Shame, Guilt, and Eating Disorders
A study of 94 college students supported the hypothesis that women with eating disorders experience more shame and guilt
in relation to eating than do either normal or depressed women, and that such shame and guilt differentiate the eating
disorders from other psychopathology.
Findings revealed an apparent difference in the nature of the depression experienced
by eating disordered women and that of depressed women without such disorders.
What Are Eating Disorders?
Eating disorders often are long-term illnesses that may require long-term treatment. In addition, eating disorders
frequently occur with other mental disorders such as depression, substance abuse, and anxiety disorders.
The earlier these disorders are diagnosed and treated, the better the chances are for full recovery. This fact sheet
identifies the common signs, symptoms, and treatment for three of the most common eating disorders: anorexia nervosa,
bulimia nervosa, and binge-eating disorder.
Who Has Eating Disorders?
Research shows that more than 90 percent of those who have eating disorders are women between the ages of 12 and 25.
However, increasing numbers of older women and men have these disorders. In addition, hundreds of thousands of boys
are affected by these disorders.
What Are The Symptoms of Eating Disorders?
Anorexia nervosa - People who have anorexia develop unusual eating habits such as avoiding food and meals,
picking out a few foods and eating them in small amounts, weighing their food, and counting the calories of everything
they eat. Also, they may exercise excessively.
Bulimia nervosa - People who have bulimia eat an excessive amount of food in a single episode and almost
immediately make themselves vomit or use laxatives or diuretics (water pills) to get rid of the food in their bodies.
This behavior often is referred to as the "binge/purge" cycle. Like people with anorexia, people with bulimia have
an intense fear of gaining weight.
Binge-eating disorder - People with this recently recognized disorder have frequent episodes of compulsive
overeating, but unlike those with bulimia, they do not purge their bodies of food. During these food binges, they
often eat alone and very quickly, regardless of whether they feel hungry or full. They often feel shame or guilt
over their actions. Unlike anorexia and bulimia, binge-eating disorder occurs almost as often in men as in women.
How are Eating Disorders Treated?
Anorexia nervosa - The first goal for the treatment of anorexia is to ensure the person's physical health,
which involves restoring a healthy weight. Reaching this goal may require hospitalization. Once a
person's physical condition is stable, treatment usually involves individual psychotherapy and family therapy during
which parents help their child learn to eat again and maintain healthy eating habits on his or her own. Behavioral
therapy also has been effective for helping a person return to healthy eating habits. Supportive group therapy may
follow, and self-help groups within communities may provide ongoing support.
Bulimia nervosa - Unless malnutrition is severe, any substance abuse problems that may be present at the time
the eating disorder is diagnosed are usually treated first. The next goal of treatment is to reduce or eliminate
the person's binge eating and purging behavior. Behavioral therapy has proven effective in achieving
this goal. Psychotherapy has proven effective in helping to prevent the eating disorder from recurring and in
addressing issues that led to the disorder. Studies have also found that Prozac, an antidepressant, may help
people who do not respond to psychotherapy. As with anorexia, family therapy is also recommended.
Binge-eating disorder - The goals and strategies for treating binge-eating disorder are similar to those for
bulimia. Binge-eating disorder was recognized only recently as an eating disorder, and research is under way to
study the effectiveness of different interventions.
Psychotherapy can help someone with an eating disorder to look as and understand the emotions that underlie eating
problems, such as shame, anger, guilt, sexual difficulties, and the fear of success.
References (To view, roll mouse over the "References" heading; to hide, click on the heading)
Becker, A. E., Arrindell, A. H., Perloe, A., Fay, K., & Striegel-Moore, R. H. (2009). A qualitative study of perceived social barriers to care for eating disorders: Perspectives from ethnically diverse health care consumers. Int J Eat Disord, Oct 5. [Epub ahead of print]
Goss, K., & Allan, S. (2009). Shame, pride and eating disorders. Clin Psychol Psychother, 16(4), 303-316.
Keith, L., Gillanders, D., & Simpson, S. (2009). An exploration of the main sources of shame in an eating-disordered population. Clin Psychol Psychother, 16(4), 317-327.
Macdonald Clarke, P., Murnen, S.K., & Smolak, L. (2009). Development and psychometric evaluation of a quantitative measure of "fat talk". Body Image, Oct 29. [Epub ahead of print]
Rørtveit, K., Vevatne, K., & Severinsson, E. (2009). Balancing between mental vulnerability and strength in daily life when suffering from eating difficulties. J Psychiatr Ment Health Nurs, 16(4), 317-225.
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