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Eating disorders are complex illnesses for both the individuals who experience them and the professionals who seek to treat them. Among the complicating factors is that they seldom exist in isolation. Many people suffering from anorexia, bulimia, BED, and other eating disorders also experience other mental health conditions, such as anxiety, depression, substance use disorders, or a history of trauma.

The high prevalence of anxiety and depression among those with eating disorders hints at a biological connection between these conditions. Further research is needed to fully understand this relationship—to discern whether anxiety and depression are distinct diagnoses independent of eating disorders or if they are intricately intertwined outcomes of the same underlying biological factors. It’s also possible that these conditions are correlated to the change in brain chemistry that occurs with starvation, bingeing, purging, and/or other eating disorder behaviors.

CBT, CBT-E, DBT… Have you ever wondered what all those letters stand for and why they are so often talked about at The Emily Program and by other eating disorder professionals? If so, this is the post for you. Let’s dissect these terms, help you understand them, and explain why they are important to the work clients and clinicians do every day.

Cognitive Behavioral Therapy (CBT)

“By correcting erroneous beliefs we can lower excessive reactions.” – Aaron Beck, MD

Cognitive behavioral therapy (CBT) was developed by Dr. Aaron Beck in the 1960s. His work focused on how the conscious mind plays a role in how people interact with the world around them. Prior to his work, most therapeutic models focused on the unconscious mind—concepts like impulses, analyzing unconscious thoughts, conditioning, and “uncontrollable thoughts.” Dr. Beck changed mental health by introducing the belief that our thoughts are fundamental to how we interpret our experiences and consequently behave or respond. Dr. Beck and many other researchers have discovered that by identifying, monitoring, and effectively changing our thoughts, we can change or alter our maladaptive perceptions, leading to positive behavioral change.

We live in a society that’s always on the go, and this constant activity can often lead to stress and anxiety. When anxiety creeps up, we may feel overwhelmed, stuck, or out of control. We may get distracted, hyperfocus or avoid responsibilities. While severe anxiety should be addressed with a therapist or doctor, there are some lifestyle changes you can make to alleviate symptoms.

Episode description:

Val Schonberg joins Peace Meal to discuss eating disorders during menopause, an often-overlooked period of vulnerability for midlife individuals. She begins by explaining why this life stage carries an increased risk for disordered eating and eating disorders. Our cultural biases toward aging and weight are partially to blame, she says, which can lead providers to misdiagnose or completely miss disordered eating behaviors. To better serve midlife individuals during this vulnerable period, Val urges healthcare providers to re-evaluate their own beliefs about aging, weight, and menopause. She emphasizes that menopause is a natural phase of life and not a “disease” that must be “fixed,” as many problematic cultural messages suggest. Val ends the podcast by expressing her belief that everyone can recover – no matter their age – and that aging is a precious gift. 

Val Schonberg is a Registered and Licensed Dietitian with a master’s degree in nutrition science from the University of Minnesota. She is Board Certified as a Specialist in Sports Dietetics, a Certified Menopause Practitioner with the North American Menopause Society, and a Fellow of the Academy of Nutrition and Dietetics. Val owns a private practice in Atlanta, Georgia, where she specializes in midlife health and menopause, recreational and professional sports nutrition, all types of eating disorders, and helping individuals break free from dieting and disordered eating. 

**Content warning: This is one person’s story; everyone will have unique experiences in recovery and beyond. Some stories may mention eating disorder thoughts, behaviors, and symptoms. Please use your discretion when reading and speak with your support system as needed.

Melissa L. Johnson is a licensed marriage and family therapist, adjunct professor at Bethel University, and the founder of Impossible Beauty, a blog and podcast dedicated to redefining beauty as “the life of God at work in us and among us” (impossible-beauty.com). Melissa’s writing and podcast interviews seek to uncover what true beauty is, what it is not, and how we go about finding beauty in a broken world. Melissa is releasing her debut book with Bethany House publishing in June 2023, entitled Soul-Deep Beauty: Fighting for our True Worth in a World Demanding Flawless.

In this blog, Melissa tells us about her new book, Soul Deep Beauty: Fighting for Our True Worth in a World Demanding Flawless, how her eating disorder inspired her to reconsider her definition of beauty, and how others can join her in deconstructing harmful societal beauty ideals. 

Regular doctor visits are essential to a child’s and teenager’s overall health. These routine checkups are an opportunity to not only chart growth and development, but also to screen for a range of physical and mental health conditions, including eating disorders.

In fact, pediatricians and other primary care providers are often our first line of defense against eating disorders. Well-positioned to monitor ongoing health at well-child visits and other physicals, providers have a unique role in detecting and addressing any issues with food and body. Early identification of eating disorder symptoms can help prevent and interrupt the development of these serious disorders.