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Stress and Disordered Eating

Posted Mar 26 2009 3:41pm

Some of you are eating disorder specialists and see many patients whose presenting issues surround their weight, unhealthy food patterns, and eating disorder symptoms. However, most of you may not see patients who present with an eating disorder as their main concern. Perhaps most of you see clients/patients who come in with other concerns, such as anxiety, depression, family conflict, or relationship issues, and then at a later point in treatment reveal that they struggle with negative body image or engage in eating disorder behaviors.

A new research finding relates to you.

Research conducted by a team from the University of Minnesota, and which includes renown ED specialist Diane Neumark-Sztainer, sheds light on a fact with which we are all-too-familiar in our healthcare practices. Namely, that disordered eating behaviors are not just a problem at clinical levels but can also lead to impaired functioning at sub-clinical levels as well.

Their study, published in a recent issue of  Adolescent Health, found that stressful life events in adolescence are related to disordered eating behaviors, including binge eating and unhealthy weight control methods.

These findings reinforce the need to evaluate for eating disordered behaviors during periods of time when clients experience stressful and negative life events.

As we know, unhealthy eating behaviors can be a means of coping for some. Imparting healthy coping mechanisms to clients during times of stress reduces the risk of eating disordered behaviors becoming a part of their coping arsenal.

Fellow Blogger and author Karen Koenig says this in her latest book:

"Although not every client has eating concerns that are central to therapy, many have an unhealthy relationship with food and their body, which impacts and impinges on nearly every aspect  of life. Just as no competent therapist believes that sexual abuse, marital difficulties, or addictions are self-contained, no therapist should treat eating and weight issues per se as irrelevant or inconsequential to a client's overall mental (and physical) health."

Food and weight issues are never irrelevant in therapy. We need to become more vigilant in screening for unhealthy food and weight patterns in our clients, regardless of the presenting problem, as they can be a signal --- both of underlying issues and stress, as well as of potential, future clinical eating disorders.

Please consider including eating patterns on all of your standard intake forms, including past/present (minimally) unhealthy weight control methods, binge eating, episodes of food restriction and dieting, purging events, laxative use/abuse, and body image concerns. You may also want to ask what a typical day of food consumption includes, (e.g. how many meals/day, typical foods eaten, typical amount eaten). These are standard health questions that may tend to go overlooked, but they can be a valuable window into a client/patients's overall functioning.

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