Eating disorders and ACT

What is an eating disorder?

An eating disorder is a serious mental health condition characterised by abnormal eating habits and thoughts about food and body weight. It involves a complex interplay of psychological, emotional, and physical factors. Individuals with eating disorders often have a distorted perception of their body image and an intense fear of gaining weight.

There are several types of eating disorders, including:

• Anorexia nervosa: People with anorexia nervosa have an extreme fear of gaining weight and a relentless pursuit of thinness. They severely restrict their food intake, leading to significant weight loss and a distorted perception of their body size and shape.
• Bulimia nervosa: Individuals with bulimia nervosa engage in recurrent episodes of binge eating, followed by compensatory behaviours such as self-induced vomiting, excessive exercise, or the misuse of laxatives or diuretics. They often feel a loss of control during binge episodes and are preoccupied with their body shape and weight.
• Binge eating disorder: This disorder involves recurrent episodes of binge eating without the compensatory behaviours seen in bulimia nervosa. People with binge eating disorder may consume a large amount of food rapidly, feel a lack of control during the episode, and experience distress or guilt afterward.
• Other specified feeding or eating disorders (OSFED): This category includes eating disorders that do not meet the specific diagnostic criteria for anorexia, bulimia, or binge eating disorder but still cause significant distress and impairment. Examples include atypical anorexia nervosa (characteristics of anorexia but without low body weight) and purging disorder (engaging in purging behaviours without binge eating).

Eating disorders can have severe physical, emotional, and social consequences. They require professional diagnosis and treatment, typically involving a combination of psychological therapy, nutritional counselling, and medical monitoring.
What are some common signs and symptoms of eating disorders?

Here are some common signs and symptoms associated with eating disorders:

• Drastic weight changes: Significant weight loss or fluctuations may be a noticeable sign, especially in cases of anorexia nervosa or bulimia nervosa. However, it’s important to note that individuals with binge eating disorder may have a range of body weights.
• Distorted body image: A distorted perception of one’s body size, shape, or weight is a common characteristic of eating disorders. Individuals may perceive themselves as overweight, even when they are underweight or at a healthy weight.
• Restrictive eating patterns: Strict dietary rules, avoiding specific food groups, or severely restricting caloric intake are common behaviours in eating disorders. Meals may be skipped, and portion sizes may be excessively small.
• Preoccupation with food and weight: Constant thoughts about food, calories, and weight are common in individuals with eating disorders. They may obsessively count calories, read food labels, or engage in excessive meal planning.
• Disordered eating behaviours: This includes binge eating (consuming large amounts of food in a short period with a loss of control), self-induced vomiting, excessive exercise, laxative or diuretic misuse, or fasting.
• Emotional and behavioural changes: Individuals with eating disorders may exhibit mood swings, irritability, anxiety, depression, social withdrawal, or a loss of interest in previously enjoyed activities.
• Physical symptoms: Physical signs can vary depending on the specific eating disorder but may include fatigue, dizziness, weakness, fainting, hair loss, dry skin, brittle nails, constipation, irregular menstrual cycles (in females), and cold intolerance.
• Rituals around eating: Developing elaborate rituals or specific behaviours around food, such as cutting food into small pieces, eating in secret, or avoiding eating in public, are common indicators.

It’s important to note that not all individuals with eating disorders exhibit all these signs and symptoms. Additionally, the severity and combination of symptoms can vary widely among individuals.

How can ACT therapy be used to support someone with an eating disorder?

Acceptance and commitment therapy (ACT) can be a valuable approach in supporting individuals with eating disorders. Here are some ways in which ACT can be used:

• Mindfulness: Mindfulness techniques can help individuals with eating disorders develop non-judgemental awareness of their thoughts, emotions, and bodily sensations related to food, eating, and body image. This awareness can help them disengage from unhelpful thoughts and develop a more compassionate and accepting relationship with themselves.
• Self-compassion: Individuals with eating disorders often have high levels of self-criticism and self-judgement. ACT helps individuals cultivate self-compassion by encouraging them to treat themselves with kindness, understanding, and acceptance. Through cognitive defusion techniques, individuals can reduce the impact of negative self-talk and develop a more flexible and compassionate perspective.
• Values clarification: By clarifying their values, individuals with eating disorders can shift their focus from pursuing weight loss or controlling food to living a meaningful and fulfilling life aligned with their values. This shift can provide motivation and guide decision-making regarding their behaviours around food and body image.
• Commitment to change: ACT encourages individuals to make a commitment to take actions aligned with their values despite the presence of difficult thoughts, emotions, or urges. In the context of eating disorders, this may involve engaging in behaviours that promote a healthy relationship with food, body acceptance, self-care, and seeking support. ACT supports individuals in building resilience and persistence in making sustainable changes.

It’s important to note that ACT is just one therapeutic approach, and its effectiveness may vary for each individual. A qualified mental health professional with experience in treating eating disorders can tailor ACT techniques to the specific needs and circumstances of the individual.

For individuals:

If you have concerns that you or someone you know might be experiencing an eating disorder, it is vital to seek assistance from a healthcare professional or a specialist in mental health. We offer high quality, evidence based psychological therapy for a range of issues, including eating disorders. Visit our therapy page to learn more or self-refer.

For professionals:

If you would like to learn more about how ACT can support people with eating disorders take a look at our workshop schedule or visit our blog for the latest insights into ACT therapy.