In recognition of Eating Disorder Awareness Week in Canada (February 1-7), we wanted to spotlight the services Saterra Psychological & Counselling Services has available to support individuals experiencing difficulty with eating and/or body image concerns. My name is Dr. Danielle Ransom, C.Psych (Supervised Practice) and I am one of the Saterra associates who regularly sees both adolescent and adult clients with such concerns.
Over the years, I have found that clients sometimes have worries, questions, assumptions, or misconceptions about treatment for eating disorders. Sometimes, these concerns hold people back from seeking treatment. I thought it might be useful to spend some time answering some commonly asked questions about eating disorder treatment that I have encountered from individuals seeking services in the past.
What is eating disorder treatment like?
The treatment process at Saterra typically begins with contacting our receptionist, either yourself, or through a referring physician. Our receptionist will ask you for a brief description of the reason you are seeking therapy and match you with a therapist that works with your concerns. Depending on how your therapist’s availability, you may have to wait a bit to meet with them. But, that’s okay! You’ve already taken the most challenging step of reaching out for help.
Your first couple of appointments will focus on what we call an “assessment for treatment”. Your therapist will ask a variety of questions about your experiences, including different thoughts, emotions, and behaviours related to disordered-eating or body image, and the impact your concerns have on your day-to-day functioning. You may also be asked to complete some questionnaires. Your therapist will also ask you about and help you develop goals for therapy. The purpose of the “assessment for treatment” is to help the therapist understand as best they can your experience of disordered-eating, so they can develop an individualized treatment plan.
After the assessment for treatment is complete, your therapist will work with you to develop a “treatment plan”. Your therapist, based on their experience and training, will have ideas about what kind of treatment is likely to work best for you. Possible options for therapy for eating disorders might include: Cognitive-Behavioural Therapy, Dialectical-Behaviour Therapy, Interpersonal Therapy, or other evidence-based approaches for treatment. Sometimes, a treatment plan includes components from several difference therapy approaches. The important part is that the treatment plan is designed for your individual concerns, and that you also agree with the plan for treatment. Your therapist will give you an overview of what your individual treatment plan will involve, so that you can make the decision to move forward. Then, we start!
How do I know if my concerns with eating are serious enough for therapy?
Sometimes people feel that they “aren’t sick enough” or that their problems with eating aren’t severe enough for therapy. This is simply not the case. If you find that your life is negatively impacted by concerns with eating, weight, or shape, then you may find benefit in seeking therapy. You do not need to have a diagnosis for therapy to be effective.
Are you going to make me gain weight?
At times, the fear that one will gain weight makes people hesitant to seek treatment. If you are underweight, it is likely going to be part of the treatment plan to achieve a healthy weight. If you are not underweight, you may notice some variation in your weight throughout the therapy process. If weight gain is a concern for you, it may be helpful to know that your therapist will work with you to address this, at your own pace. You will work with your therapist to learn new ways of thinking about your weight, which will eventually help with the distress associated with the fear of gaining weight.
“If you find that your life is negatively impacted by concerns with eating, weight, or shape, then you may find benefit in seeking therapy.”
I’m a teenager… Do my parents have to be involved in my treatment?
Some adolescents benefit from treatment approaches that have a strong family involvement. However, your parents do not have to be a part of your treatment, if you do not want them to be (though, your therapist might suggest it may be helpful, at times). The only situation where your therapist may need to break your confidentiality is if you had a serious health risk or imminent risk of suicide.
If I come to therapy, will my therapist expect me to change my eating right away?
No. During the “assessment for treatment” your therapist will also assess how ready you are to make changes, and work with you where you are in that process. Many times people describe wanting to be free from their disordered-eating concerns AND at the same time describe a fear of living without them. Sometimes, people think they might need help AND don’t want to change at all (just yet). Your therapist will help you move toward change and to take small steps toward your goals at a pace that is challenging, yet do-able.
How long does treatment last?
It is not possible to provide a general response to this question, as every person is different. Some people achieve benefit from short-term intervention, others need more than a year to reach their goals. If cost is a barrier, your therapist will attempt to design a treatment plan that fits with your budget, if appropriate (e.g., guided self-help).
I think my teenage son/daughter may have disordered-eating and/or body image concerns, but they won’t talk to me about it and/or insist they don’t need help. What should I do?
It can be difficult to watch a child struggle with eating or body image concerns. You may find the following website helpful: http://nedic.ca/give-get-help/help-friends-family. If your child consents to therapy, their therapist will attempt to assess the problem, and provide appropriate treatment. Treatment for an adolescent not ready to acknowledge or change their disordered-eating may include motivational strategies to increase readiness to change, and/or working on the concerns underlying the disordered eating behaviours.
I’m a male. Are there treatments available for me?
Yes, absolutely. Research focused on the eating concerns of men has increased significantly, as the number of men discussing and seeking treatment for such concerns has also increased. The current evidence-based approaches to treatment can be adapted to be relevant and effective for men’s specific concerns.
Is life without an eating disorder possible?
Yes. Just like other mental health concerns, remission (i.e., no longer meeting diagnostic criteria for a disorder) is possible. Beyond no longer having symptoms of disordered-eating, it is also possible to reach your own specific treatment goals. For example, you may want to re-learn to enjoy the foods you eat, be able to socialize without discomfort at restaurants, and even learn to accept your body as it is, regardless of your weight or shape. Reaching your treatment goals in therapy will likely be challenging, require a time commitment, and be an emotional struggle at times. However, it is absolutely possible to achieve a way of living that is no longer dictated by thoughts or behaviours related to eating, weight, or shape.
Where can I get more information?
The National Eating Disorder Information Centre (nedic.ca) is an excellent resource for eating disorder education and support. NEDIC also operates a toll-free helpline (1-866-633-4220).
Hopewell (Hopewell.ca) provides eating disorder support and information on resources in Eastern Ontario.