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Recognizing the Signs of an Eating Disorder

Dec 28, 2016 11:15AM ● By MED Magazine
By Alex Strauss

An estimated 20 million women and 10 million men suffer from eating disorders at some time in their lives, according to the National Eating Disorders Association. Although healthcare professionals may immediately think of anorexia or bulimia, which are most often seen first in adolescents, clinical social worker Brandy Bunkers, CSW-PIP, of Clarity Counseling in Sioux Falls says binge eating disorder should also be on the healthcare professional’s radar.

“Bulimia and anorexia are often about control issues,” says Bunkers. “With binge eating, it’s a feeling of being out of control. A person may eat beyond full, eat very fast, eat alone, or eat when they are not hungry. They often feel very bad about themselves afterward. It’s more than just occasional overindulgence.”

Although some of Bunkers’ clients are sent to her by concerned parents, many are referred by healthcare providers who have learned to recognize the warning signs of a potential eating disorder. These may include weight fluxuations, a tendency toward chronic dieting, amenorrhea, regurgitation issues, elevated creatinine, metabolic disturbances or bradycardia. 

“Another situation to be aware of, if an eating disorder is suspected, is a family history of chemical dependency, anxiety, eating problems or depression,” says Bunkers. “As with many mental health issues, there can be more than one component. Sometimes, a trauma will underlie the problem or may even have triggered it.”

Even providers who know the signs may be reluctant to broach the sensitive subject of eating disorders with patients. But Bunkers warns that it can be a mistake to try to “lighten the mood” or allay patient concerns with a dismissive comment.

“Sometimes, providers don’t realize the potential impact of a casual or flippant remark,” says Bunkers. “For a patient who is struggling with an eating disorder, the number that they get on that scale can represent a lot more than their physical health. It can be closely connected to a their feelings of control, self-esteem, and even self-worth.”

Patients struggling with such issues may also have problems concentrating, may exhibit mood changes, foggy thinking, low energy and even changes in the way they socialize. “Patients with eating disorders may isolate themselves,” says Bunkers. “Asking questions about how they are spending their time can sometimes indicate if there is a problem.”

Fortunately, eating disorders typically respond well to a combination approach of nutritional counseling and cognitive behavioral therapy to work through the emotional issues underlying the disorder. Bunkers says counseling records should be shared with the referring physician to ensure a continuum of care for the patient.

“It is important that everyone is one the same page,” she says. Counseling may last three to six months and may require ongoing maintenance visits.

Brandy Bunkers, CSW-PIP, owns Clarity Counseling, LLC, in Sioux Falls. She is a member of the Academy for Eating Disorders and The International Association of Eating Disorders Professional Foundation.