Help from a psychotherapist for eating disorders. Eating disorders. Psychotherapy for neurogenic overeating

Founder and director of the Eating Disorders Clinic, psychologist, expert on eating disorders, author of methods for treating anorexia, bulimia, and compulsive overeating.

Treatment of Eating Disorders and the Path to Recovery

How to Overcome an Eating Disorder and Regain Your Self-Confidence

Many patients being treated for anorexia and bulimia are convinced that they will never be able to become happy, that they will constantly be forced to go on strict diets in order to be slim and beautiful, that they will never get rid of suffering, pain, constant fatigue from race for a thin and athletic figure. But it is not so. The main thing to remember is that nothing is impossible and that everything is in your hands.The help of a qualified therapist, a specialist in eating disorders, support from loved ones and work on yourself can save you from depressive thoughts, destructive methods of losing weight, help you get rid of food addiction and restore self-confidence, happiness and pleasure in life.

How to get rid of an eating disorder, where to start?

First of all, you need to find the strength within yourself to admit that there is a problem. This can be difficult, especially if you still believe (somewhere deep down) that losing weight through bulimia or anorexia is the key to success, happiness and self-confidence. Even if you “intellectually” understand that this is not at all true, it may be difficult for you to break old habits.

The good news is that if you are serious about change and are willing to ask for help, you will succeed. But it is important to understand that for complete recovery it is not enough to simply “forget” about unhealthy eating behavior. You will have to “get acquainted” again with the girl who is hiding behind these bad habits, thoughts about losing weight and the desire for the “ideal picture”.

Final recovery is only possible if you learn:

• Listen to your feelings.
• Feel your body.
• Accept yourself.
• Love yourself.

You may feel that you are unable to cope with this task. But remember - you are not alone. Qualified specialists are always ready to help you, you just need to take the first step!

Step One: Get Help

You may be scared and terribly embarrassed to approach strangers about such an issue, but if you really want to get rid of your addiction, you must overcome your fear. The main thing is to find someone who can really support you and listen without judging or criticizing you. This could be a close friend or family member, or someone you trust. You may feel more comfortable discussing this problem with a therapist or psychologist.

How to confess to your interlocutor about your illness?

There are no clear rules regarding how to tell someone you are sick about your illness. But pay attention to the time and place - ideally, no one should rush or interrupt you.

Where to start the conversation. This is perhaps the most difficult thing. You can simply say: “I need to confess something very important to you. It’s very difficult for me to talk about this, so I will be very grateful if you let me talk and listen to me carefully.” After this, you can talk about how your disease arose, how it all began; about your experiences, feelings, new habits, and how your eating disorder has changed your life.

Be patient. Your friend or family member will probably have a very emotional reaction to your confession. They may be shocked, amazed, confused, upset and even annoyed. It is possible that they will not even know how to properly respond to your confession. Let them digest what they heard. Try to describe the specific features of your eating disorder in as much detail as possible.

Explain how exactly your interlocutor can support you. For example, say that he can periodically check on your well-being, ask if you have sought help from a specialist, help you create a healthy meal plan, etc.

There are many different treatment options available to patients today, but it is important to find the approach or course of treatment that is best for you.

• Find a Subspecialty Specialist in Eating Disorders
• The selected specialist must have a higher education in the specialization “psychotherapy” or “medicine”, as well as a higher education in the field of psychology and sufficient experience in the treatment of eating disorders
• You should not contact gastroenterologists, psychiatrists, neurologists, or nutritionists at the first stage of treatment for an eating disorder. All these specialists should be contacted already at the stage of an eating disorder. Our Clinic employs all the necessary specialists to successfully complete the recovery phase.

Step 2: Create a long-term treatment plan

Once you have addressed your health issues, your personal “treatment team” can create a long-term treatment plan for your eating disorder. It may consist of:

Individual or group psychotherapy. Working with an eating disorder specialist is necessary to uncover the underlying issues that led to the eating disorder. A specialist will help you restore your self-esteem and also teach you how to respond correctly to stress and emotional experiences. Each specialist has his own treatment methods, so it is important to discuss with him in advance what results you expect from the course of treatment.

Family therapy. Family therapy can help you and your family understand how an eating disorder affects your relationships and how family problems can contribute to the disorder and also hinder its recovery. You will relearn how to contact each other, respect and support each other...

Inpatient treatment. In rare cases, you may need hospitalization and inpatient treatment. In most cases, inpatient treatment is required for severe anorexia and severe bulimia. You will be under the supervision of specialists 24 hours a day, which will significantly increase your chances of recovery. As soon as doctors are sure that your condition is stable, you can continue treatment at home.

Step 3: Learn Self-Help Strategies

When entrusting the solution to the problem to specialists, do not forget that your personal contribution to treatment is no less important. The faster you figure out what exactly led to you developing an eating disorder, and the faster you learn “healthy” ways to solve this problem, the faster you will get better.

How to Build a Healthy Relationship with Food

While food itself is not the problem, building a healthy relationship with it is essential to your recovery. Many patients find it very difficult to control their behavior when it comes to food - they often first severely limit their diet, and then suddenly break down and begin to uncontrollably absorb everything that comes to hand. Your task is to find the optimal balance.

Forget about strict nutrition rules. Severe food restrictions and constant monitoring of everything you eat during the day can trigger the development of an eating disorder. That's why it's so important to replace them with healthy eating habits. For example, if you constantly limit yourself to sweets, try to soften this “rule” at least a little. You can occasionally allow yourself to eat ice cream or a cookie.

Stop dieting. The more you restrict yourself from food, the more likely you are to think about it constantly and even become obsessed with it. So instead of focusing on what you "shouldn't" eat, focus on nutritious foods that will give you energy and vitality. Think of food as fuel for your body. Your body knows very well when it needs to replenish its energy reserves. Listen to him. Eat only when you are truly hungry, and stop eating as soon as you feel full.

Stick to a regular eating schedule. Perhaps you are used to skipping certain meals or not eating anything for a long time. But remember that when you don't eat anything for a long time, all your thoughts become only about food. To avoid this, be sure to eat something every 3-4 hours. Plan your main meals and snacks in advance and don't skip them!

Learn to listen to your body. If you have an eating disorder, you've likely learned to ignore the hunger and satiety signals your body sends. You may not even recognize them anymore. Your job is to relearn how to respond to these natural signals so that you can plan your meals according to your physiological needs.

Learn to accept and love yourself for who you are.

When you base your self-worth solely on your appearance, you forget about your other qualities, accomplishments, and abilities that make you attractive. Think about your friends and family members. Do they love you for the way you look? Chances are, your appearance ranks low on the list of things they love about you, and you probably rate them on roughly the same scale of values. So why is your appearance so important to yourself?

Paying too much attention to how you look can lead to low self-esteem and loss of self-confidence. But you can learn to perceive yourself in a positive, “harmonious” way:

Make a list of your positive qualities. Think about all the things you like about yourself. Smart? Good? Creative? Faithful? Cheerful? What do people around you consider your good qualities? List your talents, skills, and accomplishments. Also think about the negative qualities YOU DON'T HAVE.

Focus on what you like about your body. Instead of looking for flaws when you look in the mirror, evaluate what you like about your appearance. If you find yourself distracted by “imperfections,” remind yourself that no one is perfect. Even supermodels have their photos retouched.

Stop thinking about yourself in a negative way. As soon as you notice that you are again starting to think negatively, harshly criticize yourself, judge, or feel guilty, stop. Ask yourself, do you have any real basis for such judgments? How can you refute them? Remember, your belief in something is not a guarantee of truth.

Dress for yourself, not for others. You should be comfortable in the clothes you wear. Choose clothes that highlight your personality and make you feel comfortable and confident.

Get rid of fashion magazines. Even if you know that all the photos in these magazines are completely photoshopped, they can still develop insecurity and feelings of inferiority in you. It's best to stay away from them until you're sure they're not damaging your self-esteem.

Pamper your body. Instead of treating your body like an enemy, look at it as something valuable. Treat yourself to a massage, manicure, facial, candlelit bath, or scented lotion or perfume that you like.

Lead an active lifestyle. Movement is essential for your mental and physical well-being. It's best if it's outdoor training.

Tips for Preventing Eating Disorders

Treatment for eating disorders is a long process. It is very important to maintain the achieved results to avoid relapse of the disease.

How to prevent the return of an eating disorder?

Gather a “support group” around you. Surround yourself with people who support you and want to see you healthy and happy. Avoid people who drain your energy, encourage disordered eating, or make you feel bad. Avoid hanging out with friends who always comment on your weight changes. All these comments are given not from good intentions, but from envy.

Fill your life with something positive. Make time for things that bring you joy and satisfaction. Try something you've always wanted to do, learn something new, pick up a hobby. The healthier your life becomes, the less you will think about food and losing weight.

You need to know the enemy by sight. Decide under what conditions the likelihood of relapse is highest - during the holidays, during the exam session or during the “swimsuit season”? Identify the most dangerous factors and develop an “action plan”. For example, during these times, you may want to see your eating disorder specialist more often or ask for additional emotional support from your family and friends.

Avoid internet sites that promote unhealthy body image behavior. Avoid information resources that advertise and encourage anorexia and bulimia. Behind these sites are people who are trying to justify their unhealthy attitudes towards their bodies and diet. The “support” they offer is dangerous and will only hinder your recovery.

Follow your individual treatment plan closely. Don't skip appointments with an eating disorder specialist or other parts of your treatment, even if you notice improvements. Strictly follow all recommendations developed by your “treating team”.

Any eating disorder can cause serious health problems. As a rule, it is based on psychological factors. Therefore, it is necessary to get rid of them together with specialists.

Types of problems

Experts know that eating disorders can manifest in different ways. Treatment tactics in each specific case should be selected individually. It will depend on the diagnosis and condition of the patient.

The most popular types of disorders are:

It is not always possible to recognize people who suffer from any of these disorders. For example, with bulimia nervosa, weight may be within the normal range or slightly below the lower limit. At the same time, people themselves do not understand that they have an eating disorder. Treatment, in their opinion, they do not need. Any condition in which a person tries to create dietary rules for himself and strictly adheres to them is dangerous. For example, a complete refusal to eat after 16 hours, a strict restriction or complete refusal to consume fats, including those of plant origin, should raise red flags.

What to look for: dangerous symptoms

It is not always possible to understand that a person has an eating disorder. You need to know the symptoms of this disease. A small test will help determine if there are problems. You just need to answer the following questions:

• Do you have a fear that you will gain weight?
• Do you find yourself thinking about food too often?
• Do you refuse food when you feel hungry?
• Are you counting calories?
• Do you cut food into small pieces?
• Do you periodically experience bouts of uncontrolled eating?
• Do people often tell you that you are thin?
• Do you have an obsessive desire to lose weight?
• Do you vomit after eating?
• You get
• Do you refuse to eat fast carbohydrates (baked goods, chocolate)?
• Does your menu include only dietary dishes?
• Are people around you trying to tell you that you could eat more?

If you answered “yes” to these questions more than 5 times, then it is advisable for you to consult a specialist. He will be able to determine the type of disease and choose the most appropriate treatment tactics.

Characteristics of Anorexia

Refusal to eat occurs in people as a result of mental disorders. Any strict self-restraint, unusual choice of foods are characteristic of anorexia. At the same time, patients have a constant fear that they will get better. Patients with anorexia may be 15% below the established lower limit of normal. They have a constant fear of obesity. They believe that weight should be below normal.

In addition, people suffering from this disease are characterized by the following:

• the appearance of amenorrhea in women (lack of menstruation);
• disruption of body functioning;
• loss of sexual desire.

This eating disorder is often accompanied by:

• taking diuretics and laxatives;
• exclusion of high-calorie foods from the diet;
• inducing vomiting;
• taking medications intended to reduce appetite;
• long and exhausting workouts at home and in the gym in order to lose weight.

To establish a final diagnosis, the doctor must fully examine the patient. This allows you to exclude other problems that manifest themselves in almost the same way. Only after this can treatment be prescribed.

Characteristic signs of bulimia

But people with food-related disorders can develop more than just anorexia. Specialists can diagnose a neurogenic disease such as bulimia. With this condition, patients periodically lose control of how much they eat. They have bouts of gluttony. Once the overeating is completed, patients experience severe discomfort. There is pain in the stomach, nausea, and often episodes of gluttony end with vomiting. Feelings of guilt for such behavior, self-loathing and even depression cause this eating disorder. It is unlikely that you will be able to carry out treatment on your own.

Patients try to eliminate the consequences of such overeating by inducing vomiting, gastric lavage, or taking laxatives. You can suspect the development of this problem if a person is haunted by thoughts about food, has frequent episodes of overeating, and periodically feels an irresistible craving for food. Often episodes of bulimia alternate with anorexia. If left untreated, this disease can lead to rapid weight loss, but at the same time the established balance in the body is disrupted. As a result, severe complications arise, and in some cases, death is possible.

Symptoms of compulsive overeating

When figuring out how to get rid of an eating disorder, many people forget that such problems are not limited to bulimia and anorexia. Doctors are also faced with such a disease as compulsive overeating. In its manifestations it resembles bulimia. But the difference is that people suffering from it do not have regular fasting. Such patients do not take laxatives or diuretics and do not induce vomiting.

With this disease, bouts of gluttony and periods of self-restraint in food may alternate. Although in most cases, between episodes of overeating, people constantly eat a little something. This is what causes significant weight gain. For some, this may only occur periodically and be short-term. For example, this is how certain people react to stress, as if eating away at problems. With the help of food, people suffering from compulsive overeating seek an opportunity to gain pleasure and provide themselves with new pleasant sensations.

Reasons for the development of deviations

For any nutritional disorders, you cannot do without the participation of specialists. But help will be effective only if the causes of eating disorders can be identified and eliminated.

Most often, the development of the disease is provoked by the following factors:

• high self-standards and perfectionism;
• presence of traumatic experiences;
• stress experienced due to ridicule in childhood and adolescence regarding;
• mental trauma resulting from sexual abuse at an early age;
• excessive concern for the figure and appearance in the family;
• genetic predisposition to various eating disorders.

Each of these reasons can cause self-perception to be impaired. A person, regardless of his appearance, will be ashamed of himself. People with such problems can be identified by the fact that they are not happy with themselves, they cannot even talk about their body. They attribute all failures in life to the fact that they have an unsatisfactory appearance.

Problems in teenagers

Very often, eating disorders begin during adolescence. Significant hormonal changes occur in the child’s body, and his appearance becomes different. At the same time, the psychological situation in the team also changes - at this time it is important for children to look as is customary, and not to go beyond the established standards.

Most teenagers are concerned about their appearance, and against this background they may develop various psychological problems. If the family did not devote sufficient time to the development of an objective, adequate self-esteem in the child, and did not instill a healthy attitude towards food, then there is a risk that he will develop an eating disorder. In children and adolescents, this disease often develops against the background of low self-esteem. At the same time, they manage to hide everything from their parents for quite a long time.

These problems develop, as a rule, at the age of 11-13 years - during puberty. Such teenagers concentrate all their attention on their appearance. For them, this is the only means that allows them to gain self-confidence. Many parents play it safe, fearing that their child has developed an eating disorder. In adolescents, it can be difficult to determine the line between normal preoccupation with appearance and a pathological condition in which it is time to sound the alarm. Parents need to start worrying if they see that their child:

• tries not to attend events where there will be feasts;
• spends a lot of time on physical activity in order to burn calories;
• too dissatisfied with his appearance;
• uses laxatives and diuretics;
• obsessive about weight control;
• is overly scrupulous about monitoring the calorie content of foods and portion sizes.

But many parents think that children cannot have an eating disorder. At the same time, they continue to consider their teenagers at the age of 13-15 as kids, turning a blind eye to the disease that has arisen.

Possible consequences of eating disorders

The problems that these symptoms can lead to should not be underestimated. After all, they not only have a detrimental effect on health, but can also cause death. Bulimia, like anorexia, causes kidney failure and heart disease. With frequent vomiting, which leads to a lack of nutrients, the following problems may develop:

• kidney and stomach damage;
• feeling of constant pain in the abdomen;
• development of caries (it begins due to constant exposure to gastric juice);
• lack of potassium (leads to heart problems and can cause death);
• amenorrhea;
• appearance of “hamster” cheeks (due to pathological enlargement of the salivary glands).

With anorexia, the body goes into what is called starvation mode. The following signs may indicate this:

• hair loss, brittle nails;
• anemia;
• amenorrhea in women;
• decrease in heart rate, respiration, blood pressure;
• constant dizziness;
• the appearance of hair fuzz throughout the body;
• the development of osteoporosis - a disease characterized by increased bone fragility;
• increase in joint size.

The sooner the disease is diagnosed, the faster it will be possible to get rid of it. In severe cases, even hospitalization is necessary.

Psychological help

Many people with obvious eating disorders believe that they do not have any problems. But without medical help it is impossible to correct the situation. After all, you can’t figure out how to conduct psychotherapy for an eating disorder on your own. If the patient resists and refuses treatment, then the help of a psychiatrist may be needed. With an integrated approach, a person can be helped to get rid of problems. Indeed, in case of severe disorders, psychotherapy alone will not be enough. In this case, drug treatment is also prescribed.

Psychotherapy should be aimed at a person working on his own image. He must begin to adequately evaluate and accept his body. It is also necessary to correct the attitude towards food. But it is important to work through the reasons that led to such a violation. Experts who work with people suffering from eating disorders say that their patients are overly sensitive and prone to frequent negative emotions such as anxiety, depression, anger, and sadness.

For them, any restriction in food or overeating, excessive physical activity is a way to temporarily alleviate their condition. They need to learn to manage their emotions and feelings, without this they will not be able to overcome an eating disorder. How to treat this disease needs to be discussed with a specialist. But the main goal of therapy is to develop the patient’s correct lifestyle.

Those who have difficult family relationships or constant stress at work do a worse job of getting rid of the problem. Therefore, psychotherapists must also work on relationships with others. The sooner a person realizes that he has a problem, the easier it will be to get rid of it.

Recovery period

The most difficult task for patients is developing self-love. They need to learn to perceive themselves as individuals. Only with adequate self-esteem can one restore one’s physical condition. Therefore, nutritionists and psychologists (and in some cases psychiatrists) should work on such patients simultaneously.

Professionals should help you overcome your eating disorder. Treatment may include:

• drawing up a nutrition plan;
• inclusion of adequate physical activity in life;
• taking antidepressants (only necessary if there are certain indications);
• work on self-perception and relationships with others;
• treatment of mental disorders such as anxiety.

It is important that the patient has support during the treatment period. After all, people often break down, take breaks from treatment, and promise to return to the planned plan of action after a certain time. Some even consider themselves cured, although their eating behavior remains virtually unchanged.

Eating disorders or eating disorders - a group of mental disorders that are associated with food intake. An eating disorder can manifest itself as partial refusal of food, periods of overeating alternating with periods of fasting, artificially induced vomiting after eating, as well as other eating habits that go beyond the norm. The most common eating disorders are anorexia and bulimia.

The causes of eating disorders are varied. This is a disruption of the functioning of the nervous system, a failure of processes occurring in the body, heredity, childhood psychological trauma and characteristics of upbringing, the pressure of beauty standards imposed by society and disorders of the emotional sphere. Some occupations increase the risk of developing eating disorders. So among models, dancers and television presenters the figure reaches 40-50%. All professions associated with publicity and requiring an impeccable appearance are considered risky in this regard.

Over the past 50 years, the number of people with eating disorders has increased tenfold. Such statistics are associated with an increase in the number of urban residents, an increase in stress levels, and the cult of thinness and a fit figure. The majority of people with eating disorders are women, but a rapidly increasing percentage are men. Over the past 10 years, their number has doubled and now accounts for 15% of those suffering from eating disorders. The number of children with eating problems is also increasing.

The consequences of eating disorders are not nearly as harmless as they might seem. Anorexia and bulimia rank first in mortality among mental disorders of all types. Among their consequences: diabetes, heart and kidney failure. People with eating disorders are at high risk of attempting suicide.

How is appetite formed?

In order to understand the nature of eating disorders, it is necessary to understand how appetite is normally formed.

In the cerebral cortex, hypothalamus and spinal cord there are centers responsible for eating behavior. They analyze signals coming from the digestive system and the entire body and then analyze them. When it's time to replenish nutrients, blood glucose levels drop. Sensitive cells in the “hunger centers” pick up these signals and analyze them. In response, foci of excitation appear in the brain, which form appetite.

Appetite- This is a pleasant anticipation of eating food. It is he who is responsible for a person’s actions in obtaining and preparing it: buying food, cooking and eating food. Appetite also activates the functioning of the digestive organs - saliva, gastric juice, pancreatic secretions, and bile are produced. This is how the body prepares to process and absorb food.

There are two forms of appetite

General appetite- occurs when the sensitive cells of the hypothalamus feel a lack of all nutrients. At this moment, a person wants to eat any familiar food.

Selective appetite- this is a state when there is a desire to eat a certain type of food - sweets, fruits, meat, fish. Selective appetite is formed in the cerebral cortex when sensitive cells detect a deficiency of certain substances.

After eating, a person feels full and satisfied with food. The stomach receptors send a signal of satiety to the digestive centers, at this stage the person feels that he has eaten enough and stops eating.

What problems may arise

Lack of appetite– no excitement occurs in the centers that are responsible for its appearance. This is possible if there is a disruption in signal transmission from the digestive system to the brain, a disruption in the interaction between nerve cells, problems with the reuptake of serotonin, or a predominance of inhibition processes in the brain (for example, with depression)

Increased general appetite– associated with a persistent focus of excitation in the hypothalamus. Causes bouts of gluttony and a tendency to overeat.

Desire to eat only certain foods. The cerebral cortex, or more precisely a group of neurons located in hunger centers, is responsible for this behavior. Selective eating, orthorexia, and perverted appetite are signs that these areas of the brain are not functioning properly.

Relationship between eating disorders and mental factors

The appearance of eating disorders is associated with a number of mental factors. Several personality traits are thought to contribute to these disorders:

• Low self-esteem;
• Dependence on the opinions of others;
• Need for approval;
• The desire to control what is happening, at least within the confines of your body;
• The desire for perfectionism and unattainable ideals of beauty.
• As a rule, the beginnings of eating disorders begin in childhood, which is facilitated by:
• Lack of emotional support from parents;
• An overbearing mother and a father who paid little attention to the child;
• Excessive demands on the child, which he is unable to justify;
• Frequent reproaches, expressions of dissatisfaction, criticism of appearance, manners;
• Problems with separation from parents during adolescence. Increased dependence of the child on parents. Thus, one of the popular theories explains the development of anorexia and bulimia by the desire to return to childhood;
• Excessive care and lack of freedom in adolescence.
• It can be argued that an eating disorder develops in a person with certain mental characteristics if life circumstances contribute to this.

Anorexia nervosa

Anorexia nervosa– an eating disorder, which is manifested by refusal to eat and an obsessive desire to lose weight. The purpose of not eating is to lose weight or prevent obesity. It is common for patients to experience unreasonable fears about being overweight, although, as a rule, they are thin or have a normal physique.

The vast majority of patients are young women and girls. Up to 5% of this population group suffers from various manifestations of anorexia. Anorexia nervosa occurs 10 times less frequently in men than in women.

Causes of Anorexia Nervosa

– from parents to children, peculiarities of the functioning of the nervous system are transmitted, which determine the tendency to the appearance of anorexia nervosa (low self-esteem, immaturity, need for approval). The claim increases for people who have close relatives suffering from anorexia and bulimia.

Disorders of neurotransmitter metabolism(serotonin and dopamine), which provide communication between nerve cells. This disrupts the interaction of cells in the brain centers responsible for eating behavior.

Wrong upbringing. Anorexia nervosa develops if in childhood a person did not feel unconditional approval: “No matter what happens, you’re doing great. There are mistakes, but they can be corrected.” Criticism, high demands and lack of praise did not allow the child to develop healthy self-esteem. Fighting appetite and conquering yourself in the form of refusing to eat is a perverse way to increase self-esteem.

Severe teenage crisis. Loss of contact with parents and reluctance to move into adulthood. The thinking model is approximately this: “I am thin and small, which means I am still a child.”

Social standards. Thinness in modern society is associated with beauty, health and willpower. The stereotype that it is easier for thin people to achieve success in their personal lives and careers pushes people to constantly experiment with diets and weight loss medications.

Offensive remarks about excess weight from parents, peers, teachers. Sometimes memories of mental trauma can resurface in memory years later and trigger the development of the disorder.

Some activities. Modeling, show business, dancing, athletics.

Stages of anorexia nervosa

There are three stages of development of anorexia nervosa:

Pre-anorexic stage- obsessive desire to quickly lose weight. Constant criticism of your body and appearance. The discrepancy between one’s appearance and the “ideal image” that a person has drawn in his mind, which is caused by low self-esteem. A person constantly tries various radical methods of losing weight: diets, medications, procedures, intense exercise. Duration 2-4 years.

Anorexic stage– refusal of food and weight loss. Losing weight brings satisfaction, but patients continue to consider themselves fat and refuse to eat. The patient constantly has a fear of getting better, his emotional background and vitality are reduced. The result is weight loss of 20-50% of the initial body weight. Menstrual irregularities or complete cessation of menstruation.

Cachexia stage– severe exhaustion of the body. The patient's weight is less than 50% of normal, while he continues to limit himself in food, fearing obesity. Dystrophy of the skin, skeletal muscles, and heart muscle begins. Changes occur in all internal organs. Exhaustion is accompanied by increased fatigue and inactivity.

Some researchers distinguish the elimination stage of cachexia. This is the stage of treatment, which is accompanied by anxiety associated with weight gain, unusual sensations associated with the digestion of food, which are perceived as painful. Patients continue to try to limit themselves in food. Delusional thoughts may appear: “food spoils the skin.”

Symptoms and manifestations of anorexia nervosa

Symptoms of the preanorexic stage

Dissatisfaction with your appearance. The discrepancy between the invented ideal image and the reflection in the mirror. As a rule, this coincides with the onset of puberty, when the teenager critically perceives the changes occurring in his body.

Constant struggle with excess weight. Regular attempts to lose weight by exercising and dieting.

Causes of Bulimia Nervosa

Mental illness, inherited. High need for endorphins, impaired neurotransmitter metabolism.

Metabolic disorders– known insulin resistance, impaired metabolism of fats and carbohydrates.

Excessive demands on the child in family, which cause fear of not meeting expectations and disappointing parents.

Low self-esteem. It provokes an internal conflict between the ideal idea of ​​oneself - “what I should be” and the real situation - “what I really am.”

Loss of control over emotions. The development of bulimia is promoted by depressive moods and strong negative emotions.

Family conflicts– disruption of interaction between family members (parents, partner).

Addiction to diets and fasting. It is noted that the stricter and longer the diet, the higher the risk of failure. With systematic adherence to diets, the behavior pattern of “fasting-breakdown-cleansing” is reinforced.

Mental illnesses. Bulimia nervosa can be a symptom of epilepsy and schizophrenia.

Types of Bulimia Nervosa

Primary bulimia– uncontrollable hunger followed by bouts of gluttony and periods of purging.

Secondary bulimia, which arose on the basis of anorexia. Bouts of gluttony after prolonged refusal to eat.

Types of bulimia according to the “purification” method

Bouts of gluttony are followed by periods of “cleansing” - vomiting, taking laxatives, enemas;

Bouts of gluttony are followed by periods of strict diets and fasting.

Symptoms and manifestations of bulimia nervosa

As a rule, the onset of the disease occurs at 13-14 years of age due to dissatisfaction with one’s figure. As in the case of drug addiction, patients are obsessed with thoughts about food and fear of excess weight, while denying the existence of a problem. Most of them believe that they can return to normal eating as soon as they want.

Obsessive thoughts about food. A person constantly wants to eat. The feeling of hunger is aggravated by diets and restrictions.

Stealth. Bulimics keep their habits private, unlike anorexics who like to discuss diets.

Haste when eating. Insufficient chewing, swallowing food in chunks.

Eating large amounts of food. Bulimia sufferers specially prepare a lot of food to get the most out of their meal. This could be sweet food, favorite dishes, or vice versa, less edible food.

Artificially induced vomiting. After eating, people with bulimia often retreat to the toilet to induce vomiting. They also use laxatives or enemas to cleanse the body of what they have eaten.

Dieting. To maintain a desired weight, people with bulimia nervosa diet most of the time.

Physiological manifestations of bulimia

Weight changes. A person with bulimia may gain weight and then lose weight dramatically.

Frequent throat diseases. Frequent vomiting leads to inflammation of the mucous membrane of the throat, causing pharyngitis and sore throats. When the vocal cords are irritated, the voice becomes hoarse.

Dental problems. The acid contained in gastric juice destroys tooth enamel. This leads to caries and tooth loss.

Digestive system diseases. There is a high probability of developing gastritis, peptic ulcer of the stomach and duodenum, pain in the right hypochondrium and along the intestine.

Increased salivation and enlarged salivary glands are characteristic signs of bulimia.

Decreased vitality. Food restrictions and an unhealthy lifestyle disrupt metabolism. This is manifested by general weakness and increased fatigue during exercise.

Signs of dehydration. Flabbiness of the skin, dry mucous membranes and eyes, and infrequent urination are caused by large losses of water during vomiting and taking laxatives.

Diagnosis of bulimia nervosa

The diagnosis of bulimia nervosa is made if the following diagnostic criteria are met:

• Bouts of gluttony (consuming large amounts of food in a short period of time), recurring at least 2 times a week for 3 months;
• Loss of control over food cravings during a bout of gluttony;
• Compensatory behavior aimed at eliminating the consequences of overeating - inducing vomiting, fasting, significant physical activity;
• Excessive fear of fullness, constantly present;

Treatment for Bulimia Nervosa

Psychotherapy for bulimia nervosa

Cognitive behavioral psychotherapy. The psychologist teaches you to identify “eating disorder thoughts” and replace them with healthy attitudes. He gives the task to track in what situation obsessive thoughts about food most often appear and what feelings they cause. In the future, it is recommended to avoid these situations, for example, delegate the purchase of groceries to other family members.

Family-oriented psychotherapy. The most effective option for patients of adolescence and youth. The task of loved ones is to help strengthen self-esteem and instill proper eating habits that will help maintain normal weight without suffering from hunger.

Drug treatment for bulimia nervosa

Antidepressants third generation SSRIs increase the activity of serotonin and the transmission of impulses along the chain of nerve cells - Venlafaxine, Celexa, Fluoxetine.

Tricyclic antidepressants– Desipramine

Treatment of bulimia with antidepressants reduces the likelihood of binge eating by 50%, regardless of whether the patient is depressed or not.

Prevention of bulimia nervosa

Preventive measures are the formation in a child of adequate self-esteem, a correct attitude towards food, and the preparation of a diet that corresponds to energy costs.

Psychogenic overeating

Psychogenic overeating or compulsive overeating– an eating disorder that involves overeating in response to stress and leading to obesity. In other words, this is overeating due to nervousness. It can be a reaction to the death of a loved one, troubles at work, loneliness, illness and other psychological trauma. Binges of overeating can be rare or systematic and occur in response to any negative emotions.

This eating disorder is more common among adults, and especially people who are overweight. According to statistics, 3-5% of the adult population suffer from it.

The consequences of psychogenic overeating are obesity, diabetes, atherosclerosis, heart and joint diseases.

Causes of psychogenic overeating

Genetic predisposition. Individual genes have been identified that are responsible for overeating even in the absence of hunger, and low sensitivity to satiety. The tendency to psychogenic overeating is inherited from relatives with diabetes and obesity.

Inability to cope with negative emotions– fear, melancholy, sadness, guilt, anxiety. Eating food, especially sweet foods, quickly increases blood glucose levels. “Sweet” blood, washing the brain, promotes the production of the neurotransmitters serotonin and dopamine, which are also called pleasure hormones. As a result of eating food, the mental state temporarily improves. However, it is followed by a feeling of guilt and dissatisfaction with one’s weak will and one’s own body.

Feelings of inferiority and one’s own failure to meet other people’s expectations. These feelings are based on low self-esteem.

Psychological trauma in childhood age. It has been established that people with psychogenic overeating in childhood suffered from rough treatment by their parents, conflicts between adults, and were brought up in a family where there was a cult of food.

Social standards. Modern standards of beauty imply the absence of excess weight. People who suffer from their obesity experience a feeling of guilt and displeasure with their body. Negative emotions push them to “seize” problems, which leads to further weight gain. Thus, a vicious circle is formed.

Types and forms of psychogenic overeating

External overeating– a person eats food when it is available to him. Buys too much food, overeats when visiting, cannot stop while there is food on the table. The provoking factor is the sight and smell of food.

Emotional overeating– the cause of strong cravings for food is not hunger, but an increased level of the stress hormone – cortisol. A person overeats when experiencing negative emotions.

Symptoms and manifestations of psychogenic overeating

Uncontrollable bouts of gluttony, which are caused by stress and negative emotions, and not by hunger. Boredom is often a provoking factor, so watching TV and reading are also accompanied by eating.

Lack of power system. A person eats not according to a schedule, but according to desire. Sometimes a bout of overeating can last throughout the day. Overeating at night also happens.

During an attack, a person eats large amounts of food. He is unable to stop, despite the feeling of fullness in his stomach.

The process of eating is accompanied by pleasure, however, soon afterwards feelings of guilt and self-loathing appear. A person reproaches himself for lack of self-control. Negative emotions about one’s appearance and character weaknesses cause new bouts of overeating.

Trying to hide the amount you eat. When eating in the company of other people, a person can consume food in moderation. Left alone, the patient consumes food in large quantities, usually until everything is eaten.

Stockpiling food to eat alone. The patient tends to prepare for overeating by buying or preparing food in large quantities.

There are no attempts to cleanse the body of food. People don’t induce vomiting and don’t exhaust themselves with training. At the same time, they often try to adhere to diets, but cannot withstand the restrictions.

Despair and depression about the inability to control the amount of food eaten.

Weight gain. Within a few weeks of the onset of the disorder, significant weight gain is observed.

Diagnosis of psychogenic overeating

A diagnosis of psychogenic disorder is made if a person exhibits 3 or more signs of the disease:

• Eating large amounts of food despite not feeling hungry;
• Episodes of overeating that last a certain time (up to several hours), ending with an unpleasant feeling of fullness;
• Eating much faster than most people do;
• Feelings of guilt that arise after bouts of overeating;
• Embarrassment over eating too much, causing people to prefer to eat alone.

Treatment of psychogenic overeating

Psychotherapy for neurogenic overeating

Information psychotherapy. The psychologist explains that compulsive overeating is a complex biopsychic disorder. The reason for his development is not weak character and spoiledness. He talks about the futility of trying to diet. Instead, a rational nutrition system will be proposed. The psychologist will teach you how to keep a food diary, indicating what time and what was eaten. A psychologist helps increase motivation, which allows a person to adhere to a healthy diet and exercise.

Cognitive therapy. It is aimed at reducing dependence on food. The psychologist’s task is to teach the patient constructive ways to deal with stress, increase stress resistance and self-control. The technique has proven itself well in cases of psychogenic overeating. Therefore, it is recommended to use it from the beginning of treatment.

Psychoanalysis. During the sessions, the psychologist helps to identify the underlying problems that caused the eating disorder. One of the main stages of treatment is accepting tormenting thoughts and speaking them out.

Group psychotherapy. When treating compulsive overeating, it is helpful to interact with people who have the same problem.

Drug treatment of neurogenic overeating

Appetite suppressants are not effective for compulsive overeating. Preference is given to drugs acting on the central nervous system.

Antidepressants. This group of drugs normalizes serotonin levels in the nervous system - Topamax.

Prevention of psychogenic overeating

Prevention of compulsive overeating is the formation of correct attitudes about nutrition - food is not a pleasure or a reward, but a necessity. It is also necessary to increase stress resistance and develop healthy eating habits - eating small portions by the hour.

Psychogenic loss of appetite

Psychogenic loss of appetite– lack of need for food due to nervous shock. Refusal to eat can be caused by stress, conflicts in the family and at work, or the loss of a loved one. The consequence of loss of appetite due to nervousness is rapid exhaustion of the body, loss of physical strength, worsening emotional state, and the development of depression.

With psychogenic loss of appetite, unlike anorexia, a person’s goal is not to fight excess weight. He does not consider himself fat and perceives his body adequately.

The prevalence among women is 2-3%. It is more common among those trying to lose weight, since at a subconscious level they have a desire to give up food.

Psychogenic disorders do not include loss of appetite due to infectious diseases and diseases of the digestive system.

Causes of psychogenic loss of appetite

Stress and strong emotional stress. Conflicts, situations that pose a threat to life or well-being, preparing for exams or reports, loss of a job, breakup of relationships.

Disturbances in hormone production due to stress. Decreased synthesis of digestive system hormones (ghrelin and insulin), which are responsible for appetite. Disturbance in the production of hormones of the hypothalamus and pituitary gland.

Disturbances in the functioning of hunger centers in the brain and spinal cord. Negative emotions and intense mental work can change how the brain works. Stress causes disturbances in the transmission of nerve impulses between appetite centers.

Depression This is one of the most common causes of loss of appetite.

Types of psychogenic loss of appetite

Primary psychogenic loss of appetite– develops immediately after stress or during severe mental or mental stress. Provokes the development of depression

Secondary psychogenic loss of appetite– develops against the background of depression and neurosis that arose after suffering psychological trauma.

Symptoms and manifestations of psychogenic loss of appetite

Lack of appetite. The person does not feel the need for food. At the same time, he may feel discomfort in the stomach caused by hunger, but not react to them.

A person deliberately forces himself to eat, despite lack of appetite. This is a favorable course of the disorder.

Refusal of food. The offer to eat is rejected on principle - this is the second possible model of behavior in this situation. She talks about severe psychological trauma.

Diagnosis of psychogenic loss of appetite

The diagnosis of “psychogenic loss of appetite” is made on the basis of complaints from the patient or his relatives, provided that the person does not have diseases of the digestive system or other causes of loss of appetite. The following are taken into account:

• Refusal of food
• Weight loss,
• Depressed mental state
• Signs of physical exhaustion.

Treatment of psychogenic loss of appetite

Psychotherapy for psychogenic loss of appetite

Cognitive behavioral therapy. At the initial stage of psychotherapy, it is necessary to minimize the consequences of mental trauma, after which treatment of the eating disorder begins. A psychologist helps to form a positive attitude towards eating.

Drug treatment psychogenic loss of appetite

Vitamin complexes with minerals to combat vitamin deficiency - Multitabs, Pikovit.

Drugs to increase appetite plant-based - wormwood tincture, plantain juice.

Nootropics to improve the functioning of the nervous system - Bifren, Glycised.

Prevention of psychogenic loss of appetite

Prevention involves increasing resistance to stress and developing healthy self-esteem and attitudes towards food.

Psychogenic vomiting

Psychogenic vomiting or nervous vomiting - a reflex eruption of stomach contents under the influence of stress. Sometimes psychogenic vomiting is not preceded by nausea. The contents of the stomach are expelled spontaneously as a result of spasm of the muscles of the abdominal wall and stomach.

Unlike bulimia, vomiting occurs unintentionally. A person does not set a goal to cleanse the stomach in order to avoid digesting food and gaining excess weight.

Isolated cases of psychogenic vomiting occurred in 10-15% of people. People with an excitable nervous system regularly face this problem. In most cases, these are children, adolescents and young women under 35 years of age. Only 1/5 of those suffering from this disorder are men.

Causes of psychogenic vomiting

Fear and anxiety. The most common reasons. In this case, vomiting occurs exclusively before a significant and exciting event.

Stress. Psychogenic vomiting is caused by acute stress, chronic stressful situations (loneliness, parental divorce), prolonged nervous tension - a difficult period at work.

Excessive emotionality - a personality trait that increases the likelihood of nervous vomiting.

Increased excitability nervous system. Excitation processes predominate in the brain, which can affect the functioning of the vomiting centers located in the medulla oblongata, thalamus and cortex. Excitation in this area causes morning psychogenic vomiting in children.

Hereditary predisposition. The risk of developing the disorder is higher in people whose parents suffered from motion sickness and psychogenic vomiting.

Types of psychogenic vomiting

Anxious vomiting- reaction to fear and anxiety.

Jet vomiting- appears on the basis of unpleasant associations when seeing food: pasta - worms, homemade sausage - excrement.

Hysterical vomiting– reaction to stress and associated negative emotions;

Habitual vomiting- a manifestation of the fact that a person constantly suppresses his emotions.

Symptoms and manifestations of psychogenic vomiting

• Vomiting without nausea, especially occurring on an empty stomach and not associated with poisoning, infections or diseases of the digestive system.
• Vomiting after stress or before frightening events.
• Vomiting at the sight of food that causes unpleasant associations.
• Vomiting against the background of negative emotions that a person cannot throw out.

Diagnosis of psychogenic vomiting

First, you need to be examined by a gastroenterologist to rule out diseases of the digestive system. When diagnosing nervous vomiting, the doctor pays attention to the connection of attacks with the emotional and mental state of a person, with food intake, as well as their frequency and regularity.

Treatment of psychogenic vomiting

Psychotherapy

Cognitive and behavioral therapy. The techniques used by a psychologist will help increase stress resistance and make it easier to respond to problems and conflicts.

Suggestive therapy. Its goal is to improve the functioning of the central and autonomic nervous systems. Elimination of foci of excitation in the vomiting centers.

Drug treatment

Electrolyte solutions for the correction of electrolyte disturbances. Necessary for dehydration caused by frequent bouts of vomiting - rehydron, humana electrolyte.

Antipsychotics used to treat nervous nausea and vomiting - Haloperidol, Prochlorperazine.

Antidepressants used to reduce the excitability of the nervous system - Coaxil

Prevention of psychogenic vomiting

Allotriophagy

Allotriophagy has other names - perversion of taste or perversion of appetite. This is an eating disorder in which a person has a tendency to lick or swallow inedible or inedible objects - coal, chalk, coins.

Perversion of taste is more common in low-income and dysfunctional families. Young children and pregnant women are more susceptible to it. Similar behavior occurs in mentally healthy people, as well as in autism and schizophrenia.

Perversions of appetite are a common problem among children under 3 years of age, but the older the child becomes, the less often perversions of taste occur.

Psychological trauma– separation from loved ones, pathological relationships with parents.

Boredom. This reason is typical for children. It has been established that allotriophagy occurs in children who lack toys and attention.

Hormonal changes in the body during pregnancy and adolescence.

Nutrient deficiency with improper or insufficient nutrition. For example, eating dirt may indicate a lack of iron or charcoal in the body, eating chalk - a calcium deficiency, soap - a lack of zinc.

Incorrectly formed ideas about edible and inedible. The reason may be characteristics of upbringing or cultural traditions.

Types of allotriophagy

Eating inedible objects– sand, stones, nails, paper clips, glue;

Eating inedible objects - coal, chalk, clay, animal food;

Eating raw foods - minced meat, raw dough.

Symptoms and manifestations of taste perversion

Licking and chewing. Associated with a strong desire to feel their taste.

Eating inedible substances. The goal is boredom, the desire for new experiences and sensations.

Swallowing inedible objects – caused by an inexplicable desire that a person is unable to resist.

Diagnosis of allotriophagy

The diagnosis of “allotriophagy” is made when eating inedible objects based on complaints from the patient or his relatives.

Treatment of allotriophagy

Psychotherapy

Behavioral psychotherapy. Its basic principles are to avoid situations in which there is a desire to taste inedible objects (do not play in the sandbox while eating sand). Noticing thoughts about eating and replacing them with others, as well as rewarding success for success, is a method of positive reinforcement.

Family therapy- building relationships in the family. Parents are advised to communicate more with their child. The tone should be calm and friendly. The method of isolation from stress is practiced. If possible, it is necessary to exclude all factors that overstimulate the nervous system: do not scold the child, limit time in front of the TV, tablet, phone. Keep your child busy with calm games.

Prevention of allotriophagy

Prevention of allotriophagy includes: good nutrition, varied activities and hobbies, and a friendly atmosphere in the family.

Orthorexia nervosa

Orthorexia nervosa- obsessive desire to eat right. Orthorexia differs from the desire for a healthy lifestyle by obsession; it crowds out other interests and hobbies. The topic of healthy food dominates conversations; the person actively encourages others to switch to his diet.

Orthorexia nervosa makes a person indifferent to the taste of food. Products are judged solely on their health benefits. At the same time, a person significantly limits the list of foods consumed, which can lead to a lack of nutrients. For example, vegetarians suffer from a deficiency of essential amino acids and B vitamins.

The consequences of orthorexia are: limited social circle and deficiency of vitamins and chemical elements. Restrictions in food can lead to anemia, vitamin deficiency, and changes in internal organs.

Causes of Orthorexia Nervosa

Tendency to hypochondria- fear of getting sick. Proper nutrition is an attempt to prevent disease.

Neurotic character. The development of orthorexia in mentally healthy people is facilitated by increased suggestibility and scrupulousness. In addition, an obsessive desire for healthy food can be a manifestation of obsessive-compulsive neurosis.

Heightened self-esteem. By adhering to his own nutritional system, a person feels superior to others.

Types of Orthorexia Nervosa

The most common nutritional systems that can become the basis of an eating disorder:

Veganism and vegetarianism– exclusion of animal products.

Raw food diet– refusal of food that has undergone heat treatment (frying, boiling, stewing).

Refusal of products containing GMOs. Genetically modified organisms are products with an altered genetic structure.

Symptoms and manifestations of orthorexia nervosa

Obsessive desire to consume only “healthy” foods. Moreover, the degree of usefulness is assessed subjectively. Often his interests, thoughts and conversations are limited to the topic of proper nutrition.

Limited diet. A person refuses food that is not on his list of “healthy” foods. In some cases, only a few products are included in the menu.

Cooking can be a ritual. Only the right products are used, the cutting board and knife must be ceramic, the dish must be marinated or boiled for a strictly defined period of time.

Changes in social circle. A person communicates exclusively with like-minded people who adhere to the same principles of catering. There have been cases when such people organized a commune to grow food and live separately.

Feelings of guilt that arise when consuming “harmful” foods, although in reality they do not pose a health hazard. When one’s “diet” is violated, a person experiences psychological discomfort and severe anxiety. Due to nervousness, after consuming unusual foods, nausea, vomiting, and abdominal pain may occur.

Fear of “harmful” foods can look like a phobia. In this case, they are disgusting. A person will not consume them for food, even if he is hungry and there is no other food.

Diagnosis of orthorexia nervosa

To date, the diagnosis of “orthorexia nervosa” is not included in the list of diseases.

Treatment of orthorexia nervosa

Psychotherapy is the main method of treatment. In most cases, the method of persuasion is used. A psychologist talks about the benefits of other products. If you eat only certain foods, they, like medicine, can cause side effects: peptic ulcers from eating sour fruits, phosphate kidney stones from dairy products.

Prevention of orthorexia nervosa

Formation of rational ideas about proper nutrition in children and adults.

Selective eating disorder

Selective eating disorder– a type of eating disorder that is characterized by a refusal to consume certain foods. In this case, a person is guided not by health benefits, but by subjective criteria: color, shape, associations. When he sees these products, he experiences fear and disgust. The phobia can be triggered by the smell of this food, and even talking about it.

This disorder differs from ordinary picky eating by a large range of foods that a person cannot tolerate. This significantly impoverishes the diet, causes weight loss and complicates communication with others. For example, a person is forced to refuse business lunches or family holidays accompanied by a feast.

Selective eating disorder is a relatively rare disorder that is more susceptible to children.

Selective eating disorder can pose a health risk when most foods are excluded from a person's diet and their diet is limited to only certain foods.

Causes of selective eating disorder

Psychological injuries associated with these products.

Diseases that develop after consuming these products. Moreover, it is not necessary that the product caused poisoning or food intoxication; perhaps its consumption coincided with the onset of the disease.

Incorrect introduction of complementary foods. Often disgust and phobia are associated with foods that parents forced the child to eat against his will.

Types of Selective Eating Disorder

• Refusal of vegetables and fruits
• Avoidance of animal products
• Avoiding any solid food

Symptoms and manifestations of selective eating disorder

Fear arising from the thought, sight or smell of certain foods or dishes. These can be a variety of phobias: fear of hot or cold, round or colored foods, fear of sour, bitter, salty tastes.

Rationalization of fear. The person explains his fears: “I’m afraid to choke, choke. I'm afraid the food will stick to my throat and I won't be able to breathe. I'm afraid of getting poisoned."

Diagnosis of selective eating disorder

Selective eating disorder is a disease only if one or more of the following conditions are met:

• Refusal of a large range of products;
• The disorder negatively affects a person's health by causing vitamin or protein deficiency;
• Body weight decreases in adults, physical development slows down in children and adolescents;
• Dependence on certain foods develops;
• Fear and negative emotions associated with foods disrupt emotional well-being.

Treatment of selective eating disorder

Behavioral therapy. During the treatment process, a person performs tasks that are aimed at getting used to the products. For example, he is asked to choose vegetables, then cook them, and in subsequent sessions they move on to tasting new dishes. Gradually, addiction sets in and the fear goes away.

Preventing selective eating disorder

Prevention is the gradual and non-violent introduction of a child or adult to a variety of dishes. Expanding its menu according to age.

Eating disorders in children

Eating disorders in infancy and childhood

Eating disorders in children early ages are widespread. To one degree or another, they are observed in 25-40% of children from 6 months to 6 years. In most cases, these are temporary phenomena that disappear with age.

Causes of eating disorders in children

• Violation of mother-child contact when little attention is paid to the child.
• The wrong type of feeding is feeding the baby while sleeping, long feedings lasting more than an hour.
• Food that is not appropriate for the child’s age does not taste good to him. Too early introduction of complementary foods and solid foods, early spoon feeding.
• Too persistent introduction of new food causes internal protest and aversion to any food.
• Psychological conflicts in the family.
• Stress – animal attack, injury, hospitalization.
• Attempts to manipulate adults in demanding children who are the center of attention of the family.
• Extreme pickiness about food.
• Curiosity. The child is interested in new tastes and new behavior patterns. If his action caused an emotional reaction from an adult, then the child will most likely repeat this action.
• Among the causes of eating disorders, we do not consider mental retardation, diseases of the oral cavity or digestive organs, although these diseases can have the same manifestations as eating disorders.

Types of eating disorders in children

• Refusal of food. The child refuses to open his mouth, turns away when feeding, and spits out food. This is the so-called childhood anorexia.
• Rumination disorder. Regurgitation of food followed by chewing. The baby regurgitates a small amount of food and chews it again. At the same time, he does not feel nausea or the urge to vomit.
• Perversion of taste – eating inedible objects. It is very widespread, since up to 2 years of age a child may not distinguish edible from inedible. Because of this, this behavior in younger children is not considered a disorder.

Diagnosis of eating disorders in children

The described violations appear every day for a month or more, despite the parents’ attempts to change the situation.

Treatment of eating disorders in children

• The basis of treatment is psychotherapy. It includes:
• Creating a calm and friendly environment - spend more time with the child, keep him busy with quiet games and walks, and reduce watching TV.
• Eliminating situations in which eating disorders manifest themselves is not allowing them to play in the sandbox if the child eats sand.
• Adjust your diet. Feed when the child is hungry, no earlier than 4 hours after the previous feeding, exclude snacks - cookies, fruit. They are offered after the main meal.

Prevention of eating disorders in children

The child must receive food appropriate for his age. If he refuses to try new foods, then don't insist. Re-offer them in 2-3 weeks. Don't force feed. Make sure your child works up an appetite. If possible, relieve him of stress.

Eating disorders in adolescents

Eating disorders in adolescents are widespread and are associated with a variety of causes. Teenagers focus on their appearance, considering appearance and slimness the basis for success among their peers. In addition, adolescence is difficult psychologically - mood swings and changes in appearance caused by hormonal changes, separation from parents and the formation of independence, as well as instability of self-esteem create the ground for eating disorders.

Causes of eating disorders in teenagers

Disturbances in the relationship between mother and child in the first year of life. From the point of view of psychoanalysis, attention deficit and early refusal of breastfeeding cause fixation on the oral-dependent period. It is believed that this can cause eating disorders in children and adults.

Hereditary predisposition. Often, eating disorders in adolescents are caused by genetically determined characteristics of the nervous system, which are inherited from their parents.

Social factors. Statements from parents and peers about excess weight, the imposed stereotype of being thin as an essential component of success, and the desire to please members of the opposite sex push teenagers to extreme weight loss measures. Due to ignorance, teenagers do not realize the danger and harm of their actions.

Personality characteristics. Low self-esteem and uncertainty about one’s attractiveness are the main factors that form all eating disorders in adolescents.

Types of Eating Disorders in Teens

Teenage anorexia– refusal of food in order to lose weight. Teenagers consider themselves fat for no reason and actively use all means of losing weight available to them. Anorexia ranks 3rd among chronic diseases among adolescents.

Teenage bulimia– artificially induced vomiting to reduce food absorption. Also aims to reduce weight.

Psychogenic vomiting– unintentional vomiting associated with nervous tension, mental fatigue and stress.

Perversion of taste, perversion of appetite - the desire to taste inedible and inedible objects (lime, chalk, coal, matches), sometimes swallowing them. It is less common than other eating disorders in adolescents.

Symptoms and manifestations of eating disorders in adolescents

Symptoms of teenage anorexia

• Expressing dissatisfaction with your body, fatness, hip size, chubby cheeks.
• Refusal of high-calorie foods. Significant reduction in portions of food eaten.
• Sudden weight loss in a short period of time. Stopping growth.
• Intense exercise, other means to accelerate weight loss, appetite suppressant pills, weight loss tea.
• Depressed mood, lethargy.
• Chilliness, cold hands and feet.
• Menstrual irregularities or absence of menstruation.

Symptoms of teenage bulimia

• Alternating periods of restricting oneself in food, gluttony and “cleansing” the body.
• Careful calorie counting and selection of low-calorie foods.
• Dissatisfaction with excessive completeness. Pangs of conscience after overeating.
• The habit of seclusion after eating in order to induce vomiting and clear the stomach.
• As a rule, teenagers keep binge eating and purging secret and parents may not know about it for a long time.
• Depression, tendency to depression.
• Multiple caries, frequent throat problems, hoarseness.
• Weight changes. Stunted growth.

Symptoms of adolescent psychogenic vomiting

• Attacks of vomiting during periods of increased mental stress, worries, fear, anxiety, after stressful situations.
• Vomiting as a manifestation of protest. It can occur when a teenager is forced to do something against his will, be it traveling, studying or eating.
• Vomiting as a way to attract the attention of adults.
• Increased excitability of the nervous system, manifested by excessive emotionality, anger, and tearfulness for minor reasons.
• The attacks are not associated with food intake, poisoning or diseases of the digestive system.

Symptoms of teenage taste perversion

The diagnosis for a teenager is made based on information collected during a survey of the child and his relatives. In this case, it is necessary to examine the general condition of the body in order to identify disorders in the organs caused by an eating disorder. The examination includes:

• Blood, urine, stool tests;
• Ultrasound of the abdominal organs;
• Gastroscopy and other studies (if necessary).

Treatment of eating disorders in adolescents

Diet becomes the basis of treatment. Food is given in small portions 5-6 times a day. At first, the calorie content of the daily diet is 500 kcal, gradually increasing it to the age norm.

Psychotherapy

Family therapy plays a leading role in the treatment of adolescents, since support and good relationships within the family are the basis for successful treatment. The psychologist gives advice on how to improve relationships with a teenager and between other family members.

Behavioral therapy is aimed at changing thinking patterns, developing a healthy attitude towards your body and food, and increasing self-esteem. The psychologist will tell the teenager how to change his thinking and behavior in order to get rid of an eating disorder. A change of environment and social circle is recommended. Treatment in a sanatorium gives good results.

Suggestive and hypnotherapy. Suggestion in a state of half-asleep helps to remove a negative attitude towards treatment and food.

Drug treatment of eating disorders in adolescents

Treatment begins with restoring the functions of internal organs. Gradually return the teenager to a normal diet.

Antidepressants, tranquilizers and antipsychotics are prescribed only in cases where the disorder does not respond to other treatment methods.

Prevention of eating disorders in adolescents

• It is important to avoid heavy stress on the nervous system. Significant educational loads and a large number of additional tasks cause overwork of the nervous system and foci of excited neurons in different parts of the brain.
• Balanced diet. The menu should include tasty and varied dishes. The amount of food should meet the needs of the teenager and ensure normal growth and development.
• Food should not be a reward or the main source of pleasure.
• It is necessary to support a teenager to develop adequate self-esteem.

Now no one will argue that mental health most directly affects physical health. But it is difficult to imagine such a direct connection between these two concepts, as is the case with the consequences of mental disorders called “ eating disorders».

What are eating disorders?

Eating disorders or eating disorders are deviations from normal eating behavior. Normality is understood as regular healthy eating that does not cause any physical or psychological discomfort in a person. But in the case of eating disorders, the emphasis shifts either to cutting down your diet or to exaggerating its increase. At the same time, it is worth distinguishing between such concepts as “dietary nutrition” and “eating disorders”.

The goal of the diet is to restore health; ideally, it should always be prescribed by a nutritionist, and some restrictions in the diet only contribute to recovery and sometimes weight loss. If we talk about eating disorders, then we should mean, firstly, unauthorized operations uncontrolled by doctors to change one’s normal diet, which ultimately lead not to recovery, but to a significant deterioration in a person’s health, and sometimes to death, because the body urgently needs a balanced diet for normal functioning, otherwise you should expect trouble.

Let's talk in more detail about the main typical cases of eating disorders.

– pathological behavior in which a person specifically refuses to eat, driven by dominant desires for thinness and fear of gaining weight. Often, the actual state of affairs regarding the weight of an anorectic does not correspond to his ideas about himself, that is, the patient himself thinks that he is too fat, while in reality his weight can hardly be called sufficient for life.

Psychological symptoms of anorexia are: obsessive thoughts about one’s own fatness, denial of the presence of a problem in the area of ​​nutrition, violation of eating methods (cutting food into small pieces, eating while standing), depression, poor control over emotions, changes in social behavior (avoidance, reclusiveness, sudden changes in priorities and interests ).

Physical symptoms of anorexia: problems with the menstrual cycle (amenorrhea - absence of menstruation, algodismenorrhea - painful menstruation), cardiac arrhythmia, constant weakness, feeling cold and inability to warm up, muscle spasms.

The consequences of anorexia are dire. In pursuit of the modern ideal of beauty, which is expressed in emphasized thinness, anorexics forget about the other components. As a result, patients begin to look terrifying: due to insufficient supply of nutrients, the skin becomes dry and pale, hair falls out on the head and small hair appears on the face and back, numerous swelling appears, the structure of the nails is disrupted, and all this against the background of progressive dystrophy in the form protruding under the skin of the skeleton.

But all this cannot be compared with the danger of death of patients. According to statistics, if anorexia is not treated, every tenth patient dies. Death can occur as a result of a malfunction of the heart, due to a general inhibition of all body functions, or due to.

Bulimia nervosa– an eating disorder, manifested in the inability to control one’s appetite, is expressed in periodic bouts of painful hunger, which is very difficult to satisfy.

People with bulimia experience an obsessive desire to eat, even if they do not feel hungry. Often this behavior leads to obesity, but this is not a necessary indicator, since many patients, driven by a sense of guilt, prefer to empty the stomach of food by inducing vomiting. The patterns in which patients with bulimia act can be different, but basically the disease manifests itself in an attack-like desire to eat (sudden manifestation of increased appetite), in nighttime overeating (hunger increases at night) or in the constant incessant absorption of food.

The mental symptoms of bulimia are similar to the mental symptoms of anorexia, but the physical symptoms are different. If a bulimic, subject to ravenous hunger, does not stop eating, then the natural and least of the consequences will be obesity. However, if the patient prefers to empty the stomach after each meal, the situation gets worse.

Firstly, bulimics, like anorectics, try to hide their behavior for as long as possible, if in the latter it manifests itself quite quickly (relatives notice that the person does not eat anything), then in the former it is possible to hide their condition for a relatively long time, because with the help of vomiting the weight is kept in a stable state within the normal range and the person often demonstrates a good appetite, which does not prevent him, however, from flushing what he eats down the drain after a while. Therefore, loved ones may not even realize that there is a person next to them who is in dire need of help. After all, after some time and as a result of such manipulations with your body, your health fails.

Secondly, vomit contains gastric juice, which consists of hydrochloric acid and some other digestive agents. These substances, when regularly inducing vomiting, destroy the delicate walls of the esophagus, which is not at all intended for such an effect, becoming the causes of ulcerations. The oral cavity also suffers, tooth enamel is destroyed and there is a real risk of tooth loss. We should not forget that those who use such a “weight control method” for bulimia, just like anorectics, do not receive sufficient nutrition, because the food simply does not have time to be digested, which in the future threatens exactly the same problems with physical health and death.

In addition to these two types of eating disorders, researchers have identified many others. For example, orthorexia (obsessive desire to eat only the right healthy food), selective eating disorder (when a person necessarily strives to eat only certain foods, avoiding all others and also new unfamiliar foods), eating inedible things, obsessive-compulsive overeating (when eating is caused by obsessive desire to be safe and plays the role of a “ritual” when ).