As specialists in eating disorders, our team here at Flourish Psychology often work with individuals that do not necessarily fit the mold of what an eating disorder looks like. Most of us are at least moderately familiar with conditions like anorexia and bulimia, which tend to be not only more widely reported, but also more likely to have symptoms that are associated with disordered eating, such as starvation, binging, and purging.
But not all forms of disordered eating fit into these labels. Some people – even more so now with the rise in social media influencers – have eating disorders that manifest in different ways, and one of those ways, which is frequently hard to spot, is in those that would otherwise be considered healthy eaters.
Healthy Eating that Goes Too Far
Not enough of us eat as healthy as we should. Most of us do not eat enough greens. Most of us have too much fat or processed foods. Many of us do not get enough protein, or have enough vitamins and minerals in our diet. It would absolutely be better for most of us if we were more conscientious eaters and aware of what we put into our bodies.
But, like most things, healthy eating can go too far. We should eat healthier. But healthy eating shouldn’t be an all consuming trait – or one where we feel intense distress when the foods that we deem healthy (that may or may not be healthy) are not available. We also benefit as human beings from a slightly more varied diet, from carbohydrates, and from types of food that aren’t always available in a “clean” way.
This type of healthy eating disorder has even been given a term, called “Orthorexia.” People with orthorexia often display patterns with food that mirror those with anorexia, but instead of caloric restriction, the focus is on healthy eating. Examples include:
An unhealthy obsession with food and what you eat.
Intense distress when you are expected to (or forced to) eat food that you do not feel is healthy.
Compulsive checking of the nutritional labels of different foods.
Strong interest in social media and blogs as it relates to healthy eating.
Some people with this type of condition do eat what most doctors would agree is a healthy diet. But the level of intense distress they experience as a result of their connection to food dramatically impacts their quality of life for the worse. In addition, while some people with “orthorexia” are still generally healthy, others may not be. That is because this same obsession with healthy eating can lead to:
Cutting out otherwise important food groups, like carbohydrates, because you deem them to be unhealthy, in ways that may hurt your body in the long term.
Accidental caloric restriction – for example, eating salads without enough fats or proteins and not receiving enough calories from other food groups.
Openness to propaganda and misinformation as it relates to food and health. For example, seeing an influencer claim that something is unhealthy because it is unnatural, even against the findings of science.
Somep people with this type of eating disorder do eat healthy enough, but not everyone will and even those that do eat healthy are often suffering from psychological and social consequences as a result of this healthy food obsession.
How is “Orthorexia” Treated?
Even something as generally good as healthy eating can go too far, and unfortunately many of those that struggle with this condition do not seek help, because it is very difficult to identify it as a problem. In addition, these behaviors appear to be more common now than they were in the past, and so there have not been many studies that address this as a specific condition.
Still, this type of disordered eating does respond very well to existing treatments, and therapy that provides support for conditions like anorexia, obsessive compulsive disorder, and more do seem effective at helping people with this type of challenge.
If you or someone you love may have “Orthorexia,” or have an unhealthy relationship with food in any capacity even if it does not fit what we traditionally consider an eating disorder, we encourage you to contact Flourish Psychology in NYC, today.
Eating disorders are unfortunately common. Caused by a number of factors – including a society that puts pressure on weight loss, trauma, and even genetics – it is common to develop an unhealthy relationship with both food and body weight.
However, one component of this relationship that is often misunderstood is the idea that it is based on some type of real, tangible problem. Sometimes, eating disorders occur because the person’s reality is different from the reality of others, in a way that makes it more complex to treat and to understand. That is especially true of anorexia.
How We View Our Bodies
Anorexia is often viewed solely as an “intense desire to be thin.” In some ways, that is true. Those that struggle with anorexia do have a desire to be thin, and a perception that being thin is an admirable goal. This extreme caloric restriction is one of the ways that they feel they can achieve that.
But what can be challenging for family members to understand is how a person can continue to try to aggressively lose weight after they are already thin. That is because, although they are watching their loved one get thinner and thinner to the point of visible malnutrition, the person with anorexia doesn’t see the same body they do.
When a person with anorexia looks in the mirror, the body they see staring back at them is larger than the one that we see with our eyes. Their body has a different reality than it does to us. That is why it is so challenging for those with anorexia to stop, or to believe that they have lost enough weight and can move towards management. No matter how thin they are, the scale and the mirror tells them that they’re bigger, and that causes extreme distress that leads to more caloric restriction.
Why Anorexia Therapists Are Necessary
Because those with anorexia and their families are living in different realities, it is often very difficult for the families to try to convince their loved one that their low body weight is a problem. They typically cannot see it, and do not know that their reality is distorted or different from yours.
Therapy for anorexia requires a multifaceted approach, combining psychotherapy such as cognitive behavioral therapy and dialectical behavior therapy with treatments, including those that involve the family or address related issues like anxiety and depression. Sometimes, different approaches may be needed depending on the “reality” of the person with anorexia, how it developed, how long they’ve struggled with, and more.
But anorexia can be treated. There are ways to help people see their body in a healthier way, and identify better coping habits and eating habits to improve their mental and physical health. For anorexia therapy in Brooklyn and NYC, call Flourish Psychology.
Flourish Psychology is a boutique private practice that specializes in eating disorders and eating disorder treatment. Dr. Sadi Fox and her team of therapists work with adults that struggle with anorexia, bulimia, binge eating, and other disordered eating challenges, offering a safe and open space to help rebuild a healthier relationship with food and body image.
One challenge that many people face in silence is known as “night eating syndrome.” It is classified as an “OSFED” – an “Other Specified Feeding and Eating Disorder,” and many of the people that struggle with it do not realize that it is a type of disordered eating, or that it may be affecting their life.
Night Eating Syndrome: Symptoms and Challenges
Night eating syndrome is exactly as it sounds – a condition where a person tends to eat either late at night or in the middle of the night. The quantity of food is not important – some people eat large quantities of food (known as “binge eating”) but most just eat normal or even smaller quantities of food.
This type of challenge often goes unnoticed, because most people do not realize that it is a problem. After all, the quantity of food is normal, and the person feels hungry, so it feels like a logical action – “I woke up because I am hungry, so I am going to eat a little and go back to sleep.”
But the problem is that night eating is associated with many problematic issues, and often causes life impairment in ways that or often ignored:
Obesity – Night eating often adds unnecessary calories at a time in the digestion cycle where calories process more slowly. 10% of all individuals struggling with being medically overweight are found to be night eaters.
Disrupted Sleep – Those with night eating syndrome wake up multiple days of the week in the middle of the night to eat. Some others may wake up multiple times throughout the night. This causes disrupted sleep and a poor quality of life.
Nighttime Anxiety/Depression – Those with night eating syndrome tend to have or develop depression and anxiety at night. Eating may or may not relieve some of those symptoms.
These represent only a few of the physical, social, and emotional challenges that night eating can cause. Because night eating isn’t generally seen as a problem, these issues can persist for months or years before someone seeks help.
How is Night Eating Treated?
Night eating can be treated in several ways. From a therapist’s standpoint, the best approach is typically – although not always – cognitive behavioral therapy. Often there are psychological patterns and thought processes that need to be addressed in order to help people take control of not only their night eating habits, but also any struggles they may have with anxiety, depression, and self-esteem.
Other treatment options may include DBT and relaxation exercises. Your therapist at Flourish Psychology will talk to you about the different treatment choices and what makes the most sense based on your struggles.
Disordered Eating and Your Health and Happiness
Night eating syndrome is one example of the many ways that disordered eating can affect your life. Sometimes, the effects are more subtle or not well associated with mental health, but the damage it can do to a person’s health, happiness, and sleep quality can be substantial.
Exercise is one of the healthiest activities we can do for our bodies. Yet, like most activities, it is possible to exercise *too* much. That is the case with those in New York City that struggle with “exercise bulimia,” a type of eating disorder where a person exercises excessively to burn away the calories they consumed after binge eating.
This type of eating disorder can be difficult to notice. That is why it helps to speak with a professional therapist that understands how to identify body image issues and eating disorders, as there is a fine line between a healthy passion for exercise and exercise bulimia.
What is Exercise Bulimia?
Hundreds of thousands of people – both children and adults – struggle or have struggled with eating disorders in Brooklyn and NYC alone. It is estimated that as many as 10% of all Americans will have an eating disorder and some point in their lives, and – while some people do learn to manage eating disorders on their own – many others need psychological intervention to take control of their habits.
But eating disorders do not always manifest in the same way.
Bulimia nervosa – which is the condition most people think about when they hear the term “bulimia” – is characterized by eating large doses of food (known as binge eating) and then forcing oneself to regurgitate that food (known as purging) to prevent themselves from consuming too many calories. Not everyone with bulimia nervosa will being eat, but they will consume food and then purge it through self-inflicted vomiting.
Exercise bulimia is similar, but rather than regurgitate the food, they “purge” the calories through extensive, intense exercise.
What makes exercise bulimia difficult to spot is that a commitment to exercise can be healthy. Athletes, for example, often spend hours working out to hone their skills. Distance runners will practice running for hours as well, looking to improve their strength and stamina.
Exercise bulimia takes this a step further. A person works out far beyond what their body needs, often with intense exercise designed solely to burn calories. There are typically very few fitness or athletic goals outside of losing weight or burning calories, nor is it an activity that is liberally scheduled when convenient. Instead:
Exercising interferes with other responsibilities in life.
Exercising shows signs of being an obsession/preoccupation, especially after eating.
Exercising co-occurs with body image issues.
Exercising continues to be a priority even with illness or injury.
Exercising takes precedence over all other forms of self-care.
People with exercise bulimia will often track and reference calories, since a calorie purge is their exercise goal. They may also show signs up withdrawal, stress, or anxiety when they miss a workout.
Exercise Bulimia in NYC – Why This Eating Disorder is Common
Here in Brooklyn, and the rest of New York City, we are also at significant risk of exercise bulimia (and other eating disorders) because we have a very celebrity and looks-oriented culture here. Surrounded by film, theatre, models, and fashion, many people develop eating disorders due to external pressures. Those that work within the industry may also find that they feel body image pressures.
Exercise bulimia is one of the ways that this may manifest. While other eating disorders tend to be more common, especially anorexia and bulimia nervosa, we consistently meet people that have struggled with exercise bulimia, and body image issues that have led them to try to extensively burn calories through exercise and other means.
If you or someone you love may be struggling with exercise bulimia in Brooklyn, or anywhere in New York, contact Flourish Psychology. We have therapists that specialize in eating disorders and body image issues, able to provide you with the support that you need to manage these challenges. Call today.
Holidays are celebrated as a time for gathering with loved ones, sharing meals and creating memories. But this time of year can be especially difficult for those dealing with an eating disorder or body image issues. Food is a central element of holiday celebrations and there’s often a lot of it on display. You may be expected to consume certain types of food or a large amount of food. Holidays may also force you to interact with relatives who have a negative impact on your mental health and body image, whether with their words, actions, or their very presence. Sometimes, the anxiety associated with going home for the holidays can even trigger a worsening of symptoms.
Large family gatherings present many challenges for those with an eating disorder. Maybe your relatives don’t know about it and you’re anxious about it being found out. Maybe you’re triggered by just the sight of a large display of food or constant conversations about food. Then there are the relatives who make comments about your body or your food.
Here are a few coping strategies to consider as you navigate the festive season.
Setting Boundaries with Relatives
Family gatherings can be especially stressful when our relatives cause us to feel uncomfortable. The holidays are often a time when friends and family provide unsolicited and unhelpful comments about your body or your eating habits. You may be forced to deal with remarks on weight loss or gain, and questions about the quantity or frequency of your meals. Sometimes, these comments are well-meaning and may be coming from someone who doesn’t understand how triggering they can be. Regardless of their intentions, the effect of these comments can still be detrimental.
Anticipate these comments ahead of time and come up with a game plan for responding to them. For example, you can decide that you will say “I’m not hungry. Please stop trying to force me to eat that” and physically distance yourself from anyone who causes you to feel uncomfortable. If your family is aware of your eating disorder, is it possible to have a conversation with them before the big gathering?
Here are some phrases that can help you to politely, but assertively set boundaries during these scenarios:
I won’t continue this conversation if you keep making those comments.
No, thank you.
I don’t want that.
I’m not comfortable discussing this topic.
You’re making me uncomfortable, so I’m going to leave.
Thanks for your concern, but I can take care of myself.
Let’s talk about something else.
I don’t like being called that name.
I didn’t find that funny. Please don’t say that again.
Rely on Your Support Systems
Who do you usually rely on for emotional support? Are you able to access them at this time? Sometimes during the holidays, we’re separated from our usual environments or social groups, as we head elsewhere to spend time with family. If a friend is your usual support system, but you’ll be apart for the holidays, be sure to let them know what’s happening. Inform them ahead of time of the difficulties you’re anticipating during this season, and that you’ll need their support. Texts, calls and video chat can all be incredibly useful tools for connecting with your support system. Knowing that they’re on standby can bring a feeling of comfort as you navigate this challenging time.
Don’t Neglect Self-Care
Holidays bring huge changes to our daily routines and environment. With all these changes, it can be difficult to stick to your own routine and self-care may fall to the wayside. But during emotionally challenging times, we need more self-care than ever. If you have been prescribed medication, be sure to continue taking them as directed. Keep up with your hygiene habits and, if you’re menstruating, ensure you have everything you need to make yourself comfortable (such as a heating pad or pain medication). During stressful times, it’s especially important that you get enough sleep, water and nutrition. If you have a special hobby that brings you peace, are you able to engage in this hobby during the holidays?
Financial self-care is important during the holidays, since this is often a season of spending. Check in with your finances to ensure you’re sticking to your budget, to avoid any undue stress come January.
Remember to Recharge
This can be an extremely overwhelming time. How will you recharge your body and mind? It can be as simple as taking a ten-minute walk to clear your head before heading back into the gathering. Maybe you have a playlist that puts you in a better mood or you enjoy watching videos of cute animals online. Have these things at the ready for when you need a moment to catch your breath. Writing in a journal is an effective way of reducing stress and recharging. Spend a few minutes to check in with yourself by writing about how you’re feeling. Meditation, breathing exercises, coloring and taking a short break from technology are all simple ways of finding peace during chaotic moments. Bring along a good book, magazine or video game for a quick escape.
Flourish Psychology offers treatment for anorexia, bulimia, binge eating and other disordered eating and body image issues. By working with a therapist, you can equip yourself with the tools and resources needed to handle your day-to-day challenges. You will notice increased levels of self-esteem and a decrease in feelings of fear and stress. We want to help improve your relationship with your body, food and exercise.
Self-care related to working out has drastically changed in quarantine. Thus, many at home workout programs are trending. We’ve all seen online workout programs that promise results in 7 days, weight loss, or a changed body. These fake promises can really scare us into paying money for “quick change” that society deems necessary. They also lead us to question whether or not their workouts work for us. So, before jumping into a workout, we first have to ask ourselves a few questions, such as “what is a perfect workout, and how can I achieve it?
The Perfect Workout Is One Where You Have Fun
Are you having fun when working out, or do you dread having to pull out your yoga mat, or weights to prepare for exercise? This is an important question to ask yourself before starting a workout. Workouts are supposed to be fun. You should always leave a workout feeling good. A workout should make you want to do it again. If you find yourself being anxious about working out, then it may not be the best workout for you. Workouts should be done willingly and freely, not out of fear or panic.
One way to combat boring, or lackluster workouts is to find a workout that aligns with one of your hobbies. If you like to dance try Zumba, hip hop workouts, or ballet-focused workouts. if you like to sing find workouts that are set to your favorite songs. If you are a big fan of celebrities try learning the choreography to one of their songs. if high-impact workouts are too draining, switch to low-impact or ” no jumping” workouts. This keeps things exciting, new, and fresh. They also make for a fun workout that you will want to do again.
MAKE SURE YOU FEEL CONFIDENT
A perfect workout helps you feel strong and confident. Workouts that help you love the body you’re in while working towards the body you want are the best for you. Workouts should focus on helping you feel great, and take the focus off of obsessing over weight or burning calories. Workout instructors that do not shame you or put you down when working out help you feel more confident. Workouts that nurture you and are patient with you in the learning process build up your confidence. This also allows you to feel powerful, and sure of your own abilities.
When tuning into a workout video, pay attention to how the instructor speaks to your or the audience. Is the voice nurturing, caring, motivating, and kind? is the voice demeaning, harsh, or unkind? If the voice of the instructor or the mood of your workout feels like the latter, then it is time to find another workout. Make sure to find a workout that helps you feel motivated, praised, and comfortable. Once you find a workout that does that, you find that it’s worth the search.
A PERFECT WORKOUT ALLOWS YOU TO DE-STRESS
Workouts that help you de-stress and relax are great. This is because they can serve as an outlet, and create a space that allows you to feel calm. Workouts that add to your stress only increase anxiety. and this is not ideal. This connects to the point of workouts being fun. A workout should not feel like an obligation, or a job. The combination of fun, feeling confident and strong, and less focus on weight and calorie burning leads to a workout that is void of stress. Workouts that are aimed at decreasing stress and tension include yoga, pilates, tai-chi, or cardio. Focus on finding workouts that take away some of your stress, avoid workouts that add to it.
Overall, the perfect workout is the one that feels good. They should be fun and allow you to feel strong and confident. They should not control you or make you feel like you need to change. If a workout feels negative, it’s not you that needs to change, it’s the workout! Seek workouts that you can customize to your level, needs, and body! For example, The Down Dog app has workouts that you can customize fully from the length of the workout to the area of the body you are working. An added plus is you can customize the instructor’s voice and music too!
Your workout is for you! So, the “perfect workout” is one that decreases stress and makes you feel positive about every part of you.
ARE YOU STRUGGLING WITH YOUR BODY IMAGE OR DISORDERED EATING?
If you are struggling with your body image, or if you are worried you may have an eating disorder, contact us to schedule a free consultation. Our psychologists specialize in body image and eating disorders and will help you regain a positive self-esteem while decreasing disordered eating issues.