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How CBT Can Help Address Cognitive Distortions in Eating Disorders

How CBT Can Help Address Cognitive Distortions in Eating Disorders

Cognitive Behavioral Therapy, or “CBT,” is largely considered the most effective and widely recognized therapy approach for addressing many mental health disorders. While it is not considered appropriate for all mental health challenges or all patients, it is considered an evidence-based, effective choice that is very useful for patients that are struggling with most psychological challenges.

It is one of the most common approaches for those with eating disorders, especially for addressing very specific components of eating disorders that many people experience. CBT is often utilized by therapists to address what are known as “cognitive distortions,” a common issue that affects many – if not most – of the people struggling with disordered eating.

What Are Cognitive Distortions?

Cognitive distortions are the term used to describe irrational or exaggerated thought patterns that affect many patients with anorexia, bulimia, and other forms of disordered eating. Examples of these may vary between patients, but include:

  • All-or-Nothing Thinking – Viewing situations in only two categories instead of on a continuum – for example, you are either 100% perfect or a total failure.
  • Catastrophizing – Anticipating the worst possible outcome in a situation, such as extreme weight gain from a single meal.
  • Emotional Reasoning – Believing something is true because it feels true, like feeling fat, therefore believing one is overweight.
  • Body Image Distortion – A significantly distorted perception of one’s body, leading to an unrealistic view of body size and shape.

Cognitive distortions both create and contribute to disordered eating, which is why part of treating eating disorders often requires addressing these distortions

Brief Introduction to CBT and How it is Related to Cognitive Distortions

We encourage you to read more about cognitive behavioral therapy on our CBT page, which goes into more depth on the topic and also discusses our CBT services. But the core features of CBT are that it is a therapy approach that addresses thoughts, feelings, and behaviors.

Through CBT, the goal will be to identify the distorted thoughts, challenge them, and ultimately change them. Together, we also learn more about these distortions and teach patients more about how eating disorders are developed and maintained by them. This is known as psychoeducation, because sometimes, the mind needs to know something in order to change it.

What CBT Techniques Are Used to Address Cognitive Distortions?

Perhaps unsurprisingly, cognitive distortions are not addressed in any one specific way. Instead, you and your therapist work together to determine what approach(es) make the most sense, even within CBT. We may decide to use strategies that include:

  • Cognitive Restructuring – Identifying and challenging distorted thoughts about food, weight, and body image, and replacing them with more balanced and realistic thoughts.
  • Exposure and Response Prevention (ERP) – Involves gradual exposure to feared foods or situations (like eating in public) and learning to refrain from typical disordered responses (like purging).
  • Behavioral Experiments – Patients test their beliefs in real-life situations to see if their predictions (like significant weight gain after eating certain foods) come true.
  • Mindfulness and Acceptance Strategies – Involves teaching patients to observe their thoughts and feelings related to food and body image without judgment, reducing the emotional impact.

We may also want to address body image distortions with CBT. We can use techniques like mirror exposure therapy to help patients confront and become desensitized to body image fears, or we may integrate exercises and activities that promote a more positive body image.

CBT as an Individual or Combination Treatment

At Flourish Psychology, we truly believe in CBT. But we also believe that it is not appropriate for everyone. Some people may benefit by including CBT with other treatments. Sometimes, we may need to explore other therapies that address underlying trauma. CBT is an effective tool for cognitive distortions, but it is not the only one.

Still, CBT has an excellent success rate, both on its own and as part of a broader treatment strategy. If you’d like to learn more about CBT, or you or a loved one is struggling with eating disorders and would like to seek help, contact Flourish Psychology, today.

How Often Do People Binge Eat When They Have Binge Eating Disorder?

How Often Do People Binge Eat When They Have Binge Eating Disorder?

Understanding the Frequency of Binge Eating Episodes

Talking about binge eating disorder can be difficult. It can also be confusing. Sometimes, a person that suspects they may have binge eating disorder may not fully understand the condition in a way that makes it harder to get help.

One of the most commonly asked questions about Binge Eating Disorder (BED) pertains to the frequency of binge eating episodes. While the answer can vary considerably from person to person, understanding the general patterns can offer valuable insights for both healthcare providers and those experiencing the disorder.

Criteria for Diagnosing Binge Eating Disorder

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) outlines specific criteria for diagnosing BED, one of which is the frequency of binge eating episodes. According to the DSM-5, a diagnosis of BED may be considered if binge eating episodes occur at least once a week for three months.

Now, a diagnosis is not always required to receive support for binge eating, but – on average – we can assume that a person with binge eating disorder will binge eat roughly once weekly.

Factors That Influence Frequency

While once weekly is used in diagnosis, the actual frequency is going to vary from person to person. Some of the factors that can affect frequency include:

  • Personal Triggers – Emotional or psychological triggers such as stress, anxiety, or depression can have a significant impact on the frequency of binge eating episodes.
  • Environment – Certain environments, such as home or work, can either exacerbate or mitigate tendencies to binge eat.
  • Availability of Food – The type and quantity of food that is easily accessible can also play a role in how often episodes occur.

The frequency of binge eating episodes can vary significantly among individuals. Some may experience episodes several times a week, while others might have episodes only once in a few weeks. This variability often depends on a range of psychological, social, and even physiological factors, including emotional well-being and stress levels.

Why Understanding Frequency Matters

Determining the frequency of binge eating episodes is crucial for several reasons:

  • Diagnosis – Sometimes, a person may try to convince themselves that they don’t have binge eating disorder because “other people have it worse.” Knowing the frequency helps a person receive help.
  • Treatment Plans – Knowing how often episodes occur can help healthcare providers tailor treatment plans more effectively.
  • Monitoring Progress – Tracking the frequency over time can be a useful metric in evaluating the effectiveness of interventions.
  • Quality of Life – Frequent binge eating episodes can have a severe impact on an individual’s quality of life, affecting both physical health and mental well-being.

If you find yourself or someone you know struggling with frequent binge eating episodes, it’s essential to consult a healthcare provider for a proper diagnosis and treatment plan. Treatments may include psychotherapy, medication, and lifestyle changes aimed at reducing the frequency of episodes and improving overall well-being.

The frequency of binge eating episodes in BED can vary considerably among individuals, influenced by a host of psychological and environmental factors. Understanding the frequency can be critical for diagnosis, treatment planning, and monitoring progress. If you’re dealing with BED, consult Flourish Psychology today for an accurate diagnosis and individualized treatment plan.

The Relationship Between Perfectionism and Anorexia

The Relationship Between Perfectionism and Anorexia

In the vast web of psychological concepts and factors that influence our behavior and mental well-being, perfectionism stands out as a trait that often draws significant attention. Its impact on our daily actions, thoughts, and self-worth is undeniable. People that struggle with perfectionism often find that it directly or indirectly controls everything they do.

One of the most concerning manifestations of perfectionism is its intricate connection with eating disorders, most notably anorexia nervosa. Delving into this relationship helps shed light on the complexities of both perfectionism and anorexia, offering valuable insights for those seeking to understand or manage these challenges.

What Is Perfectionism?

At its core, perfectionism isn’t just about striving for excellence or aiming high. It’s the persistent belief that one must be perfect, often coupled with a harsh self-critique when perceived standards aren’t met. It can manifest in various forms, like setting unrealistically high goals, fearing mistakes, or basing one’s self-worth on achievements. It’s a double-edged sword – while it can drive ambition, it can also cripple self-esteem.

How Does Perfectionism Relate To Anorexia?

Anorexia nervosa is a severe eating disorder characterized by restrictive eating and an intense fear of gaining weight. Individuals with anorexia often possess a distorted body image, viewing themselves as overweight even when they’re underweight. But where does perfectionism fit into this picture?

  1. Control and Standards – Perfectionism is deeply rooted in the need for control. Similarly, anorexia often emerges from the desire to control one’s body, shape, and weight. Both conditions revolve around setting and adhering to stringent standards, even if they pose health risks.
  2. Fear of Failure – An intense fear of failure is a hallmark of perfectionism. For those with anorexia, the “failure” can be perceived weight gain or not adhering to a strict dietary regimen.
  3. Self-worth and Validation – Many perfectionists base their self-worth on their achievements. In the context of anorexia, the achievement can be maintaining a certain weight or body shape, leading to validation and a distorted sense of accomplishment.
  4. Coping Mechanism – For some, perfectionism becomes a coping mechanism against feelings of inadequacy or insecurity. Anorexia, too, can emerge as a way to cope with emotional turmoil, with the act of restricting food serving as a form of self-control and order amidst chaos.

Perfectionism can also lead to other conditions, like anxiety, which can further the development of anorexia. Mental health is complex, and it can touch the way we feel in many ways.

The Spiraling Effect Of Perfectionism And Anorexia

While perfectionism can contribute to the onset of anorexia, the relationship often becomes cyclic. As one grapples with the eating disorder, the need to maintain control and achieve the “perfect” body can intensify, further deepening the perfectionist tendencies. This spiraling effect can make treatment and recovery more challenging.

Navigating The Complex Web

Understanding the relationship between perfectionism and anorexia is crucial for both prevention and treatment. Recognizing the signs and seeking early intervention can make a significant difference. Therapy, especially cognitive-behavioral therapy, can be effective in addressing both perfectionist tendencies and the underlying triggers of anorexia.

If you or someone you know is struggling with the intertwined challenges of perfectionism and anorexia, it’s vital to seek professional help. With the right guidance, it’s possible to navigate this complex web and find a path to healthier self-perception and well-being.

Should you wish to delve deeper into this topic or seek assistance, do not hesitate to reach out to Flourish Psychology.

Can “Healthy Eating” Be an Eating Disorder?

Can “Healthy Eating” Be an Eating Disorder?

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.

Anorexia and Body Image: How Our Brains Interpret Reality

Anorexia and Body Image: How Our Brains Interpret Reality

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.

What is Night Eating Syndrome?

What is Night Eating Syndrome?

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.

If you or a loved one struggles with eating disorders in NYC, please contact Flourish Psychology, today.

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