the development of anorexia (weight loss, avoiding meals and high-calorie foods). Instead, since Anna seemed happy, you convinced yourself that things were fine. Eating disorders thrive in secrecy, so Anna may have been trying very hard to hide her behavior and she likely spent so much time away from home so that she could avoid eating. Once she returned to school, it would have been extremely difficult for you to detect additional symptoms.

If your daughter begins to exhibit any worrisome symptoms, even if they don’t seem extreme, it’s important to maintain a close relationship with her and to keep an open line of communication. Make sure your daughter understands the dangers of eating disorders and talk to her about any your concerns you have.

Sofia, age 16Sofia, age 16

Sofia, age 16Imagine you have a 16-year-old daughter named Sofia. Sofia is a talented ballerina with hopes of becoming a professional dancer. She is outgoing and has many friends who visit your home frequently after school. You keep your pantry well-stocked with snack foods for Sofia and her friends, but lately you have had to replace pantry items much more frequently than usual. Yesterday, as you are putting laundry away in Sofia’s room, you discover a large stash of candy bars hidden under a sweater in one of her drawers. Alarmed, you quickly consider several possible explanations.

Sofia has anorexia nervosa.

Sofia has bulimia nervosa.

Sofia has binge eating disorder.

Sofia has an eating disorder not otherwise specified (EDNOS).

Diminishing pantry stores are the result of increased number or frequency of Sofia’s visitors and the hidden candy bars are for some specific purpose unknown to you (e.g. gift, sleepover, etc.)

Which of the following explanations would you consider? Select all that apply and click submit.

Sofia, age 16Imagine you have a 16-year-old daughter named Sofia. Sofia is a talented ballerina with hopes of becoming a professional dancer. She is outgoing and has many friends who visit your home frequently after school. You keep your pantry well-stocked with snack foods for Sofia and her friends, but lately you have had to replace pantry items much more frequently than usual. Yesterday, as you are putting laundry away in Sofia’s room, you discover a stash of candy bars hidden under a sweater in one of her drawers. Alarmed, you quickly consider several possible explanations.

Feedback:

Not likely. Anorexia is generally associated with restricted caloric intake.

Strong possibility. Eating large amounts of food is a common feature of bulimia. Obtain additional information.

Possibly, but since Sofia is a dancer, use of compensatory mechanisms to reduce the effect of extra calories is more likely.

Possibly. Many people with eating disorders do not meet the specific criteria for anorexia or bulimia.

Possibly. Obtain additional information. However, consuming large amounts of food and hiding food should raise red flags.

Sofia, age 16After you have determined that Sofia may have some type of eating disorder, what actions would you take next? Give some consideration to how you would respond, then list your ideas here and click submit.

Sofia, age 16After you have determined that Sofia may have some type of eating disorder, what actions would you take next?

What ideas came to mind? Remember to respond in a calm and rational manner. Avoid jumping to conclusions. You might also consider the following:

•Enlist the support of your spouse or a friend to discuss your concerns about Sofia.

•Talk to Sofia when you are calm. Try to gather additional information in an non-accusatory manner.

•Continue to monitor Sofia’s behavior to identify any additional warning signs.

•Schedule an appointment with Sofia’s doctor for a check-up.

Answers listed here.

Sofia, age 16When you talk to Sofia about your observations, she comes up with explanations that don’t seem plausible. You decide to carefully monitor Sofia over the next several weeks.

Click the highlight tool below to highlight any additional warning signals. [Non-functional]

For the next few weeks, everything seems to return to normal. The pantry remains stocked and you find no additional evidence of hidden food. Sofia seems happy. School is going very well for her and she just secured a lead role in an upcoming ballet. You begin to relax until one evening Sofia tells you she’s really tired and excuses herself early from dinner. When you go to check on her a few minutes later, you find she is in the bathroom. You are about to knock on the door to ask her if she is okay when you hear the sound of running water followed by bursts of muffled coughing. When Sofia opens the door, she is surprised to see you.

Sofia: Oh, hi Mom. I was just getting ready for bed.

You: Really? It sounded like you were sick, are you okay?

Sofia: Yeah, I’m fine, I’m just really tired. I have a lot of reading to do for class tomorrow, so I was just going to crawl into bed and read for awhile.

You: Are you sure you’re okay?

Sofia: Yep! Goodnight, Mom.

Despite her assurances, you decide to check out the bathroom. When you open the cupboard, you find a scale you have never seen before. “Sofia bought her own scale?”, you wonder aloud. Your concern turns to alarm when you open a drawer and find a small bottle of ipecac syrup hidden in the back. You quickly recall that ipecac syrup is used to induce vomiting.

Sofia, age 16When you talk to Sofia about your observations, she comes up with explanations that don’t seem plausible. You decide to carefully monitor Sofia over the next several weeks.

Did you highlight the following?

For the next few weeks, everything seems to return to normal. The pantry remains stocked and you find no additional evidence of hidden food. Sofia seems happy. School is going very well for her and she just secured a lead role in an upcoming ballet. You begin to relax until one evening Sofia tells you she’s really tired and excuses herself early from dinner. When you go to check on her a few minutes later, you find she is in the bathroom. You are about to knock on the door to ask her if she is okay when you hear the sound of running water followed by bursts of muffled coughing. When Sofia opens the door, she is surprised to see you.

Sofia: Oh, hi Mom. I was just getting ready for bed.

You: Really? It sounded like you were sick, are you okay?

Sofia: Yeah, I’m fine, I’m just really tired. I have a lot of reading to do for class tomorrow, so I was just going to crawl into bed and read for awhile.

You: Are you sure you’re okay?

Sofia: Yep! Goodnight, Mom.

Despite her assurances, you decide to check out the bathroom. When you open the cupboard, you find a scale you have never seen before. “Sofia bought her own scale?”, you wonder aloud. Your concern turns to alarm when you open a drawer and find a small bottle of ipecac syrup hidden in the back. You quickly recall that ipecac syrup is used to induce vomiting.

Sofia, age 16

Recognize the problem.

You have recognized that Sofia definitely has a problem. Review the following information.

General symptoms of eating disorders include:

•Dramatic reduction of food intake or excessive overeating•Preoccupation with weight or body shape•Sudden weight loss or gain (may be dramatic)•Evidence of purging behaviors (vomiting, fasting, laxative or diuretic use, over-exercising)

Nonspecific symptoms may include: irritability, mood swings, isolation from friends or family, fatigue, difficulty concentrating, depression, anxiety or sleep disturbances.

Symptoms specific to bulimia may also include: chronic sore throat, hoarseness, deterioration of teeth, puffy cheeks due to swelling of the salivary glands, reflux, dehydration, and intestinal or kidney problems.

Sofia, age 16

Address the issue.

You have attempted to talk to Sofia about your concerns on more than one occasion. After discovering the scale and ipecac, you know Sofia has been dishonest and you are furious, but you are also extremely worried about her.

What should you do? Grab a family member or friend and role play your approach. Ask your friend to be creative in imagining different ways a 16-year-old might respond. Give consideration to the fact that Sofia might be angry, worried, confused or emotional.

Did you remember to take some time first to manage your anger? Did you remain calm during the conversation with Sofia? Were you supportive? Did you take the time to listen to her?

Seek treatment.

Sofia, age 16

www.something-fishy.org/treatmentfinder

www.edreferral.com

After you have talked at length with Sofia about what’s been happening, she tearfully agrees to treatment. Where do you start? Making an appointment for Sofia with her physician is a good first step.

To learn more about treatment options near you, visit these websites and experiment with the treatment finder features.

Now identify at least one additional websites that provides eating disorder education and treatment information.

Support recovery.

Sofia, age 16

At Sofia’s appointment with her doctor, her vital signs are stable and her lab work doesn’t show any critical values. Her doctor recommends outpatient treatment in a nearby eating disorder treatment center. During the initial stages of treatment, you notice Sofia struggling frequently with bingeing and purging.

What is the most appropriate response to her harmful behavior?

[Answer choices needed here]

Christina, age 22Christina, age 22

Christina, age 22Now imagine that you have a 22 year-old daughter, Christina, who just graduated from college. She returns to live at home following graduation while she looks for a job in public relations. When Christina was younger, she had been diagnosed with anorexia, but has been in recovery for the past five years. As the summer passes, Christina becomes increasingly frustrated at her inability to find a job – the economy is slow and there are few available opportunities. She becomes withdrawn and stops wanting to go out with her friends. You notice she isn’t eating much and doesn’t seem to be sleeping well. You are worried that Christina is suffering from depression.

When you ask Christina if she feels like she is depressed, she admits that she probably is and asks for help in finding some good treatment. Christina also tells you that she finds it extremely difficult to eat and is afraid she is also suffering from a relapse of her eating disorder.

Christina, age 22

Recognize the problem.

You have recognized that Christina may be suffering from depression and an eating disorder relapse and you have addressed the issue with her.

Other psychological conditions, such as depression and anxiety, frequently coexist with eating disorders. In many cases these are secondary to the eating disorder, but in other cases, the eating disorder may be secondary to an underlying psychological condition. Individuals with eating disorders may also suffer from personality disorders, obsessive-compulsive disorder or post-traumatic stress disorder. They may also abuse substances, engage in self-harm behaviors or deal with other addictions.

Address the issue.

Seek treatment.

Christina, age 22

How would you help Christina find treatment? Select all that apply.

This is a great choice if you live in the same area. Some treatment centers only treat adolescents, but if this is this case, they would still be able to recommend good treatment options for adults.

Since Christina recently graduated from college, it is likely she was using student health services and may not have a primary care physician. You may need to help her find a good physician.

Since Christina is an adult, let her deal with finding treatment.

Research treatment options online.

Ask Christina to make an appointment with her physician.

Check with the treatment center that treated Christina for anorexia as a teenager.

This is always a good option to help determine what types of treatment are available in your area. Try visiting www.something-fishy.org/treatmentfinder or www.edreferral.com

This is not the best choice. Offering to help Christina locate treatment is a great way to provide support and encouragement.

Seek treatment.

Christina, age 22

You help Christina schedule an appointment at the Bright Horizons Treatment Center, where she had previously received treatment. Their adult program is well-equipped to handle Christina’s eating disorder and depression. At her first appointment, Christina discusses the difficulty she has had with eating for the past several months and reveals that she sometimes doesn’t eat anything at all for 2 or 3 days at a time. She talks about her insomnia, social isolation and feelings of hopelessness. After a thorough assessment, Christina is diagnosed with Major Depressive Disorder and EDNOS, or Eating Disorder Not Otherwise Specified. She is slightly underweight, but not enough to meet the criteria for anorexia. She also does not the severe body image distortion she had when she was younger.

A EDNOS diagnosis is made when the individual suffers from disordered eating and associated symptoms, but does not meet all of the specific diagnostic criteria for either anorexia or bulimia.

Support recovery.

Christina, age 22

Christina’s struggle with anorexia in adolescence was extremely difficult and her recovery required great effort. She is anxious to follow her treatment plan now to avoid becoming as sick as she was when she was younger.

Suggestions for supporting Christina in her efforts to recover may include:

•Be observant and watch for signs of increasing difficulty, but avoid being overbearing.

•Be a good listener. Spend time together in ways that encourage communication.

•Offer to help with meal planning and buy groceries that fit into her plan.

•Express your love and concern for her frequently.

•Make sure she is keeping her appointments at the treatment center.

Tracy, age 24Tracy, age 24

Tracy, age 24Finally, let’s meet Tracy, a 24 year-old kindergarten teacher in her third year of teaching. She is recently engaged to Tom with plans to marry in November. They are very happy together, but Tracy is worried about shopping for wedding dresses because she has recently gained about 35 pounds. She is also nervous about an upcoming trip to visit her parents, Jim and Sharon, who haven’t seen her since she gained weight.

When she arrives at her parents house, they are surprised to see the change in her weight, but say nothing. Later that night, Jim and Sharon discuss Tracey’s sudden change in appearance and decide to look up causes of rapid weight gain on the internet. They find information on several medical conditions, such as hypothyroidism, but also find information on a condition called Binge-eating disorder (or BED). Sharon decides to take Tracy out to lunch the next day to gather more information.

At lunch the next day:

Sharon: So how have things been going, Trace?

Tracy: I am so stressed out, Mom! I’ve gained so much weight – I’ll never fit into a wedding dress!

Sharon: Why do you think you’ve gained weight?

Tracy: I’ve been to the doctor and they ruled out medical causes. They diagnosed me with Binge-eating Disorder, have you heard of it?

Recognize the problem.

Address the issue.

One final look at the steps…

Seek treatment.

Support recovery.

Tracy, age 24In this scenario, Tracy’s parents recognized the problem and addressed the issue. Now their challenge will be to encourage Tracy to seek treatment and then support her recovery from Binge-eating Disorder.

Binge-eating Disorder is a form of EDNOS, characterized by frequent episodes of binge eating where a large amount of food is consumed at one time. Those with BED may consume the food rapidly when they are alone and often feel ashamed or disgusted following a binge. Unlike bulimia, those with BED do not engage in any behaviors to compensate for the extra calories. Associated weight gain may lead to obesity. Binge-eating behaviors must occur at least twice a week for a period of 6 months or longer for a diagnosis of BED to be made.

Recommended treatment may include meeting with a nutritionist, attending 12-step Overeaters Anonymous meetings or Cognitive-Behavioral Therapy (CBT). Antidepressants are helpful for some people.

Insert interactive review slides here

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