Last month was eating disorder prevention month, but I would like to endorse the prevention of eating disorders year round! Loved ones often ask the question “How did this happen to my lovely daughter, son, or spouse?” Most people who are at risk for an eating disorder are high-achievers who have a higher IQ than the normal populations and often excel with their academics (i.e., gifted and talented students) and career development (i.e., accomplished interior designer or sports broadcaster). Moreover, their pursuit for civic pursuits (i.e., fundraising for the arts) and extracurricular activities are exceptional: a philanthropist, ice dancer or professional athlete.

There is no specific etiology for eating disorders, but they may develop as a result of genetic predispositions (i.e., addictive disorders, depression, obsessive-compulsive disorder and anxiety disorders), biological factors, psychological (i.e., loss of a horse for an equestrian, or a beloved pet or loved one), social and familial issues (i.e., socioeconomic status where there may be pressure to look a certain way). As a psychotherapist, I have over 25 years of clinical experience specializing in eating disorders, body image, and body dysmorphia. There are several types of eating disorders such as anorexia nervosa, bulimia nervosa, and binge eating disorder (BED).

Eating disorders have the highest mortality rate of any mental disorders due to medical issues. Serious health complications may arise as a result of an eating disorder: cardiac issues, amenorrhea (i.e., loss of menstrual cycle for a minimum of three consecutive months which can lead to infertility), and osteopenia or osteoporosis. Therefore, it is important to complete a cardiac assessment with an EKG, a bone density test such as the (DEXA), and a comprehensive physical exam with a CBC. We require medical clearance in our clinic at Walker Wellness Clinic at Cooper Aerobics Center as a criterion for admission to outpatient clinical services.

There are many precipitating factors that may lead to unhealthy body image and eating disorder. The paradoxical messages from media and being bombarded by social media and cultural pressures can wreak havoc on children and adolescents. Personality traits that are genetically predisposed such as perfectionism set the stage for an eating disorders and stressors such as significant losses (i.e., divorce), abandonment, trauma (i.e., sexual abuse or sexual misconduct and sexual harassment), and chronic illness (i.e., breast mastectomy) may contribute. Perhaps these stressful events lead to feeling powerless over life’s circumstances and learned helplessness sets in. We offer stress assessments as part of the comprehensive psychological test battery to identify any of these underlying issues as a contributing factor for an eating disorder.

Our comprehensive approach to treatment includes: a psychological assessment, individual psychotherapy, group psychotherapy, family psychotherapy, nutrition counseling, meal therapy, resting metabolic rate test to determine individual caloric needs, exercise prescription, psychiatric consult, and adjunct therapy such as art, music, and cooking classes.

My new book: Body Esteem: Piece of Cake and Peace of Mind provides so many ways to boost body esteem. It is for anyone who struggles with body image issues and helps you deal with obsessionality with a full range from chronic dieting to building self-efficacy and self-confidence.  You can buy a copy of it here.

I invite you to join me in the body esteem movement (#BEM) and no longer focus on a paradigm or standard of beauty for all, but celebrate our extraordinary differences. This can revolutionize how we see ourselves. We can teach children at an early age how to foster body esteem. And, we can end body shaming and body bullying by standing up to people who engage in this cruel and unkind act. Moreover, we can establish body esteem etiquette (#BEE), a communication style where we no longer make self-deprecating comments about our bodies or derogatory comments about others. Be your own kind of beautiful!