Eating Disorders Counselor Certificate Training Part 6

Dr. Dawn-Elise Snipes PhD, LPC, LMHC, CRC, NCCClinical Director, AllCEUs.com

Unlimited CEUs $99 per year. Copyright AllCEUs.com

In this modern age we find ourselves asking whether or not food has more than symbolic meanings.

Recent research has practical implications for everyday life.

Meals low in carbohydrates alter neurotransmitters and affect moods

Lack of some large neutral amino acids that occurs when fasting increases serotonin uptake increasing depression.


Eating carbohydrate rich foods raises tryptophan levels reducing carbohydrate craving

Tryptophan is converted to serotonin.

In addition to the biochemical components, carbohydrate snacks are craved because they soothe.

Bulimic individuals may binge on carbohydrates to make up for serotonin deficits and for comfort

Some antidepressants (Selective Serotonin Reuptake Inhibitors: SSRIs)have been shown to be helpful in

decreasing binge episodes.


Carbohydrates should comprise about 50 to 60% of the food we eat

When deprived of them we quickly become carbohydrate depleted and a crave them

When a person has enough intake of carbohydrates and serotonin, carbohydrate craving stops. ◦ How can we help that persons with eating disorders

identify the difference between a true carbohydrate craving versus and emotional craving?


Persons with eating disorders have a love-hate relationship with water

It fills them up / Makes them feel bloated

Dehydration leads to ◦ Cravings for salt, sugar◦ Constipation◦ Lethargy which can be misinterpreted as laziness

by the overly self-critical ED patient


Most, if not all, eating-disordered patients will vehemently resist any attempts to get them to eat 60% carbohydrates.

◦ How can you approach this in solution focused therapy?


Disturbances of serotonin systems have been postulated to occur in anorexia and bulimia.

Elevated levels of certain serotonin metabolites in renourished anorexic patients indicates increased serotonin activity predisposing the person to anxiety of obsessiveness and inhibitions.

Starvation to decrease serotonin may be a “solution” to reduce obsessiveness, or anxiousness.

Bulimics do not have enough serotonin which leads to increased meal size, longer meal duration, increase carbohydrate consumption and reduced satiety.


Food restriction has been shown to produce psychological deterioration for many women including anxiety, depression, irritability, and moodiness.

Therefore, the emotional and physiological disturbances associated with Eating Disorders may be brought about by the actual dieting and purging


Developing sound eating habits empowers individual to take as much control of her life as she can.

Patients cannot change a brain based difficulty, but they can exercise and eat foods that correct neurochemical imbalances and help regulate body weight.

Research suggests eating three balanced meals every four to five hours with snacks as needed is the best approach

One main point to emphasize is that all food groups can and should be part of a healthy diet.

To lose weight, it is better to cut down on the portion size than to eliminate a food group altogether.


Since most patients with eating disorders fear carbohydrates they will need to be supported as they increase intake

It should be emphasized that increasing these foods should not begin until the later stages of treatment.

Assisting the client to increase her overall carbohydrate intake while maintaining a low "net carb" intake will ◦ help reduce some of the superstitious anxiety surrounding

carbohydrates and gaining weight◦ raise serotonin levels without encountering extreme

resistance◦ empower the client still maintain controls over that which

she most fears.


Caffeine◦ It is recommended to abstain from caffeinated beverages.

◦ This runs contrary to the suggestion that no food group

should be eliminated. ◦ Encourage the patient to reduce her amount of caffeine◦ In no way should you take control over a patient’s eating

or order her to stop drinking caffeine.


Help the client identify◦ triggers for a binge◦ cues that elicit mindless eating ◦ help the patient identify ways to feel less powerless over

food.

Help the client devise:◦ Ways to avoid triggers◦ Ways to break the automatic “knee-jerk” response to

binge◦ alternatives to eating to cope with stress


Most patients with eating disorders are well aware of the fat, carbohydrate, protein and calorie content of foods.

Often they lack an awareness of why some foods, lead them to feel “fat”◦ Prior conditioning and associations◦ Disinhibition◦ Heaviness = Fatness

Encouraging them to focus on what they're eating only encourages the obsessive behaviors

Instead, encourage them to focus on ◦ Why they are eating◦ The rate at which they are eating◦ What their body is craving


A balanced diet will ensure adequate supply of building blocks for neurotransmitters

If the client is not in medical jeopardy, let her set the pace for adjusting eating behaviors

Start re-introducing carbohydrate rich foods that are also high in fiber

Most ED clients will never accept a diet with 60% carbs, aim for 40% high quality carbs, 30% fat, 30% protein

Clients may use food and binges as a distraction to “throw focus” from treatment or “blame” you if her behaviors exacerbate.


Health & Medicine

Eating Disorders Counselor Certificate Training Part 6