Weight and Mental Health

Let’s not forget the mental health aspect of weight and obesity!

Americans are getting bigger. There is a wealth of research data to support what all of us who have lived long enough to see. A quick Internet search of the oft-repeated mantra of “eat to live, don’t live to eat” found 366 million hits.

Clearly weight and eating are hot button topics.

Although obesity is in the spotlight, there are other eating disorders recognized by the mental health community.

Anorexia nervosa is a disorder in which individuals have a distorted body image. The anorexic sees herself as overweight, even when she is extraordinarily thin.

People suffering from this disorder may refuse to eat, have rigid rules about eating, may exercise excessively, and may vomit or abuse laxatives to control their weight. On rare occasions the anorexic may literally starve to death.

Individuals suffering from bulimia anorexia are often of average weight. They tend to eat excessive quantities of food and use laxatives, enemas, diuretics, vomiting, or excessive exercise to counter the binge episode and thus undo the damage.

Similar to individuals suffering from bulimia, those with binge eating disorders experience episodes of out of control eating, frequently with easily digestible and high caloric food. Unlike the bulimic, the binge eater does not resort to purging or exercise regimes.

Eating disorders have at their root certain psychological factors. Common themes include low self-esteem, feelings of helplessness, and unhappiness about appearance.

Research finds that there are common triggers to the development of an eating disorder. Having been teased about one’s appearance or nagged about weight as a child have been frequently found.

Certain sports, such as wrestling, and gymnastics, put a high degree of emphasis on maintaining a slim and lithe figure and can contribute to body distortion. Trauma and negative emotions can also trigger an eating disorder.

Once an eating disorder begins, the problem often becomes self-perpetuating. With the bulimic, the relief of undoing the caloric intake through purging is immense and very reinforcing. The anorexic may take pride in being model thin, ignore the health complications, and disregard how eating is now ruling her life. The binge eater finds temporary relief from emotional pain through the enjoyment of food.

Eating disorders don’t go away on their own. An eating disorder can be highly destructive to physical health and can cause immense personal misery.

Potential health problems include high blood pressure, cardiac disease, high cholesterol, diabetes, dental cavities, bone loss, disruption to the menstrual cycle, and anemia. A person with an eating disorder is likely to also suffer from depression as well as problems with anxiety, anger, and interpersonal relationships.

Counseling is very helpful to the treatment of eating disorders. With seriously disruptive eating patterns, a treatment team approach is optimal. In addition to the psychotherapist, the treatment team is often composed of a physician, a nutritionist, and the patient.

The role of counseling is to help the client change thoughts and behaviors so as to alter the eating patterns. Psychotherapy will help the client become mindful about eating and self, replace negative thoughts and behaviors, and work to improve interpersonal relationships.

Dorothy Rosenke, PsyD, is a psychologist with Albemarle Counseling Group. She may be reached at 335-2018


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