Frequently Asked Questions about Eating Disorders

  • What causes eating disorders?
  • What is anorexia nervosa?
  • What is bulimia nervosa?
  • How prevalent are eating disorders?
  • What’s the typical profile of a person with an eating disorder?
  • How serious is eating disorder?
  • Can eating disorders be overcome?
  • What does the family have to do with the eating disorder?
  • What is Intensive Structural Therapy?
  • How long is therapy?
  • What are the common misconceptions about eating disorders?

What causes eating disorders?

There are many theories on the causes, but there is no general consensus that everyone agrees on.

Our view is that, regardless of the causes, a person’s social environment makes eating disorders more severe. Each person’s cause may be lost in history, so we don’t dwell on what causes the eating disorder but focus on the social pressures that keep the problems maintained.

What is anorexia nervosa?

Anorexia nervosa is a state when a person can’t maintain their body weight at or above a minimal normal weight, based on the norm for their age and height.

Anorexics normally have a body mass index (BMI) of under 17.5, the normal range for an adult is 20-25. They are obsessed with gaining weight or fearful of becoming overweight, though they are considered underweight medically. An anorexic’s view of their weight and shape is distorted and not what others see. They are often in denial of how serious their low body weight is to their health.

What is bulimia nervosa?

Bulimia nervosa is a state when a person has episodes of immense binge eating, that is eating large amounts of food that most people would be unable to eat in a similar period of time.

Bulimics have a lack of control over eating and exhibit harmful behaviours to prevent weight gain. These include self-induced vomiting; the abuse of laxatives, diuretics and other medications; excessive exercise and fasting.

How prevalent are eating disorders?

If the emphasis of women being thin as portrayed in the magazines was responsible for eating disorders then wouldn’t they be far more common? Though it has been found that anorexia affects only 1% of women and bulimia 2% of the population, eating disorders are tenacious and dangerous.

What’s the typical profile of a person with an eating disorder?

Anyone can be affected by an eating disorder, they just don’t affect teenage girls but often begin in the teens. They afflict a range of ages. Males are also susceptible. Statistics showing one in every ten people suffering from anorexia is a male.

Common traits that individuals with eating disorders show can include being perceived as a perfectionists, having low self esteem and confidence and a lack of assertiveness or control in their life.

How serious is eating disorder?

Eating disorders can be fatal. Anorexia has the highest mortality rate of any psychiatric disease per capita and is the third most common chronic illness in women between 15 and 25 years in developed countries.

Research shows the anorexics are 11 times more likely to die then their peers of the same age and gender. Their rate of suicide is staggeringly 37 times greater.

Eating disorders cause severe depression, psychological distress on the person and family members and a range of long-term damage to their body which can affect vital organs.

Can eating disorders be overcome?

Eating disorders are notoriously difficult to treat, but YES they can be overcome by working on the social pressures in a person’s life.

Our therapy has been used with individuals as long as 20 years ago. Follow ups with patients even from that time show after initial treatment; there has been no recurrence of the problem.

What does the family have to do with the eating disorder?

The goal of our therapy is to address the eating disorder by targeting the individual’s personal stresses and interpersonal relationships. The eating disorder is not just a problem residing in the person but a problem that is part of their social environment; that is the family or other influential member in their life.

What is Intensive Structural Therapy?

Intensive Structural Therapy (IST) is the evidence-based, successful approach we use to treat eating disorders. Unlike other forms of family therapy, IST focuses on the specific interactions that maintain eating disorders that our specialists can see during sessions with the person and the family members.

More information on Intensive Structural Therapy.

How long is therapy?

Our family therapy approach shows the longest time to get control over the eating disorder is six months. Frequently, there is significant control of the problem within two months but this varies with each person. We don’t believe that what may have been a long-term problem for a person requires treatment and recovery over many years.

Therapy tends to be one to two sessions held per week with the person and family members. Sessions typically last one hour and then half sessions as progress is being made.

Next: Publications by Dr Fishman about Eating Disorders

Recent Comments

  • carole: this makes a lot of sense to me too.I instead of asking and asking for help with my partner and kids do the...
  • Jennifer: Try looking up F.E.A.S.T. on the internet and going onto ‘Around the Dinner Table’. It is a...
  • Jenny: What about spitting? My daughter has changed from anorexia, to a habit of chewing but not swallowing food....
  • Jenny: I just showed my other daughter this (the one without an eating disorder) and she looked skeptical… Do...
  • pip: He’s just moved to CREDS today after his second sectioning. Hoping this is the break we are needing

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Book: Enduring Change in Eating Disorders

Enduring Change in Eating Disorders - Book Cover

Dr Fishman is the author of 'Enduring Change in Eating Disorders – Interventions with long -term results' (Brunner-Routledge 2004).

This book presents the powerful and proven effective model of Intensive Structural Family Therapy and its application to the treatment of eating disorders.