Emily Gaber MS, LPC-IT, NCC

• – symptoms and warning signs • Inadequate food intake • Weight loss leading to dangerously low weights • Intense fear of weight gain, obsession with weight, calories, dieting • Refuses to eat certain foods – even denies hunger, may have food rituals or very rigid behaviors • Socially withdrawn • Restrictive type or binge/purge type

Why you should seek help: Anorexia is deadly. It attacks on both a physical and mental level, putting your heart and bone at risk. Its progression can be rapid, and early intervention is key to recovery. • – symptoms and warning signs • Frequent episodes of consuming very large amounts of food followed by behaviors to “purge” such as self induced vomiting and/or exercise • One feels out of control during the binge-eating episode and it is followed by intense guilt and shame. • One might have unusual or frequent trips to the bathroom after meals – and have unusual swelling or cheeks or jaw area. Stains on teeth. Calluses on back of hand or knuckles (Russell’s sign). Perhaps a rigid exercise regime.

Why you should seek help: Bulimia is also deadly – entire GI system is at risk, electrolyte and chemical imbalances can affect vital organs. This disease simulates a drug addiction in its effects on the brain. • Binge • Frequent episodes of consuming very large amounts of food without behaviors to “get rid” of the food. • One feels out of control during the binge eating episode with strong feelings of guilt and shame • Often accompanied by yo-yo dieting

Why you should seek help: Medical concerns such as high blood pressure, , heart disease, diabetes, gallbladder disease, and more! • Feeding or Eating Disorders • Avoidant/Restrictive Food Intake Disorder • PICA • Rumination Disorder • Orthorexia • Other Unspecified Feeding or Eating Disorder

• Body Dysmorphia • Disordered Eating • ED’s are highly emotional illnesses • No two eating disorders are the same • Comorbidities • , anxiety, trauma, self-harm, substance abuse, etc. • Weight assumptions • Reality of denial • Addiction model • A review of nearly 50 years of research confirms that AN has the highest mortality rate of any psychiatric disorder. (Arcelus, Mitchell, Wales, & Nielsen, 2011) • Outpatient counseling and nutrition counseling: • 1-2x per week • Intensive Outpatient Counseling (IOP) • 3 days per week 3 hours per day • Partial Hospitalization (PHP) • 5 days per week 6-8 hrs per day • Residential • Typical stay is 15-90 days • Inpatient • Stay until medically stable – typically <2 weeks • Family History • Alcoholism in first-degree relatives • Visual Sports • Personality Traits • Parental eating behavior and weight • Physical, mental, or sexual abuse • Trauma • Low self-esteem • Body-image dissatisfaction • History of excessive dieting, frequently skipped meals, or compulsive exercise • Why or how do you “get” an eating disorder? • Just like any other illness - multifactorial • Genetic component – the seed • ESRRA and HDAC4 • Environment – the soil • Media, diet industry • Trigger – the storms

Proper and early treatment have the best outcomes – Seed will always be there, environment can change some, and you will be well equipped to weather the many storms life will inevitably bring. Personalized, compassionate, team approach to recovery.

Power of Photoshop https://www.youtube .com/watch?v=17j5 QzF3kqE • Eating less makes you weigh less • Set point theory • 95-96% diet failure rate • Diet Industry makes $59 billion per year • Foods are good or bad • Overweight = unhealthy • Problem with BMI • Food Rules

• Do you ever feel irrationally scared that you will become fat? • Do you have trouble keeping your food down? • Are you highly critical of your own and/or others’ bodies? • How much of your day do you spending thinking about food, body weight, shape, or size? • Is the way you are eating or behaving around foods affecting your work, school, social life, family? • Do you ever feel guilt or shame after you eat? • Do you eat differently alone than when you are around others? • Do you have any signs that you are not eating enough? • Weight loss, hair loss, menstrual disturbance, headaches, low energy, difficulty sleeping, feel cold, faint, dizzy, chest pain, shortness of breath • Evolve – The Center for Healing Eating Disorders • Provides 1:1 session with both therapist and dietitian • Provides Meal Support • Group Support • Body Image Support

In the state of Wisconsin you can go to Rogers Memorial Hospital or Aurora Psychiatric Hospital, REDI Clinic. Bordering states have The Emily Program (Twin Cities, MN). The Center for Discovery (Chicago, IL). You should check with your insurance company if you don’t know where to start. • Be a model of healthy self-esteem and body image. Recognize that others pay attention and learn from the way you talk about yourself and your body. • Choose to talk about yourself with respect and appreciation. • Choose to value yourself based on your goals, accomplishments, talents, and character. • Refrain from letting the way you feel about your body weight and shape determine the course of your day. • Embrace the natural diversity of human bodies and celebrate your body’s unique shape and size. • Continue to educate yourself • A certain body, weight, shape, or size will never = happy • Different people have different definitions of health • QUESTION THE SOURCE • Reach out for help • Try compassion in place of criticism • Stop looking outward and start looking inward • Garner DM and Garfinkel PE (Eds) Handbook of Treatment for Eating Disorders New York: Guilford (1997) • Zerbe KJ The Body Betrayed: A Deeper Understanding of Women, Eating Disorders, and treatment Carlsbad, CA: Gurze (1993) • NEDA – nationaleatingdisorders.org • The Eating Disorders Clinical Pocket Guide by Jessica Setnick • Evolvehealing.org • AED – Academy for Eating Disorders • BEDA – Binge Eating Disorder Association • F.E.A.S.T. – Families Empowered and Supporting Treatment of Eating Disorders • Maudsley Parents • Gurze Books • IAEDP – International Association of Eating Disorder Professionals • www.mentorconnect-ed.org

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