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An Interview with ERC Eating Disorder Expert Dr. Rebecca Wagner: Symptoms, Coping, and More

[dropcap]L[/dropcap]ocated in Denver, Colorado, Eating Recovery Center serves as “the only national health care system dedicated to the treatment of serious eating disorders at all levels of care.” With centers located throughout the United States, ERC aims to create better lives for those who suffer from these disorders — disorders to which our world tends to give so little attention.

Immediately upon entering ERC’s site, viewers are provided with an opportunity to take a short self-assessment and schedule a free consultation. An informative video is presented, conveying its message through the retelling of real-life experiences. Exploring the site further, one finds critical information on not only a broad range of eating disorders, but on mood and anxiety disorders as well. Also available are inspiring alumni recovery stories.

Eating disorders are complex and scary issues that many people often face on their own, without the assistance of medical knowledge. For this reason, I teamed up with Dr. Rebecca Wagner, Clinical Director of Eating Recovery Center, Houston, to talk about eating disorders, their effects, and ways to help.

Seemingly harmless behaviors such as dieting can sometimes snowball into an eating disorder. What are some red flags for people to watch for in themselves or in loved ones that could signify an eating disorder is developing?

Sometimes people decide to go on a diet to lose a few pounds. However, once they reach their initial target weight, the loss is “not enough” so they set a new lower target weight. This could lead to a pattern of needing to lose more and more weight until the person is at an unhealthy weight. Or, a person may start eliminating foods from their diet because they want to eat more “clean.” If this too becomes a pattern in which the person eliminates food after food, for example, they cut out sugar, then carbohydrates, then meats, etc., this may signify that an eating disorder is developing.  Other signs to look out for are repeatedly leaving meals or using the restroom immediately following meals (to purge), excessive exercise, and over-eating/binge eating where someone consumes an abnormally large amount of food in a discrete period of time.

A lot of the stigma surrounding eating disorders stems from inaccurate perceptions, such as that these disorders are nothing more than shallow weight loss attempts. What are some actual, serious effects that eating disorders can have on an individual’s mental and/or physical health?

Although the disorder may start as a means to manage weight or body image, underneath it is a way to cope with intense emotions and negative core beliefs about oneself.

Some examples of negative core beliefs include feelings of being unworthy, undeserving, unlovable, not good enough, and inadequate. In addition, eating disorders are shame-based and isolating illnesses that have negative consequences on many important things in your life such as family, friends, work, leisure activities, physical health, and mental health. People with eating disorders often struggle with anxiety and depression, and physical side effects of the illness can be very debilitating. Furthermore, eating disorders have the highest mortality rate of any psychiatric illness, which means that more people will die from an eating disorder than any other mental illness.

When professional help is unavailable, it can feel nearly impossible to fight against ED urges such as binging, restricting, purging, etc. What are some coping methods for people who would like to recover but don’t know where to start?

An important first step in recovery from an eating disorder is to understand what function the eating disorder behavior serves. For example, does it make you feel in control, does it make you feel special, does it numb you out and protect you from intense emotions?

Once you know why you engage in the eating disorder behavior, you can then work toward replacing the unhealthy eating disorder behavior with healthier behaviors that serve a similar function. In addition, since eating disorder behaviors are a means to distract from intense emotions in an unhealthy way, it is vital that you learn to distract from intense emotions in healthier ways, such as talking to others, reading, going for a walk, playing a game, listening to music, etc. Another helpful coping skill is to distance or diffuse oneself from your disordered thoughts and work on reframing thoughts into something that is more helpful.

Having to gain weight can be very emotionally taxing for people who are recovering from a restrictive eating disorder. What are some coping methods for those who are having a difficult time dealing with their weight gain?

Whether someone is trying to restore weight after suffering from Anorexia (characterized by low body weight) or any other eating disorder (Bulimia, Binge Eating Disorder, Orthorexia, etc.), values-focused coping can be helpful. Recovery from an eating disorder can be a difficult process, however, using skills that are based on things that we value and are important to us can help ease the recovery process.

Focusing on the reasons for wanting to make positive changes and how being healthy will allow you to achieve them can help give your life meaning and purpose. For example, if academics are important to you, being able to think more clearly at school may be an important reason for recovery, or if athletics are important to you, then recovery may improve your strength which may be important for you, or if connecting with others is important, recovery will help you feel more engaged with friends and family. Additionally, it is important for people to know that they are not alone in this disorder. Support from professionals and peers who understand their struggles can be beneficial.

When people think of eating disorders, they tend to envision teenage girls with anorexia nervosa. Can you talk about the diversity of the types of people whom eating disorders can affect?

Eating Disorders do not discriminate and can affect anyone, male or female, at any age, and from any ethnic background. No one is immune to developing an eating disorder.

What are some ways in which friends and family members of people with eating disorders can support their loved ones?

One of the most important things that friends and family of someone suffering from an eating disorder can understand is that eating disorders are not a choice. Learning about eating disorders can help improve support to the person with the illness because despite our best intentions to be helpful, what we say or do to someone with an eating disorder may not always be helpful. In addition, it is useful to talk with your loved one about how you can be most helpful; often they have suggestions that work well for them. Finally, be patient. There is no easy fix for an eating disorder and they take time to treat.

Our readership consists primarily of teenagers. Do you have a message to give to our readers who may be struggling with eating disorders and feeling hopeless?

Eating disorders are highly treatable illnesses, particularly when they are addressed early in the course of the disorder.  Despite the shame that may exist in having the illness, you are not alone. There are many people who have struggled with, and overcome an eating disorder. There is a reason why the eating disorder developed and with the assistance of a skilled professional(s), you can uncover that reason and move forward to live a healthier fulfilling life. You are worth recovery.

For additional information about ERC, call 877-789- 5758, email [email protected], or visit www.eatingrecoverycenter.com to speak with a Masters-level clinician.

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