"When I'm binging, I eat foods I usually avoid like pizza, bread, and ice-cream. I eat as much as I can until I have to throw up."

What are eating disorders?
Eating disorders are characterized by disturbances in eating behavior and distorted beliefs about eating and body shape. The main eating disorders include:

Bulimia Nervosa
Extreme efforts to prevent weight gain, which lead to binge-eating and purging, occur in this disorder. Efforts to prevent weight gain include restriction of eating, including fasting, and purging by vomiting and/or using laxatives, diuretics, or enemas. Efforts to prevent weight gain can also involve use of diet aids or excessive exercising (more than one or two hours daily). A typical binge-purge episode in an individual who has bulimia nervosa might start when the individual, after eating very little all day, decides to have one slice of pizza for dinner but then eats a second slice and begins feeling out of control of her eating. She then eats the whole pizza and a pint of ice cream, and drinks a liter of soda. Feeling intensely uncomfortable about her actions and fearful of weight gain, she purges and redoubles her efforts to restrict her intake.

Binge Eating Disorder
Chaotic eating and periods of binge eating that may last throughout the day occur in individuals with B.E.D. For example, a man sits down to watch TV and makes his way through a "party" sized bag of Doritos, a box of Oreos, and a six-pack of soda, and several hours later, finds he has eaten the rest of the Chinese food and a pecan pie. He feels deeply ashamed by his behavior but unable to control it.

Anorexia Nervosa
Individuals with anorexia intentionally restrict their intake, eating very little or even starving, resulting in dangerously low body weight and loss of menstruation in women. The individual who has anorexia nervosa has distorted beliefs about eating and body shape, reporting that she must continue to restrict her intake in order to lose the extra three pounds that are making her look "flabby."

Cognitive-behavioral model of eating disorders
A person may be vulnerable to an eating disorder if s/he places extreme importance on shape and weight, and/or alters his/her pattern of eating in unhelpful ways by restricting food, binge eating, and purging. Numerous factors keep these problematic patterns going including unrealistic dieting standards, an intense fear of weight gain, and pleasure associated with unlimited access to foods.

Cognitive-behavior therapy for eating disorders

• Monitoring: Keeping a daily record of eating to provide information about eating patterns
• Education: Learning about your behaviors and understanding the rationale for treatment
• Meal planning: Implementing a plan to eat 3 meals and 2-3 three snacks daily
• Self-control strategies: Adjusting the environment and your behaviors to regain control over eating
• Cognitive restructuring: Modifying perfectionism and all-or-nothing thinking that promotes disordered eating
• Body image skills: Increasing comfort with body shape and weight

Additional resources

Web links:
Eating Disorders Organization
National Association of Anorexia Nervosa and Associated Disorders
The Association for Behavioral and Cognitive Therapies

Books:
For links to purchase these books and others, please go to Self-Help Books for Adults

Fairburn, C. G., (1995). Overcoming Binge Eating. New York, NY: Guilford

Cash, T. F. (1997). The Body Image Workbook: An 8-step program for learning to like your looks. Oakland, CA: New Harbinger Publications.