Women's eating disorder treatment

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Women are statistically the most affected demographic when it comes to eating disorders. It is estimated that over 20 million women in the United States will experience disordered eating in their lives, which can lead to serious physical, and physiological side effects if left untreated. (12)

With so many women currently struggling with disordered eating, it is essential to take a moment to better understand the causes, signs, symptoms and treatment options for women with eating disorders.

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Understanding women with eating disorders 

While most associate eating disorders with adolescent girls, eating disorders can present themselves in many forms and may begin at any age. Across 94 studies, approximately 8.4% of women were diagnosed with an eating disorder during their lifetime, with 2.2% diagnosed within the last 12 months. (6)

Many women with eating disorders may be ashamed of their symptoms and their bodies, and even more so of their "failure" to control their eating habits. Some women may not even realize that they have an eating disorder even when they develop more severe symptoms.

What makes things even more confusing is that eating disorder symptoms can receive positive reinforcement from others due to our societal focus on weight and the oftentimes reinforced aspect of weight loss by the medical field. Many incorrectly assume that thinness equals health, which is not always the case, and may further confuse a woman experiencing an eating disorder. 

Women with eating disorders may display varying degrees of disordered eating behaviors, such as restricting their eating, binge eating, and purging. Losing, gaining, or maintaining weight is usually the most noticeable symptom and can lead to other health problems, such as osteoporosis. In addition, changes in mood, concentration, energy, and aspects of social life are sometimes a part of the presentation of an eating disorder.

Some women with eating disorders can remain relatively “high functioning,” and may still experience success in work, academia, or socially, despite significant symptoms, suffering, and grave medical risks. 

Examining stats and trends in women with eating disorders

When examining the trends among women with eating disorders, it is crucial to consider the societal pressures on women's bodies and the role body image plays in the development of eating disorders. For instance, a study from Dove found that only four percent of women globally would consider themselves "beautiful," with approximately 85% of women admitting that they have opted out of important events in their lives when they didn’t feel like they looked “good”. (3)

In many cases, these body image issues directly result from what information is given to women by media outlets and their own surroundings. With nearly 0.5% of women experiencing anorexia nervosa and 2-3% of women having bulimia nervosa over their lifetime, it’s clear weight stigma poses a significant threat to women's psychological and physical health. (2,4)

Studies have even shown that weight stigma alone was a significant risk factor for low self-esteem, body dissatisfaction, and a myriad of other co-occurring disorders. (2,4) Recent trends indicate that eating disorders among women are on the rise with the pressures of the pandemic. 

The most common eating disorders for women

While women can suffer from any of the eating disorders listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM–5), adult women tend to struggle the most with anorexia nervosa, including atypical anorexia, and bulimia nervosa, including atypical bulimia nervosa. 

Anorexia nervosa in women

Anorexia nervosa (AN) is a psychological condition that can dramatically impact a woman's life. At any given point in time, between 0.3-0.4% of young women will suffer from AN. (8) It is characterized by a challenging relationship between food and body image. (7)

Anorexia Nervosa is an eating disorder that can start at any age, although it's more common in teenage and early adult years. AN can also be a long-term disorder, meaning the patient can live with it for years if they do not receive treatment, leading to long-term consequences. (9) The main signs and symptoms of anorexia nervosa include: 

  • A distorted body image
  • Focus on weight and shape as a core foundation of self esteem 
  • Loss of muscle and bone mass 
  • Amenorrhea (the absence of menstrual periods)
  • Depression/anxiety

Anorexia nervosa can also present as atypical anorexia nervosa, which is a separate diagnosis in the DSM-5. Women with atypical anorexia nervosa will have most of the symptoms that occur in typical anorexia, with the exception of the low body weight. It is important to remember that women can struggle with anorexia regardless of their body’s shape or size. 

Bulimia nervosa in women 

Bulimia nervosa (BN) is a psychological disorder characterized by recurring episodes of binge-eating, followed by self-induced purging. Bulimia is now widely recognized as a problem in women of all ages, with approximately one percent of patients identifying as female meeting the diagnostic criteria for the disease at any given point in time. (8)

Bulimia is often characterized by regular, excessive eating, with the symptoms ranging in severity from mild to severe. The most common symptoms and signs of bulimia include: 

  • Eating more than usual or binge eating
  • Unable to control overeating at any particular time
  • Purging (vomiting or taking laxatives)
  • Focus on weight and shape as a core foundation of self-esteem 

Bulimia nervosa can also present as atypical bulimia nervosa in the DSM-5, which includes most of the same symptoms as bulimia nervosa but at a lessened frequency. Women with atypical bulimia nervosa will still have bingeing and purging episodes, but they may happen in a cyclical nature, being more intense at certain times than others, often causing diagnosis to be more difficult.

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Signs & symptoms of women with eating disorders

Many women have never expressed any signs of eating disorders until they have a problem with their changing bodies as they age. However, once their hormones begin to change or they experience hormonal imbalances then weight gain can happen. It can also be difficult to lose weight afterward, and women who already have poor self-image can fall into unhealthy habits that lead to an eating disorder. (11)

If you think a woman you love may be suffering from an eating disorder, there are some common signs and symptoms you need to be aware of:

  • Extreme or even gradual weight loss 
  • Sudden weight gain 
  • Restriction, limiting meals, cutting out food groups, small portions, hyper focus on food content, anxiety around pressure to eat
  • Excessive exercising and running 
  • Purging behaviors, such as vomiting, laxatives, or excessive diet pills and diuretics

Treating women with eating disorders

The treatment of women with eating disorders is usually dependent on the severity of their symptoms. Generally speaking, people with eating disorders deal with many emotional and mental challenges, which can make it difficult to address their problems directly. It should, therefore, never be assumed that the degree of weight loss is associated with the degree of suffering or medical risk. 

The best treatment option available to women with eating disorders is seeking help from a team of qualified mental health professionals, and nutritionists who can help restore one's balance and incorporate healthy eating habits into their lives.

Some women may require the use of an antidepressant or anti-anxiety medication to help them alleviate some of their symptoms, or other psychotropic medications, based on the presence of an underlying co-occurring psychiatric condition.

Below are some of the eating disorder treatment modalities available to women, but it should be noted that most patients will receive aspects of many forms of these psychological treatments as part of their successful recovery. 

Cognitive-behavioral therapy (CBT)

CBT involves working with a therapist to identify the distorted thoughts and rigid thinking that lead to behaviors associated with women experiencing eating disorders. These thought patterns and behaviors are then considered together in therapy, with new, objective reality being supported to allow for the release of the negative self-talk and the resulting negative behaviors. CBT will also open the person impacted by eating disorders up to a broader world view and improved perspective on eating, health, and self. 

Interpersonal therapy

Interpersonal therapy can help with the relationship between a person and their partner, family, and friends. This type of eating disorder therapy helps the individual deal with their more challenging relationships to establish healthy ones. Oftentimes an eating disorder thrives when the person impacted is more and more interpersonally isolated, and as the connection with the therapist deepens, the opportunity to gain trust, perspective, and healing unfolds. 

Group therapy

Group therapy provides a structured environment where women can develop their ideas about eating disorder treatment and recovery through the help of other people in the same type of situation. Group therapy can be incredibly powerful as the members of the group face challenges collectively, allowing them to learn, share and become vulnerable through the group process.

Not only do the patients benefit from the actual concepts they are learning in the group, but the collaboration, connection and shared meaning with other group members can have a profound and powerful healing impact. The opportunity to experience support and feedback from others with a shared experience can strike a patient in a way that has lasting meaning. Group therapy can even help open the person’s eyes to their own inner struggles and need for support, accountability, and a new pathway. 

Nutritional therapy

Nutritional therapy is necessary for anyone suffering from an eating disorder. It involves working with a nutritionist to identify underlying dietary issues and how food may play a part in a woman's overall physical and mental health. It is vital for the patient to understand how weight stigma and internalized negative messaging about fat interfere with truly healthy eating patterns. It is also critical to have direct support and monitoring to assure that appropriate nutritional needs are met. 

Dietitians who specialize in eating disorders provide assistance both with working with the patient on the rigid belief systems with food, while also getting into very specific meal planning and monitoring during the more acute phases of eating disorders.

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How women cope with eating disorders

An eating disorder can be very destructive, and it may damage the lives of those struggling and their loved ones, but with the right care and support system, recovery is possible. Unfortunately, women sometimes do not recognize that they have the signs of an eating disorder, and if they do, the stigma surrounding the topic prevents them from seeking out the help they need to get better. 

Additionally, there are abundant fears about either going to treatment or the consequences of treatment that can interfere with receiving help, not to mention the issue of accessibility and feasibility of receiving treatment. The good news is that once you are aware of the signs, you can recognize them in yourself or in your loved ones. With this knowledge, you can seek the help you need and learn the necessary steps needed to make a full recovery.

How to help women with eating disorders

Many women are afraid to admit that they have a problem with disordered eating, so they suffer in silence. Additionally, the symptoms themselves may not be experienced as significant, or may align with societal pressures to pursue weight loss and internalized weight stigma. This combination may make awareness of the illness more challenging.

If you suspect someone you know may be suffering from an eating disorder, it's essential to help them find the support they need. Consider some of the following steps for helping a loved one recover from an eating disorder:

  • Talk to your loved one 
  • Listen to their concerns and ask them about the quality of their life
  • Ask them for permission to be a part of their healing journey 
  • Listen to their solutions 
  • Encourage them to seek help, noting that it is vital that a medical evaluation and psychiatric assessment commence as early as possible. 

If you or someone you love is experiencing disordered eating symptoms, Within Health is here to support you in your healing. Read about our first steps or call our clinical care team today to learn more about our effective at home eating disorder treatment. 

Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset.

Resources

  1. National Association of Anorexia Nervosa and Associated Disorders. (n.d.). Recovery is Possible. ANDA is Here to Help.
  2. Johns Hopkins Hospital. (2020, November 12). Frequently asked questions about eating disorders - johns hopkins hospital.
  3. Dove US. (2021, January 13). Our research. 
  4.  National Eating Disorders Association. (2019, June 27). Weight stigma.
  5. Oxford University Press. (2019, April 26). Prevalence of eating disorders over the 2000–2018 period: A systematic literature review.
  6. John Wiley & Sons, Ltd. (2012, September 6). Changes in perceived weight discrimination Among Americans, 1995–1996 THROUGH 2004–2006. Wiley Online Library. 
  7. National Eating Disorders Association. (2018, February 28). Anorexia nervosa.
  8. National Eating Disorders Association. (2021, July 14). Statistics & research on eating disorders.
  9. U.S. National Library of Medicine. (2013, July). Long-term consequences of anorexia nervosa. 
  10. National Eating Disorders Association. (2018, February 22). Bulimia nervosa.
  11. Frontiers. (2020, September). Eating disorders during gestation: Implications for mother's health, fetal outcomes, and epigenetic changes.
  12. Our work. National Eating Disorders Association. (2021, May 11). https://www.nationaleatingdisorders.org/about-us/our-work.

FAQs

How Long are Treatment Programs for Women?

Treatment programs for women with eating disorders can last anywhere from a few weeks to a few years, depending on the severity of their condition. Recovery timelines are dependent on the individual, as well as their healing environment so may vary significantly person to person.

What is the Most Common Treatment Program for Women with Eating Disorders?

This will depend on the eating disorder and any co-occurring disorders that the woman may be suffering from. However, the most common treatment will include a combination of psychotherapies and nutritional therapy by a dietitian experienced in the eating disorder recovery process and medical evaluation and monitoring.

What is the Treatment Process for Women with Eating Disorders?

The treatment process for women with eating disorders will vary depending on the severity of their condition and the program they choose. However, it will usually include an initial assessment to determine the severity of the eating disorder, as well as the outlining of an individualized treatment plan.

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