Diagnosing an Eating Disorder

Diagnosing an Eating Disorder; The Importance of Client Histories

People with eating issues often start out by being criticized about their weight as children. Feeling self-conscious, about appearance often these people go on diets.

This history is typical of with people who have eating disorders that I see in my practice. I find that a high percentage of people who have struggled with food and eating issues were put on diets and criticized about their weight or restricted from eating treats at an early ages.

Depending on one’s biology, psychology, and cultural background, the meaning of losing weight and food can be different. Besides gender, age, geography, body weight, ethnicity, and social class influence prevalence estimates.

Understanding the Specific Client when Diagnosing an Eating Disorder

In evaluating the biological, psychological, and social aspects of the client's eating disorder, it is important for eating disorder professionals to understand the biology, psychology and social history of the patient and his or her family history of eating disorders. It is also pertinent to learn about how the family dealt with the client with respect to growing up with regard to food and weight as well as the current dynamics. In my own practice I see people who are dealing with obesity. Often they have had at least one parent or sibling who were also obese.

Underlying Issues when Diagnosing an Eating Disorder

In doing this initial evaluation of eating disorder client, it seems important to remember that people who are binge eaters usually want help; bulimic clients can be ambivalent if the bulimia is working for them, and often-anorexic clients often do not want treatment. The anorexic client is often plagued with Body Dysmorphic Disorder so the last thing they want is to gain weight.

Often people with eating disorder get upset when others tell them they looked healthy,because there thoughts go to they feel fat, however if they are told they look too thin they cheer inside.

Clients self-report Difficulties in Diagnosing an Eating Disorder

Early in the evaluation stage the clients needs to feel respected and supported in their own treatment goals. Often people have come to an intial evaluation in my office after leaving another therapist who they felt was too hard on them. Frequently, these patients only come to treatment at the urging of others. They usually do not want to gain weight or eating has been a means to coping with painful problems.Since, some people appear in my office due to a loved ones pressure, the client’s self-report as to the degree of the problem can be inaccurate. This can also be the case because people with eating disorders repeatedly feel shame, embarrassment and a fear of being judged.

As a psychotherapist, I have found many times patients have not been totally honest about the amount that they eat or the quantity and types of purging they do. . On the site I have a free eating disorder evaluation. I find people who have responded to the sentence completion questioner have been very honest and have admitted quite a bit more self-destructive behavior than those who I see face to face.

In addition to self-report being a problem, due to issues of shame, also the meaning of dieting varies according to individuals, there are times it is difficult to discern whether one is merely trying to lose weight or if the individual is suffering from an eating disorder. The clinician's uncertainty over the validity of self-reported dieting has led some researchers to specify the variety of behaviors associated with intentional weight control. Healthy dieting behavior may be contrasted with unhealthy weight-control practices such as skipping meals, fasting, vomiting, taking laxatives, using diet pills, and taking up smoking

strong>Difficulties Diagnosing Eating Disorders

Diagnosing an eating disorder can also be complex. The two main eating disorders that are described in the Diagnostic and Statistical Manual of Mental Disorders-IV are anorexia nervosa and bulimia nervosa. Both anorexia and bulimia have subtypes in the DSM-IV these symptoms overlap.”This involves an intense fear of becoming fat and basing self-worth on weight and shape…” (Garfinkle, 2002 p.156).

The main difficulty in diagnosing an eating disorder is that within a specific eating disorder there are subtypes of that disoder that overlap with another. For example, in both anorexia and bulimia the subtypes include restricting type and binge/eating purging type.The definition of purging in both of these diagnoses include, self-induced vomiting, or the abuse of diaretics, laxitives or enimas.The relationship between nonpurging form of bulimia nervosa and binge eating disorder requires more clarification.

Other problems with diagnosis of eating disorders as there does not seem to be a critiria for the severity of the eating disorder as well as cultural issues and comorbid medical problems which may contribute to the eating disorder. t> Return to the top of Diagnosing an Eating Disorder Page Return to Eating Disorders Professionals Page