Help with Eating Disorders

Your Way Out of Eating Disorders

Eating disorders often begin in adolescence or early adulthood. The most common include anorexia, bulimia and binge eating disorder. The number of cases of orthorexia is also increasing; those affected suffer from compulsive healthy eating behavior. Here you can find out how to recognize the signs, what consequences chronic eating disorders can have and how I can help you with therapy.

Anorexia in children and adolescents (anorexia)

Children and young people are increasingly suffering from anorexia (medically known as anorexia). The number of cases among those under 14 is constantly increasing. However, the eating disorder manifests itself differently in these children than in adults. This makes it all the more important to recognize anorexia early on, as the effects on young people's bodies and psyches are serious.

Learn more about anorexia

Bulimia: Loss of Control
during the meal

In everyday life, we often talk about binge eating. In medicine and psychology, this eating disorder is known as bulimia. Those affected cannot be seen to have the disorder. Nevertheless, it has serious consequences and effects on the body and psyche.

Learn more about bulimia

Orthorexia: When healthy eating becomes a compulsion

If healthy eating habits go too far, psychological problems develop from the good approach. Doctors call the overall picture orthorexia nervosa. Scientific research on this is still in its infancy. One thing is already clear: orthorexic eating habits can, but do not have to, be part of a real eating disorder.

Learn more about orthorexia

binge eating

People with binge eating disorder suffer from recurring eating attacks. During these attacks, they lose control of their eating behavior. Hunger, satiety, or enjoyment play no role. Unlike bulimics, they do not want to get rid of the food they have eaten.

Learn more about binge eating

Magersucht bei Kindern und Jugendlichen (Anorexie)

Anorexic children do not count calories

Children and young people are increasingly suffering from anorexia (medically known as anorexia). The number of cases among those under 14 is constantly increasing. However, the eating disorder manifests itself differently in these children than in adults. This makes it all the more important to recognize anorexia early on, as the effects on young people's bodies and psyches are serious.

How do I recognize anorexia in children and adolescents?

Children and adolescents who suffer from anorexia do not count calories. However, they pay close attention to what they eat and are convinced that any food intake makes them (too) fat. This view is accompanied by fear and feelings of guilt in the sense of: "If you succumb to your previous preferences for food, you are too weak." It often begins with gradual changes:

individual abstinence, for example from sweets
healthy foods come to the fore
Main meals are disappearing more and more from the daily schedule
excessive physical activity, sometimes leading to self-abandonment and complete exhaustion

This distinguishes them from adult anorexics, who usually get rid of food they have eaten by vomiting or taking laxatives.

Wie erkenne ich Magersucht bei Kindern und Jugendlichen?

Answers to the following questions can give your doctor important information:
Does your child often worry about his or her weight?
Do you often talk about losing weight?
Is healthy food extremely important for your child?
Does your child always look at his or her body critically?
Does he or she suffer from persistent concentration problems?
Is it suffering from weight loss?
Does your child often feel cold, even when other people find the ambient temperature pleasant?

Causes: Dissatisfaction and insecurity

Anorexia is a complex problem because there are many different triggers. In addition, there are always individual reasons - personal or family-related.

It often starts with the hormonal changes that the organism of young people goes through. Hormones cause a lot of things to become confused. Above all, they influence our emotional life. A person who is already looking for orientation and is therefore emotionally unstable is literally overwhelmed by the unknown emotions. In addition to the hormonal fluctuations, children and young people often experience dissatisfaction and insecurity.

anorexia before puberty

Doch wie so oft, lässt sich auch dieses medizinische Zusammenspiel nicht verallgemeinern. Viele Kinder werden bereits vor der Pubertät magersüchtig. Experten sprechen in diesem Fall von einer bestehenden Körperschemastörung. Soll heißen: Betroffene nehmen ihren Körper anders wahr, als er tatsächlich aussieht. Das Körperbild im Spiegel wirkt auf sie verzerrt. Sie erscheinen sich selbst als zu dick. Werden diese Eindrücke von schulischen „Wettbewerben“, wie „Wer wiegt wie viel?“ oder „Wer ist der/die Dünnste in der Klasse?“ begleitet, bekommen die falschen Eindrücke von sich selbst neue Nahrung. Auch in diesem Fall ist es meist ein fehlendes Selbstbewusstsein oder Selbstwertgefühl, das betroffene Kinder und Jugendliche versuchen, zu kompensieren. Viele von ihnen leiden an Ängsten, in einigen Fällen kommen genetische Ursachen hinzu. Eine US-amerikanische Studie aus dem Jahre 2017 hat gezeigt, dass Magersucht vererbt werden und so eine weitere Ursache das Risiko zumindest verstärken kann.

anorexia during puberty

Puberty is a challenge for children and young people. The influence of social media and the almost immeasurable input from outside has made some things even more difficult. Is it any wonder that more and more young people are losing their bearings? Also, and especially when it comes to their own health. More and more young people are suffering from anorexia. Until a few years ago, it was mainly the group of 15 to 19-year-old girls, but the number of cases of anorexia among those under 14 is continuously increasing. Incidentally, more boys are affected in childhood than in older age groups.

Mehr über Emetophobie erfahren

Far-reaching consequences of anorexia in children and adolescents

Many anorexic children and adolescents become depressed and lose the will to live. The physical problems are particularly dangerous: certain hormones are suppressed by the self-imposed refusal to eat, which can lead to growth delays. Bone development is also impaired, which increases the risk of osteoporosis in later years. Studies have shown that anorexia in childhood and adolescence also affects brain development and slows down thought processes.

The earlier anorexia or anorexia nervosa is recognized and treated, the better. Scientists believe that 3 years is a dangerous threshold for permanent damage. However, thanks to the high sensitivity of pediatricians, this time period rarely occurs.

Behandlung: Wege aus der Magersucht

In addition to an individually developed nutrition and occupational therapy plan, anorexia should be treated with psychotherapy. In my practice, I put the background of the anorexia at the beginning of therapy. This usually begins after a stay in hospital in order to make those affected more stable in the important phase of independent, new behavior and to prevent a relapse. Treatment takes place in weekly sessions. Successful therapy can last for years, because in some cases anorexia accompanies those affected for a lifetime.

It is about the careful treatment of possible causes that triggered the anorexia. These include family aspects, sibling status, school situation, but also self-imposed expectations. I work with the so-called family board or family constellation. This is supplemented by elements of talk therapy, schema therapy, cognitive behavioral therapy, as well as hypnosis, EMDR*, EFT** or ear acupuncture.

*EMDR is the abbreviation for “Eye Movement Desensitization and Reprocessing”

**EFT stands for “Emotional Freedom Technique”, also known as “tapping”, which is a type of tapping acupressure.

Let's just talk about it

Binge Eating:
Das große Fressen

Understanding and Treating Food Addiction

Betroffene einer Binge-Eating-Störung leiden unter wiederkehrenden Essanfällen. Während dieser Attacken haben sie die Kontrolle über ihr Essverhalten verloren. Hunger, Sättigung oder Genuss spielen dabei keine Rolle. Im Gegensatz zu Bulimikern wollen sie die aufgenommene Nahrung nicht wieder loswerden.

What is binge eating?

Binge eating or binge eating disorder is a mental disorder that is accompanied by recurring eating attacks. The name is based on the English term "bing-eating disorder". "Binge" means a "binge" and "eating" the eating behavior. Binge eating is one of the most common eating disorders worldwide. The disorder was included in the DSM (Diagnostic and Statistical Manual of Mental Disorders), a psychiatric classification system, as early as 1994. However, research into triggers and the corresponding therapy has only just begun. It is therefore unknown how many binge eaters there actually are. Estimates suggest that they make up 4 to 5 percent of the population.

Binge eating disorder mainly affects young people aged 18 and over. However, eating attacks have also been described in children, even if this cannot yet be described as a fully developed binge eating disorder.

Addicted to Food

Those affected have lost control over their eating behavior. They eat large amounts of randomly selected food, as if they were addicted to food. The attacks either occur in a relatively short period of time or sometimes last up to 2 hours.

The fact is that hunger is not the actual trigger for the "binge eating". Satiety or enjoyment also play no role. This is what distinguishes the eating disorder from so-called "overeating", which we have all certainly experienced at some point: a good buffet from which we want to try as much as possible, even though we are actually already full. In this case, however, we continue to eat in order to try things out, to experience the taste.

Binge eating is different: those affected are only concerned with the food they eat. They cannot control themselves. The binge only ends when the stomach hurts or nausea sets in. Binge eaters then feel guilty and disgusted, and are ashamed of their behavior.

symptoms

People who suffer from binge eating disorder are usually very overweight. The body mass index (BMI) of these people is over 30. For comparison: a BMI value between 18.5 and 24.9 is considered normal. In addition to numerous health risks, this is another problem that overshadows the psychological suffering. Because, unlike bulimia sufferers, food addicts do not want to get rid of the food they have eaten, for example by vomiting or excessive exercise programs. Nevertheless, their figure and weight are the focus of their interest. The awareness of the bad behavior and the uncontrollability of the attacks form a contradiction and have a lasting effect on the emotional state and psyche of those affected. Binge eaters often have low self-esteem. Many sufferers withdraw and avoid social and societal contacts. The feeling of helplessness during a binge eating attack can lead to rejection of oneself and even self-hatred.

What is striking is that there is a certain discipline between the eating attacks: those affected eat irregularly, often in small amounts, or try one diet or another. All of this is ended by the next “binge”.

Psychological comorbidities and consequences of binge eating disorder are:

depression
phobias
bipolar disorders
manias

Do I suffer from binge eating disorder? These questions will help you recognize the signs.

Causes: Why binge eating?

The causes of binge eating are varied. Generally speaking, it is a failure to regulate one's own feelings. Rejection and insults in the family history, especially in childhood, are just as much a part of this as eating behavior that is determined by others at a young age. Stress is another trigger for binge eating. There are also incorrect eating habits that lack certain ingredients.

Do I suffer from binge eating disorder?

Answers to the following questions can give your doctor important information:

Have you been binge eating at least once a week for a period of three months?
Do you suffer from repeated episodes of binge eating?
If so, these episodes occur together with at least 3 of the following symptoms:
You eat noticeably faster than normal
You eat until you feel uncomfortable fullness
You eat large amounts even though you don't feel hungry
You eat alone so that no one sees the amount you eat
After eating, you feel disgust and guilt, accompanied by a depressive feeling that you have eaten so much again
After the binge eating, there is no vomiting, fasting or excessive exercise

Let's just talk about it

orthorexia

When healthy eating becomes a compulsion

In fact, orthorexia is not yet listed in the so-called ICD 10, the current "International Statistical Classification of Diseases and Related Health Problems". However, this does not mean that orthorexia is not treatable. The basic goal of therapy must be to move from extremes to moderation when it comes to nutrition. I start with established thought patterns, which must be changed for the better. The (false) beliefs of those affected must be gradually unraveled. It is a gradual process, because for many people the diet plan - or rather the list of things they do not eat - has become deeply ingrained. Breaking out of it always carries the risk of developing (new) fears and phobias, for example of illness.

What is Orthodoxy?

More and more people are choosing a healthy diet with sustainably produced food. They want to do something good for themselves and the environment. In some cases, however, the plan becomes a compulsion. In this case, medicine speaks of orthorexia nervosa. Someone who has decided against unhealthy food to the best of their knowledge and belief suddenly loses their freedom of choice. Preferences for healthy eating gradually take control of their lives and restrict everyday life. Those affected are afraid of invitations to dinner, for example. The risk of being served food other than their preferred one is unbearable for them.

Symptome: Anzeichen und Muster erkennen

The American doctor and alternative practitioner Dr. Steven Bratman coined the term orthorexia nervosa based on symptoms, i.e. certain signs or patterns that he had recognized in his patients. They asked him for nutritional advice. The focus was always on which foods should be avoided in this or that case.

Bratman realized that many of his patients ended up being too hard on themselves. He called this phenomenon orthorexia nervosa, based on the Greek words “ortho” for “correct” and “orexia” for “nutrition.”

What Bratman could not have known: 20 years later, “healthy eating” has become a real hype, fueled by celebrity photos, diet gurus and beauty ideals that promote more deprivation than pleasure.

Orthorexia nervosa is often accompanied by these symptoms:

Fear of deviating from a strict training and nutrition plan
Those affected feel tired and exhausted by their exertions
Feeling of loneliness due to renunciation of social hours, parties, invitations to dinner
Physical problems due to food restriction and lack of balanced diet

Do I suffer from orthorexia nervosa? These questions will help you recognize the signs.

Do I suffer from Orthodoxy?

Answers to the following questions can give your doctor important information. They are based on a list of questions from the American doctor Dr. Steven Bratman. He first described the term "pathological healthy eaters" in 1997.

Do you think about your diet for more than 3 hours a day?
Do you plan your meals several days in advance?
Is the nutritional value of your meal more important to you than its enjoyment?
Do you feel that the healthier you eat, the worse your quality of life is?
Have you been being harder on yourself lately?
Does your self-esteem increase when you eat healthy?
Are you giving up foods you used to enjoy in order to eat “real” foods?
Do your eating habits cause you problems in your everyday life, for example going out, and do you therefore distance yourself from friends and family?
Do you feel “guilty” when you deviate from your diet plan?
Do you feel happy and in control when you eat healthy?

Let's just talk about it

Behandlung: Falsche Denkmuster entwirren

In fact, orthorexia is not yet listed in the so-called ICD 10, the current "International Statistical Classification of Diseases and Related Health Problems". However, this does not mean that orthorexia is not treatable. The basic goal of therapy must be to move from extremes to moderation when it comes to nutrition. I start with established thought patterns, which must be changed for the better. The (false) beliefs of those affected must be gradually unraveled. It is a gradual process, because for many people the diet plan - or rather the list of things they do not eat - has become deeply ingrained. Breaking out of it always carries the risk of developing (new) fears and phobias, for example of illness.

Success takes time

Hypnosis therapy, for example, can help to eliminate incorrect ways of thinking over a period of one year, thus awakening one's own power to change.

Let's just talk about it

bulimia

loss of control when eating

In everyday life, we often talk about binge eating. In medicine and psychology, this eating disorder is known as bulimia. Those affected cannot be seen to have the disorder. Nevertheless, it has serious consequences and effects on the body and psyche.

What is bulimia?

For some people, food cravings are a real burden. Bulimics have recurrent attacks and sufferers just gorge themselves uncontrollably. The end result is disgust at the act itself and fear of having gained weight. Those affected want to get rid of the food as quickly as they have consumed it: vomiting, laxatives or excessive exercise programs are then the wrong and pathological means of choice.

Betroffene verzweifeln an sich selbst

Bulimia patients are generally not excessive in their food habits. They act in a strictly controlled manner. The sudden onset of cravings tears them out of this regulated behavior. The subsequent physical and mental suffering, accompanied by vomiting, fasting and desperate sporting activities, causes those affected to despair of themselves.

What is already bad as a snapshot has even more serious long-term consequences:

frequent inflammation of the esophagus or stomach
malnutrition
bad teeth
increased risk of cardiovascular disease, kidney damage, osteoporosis

Bulimia is not anorexia – these are the differences

By the way, bulimia and anorexia are very similar.

Both are eating disorders that require treatment and cause not only physical but also psychological stress for those affected.

bulimic

striving for a slim appearance

search for affection and recognition

fear of abandonment

shame for the behavior

anorexics

suffering from severe underweight

striving for self-control

fear of losing control

Proud of the “results”

Symptome der Bulimie

The eating disorder is not easy to recognize for outsiders. Bulimics are usually of normal weight or even only slightly underweight. The attacks of cravings and subsequent vomiting occur undetected at home, when no one is watching.

Signs for outsiders – excessive control

eating behavior
your own character
diet
of appearance

Bulimia sufferers lose this control when they have a binge. Eating high-calorie foods is usually done unconsciously. The amount consumed is alarming: experts have found that some sufferers consume up to 10,000 calories in one to two hours. By comparison, the healthy daily requirement for a woman is just under 2,000 calories.

The food craving ends with an extremely unpleasant and sometimes painful feeling of fullness. Once the attack is over, shame and disgust set in, often accompanied by self-reproach. Bulimia patients will now do everything they can to get rid of the food they have eaten.

Doctors distinguish between two types of bulimics: the "purging type" causes vomiting after the binge. To support this, he takes laxatives or goes on excessive exercise programs. The rarer non-purging type counteracts this by fasting excessively and also relies on sport and activity.

Causes: Why do I have bulimia?

Many sufferers pursue a certain image of beauty, shaped by the influence of advertising and false social norms. The reason is that they have too little or no self-esteem, which enables them to accept themselves as they are. Bulimia patients hope to gain more recognition through the ideal image they strive for. Their greatest fear is exclusion and rejection. It is not uncommon for bulimia to begin with a diet.

The “binge eating” is often caused by stress. Eating provides a form of short-term relaxation for those affected.

Other triggering factors include genetic predisposition and high performance demands. Biological influences as well as problems within childhood and the family can also be causes of an eating and purging disorder.

Do I suffer from bulimia?

Antworten auf folgende Fragen können deiner Ärztin oder deinem Arzt wichtige Hinweise geben:

Fühlst du dich zu dick?
Wie zufrieden bist du mit deinem Körper?
Kontrollierst du, was du isst?
Kennst und erlebst du Heißhungerattacken, bei denen du nicht mehr aufhören kannst zu essen?
Kommt es vor, dass du aufgenommene Speisen wieder erbrichst? – Wenn ja wie häufig?
Hast du körperliche Beschwerden? Wenn ja, welche?

I am ready for change

Treatment: Here those affected get help

The diagnosis is generally made by the doctor. He will also treat the physical symptoms.

The psychologist or psychotherapist is responsible for treating the psychological causes, because the causes lie deep beneath the surface and are rarely easy to grasp. On a psychological level, for example using hypnosis, it can also be determined whether additional stresses and illnesses, such as depression, phobias or personality disorders, are present.

The key is to break down existing and entrenched thought patterns and to provide those affected with active means to free themselves.

Let's just talk about it

Help with Eating Disorders

Your Way Out of Eating Disorders

Anorexia in children and adolescents (anorexia)

Bulimia: Loss of Control during the meal

Orthorexia: When healthy eating becomes a compulsion

binge eating

Magersucht bei Kindern und Jugendlichen (Anorexie)

Anorexic children do not count calories

How do I recognize anorexia in children and adolescents?

Binge Eating: Das große Fressen

Understanding and Treating Food Addiction

What is binge eating?

Addicted to Food

orthorexia

When healthy eating becomes a compulsion

What is Orthodoxy?

bulimia

loss of control when eating

What is bulimia?

Betroffene verzweifeln an sich selbst

Bulimia is not anorexia – these are the differences

Bulimia: Loss of Control
during the meal

Binge Eating:
Das große Fressen