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Understanding eating distress

We have been hearing a lot about eating disorders in the media over the years, but very little about eating distress. What is the difference? Marie Campion of the Marino Therapy Centre explains


Eating disorders such as Anorexia Nervosa, Bulimia Nervosa, Binge-Eating Disorder and Eating Disorders Not Otherwise Specified, as described in psychiatric manuals, are just labels which concentrate mostly on the description of a person's behaviour. Different types very often overlap, and even the top experts agree that it is difficult to make a clear diagnosis. But all of these are only the symptoms of the condition known as Eating Distress (ED).

Eating Distress is a condition where the mind amalgamates all of the negative assumptions the person has about him or herself. The negative mind becomes more powerful than the positive mind and has much more influence on the person's thinking, feeling and behaviour. This state of mind develops subconsciously and the person is not always aware that they are victims of this negative condition. Often we read that sufferers have low self-esteem. However, in reality, he or she mostly has no sense of self at all. Therefore, this condition is extremely abusive and manifests itself with highly self-destructive symptoms, of which an eating disorder is one. They are all different manifestations of one basic condition.

People suffering from Eating Distress have difficulty with the simple act of eating when hungry, and stopping when they are full. The condition takes over the control of their food intake. Often it can be recognisable by an unhealthy obsession with food and body, which comes to occupy centre stage in the sufferer's life. Food becomes the most important relationship — but it is never a happy one or an easy one. Slowly and surely, everything else is eventually excluded, while one's thoughts constantly centre on food or the body.

Eating Distress is not a problem, in itself: it is a solution of other, underlying issues. It is a way of communicating with inner unhappiness. Controlling the body is a way of controlling life. Control is the centre of the sufferer's life. ED is very preoccupying. That is the function of the disease. It occupies the mind fully and excludes other issues. It is a cushion against painful reality. ED is therefore a symptom of how the person relates to the world. Obsessive thinking about food is only a lonely substitute. ED is a very private disease and is usually not brought voluntarily to the attention of health professionals.

A person with Eating Distress wants to be trusted, wants to be liked, and wants to communicate. But, like many people he or she is afraid. ED is their language and their solution to the problems in their lives. It is a connection between eating, emotions and state of mind.

People experiencing ED are not only in need of approval from others, but inside they are ‘hungry' for care and affection as well. Despite the feeling of dependency, people with ED don't want to rely on or need other people. Feeling dependent or needy leaves them feeling weak, or like a failure, and it is avoided at all costs. For some people there is an intense fear that others will be overwhelmed by their needs and leave them, or stop loving them. To avoid this they try to be perfect inside and out. The strain is enormous. They feel that to be loved, they need to be perfect.


The philosophy of treatment

Treatment at the Marino Therapy Centre is based on the belief that emotional distress eating affects the whole person, physically, emotionally and spiritually, so we need to adopt a holistic view of each person and address all these areas.

The patient enters the proper treatment setting at MTC. In each of these settings they are provided with intensive psychological care and then begin a programme of behaviour modification that will show to break the obsession with food and weight.

The centre organises group discussions concerning topics associated with eating distress, including self-esteem, interpersonal relationships, communication, body awareness and nutrition. Each person is given the opportunity to develop emotionally with increasing responsibility for daily living.


Anorexia and overeating: two sides of one coin

Although the signs and symptoms appear dramatically different among all forms of Eating Distress, there are a great number of common causes and similarities especially when it comes to emotional factors and influences. The most common element surrounding ED is the inherent presence of an extremely low self esteem.

Having ED is much more than just being on a diet. ED permeates all aspects of every sufferer’s life as well as the lives of their loved ones. Both extreme forms of this condition are an attempt to make someone’s life better through eating or not eating. This is done with or without the awareness that it is not just the behaviour but, the attitude to life that needs to change.

Men and women living with any form of ED suffer a combination of very similar symptoms. They use their behaviour as a way to hide from their emotions; to fill a void they feel inside; and to cope with daily stresses and problems in their lives. All ED behaviours whether bingeing, starving, over-exercising or another destructive behaviour, can be used as a way to keep people away. Often these behaviours are used as self-punishment for doing ‘bad’ things, or for feeling badly about themselves.

Focusing on diagnosing ED can be dangerous. Diagnosing doesn’t help the sufferers; it only helps the professionals to communicate better about the condition. When people with ED read diagnostic criteria, they usually think, “I don’t have all these symptoms, so I must not suffer from anything, I do not really have it. That means I am okay.”

Both Anorexia and Emotional Overeating sufferers seek and desire acceptance, affection and approval from everyone. The only way they know how to achieve this is with the ED behaviour and thinking. Denial of the damage that the behaviour is causing is necessary to achieve that. Trying to find a way of coping, combined with the constant need for love and validation, and the inability to see love even when it is there, turns the person to obsessive episodes of destructive behaviours as a way to numb the pain.

Sufferers of all forms are convinced that the whole of life hinges on what size and weight they are and how they look. The underlying logic behind this is not selfish. The focus on size and shape is an attempt to control life though weight. People experiencing ED are sometimes aware that there are some abnormalities in their thinking, but shame and society’s lack of understanding push them back into denial.

Being overweight in our society means being unaccepted and lazy; someone who doesn’t have will power or self discipline; and a weak individual. We still have a “pull yourself together” attitude. People are often told to ‘just go on a diet’. This suggestion is emotionally devastating to a person suffering from Emotional Overeating in exactly the same way as ‘just eat’ impacts a person suffering from Anorexia.


Psychiatric medication and ED treatment

To write a prescription is easy, but to come to an understanding with people is hard.

— Franz Kafka

It would be far better if therapists were united in rejecting biochemical theories and toxic drugs, in encouraging the young women to face the culture values, in offering them the unconditional love that they desperately need.

— Peter R Breggin MD

Medications have either not helped or have very limited success in many cases.

— Carolyn Costin, MA, MEd, MFCC

To every complex problem there is a simple answer… and it's wrong.

— Dr Arnold Anderson, leading ED researcher, at a lecture on medication and ED


Taking medication when a person is in treatment for eating distress raises a lot of issues. Cognition, memory, concentration and motivation are affected. A person finds it more difficult to assimilate new learning and new material. Even moreso, a person has to deal with unpleasant physical side effects which cause discomfort, prolong the treatment and make the person's journey to recovery even more difficult. Inability to obtain restful sleep adds another complication.

Flattening emotion slows down the process of healing oneself. A person in recovery needs to learn to feel and deal with their feelings, and suppressing them with medication in just counterproductive.

It would appear from the experience gained at the Marino Therapy Centre that the introduction of antidepressants such as Prozac, Seroxat and other SSRIs can lead to increased suicide attempts and an increase in self-harming behaviours. This is a difficult subject to research, because many people are underweight when they start to use this medication.

Any drug taken into the body is distributed throughout the body. Even if psychiatric drugs are targeting the brain, they can affect other areas of the nervous system, spinal cord, and other organs such as kidneys and liver.

Taking medication alters the body's chemistry, which will lead to a person experiencing side effects. People experiencing eating distress are often very malnourished and they can experience these side effects in quite unpredictable ways and often in a greater intensity than others.


Some similarities between different forms of Eating Distress

  • Anxiety associated with fear of weight gain
  • Lack of self-acceptance that drives the person to look for external ways of changing themselves so that they can become acceptable in our society
  • Feeling that happiness is inevitably linked with a person’s weight
  • Weight loss or refraining from eating is viewed as a major accomplishment
  • Black and white thinking
  • Minimising important matters and maximising less important matters
  • Wasting a lot of time analysing and ruminating instead of taking action
  • Using destructive behaviours to numb feelings and to cope with unexpected life events
  • Disconnection between the body and mind; not able to listen to the body’s requirements
  • Coping with feelings and emotions like loneliness, shame and guilt by dysfunctional eating
  • Very sensitive to other people and to the environment
  • Suffering from ‘tomorrow syndrome’ and ‘if they only knew’
  • Difficulty connecting with the outside world
  • Feeling out of control but having a strong need to control their body shape, size, and eating patterns
  • Not realising that the ED controls the person
  • Constant fear of the unknown and change; worries become a major preoccupation
  • An inability to enjoy receiving and feeling deserving of the good things in life
  • Experiencing a lot of anger which is not expressed or addressed appropriately but is instead diverted toward destructive behaviour
  • Feelings of insecurity and helplessness when dealing with the world around them
  • Sensing that controlling weight will reduce negative feelings
  • Valuing perfectionism and believing that anything less than excellent means failure
  • A morbid fear of failure
  • Lack of meaning in the world


Marino Therapy Centre can be found at marinotherapycentre.com


Iceberg: sinking the ED ship

Iceberg is an online eating disorder self-help resource.

Internet social media can actively impact on those suffering from an eating disorder during their recovery, but unfortunately this is predominantly a negative experience. Iceberg attempts to shift the tide towards a positive attitude to recovery, encouraging sufferers to actively engage in their own recovery and by providing a place that counteracts the abundantly available pro-ana and 'thinspiration' websites.

Iceberg’s forums are fully moderated to uphold the central rule of the website, that users do not use the site to discuss behaviours. All submitted content is therefore reviewed by a moderator before being published to the site. The team of moderators is headed by Marie Campion, Director of Marino Therapy Centre, who is also accredited with holding the first Irish membership in the International Academy of Eating Disorders.

Also on the moderation team are a nutritionist and two care workers from MTC, all of whom contribute their time voluntarily. MTC’s psycholinguistic approach to recovery provides a natural match with text-based web content. On Iceberg, moderators focus on the language that members use in order to help both the individual and the community.

In addition to the forums, Iceberg also has a micro-messaging system called Quick Post (QP), which allows registered users to post short, unmoderated messages. Users can report a piece of content to the moderation team with one click through an easily accessible link, but all messages are public by default.

Interestingly, QP has so far not required any moderation, as Iceberg users choose not to post messages here that violate the rules. The tone of the site, as directed by forum moderation, appears to carry over to QP. The Iceberg community value the resource greatly, and are vocal about content or issues which threaten the community.

Although it is not expected that websites, help-lines or therapy groups alone can ensure recovery for the sufferer, tools such as Iceberg can assist in the process. In situations where people experiencing ED find themselves in a crisis, unable to contact a therapist immediately, Iceberg is available 24 hours a day, accessible from anywhere in the world.

The information and help can be a comfort and immediate safety net for a person experiencing a crisis situation. Iceberg is a constant source of information and a tool that sufferers can utilise in the daily struggle to overcome the ED condition.

Iceberg was founded under a partnership between Marino Therapy Centre and the Irish web firm, Trace. MTC are specialists in finalising recovery from eating disorders, with over 18 years experience helping sufferers recover from all types of eating disorders including anorexia, bulimia and emotional overeating. MTC provides a safe and structured outpatient program that is specially tailored to each individual, to over 100 clients each week. The technical partner on Iceberg, Trace, are specialists in web design and content management, and are accredited members of Engineers Ireland.

I recommend the following. It would be a good start for everybody, but for someone looking for a comprehensive individual assessment, or someone dealing with depression, a visit to a nutritionist is advised.


Iceberg can be found at eatingdisorderselfhelp.com

Resources & therapies


ICEBERG ED: This is a self-help site set up by the Marino Therapy Centre on Dublin's north side, with forums, discussions and tips and a huge range of resources to help with this dangerous set of conditions.


MARINO THERAPY CENTRE: We strongly recommend this centre for its long experience and high success rate in treating eating distress and eating disorders. Multi-language site includes Russian, Polish, French and German as well as English.


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