Eating disorders can be defined as extreme disturbances in unhealthy thoughts and behaviors regarding eating, weight, and body appearance. The main feature of eating disorders is; It is when a person perceives himself/herself as overweight, is afraid of gaining weight and being fat, experiences anxiety about this, has an excessive desire to lose weight and has negative feelings about his/her body, and overeating accompanies the negative feelings that he/she cannot cope with. According to DSM-5, there are three basic eating disorder diagnostic categories: anorexia nervosa, bulimia nervosa, and binge eating disorder. Eating disorders often begin in adolescence and young adulthood. Studies have found that the prevalence of eating disorders is higher in women than in men, and that psychological factors such as lack of self-confidence, dissatisfaction with one's body, depressive mood, constant worry, and inability to cope with problems in a healthy way cause eating disorders to occur.
According to DSM 5, there are three basic features of bulimia nervosa: Recurrent binge eating attacks, recurrent unhealthy compensatory-balancing behaviors to prevent weight gain, and self-evaluation of one's body. To meet the diagnosis, binge eating and inappropriate compensatory behaviors must occur at least once a week for three months.
According to DSM 5, the diagnostic criteria for bulimia nervosa are as follows:
A. Recurrent binge eating attacks. A binge eating episode is characterized by both of the following:
1. Eating in a discrete period of time (e.g., any two-hour period) clearly more food than most people would eat in a similar period of time under similar circumstances.
2. During this attack, there is a feeling of loss of control over eating (e.g., the feeling that the person cannot stop eating, that he cannot control what or how much he eats).
B. Engaging in recurrent inappropriate compensatory behaviors to avoid weight gain, such as self-induced vomiting, misuse of laxatives, diuretics, or other medications, hardly eating at all, or excessive exercise.
C. This is binge eating behaviors and inappropriate compensatory behaviors have both occurred, on average, at least once a week for three months.
D. Self-evaluation is unduly influenced by body shape and weight.
E. This disorder does not only occur during periods of anorexia nervosa.
The person eats a lot of food that is uncomfortably out of his control, eats very quickly and in excessive amounts, eats even though he is not hungry, and then feels shame and sadness due to this eating behavior. , may feel guilty. After eating attacks, they may exhibit various behaviors called compensatory behavior to compensate for binge eating, such as self-vomiting, using laxatives, starving themselves, or exercising excessively. They are afraid of gaining weight and exhibit these compensatory behaviors to get rid of the physical discomfort they feel.
Body image is a concept that expresses a person's thoughts, feelings and perceptions about their own body. Negative body image develops when a person develops the feeling that he does not have a physical appearance that meets the expectations of his family, social circle and media. Being at peace with one's own body and being satisfied with one's own body shows that the person has a positive body image. If a person feels negative about his body when he looks in the mirror, cares too much about what people around him think about how he looks, thinks that people evaluate his appearance negatively, and frequently evaluates his appearance, he may have a negative body image. People who have some mental problems, especially those with eating disorders, have negative evaluations of their own bodies and have intense concerns about their body appearance. They have an inaccurate perception of their bodies and see themselves as much heavier than they actually are. Their self-confidence largely depends on their weight, and they consider losing weight a success.
The person does not instantly feel these negative emotions by overeating after the negative emotions that he or she cannot cope with and is unaware of, and expresses relief. In this type of eating disorders, the person has problems with eating. The underlying reason for these thoughts and behaviors is considered to be an attempt to gain control over one's own life. In bulimia, the feeling of emptiness is at the forefront. The person eats as if to fill the feeling of emptiness inside and repeats the act of eating impulsively in order to cope with the emotional discomfort he feels.
In eating disorders that begin to appear during adolescence, it is necessary to work together in cooperation with the family. Relationships within the family, attachment, strict rules within the family, and perfectionism are evaluated and necessary studies are carried out. Studies show that the families of patients with eating disorders are less empathetic, less supportive and have higher expectations for success, and family problems and arguments, depression, anxiety, alcoholism and any eating disorders are more common. It has been revealed that eating disorders, like many psychological problems, are less common in children who feel loved, supported and cared for by their parents.
The targets during the therapy process are primarily to ensure that the person acquires healthy and appropriate eating behavior, vomiting, laxatives, etc. The aim is to eliminate compensatory / balancing behaviors such as using drugs and to study the underlying causes of the eating disorder, to ensure the development of the person's coping mechanism with negative emotions. In order to prevent this disorder from recurring, the main goal in the process should be to first investigate the cause of the person's body perception disorders and eliminate these problems with psychological support. Low self-esteem, self-harming behavior, perfectionist personality traits and feeling of emptiness are also addressed, and distortions in thoughts and perceptions about the body are tried to be corrected. If these problems are not eliminated, the person will not have a permanent recovery and the eating disorder may recur.
In therapy, the person suffering from an eating disorder is given psychoeducation on dysfunctional mindset and emotions. In therapy, the person's dysfunctional thoughts that create or trigger unhealthy eating behavior can be changed, the person can recognize his/her positive and negative emotions and be able to express the emotions he/she experiences and feels appropriately. Studies are being carried out to develop a functional coping mechanism with his/her negative emotions and feelings, to change his/her negative, distorted, unrealistic perception of his/her body, to work on his/her self-confidence and motivation, and to address personality problems.
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