Eating Disorders/
Body Image Challenges

Eating Disorders are serious, life threatening mental illnesses and the sooner someone gets the treatment they need, the better their chances of recovery. For example, the disorder most commonly thought of in the category of eating disorders is Anorexia Nervosa and this diagnosis holds the highest mortality rate by suicide of all the mental health disorders listed in the Diagnostic and Statistical Manual of Mental Health Disorders (DSM IV, 2013). There are severalEating Disorders as defined in the DSM IV. The three eating disorders that are most familiar to our society include: Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder. For people who do not "fit" into any of these categories, but who suffer symptoms that cause significant problematic outcomes, there are two more diagnostic categories to consider and those include "Other Specified and "Unspecified." Under "Other Specified" the DSM IV now recognizes that individuals can meet the criteria for Anorexia without being 'significantly under-weight,' IF that individual has lost a significant amount of weight due to restricting calories. An individual can meet the diagnostic requirements of Bulimia without the frequency and duration of the full-blown illness. Under Other specified, a person can also have a Purging Disorder without having the binge eating symptoms,if the purging is to influence weight or shape.

If you have noticed more than a few of the following symptoms, this is a potential sign of disordered eating or disordered body image, which along with other genetic pre-dispositions, may put you at risk of developing an eating disorder. Even if you do not develop an eating disorder, just a couple of the following symptoms combined can get in the way of living your life joyfully and fully. Keep in mind that having one or two of the symptoms some of the time with low intensity is different than experiencing 2 or more symptoms all the time and with high intensity or to the point where others have drawn their concerned attention towards it. This is not an all-inclusive list, but instead a list to give you a general idea of disordered eating or body image symptoms:

Eating Disorder Body

Increasingly restricting calories despite significant weight loss

Obsessing about food or certain foods (food is always on your mind)

Focus on rule-based thinking which may or may not dictate behavior. For example, thinking that says: If I eat this, I can't eat that... If I exercise, then I can have cake... No sugar can enter my body at any time or else..." Please note, that while dieting, calorie restriction or engaging in a vegetarian lifestyle are not in and of themselves disordered eating, many people with eating disorders may have started out in one or more of these categories.

Having moments of extreme anxiety about your body, being consumed with worry or body sensations of being "fat." This is called having a "fat attack."

Having medical problems as a result of calorie deprivation.


Enjoying the feeling of "specialness or superiority" that comes from losing more weight than your friends or than people thought was possible and wanting to take it further.

Experiencing high anxiety when being faced with a situation where 'normal eating' would be expected. Or high anxiety after or before a meal including excessive or ruminative worry that you won't eat the right thing, may still feel hungry or that you ate to much.

Being afraid to eat certain foods; afraid you will eat too much of a food and not be able to stop

Feeling numb or outside of your body when you eat or when you are around food.

Eating slower than everyone else, taking small bites to pretend you are eating at a normal rate. Or, Re-arranging food on your plate so that others think you are eating.

"Body Checking" several times a day or for more minutes than is necessary by looking in mirrors or trying on clothes for the soul purpose of making sure you are not gaining weight or looing as 'fat' as you feel.

Chewing an spitting out food

Hiding food or hoarding food.

Obsessing about weight or body image (your size is always on your mind)

Purging your food after meals with self-induced vomiting, laxatives, or exercise.

Eating large quantities of food in small, discrete periods of time or binging on food all day and feeling unable to stop yourself.

Obsessing about exercise and/or exercising for several hours at a time, or past the point of normal exhaustion.

Melissa Wheelock Lmft Office

Melissa Wheelock, LMFT can provide a thorough screening in her office to determine whether eating disordered symptoms are present for you or your teenager and the most appropriate treatment course. If high risk factors and symptoms are present, you will be referred to a medical doctor and/or nutritionist to be part of your treatment team. In out-patient therapy, a therapist cannot work alone with eating disorders. Eating disorders are dangerous medical conditions which require constant medical monitoring and often more than one weekly talk therapy session. Some people need more support than out-patient therapy initially or at certain points in their treatment. If this is the case, a residential treatment facility or even hospitalization can be necessary. If an eating disorder has been previously diagnosed, or you are coming out of an intensive day program, Melissa can work as part of your existing out-patient treatment team. She will work with yourdisordered thought processes, blocked or high emotional responses and help you to develop specific coping skills to address target behaviors. Mindfulness techniques as well as Graduated Exposure may also be helpful with the corresponding anxiety as it relates to specific disordered eating thoughts and behaviors.