Dr. Anita Sanz has been working in the field of eating disorders for over twenty years, providing treatment for anorexia, bulimia, binge eating disorder, and orthorexia. She uses a multi-faceted approach to help you develop a healthier relationship with food and your body.
We had the pleasure of interviewing Dr. Anita and getting some wonderful insights on issues that are not much talked about.
In this Q&A session, we talk about eating disorders, binge eating, self-esteem, professional help and much more.
What is the difference between binging and overeating?
Everyone overeats from time to time. In fact, there are national holidays that seem to be all about overeating!
But binge eating is different from overeating in some important ways.
Overeating is eating to the point of being overly full. Binge eaters do eat to the point of being overly full, but they also feel a distinct loss of control over their eating, they eat more food in a short period of time than is normal even when they are not hungry, they tend to eat alone and are embarrassed about what they are doing, and they hide food or receipts for food.
A person who is binge eating usually feels very ashamed of their overeating behavior and may become very depressed about it and feels a loss of self-esteem because of it.
Do I have an eating disorder or is it just a phase?
There is a difference between an eating disorder and disordered eating. Everyone will go through times where their eating is disordered, whether that is due to illness, grief, or stress. This means their eating will be more than or less than what it usually is.
What differentiates disordered eating from an eating disorder is the length of time and the severity of the disordered eating, as well as the reasons for the disordered eating.
Individuals with eating disorders are often struggling with poor self-esteem and distorted body image. They may turn to restricting food intake, purging, or over-exercising to attempt to manage this or other life stressors.
If thoughts or behaviors related to food, body image, or exercise are impacting one’s ability to do well at school or at work or to socialize normally, if eating or restricting food is being used as a way to cope with stress, or if disordered eating is causing severe anxiety or depression, it is more likely that an eating disorder may be developing.
What causes an eating disorder?
There are multiple factors that may affect the development of an eating disorder. These include biological factors such as genetic predisposition and temperament, personality factors such as perfectionism, psychological factors such as gender (more likely in females) or sexual abuse/assault history, family factors such as being raised in a family which values physical appearance or having a parent with an eating disorder history, and social and cultural factors such as belonging to groups which value thinness or place an emphasis on physical appearance.
As you can see, there are so many possible influences upon the development of an eating disorder that it is difficult to tease out what may be the strongest for any individual. For now, it is likely that a combination of many factors is the “cause.”
Are eating disorders like binge eating genetic? How is that possible?
There is some evidence that genetic factors may contribute to the predisposition toward developing an eating disorder.
Individuals with a family member with an eating disorder, for example, are 7-12 times more likely to develop an eating disorder themselves.
Some genes that have been identified with the development of eating disorders are related to personality traits, such as perfectionism, obsessive thinking, emotional sensitivity, rigidity, and impulsivity.
In addition, certain chemicals in the brain responsible for controlling appetite, hunger, satiety, and digestion may not function correctly in individuals with eating disorders and they may be heritable.
How do I know I need professional help?
There are two questions you can ask yourself to see if you need professional help for a possible eating disorder.
First, is your relationship with food, your body image, or exercise affecting your quality of life or your health? (Is it interrupting your ability to live a normal life like other people you know? Do you feel like it is becoming the most important thing in your life? Are you getting tired of having to live always worrying about how you look, what you can eat, or what you can/can’t do?)
Second, is your relationship with food, your body image, or exercise affecting those who care about you? (Have your friends or family members expressed concern about your weight or your behavior?
If so, this is something very important to listen to and respond to. Your eating disorder will want you to ignore them, but these are the people who care about you the most. If they are concerned, there’s a reason.
Is there a specific age for eating disorders to occur?
According to the National Institute of Mental Health the median age of onset for anorexia nervosa and bulimia is 18 and for binge eating disorder, it is 21.
This means that it is most common for eating disorders to develop anytime during adolescence through early adulthood, although eating disorders can also develop in childhood and in late adulthood, as well.
What do I do if I think I have an eating disorder? I’m afraid to tell my family.
If you are not able to tell your family directly about your eating disorder, you should find a trusted adult that you can confide in, preferably someone with some expertise in handling difficult issues such as a school counselor, spiritual advisor, or your family doctor.
They will be able to talk with you about how to access help as well as how to talk with your family. They may be willing to talk with your family first, or with you, to help ease this discussion.
Can eating disorders be fatal?
Unfortunately, the answer is yes.
Although numbers vary between studies, one new study compared records of individuals being treated at eating disorder clinics with the National Death Index and estimated crude mortality rates of 4% for anorexia 3.9% for bulimia and 5.2% for eating disorder not otherwise specified.
The reasons for death are usually due to cardiovascular complications or suicide.
Is it my fault that I developed an eating disorder?
No! Trying to ascribe fault or blame is not helpful and should be avoided.
Because there are so many factors related to the development of eating disorders, sometimes we will never know what caused it to develop in an individual.
What matters the most is that you get the treatment that you need and that you don’t delay in getting that treatment…and please don’t blame yourself!
Anita K. Sanz, Ph.D. is a licensed psychologist currently in private practice in DeLand, Florida, specializing in the treatment of depression, women’s issues, and eating disorders. She has been helping people for over twenty-five years to make positive changes in all areas of their life. She writes poetry and answers questions about psychology and psychotherapy on Quora, where she was named a Top Writer.
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