PLANO EATING DISORDER THERAPIST EXPLAINS: ALL EATING DISORDERS INVOLVE RESTRICTION

As a Plano eating disorder therapist, restriction is a topic I discuss daily with clients. On the surface, this probably makes sense. You probably assume that most of my eating disorder therapy clients have anorexia. But what if I told you that despite anorexia getting the most attention, binge eating disorder and bulimia are more common? And that restriction plays a huge role in these disorders, too? Keep reading to learn why this is important, and how I address it as a Certified Eating Disorders Specialist in Plano.

ANOREXIA ISN'T THE ONLY RESTRICTIVE EATING DISORDER

I treat all eating disorders, and this discussion isn't meant to minimize any of them. After all, eating disorders have long been the deadliest of the psychiatric illnesses (only recently overtaken by opioid addiction). I take them seriously. But while most people know anorexia involves severe food restriction, they often overlook the fact that restriction is a core component of the other eating disorders: bulimia, binge eating disorder (BED), and avoidant restrictive food intake disorder (ARFID). In truth, any form of physical or psychological food restriction can increase risk for eating disorders, disordered eating patterns, and harm to your mental and physical well-being. Yet this fact is even overlooked by some doctors and dietitians.

FOOD RESTRICTION IN DIFFERENT EATING DISORDERS

• Anorexia: Individuals with anorexia severely limit food intake, often avoiding entire food groups and strictly following specific dietary rules. In the restricting subtype, individuals restrict their food intake. In the binge-purge subtype, periods of restriction are followed by binge eating and purging.
• Bulimia: People with bulimia have recurring episodes of binge eating and subsequent purging. During these episodes, individuals experience a loss of control and feelings of shame. Binges are typically preceded by periods of food restriction. The biological hunger that results can trigger the binge eating AND a sense of loss of control. Following a binge, individuals with bulimia often restrict even more to make up for their perceived overeating.
• Binge Eating Disorder: Similar to bulimia, binge eating disorder involves episodes of binge eating but without compensatory purging behaviors. The role of food restriction in this disorder is also similar. Most binges have periods of restriction that come before them.
• Avoidant/Restrictive Food Intake Disorder (ARFID): Unlike other eating disorders, restriction in ARFID is rarely driven by concerns about weight gain or body size. People with ARFID limit the type and quantity of food they eat. This is typically due to worry about negative consequences of eating, extreme sensitivities to food texture, taste, smell, or a lack of interest in food.

THE RESTRICT-BINGE CYCLE

Many people with eating disorders judge certain foods as "good" and others as "bad." They connect their self-worth to what they eat or don't eat. Because of this, they have strict rules about food, which makes them mentally exhausted and physically hungry. They inevitably lose control over their rigid eating, eat the "bad" foods, and beat themselves up mentally. We sometimes call what happens next "fuck it" mentality, where a person thinks "Well, I've messed up already... might as well go all the way." Then the binge eating begins again. Afterward, they go back to following the strict rules, continuing the cycle. In the case of bulimia, there are also purging behaviors after the binge.

Most people do not understand that this cycle is NOT about lacking self-control or willpower. It's actually a normal biological response. When the body experiences a period of food restriction, it triggers a biological drive for food as a survival mechanism. The body sends signals to the brain indicating a lack of food, which then prompts a search for large quantities of food when it becomes available. Put simply, binge eating and purging behaviors would not occur without the period of restriction that came before them.

THE PROBLEM WITH PRAISING RESTRICTION: A SLIPPERY SLOPE

American culture (and many others) is heavily influenced by diet culture, which values thinness above all else. Dieting, a form of restriction, frequently leads to an unhealthy fixation on food and serves as a significant risk factor for developing an eating disorder. It's crucial to recognize that for individuals with eating disorders, restriction initially serves as a coping mechanism for managing difficult emotions, as it offers a distraction or numbness from challenging feelings. Restricting can also provide a sense of accomplishment due to societal praise and temporarily relieve guilt and shame associated with honoring one's hunger.

HOW A PLANO EATING DISORDER THERAPIST HELPS

Addressing restriction is one of the primary focuses in my Plano counseling practice. The restricting individual is in a malnourished state, regardless of their body weight: their brain can't think clearly, and they have difficulty taking in new information. They require a lot of support in the beginning of treatment, as returning to normal eating is very difficult physically and psychologically. This often involves a team of professionals who understand eating disorders, including a primary care doctor, a registered dietitian, and a therapist. Sometimes the treatment involves a client's family members, as well.

As a therapist, I always encourage my clients to seek help from a dietitian who is educated in eating disorders. The dietitian is the one who advises clients about what they need to eat to properly nourish themselves. A dietitian will also dispel nutrition myths and negative beliefs that may keep a person in the vicious eating disorder cycle. My job is to support the client in following the dietitian's advice, and helping the client learn to manage their emotions better so that they can do this.

STEPS INVOLVED IN EATING DISORDER TREATMENT

• Recognizing the discrepancy between daily nutritional requirements and current intake, and understanding how this keeps disordered behaviors going
• Encouraging clients to eat meals and snacks regularly throughout the day
• Learning to speak up in situations that may lead to skipping meals (for example, with dieting friends and family)
• Expanding food choices beyond "safe" foods and instead eating a variety of foods
• Identifying and challenging food rules, and coming up with strategies to break free from them
• Getting educated about nutrition and its role in overall well-being

A FREE CONSULTATION FOR COUNSELING IN PLANO

I hope this information helps you to understand eating disorders a little better! If you think you have a problem with restriction, perhaps talking to a Plano eating disorder therapist can help. I offer in-person sessions at my Plano counseling office, or video sessions for virtual therapy. Contact me at (469) 850-2420 or danesa@danesadaniel.com for a free 15-minute phone consultation. If I can't help, I can direct you to another great therapist in the Plano area. If you’re looking for help with eating disorders (binge eating or anorexia and bulimia) or anxiety, you can read more about how I can help on my website.