Eating Disorders
DSM-5 criteria for Anorexia Nervosa:
- Restriction of energy intake relative to requirements leading to a significantly low body weight in the context of age, sex, developmental trajectory, and physical health.
- Intense fear of gaining weight or becoming fat, or persistent behaviour that interferes with weight gain, even though at a significantly low weight.
- Disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight.
DSM-5 criteria for ARFID (Avoidant Restrictive Food Intake Disorder)
- An eating or feeding disturbance (e.g., apparent lack of interest in eating or food; avoidance based on the sensory characteristics of food; concern about aversive consequences of eating) as manifested by persistent failure to meet appropriate nutritional and/or energy needs associated with one (or more) of the following:
- Significant weight loss (or failure to achieve expected weight gain or faltering growth in children).
- Significant nutritional deficiency.
- Dependence on enteral feeding or oral nutritional supplements.
- The disturbance is not better explained by lack of available food or by an associated culturally sanctioned practice.
- The eating disturbance does not occur exclusively during the course of anorexia nervosa or bulimia nervosa, and there is no evidence of a disturbance in the way in which one’s body weight or shape is experienced.
- The eating disturbance is not attributable to a concurrent medical condition or not better explained by another mental disorder. When the eating disturbance occurs in the context of another condition or disorder, the severity of the eating disturbance exceeds that routinely associated with the condition or disorder and warrants additional clinical attention.
DSM-5 criteria for Binge Eating Disorder
- Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than what most people would eat in a similar period of time under similar circumstances.
- A sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating).
- The binge eating episodes are associated with three (or more) of the following:
- Eating much more rapidly than normal.
- Eating until feeling uncomfortably full.
- Eating large amounts of food when not feeling physically hungry.
- Eating alone because of feeling embarrassed by how much one is eating.
- Feeling disgusted with oneself, depressed, or very guilty afterward.
- Marked distress regarding binge eating is present.
- The binge eating occurs, on average, at least once a week for 3 months.
- The binge eating is not associated with the recurrent use of inappropriate compensatory behaviors (e.g., purging) as in bulimia nervosa and does not occur exclusively during the course of bulimia nervosa or anorexia nervosa.
DSM-5 criteria for Bulimia Nervosa:
- Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
- Eating, in a discrete period of time (e.g. within any 2-hour period), an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances.
- A sense of lack of control over eating during the episode (e.g. a feeling that one cannot stop eating or control what or how much one is eating).
- Recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self-induced vomiting, misuse of laxatives, diuretics, or other medications, fasting, or excessive exercise.
- Recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self-induced vomiting, misuse of laxatives, diuretics, or other medications, fasting, or excessive exercise.
- The binge eating and inappropriate compensatory behaviors both occur, on average, at least once a week for three months.
- Self-evaluation is unduly influenced by body shape and weight.
- The disturbance does not occur exclusively during episodes of anorexia nervosa.
Neourobiology of Bulimia – to reduce Stigma and Enhance Clinical Outcomes
Please find below articles that may be of interest – resources specific to the female presentation of ADHD
Treatment Modalities:
Dr Kerry Chillemi holds post-graduate training in Clinical Psychology (Professional Doctorate in Clinical Psychology). She is registered with the Psychology Board of Australia (Australian Health Practitioner Regulation Agency) and is a Medicare Provider under the Better Access to Mental Health Initiative. In addition, she has a full membership with the Australian Psychological Society (APS). Dr Chillemi’s approach is grounded in evidence-based therapies, particularly Cognitive Behaviour Therapy, Acceptance and Commitment Therapy, Schema Therapy, Dialectical Behavior Therapy and Emotion Focused Therapy. She practices from an approachable client-centred style and uses evidence-based therapies tailored to the client’s individual’s needs. Dr Chillemi is passionate about supporting people to thrive and achieve overall good mental health and wellbeing. She feels privileged to share in her client’s experiences and it is imperative to her that you feel heard and understood. Respect, hope and perseverance are key to a valuable learning experience that promotes positive and sustained outcomes.
What is a Clinical Psychologist
Clinical psychologists are highly qualified clinicians with specialist training in the psychological assessment and treatment of mental health concerns.
Clinical psychologists use evidenced based therapeutic techniques to treat a wide range of mental health concerns that range from mild symptoms to severe and complex presentations.
Learning healthy ways of sitting with distress
Gaining an awareness of the common triggers of distress and understanding the warning signs (that is the feelings, thoughts, physical sensations and behavioural urges or actions) that signal that we are experiencing distress. Once you become aware of your triggers and warning signs, you are in a better position to apply helpful coping strategies. This process also involves a commitment to dropping escape methods (situational avoidance, reassurance seeking or checking, distraction and suppression, self-medicating with alcohol or drugs, binge eating, disengaging and isolating self, etc.) that are usually automatic habits applied when we become distressed.
Schema therapy is a powerful treatment approach that allows people to identify psychological defences and self-defeating patterns that begin early in life.
Cognitive-behavioral therapy and Dialectical Behavior Therapy provides coping skills to challenge problematic cognitions (thoughts) and behaviours that can amplify distress.
Learning to be mindful of your emotions in a curious and non-judgmental manner (Acceptance Commitment Therapy) allows clients to change how they pay attention to an emotion and sets the framework for managing distress in a healthy way.
In summary, clinical psychology is a structured research informed learning experience in which clients learn coping skills that promote both positive and sustained growth.
Collaborative Care -Dieticians
https://lovewhatyoueat.com.au/
Resources-
https://www.eatingdisorders.org.au/
https://thebutterflyfoundation.org.au/
